HCPCS V2628
Fabrication and fitting of ocular conformer
Current code21 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $428 – $3,321 | — | — |
| Deaconess Medical Center | $594 – $2,067 | — | — |
| Kadlec Regional Medical Center | $749 – $1,395 | — | — |
| Mary Bridge Children's Hospital | $428 – $3,645 | — | — |
| MultiCare Auburn Medical Center | $416 – $2,146 | — | — |
| MultiCare Covington Medical Center | $416 – $2,146 | — | — |
| MultiCare Good Samaritan Hospital | $483 – $2,146 | — | — |
| MultiCare Valley Hospital | $475 – $2,062 | — | — |
| Overlake Hospital Medical Center & Clinics | $455 – $1,366 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $769 – $1,648 | — | — |
| Providence Centralia Hospital | $839 – $1,857 | — | — |
| Providence Regional Medical Center Everett | $596 – $1,152 | — | — |
| Providence St Peter Hospital | $422 – $1,622 | — | — |
| Swedish Edmonds Hospital | $745 – $1,822 | — | — |
| Swedish Issaquah | $745 – $1,103 | — | — |
| Swedish Medical Center | $745 – $1,774 | — | — |
| Swedish Medical Center / Cherry Hill | $745 – $1,774 | — | — |
| Tacoma General Allenmore Hospital | $416 – $2,146 | — | — |
| Virginia Mason Medical Center | $475 – $1,727 | — | — |
| Wellfound Behavioral Health Hospital | $1,253 | — | — |
| Yakima Valley Memorial | $428 – $1,288 | — | — |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Equipment fee, Washington
- $497 (fee)