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.
Original text from hospital filings
LENS ANT MTA4UO+21.5
Rochester, NY
See all hospitals reporting HCPCS V2632 →Price type
Highland Hospital’s median price of $254 is 7% below the median hospital's median price ($274), higher than 47% of the 1,552 hospitals reporting HCPCS V2632. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 3 payers, 8 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Excellus excellus child health plus [220108] fee schedule · outpatient | $253.87 | $186.58 | $21.69 – $338.07 |
| 2 | Excellus excellus essential (no medicaid) [220109] fee schedule · outpatient | $253.87 | $186.58 | $21.69 – $338.07 |
| 3 | Excellus excellus essential (w/ medicaid) [170604] fee schedule · outpatient | $253.87 | $186.58 | $21.69 – $338.07 |
| 4 | Molina molina essential (no medicaid) [518902], molina essential pa 3 and 4 [172302] fee schedule · outpatient | $649.24 | $477.16 | $55.46 – $864.56 |
| 5 | UnitedHealthcare united healthcare medicaid [171601] fee schedule · outpatient | $253.87 | $915.72 | $21.69 – $2,981 |
| 6 | Molina molina child health plus [518901], molina healthcare [172301] fee schedule · outpatient | $2,239 | $1,645 | $191.25 – $2,981 |
| 7 | UnitedHealthcare united healthcare essential (no medicaid [515812] fee schedule · outpatient | $2,239 | $1,645 | $191.25 – $2,981 |
| 8 | Excellus blue choice option medicaid [170601] fee schedule · outpatient | $2,239 | $1,647 | $191.25 – $2,981 |
Last updated: Jul 1, 2026
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