go back

Missouri rates for HCPCS 21076

Impression and custom preparation; surgical obturator prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$595.59 / $726.09 / $900.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.41 / $787.68 / $1,324.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$811.78 / $1,002.17 / $1,600.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$800.76 / $1,154.76 / $1,831.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$688.09 / $1,169.00 / $2,544.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$934.36 / $1,411.37 / $6,495.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,216.00 / $2,306.00 / $3,071.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$747.49 / $1,120.43 / $1,724.56