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Indiana rates for HCPCS 21076

Impression and custom preparation; surgical obturator prosthesis

Facilitymedian $8,318 · 10th–90th $1,380–$10,4710%10%10th90th$8,318Professionalmedian $871 · 10th–90th $661–$1,7780%10%20%10th90th$871$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
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $1,023.29 / $1,479.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $851.14 / $1,584.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $8,912.51 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,288.25 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,318.26 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,023.29 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $3,715.35 / $6,456.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $954.99 / $1,659.59