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 INTRAOCULAR KELMAN MULTIFLEX III PMMA +22 DIOPTER CONVEXOPLANO L13 MM OD5.5 MM ANTERIOR CHAMBER 1 PIECE UV ABSORBENT STERILE CLEAR APHAKIA 115.3 A-CONSTANT
Quitman, TX
See all hospitals reporting HCPCS V2630 →Price type
Quitman Hospital, LLC’s median price of $64 is 62% below the median hospital's median price ($170), higher than 5% of the 1,301 hospitals reporting HCPCS V2630. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 16 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 | Blue Cross Blue Shield blue cross medicare advantage oos [116005] facility · percent of total billed charges · bothfrom % of charges | $36 | $36 | — | — | — | $36 – $36 |
| 2 | Cigna cigna medicare replacement [126500] facility · percent of total billed charges · bothfrom % of charges | $36 | $36 | — | — | — | $36 – $36 |
| 3 | Humana humana medicare advantage/ppo/gold [152503] facility · percent of total billed charges · bothfrom % of charges | $36 | $36 | — | — | — | $36 – $36 |
| 4 | Medicare medicare part a and b [163500] facility · percent of total billed charges · bothfrom % of charges | $36 | $36 | — | — | — | $36 – $36 |
| 5 | Medicare medicare part a only [163502] facility · percent of total billed charges · bothfrom % of charges | $36 | $36 | — | — | — | $36 – $36 |
| 6 | Medicare medicare part b only [163501] facility · percent of total billed charges · bothfrom % of charges | $36 | $36 | — | — | — | $36 – $36 |
| 7 | WellCare wellcare medicare [377501] facility · percent of total billed charges · bothfrom % of charges | $36 | $36 | — | — | — | $36 – $36 |
| 8 | Aetna aetna coventry medicare replacement [102002] facility · percent of total billed charges · bothfrom % of charges | $36 | $36 | — | — | — | $36 – $36 |
| 9 | UnitedHealthcare uhc medicare advantage [206511] facility · percent of total billed charges · bothfrom % of charges | $36 | $36 | — | — | — | $36 – $36 |
| 10 | Ambetter ambetter [293000] facility · percent of total billed charges · bothfrom % of charges | $41 | $41 | — | — | — | $41 – $41 |
| 11 | Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges | $64 | $64 | — | — | — | $64 – $64 |
| 12 | Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges | $64 | $64 | — | — | — | $64 – $64 |
| 13 | Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges | $64 | $64 | — | — | — | $64 – $64 |
| 14 | UnitedHealthcare uhc medica choice [206030] facility · percent of total billed charges · bothfrom % of charges | $128 | $128 | — | — | — | $128 – $128 |
| 15 | UnitedHealthcare united healthcare student svc [206012] facility · percent of total billed charges · bothfrom % of charges | $128 | $128 | — | — | — | $128 – $128 |
| 16 | UnitedHealthcare united healthcare texas exchange plan [206034] facility · percent of total billed charges · bothfrom % of charges | $128 | $128 | — | — | — | $128 – $128 |
Last updated: Feb 12, 2026
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