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Missouri rates for HCPCS 21076

Impression and custom preparation; surgical obturator prosthesis

Facilitymedian $3,162 · 10th–90th $871–$7,0790%5%10%10th90th$3,162Professionalmedian $933 · 10th–90th $661–$1,7380%10%10th90th$933$100.0$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
$588.84 / $741.31 / $1,122.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $870.96 / $1,737.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $4,570.88 / $8,912.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,000.00 / $1,584.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $954.99 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,148.15 / $1,778.28
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,174.90 / $2,691.53
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,445.44 / $6,456.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,230.27 / $2,818.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,000.00 / $1,513.56