Polishing or resurfacing of eye prosthesis

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Polishing artifical eye

Payers reporting HCPCS V2624

Payer pricing summary

Low

$19

Average

$100

Median

$93

High

$216

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +11 other terms	337	$89	$86	$23	27%	—	$36 – $330
2	Aetna fee schedule · outpatient · +12 other terms	322	$93	$103	$57	56%	—	$33 – $664
3	Humana fee schedule · outpatient · +10 other terms	316	$91	$136	$157	116%	—	$43 – $752
4	Blue Cross Blue Shield fee schedule · outpatient · +9 other terms	204	$96	$111	$73	66%	—	$0 – $471
5	WellCare fee schedule · outpatient · +4 other terms	202	$96	$95	$15	15%	—	$72 – $145
6	Devoted fee schedule · outpatient · +2 other terms	164	$93	$92	$10	11%	—	$75 – $104
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$95	$94	$8	9%	—	$75 – $103
8	Molina fee schedule · outpatient · +5 other terms	110	$107	$131	$52	40%	—	$71 – $256
9	Cigna fee schedule · outpatient · +10 other terms	95	$93	$101	$32	32%	—	$73 – $218
10	Anthem fee schedule · outpatient · +8 other terms	74	$93	$91	$13	14%	—	$73 – $149
11	Kaiser fee schedule · outpatient · +4 other terms	61	$97	$150	$117	78%	—	$86 – $729
12	Superior Healthplan fee schedule · outpatient	40	$103	$103	$0	0%	—	$96 – $103
13	Clover fee schedule · outpatient · +2 other terms	37	$75	$81	$12	14%	—	$73 – $103
14	Ambetter facility · fee schedule · outpatient · +5 other terms	33	$134	$140	$35	25%	—	$54 – $186
15	Oscar fee schedule · outpatient · +6 other terms	33	$96	$98	$18	19%	—	$78 – $129
16	Optum fee schedule · outpatient · +6 other terms	26	$91	$102	$50	49%	—	$72 – $244
17	Caresource facility · case rate · outpatient · +4 other terms	20	$32	$66	$60	92%	—	$20 – $199
18	Regence facility · fee schedule · outpatient · +3 other terms	19	$99	$97	$5	5%	—	$83 – $100
19	Bcbs Tx fee schedule · outpatient	18	$96	$96	—	—	—	$96 – $96
20	Medicare fee schedule · outpatient · +1 other terms	18	$91	$91	$1	1%	—	$91 – $93
21	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$89	$89	$2	2%	—	$85 – $89
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$75	$86	$21	25%	—	$41 – $118
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$64	$64	$18	27%	—	$32 – $85
24	Wellmark fee schedule · both · +2 other terms	13	$77	$78	$5	6%	—	$77 – $107
25	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$61	$66	$6	9%	—	$61 – $73

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