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Wisconsin rates for HCPCS V2629

Prosthetic Eye, Other Type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.28 / $575.28 / $575.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.28 / $575.28 / $633.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.00 / $810.05 / $874.85
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$568.46 / $575.28 / $1,035.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.28 / $575.28 / $880.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.00 / $546.00 / $546.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $70.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$568.46 / $575.28 / $1,035.50
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$730.67 / $730.67 / $759.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$714.10 / $714.10 / $714.10