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Hawaii rates for HCPCS 21076

Impression and custom preparation; surgical obturator prosthesis

Facilitymedian $1,698 · 10th–90th $1,698–$1,6980%50%100%$1,698Professionalmedian $933 · 10th–90th $708–$1,5850%10%10th90th$933$50.0$100.0$200.0$500.0$1.0K$2.0K

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $891.25 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,122.02 / $1,348.96
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,288.25 / $1,584.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,047.13 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,047.13 / $1,202.26
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $851.14 / $1,174.90