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North Dakota rates for HCPCS 21076

Impression and custom preparation; surgical obturator prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $758.58 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $870.96 / $1,862.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,819.70 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,659.59 / $2,398.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $1,202.26 / $2,290.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,698.24 / $6,456.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $4,677.35 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,479.11 / $2,041.74