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Louisiana rates for HCPCS 21076

Impression and custom preparation; surgical obturator prosthesis

Facilitymedian $1,698 · 10th–90th $832–$5,0120%5%10%10th90th$1,698Professionalmedian $933 · 10th–90th $708–$1,4450%10%10th90th$933$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$912.01 / $1,096.48 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $912.01 / $1,445.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $3,019.95 / $6,760.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,096.48 / $1,380.38
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $616.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,202.26 / $1,659.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $1,698.24 / $4,168.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $954.99 / $1,584.89