go back

Delaware rates for HCPCS 21076

Impression and custom preparation; surgical obturator prosthesis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.96 / $778.50 / $854.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$425.15 / $425.15 / $425.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.34 / $938.08 / $1,679.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,320.00 / $1,320.00 / $1,320.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$757.45 / $1,120.85 / $2,047.95