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Arizona rates for HCPCS 21076

Impression and custom preparation; surgical obturator prosthesis

Facilitymedian $1,413 · 10th–90th $708–$3,3110%5%10th90th$1,413Professionalmedian $912 · 10th–90th $692–$2,0420%10%10th90th$912$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $891.25 / $2,041.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $1,862.09 / $3,388.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,122.02 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,000.00 / $1,737.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,122.02 / $3,090.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,230.27 / $6,456.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,659.59 / $4,677.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $912.01 / $1,513.56