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Indiana rates for HCPCS 21076

Impression&Preparation Surg Obturator Prosthes

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$668.89 / $813.98 / $1,372.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.32 / $790.41 / $1,070.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,153.00 / $5,790.87 / $8,240.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$698.63 / $1,197.98 / $1,729.71
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.08 / $856.58 / $1,078.15
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$811.91 / $897.16 / $1,217.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.33 / $519.33 / $615.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$793.61 / $1,092.99 / $1,861.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,400.00 / $3,874.00 / $5,490.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$773.02 / $1,017.35 / $1,820.01