PROSTHETIC EYE OTHER TYPE

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.

Generation details were not recorded for this description.

Original text from hospital filings

SPHERE SILICONE 18MM (IMPLANT SPHERE SILICONE 18MM EA/1)

Payers reporting HCPCS V2629

Payer pricing summary

Low

Average

$370

Median

$206

High

$3.9k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Regence facility · percent of total billed charges · bothfrom % of charges	1	$208	$208	$39	19%	12–120	$176 – $270
2	Blue Cross Blue Shield facility · fee schedule · outpatient · +8 other terms	22	$2.4k	$3.4k	$2.5k	75%	—	$1.8k – $12.8k
3	Aetna fee schedule · outpatient · +11 other terms	19	$575	$1.2k	$1.1k	88%	—	$568 – $4.0k
4	Anthem facility · case rate · outpatient · +5 other terms	15	$182	$199	$47	23%	—	$124 – $309
5	Caresource facility · case rate · outpatient · +1 other terms	15	$185	$199	$46	23%	—	$124 – $315
6	Molina facility · case rate · outpatient · +5 other terms	15	$182	$199	$46	23%	—	$128 – $309
7	UnitedHealthcare facility · case rate · outpatient · +12 other terms	15	$185	$202	$47	23%	—	$128 – $315
8	Wellmark fee schedule · both	13	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
9	Humana fee schedule · outpatient · +9 other terms	11	$4	$162	$256	159%	—	$1 – $575
10	Optum facility · case rate · outpatient · +4 other terms	11	$172	$188	$42	22%	—	$155 – $279
11	Highmark fee schedule · outpatient · +1 other terms	10	$3.9k	$3.9k	—	—	—	$3.9k – $3.9k
12	MultiPlan percent of total billed charges · bothfrom % of charges · +4 other terms	9	$212	$212	$3	2%	—	$209 – $215
13	Aetna Better Health fee schedule · inpatient · +2 other terms	7	$593	$593	—	—	—	$593 – $593
14	Amerihealth Caritas percent of total billed charges · outpatientfrom % of charges	7	$221	$222	$39	17%	—	$170 – $273
15	Carefirst percent of total billed charges · outpatientfrom % of charges · +1 other terms	7	$221	$222	$39	17%	—	$170 – $273
16	Cigna Healthspring percent of total billed charges · outpatientfrom % of charges	7	$221	$222	$39	17%	—	$170 – $273
17	Kaiser percent of total billed charges · outpatientfrom % of charges · +3 other terms	7	$221	$222	$39	17%	—	$170 – $273
18	Magellan percent of total billed charges · outpatientfrom % of charges	7	$221	$222	$39	17%	—	$170 – $273
19	Phcs percent of total billed charges · outpatientfrom % of charges · +4 other terms	7	$221	$222	$39	17%	—	$170 – $273
20	Ambetter percent of total billed charges · bothfrom % of charges	4	$126	$126	$27	21%	—	$90 – $157
21	Cigna other · both · +8 other terms	4	$0	$0	—	—	—	$0 – $0
22	Oscar percent of total billed charges · bothfrom % of charges	4	$146	$146	$31	21%	—	$105 – $182
23	WellCare other · both · +1 other terms	4	$0	$0	—	—	—	$0 – $0
24	Bcbs Ks fee schedule · outpatient · +3 other terms	3	$1.7k	$1.7k	$103	6%	—	$1.7k – $1.9k
25	First Health professional · fee schedule · both · +5 other terms	3	$633	$633	—	—	—	$633 – $633

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