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Michigan rates for HCPCS 21076

Impression and custom preparation; surgical obturator prosthesis

Facilitymedian $1,230 · 10th–90th $912–$5,0120%10%20%10th90th$1,230Professionalmedian $891 · 10th–90th $692–$1,4790%10%20%10th90th$891$200.0$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
$912.01 / $933.25 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $870.96 / $1,479.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $1,071.52 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,000.00 / $1,380.38
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $2,454.71 / $2,884.03
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,096.48 / $1,949.84
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,000.00 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,630.27 / $5,623.41
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,023.29 / $1,380.38