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New Hampshire rates for HCPCS 21076

Impression and custom preparation; surgical obturator prosthesis

Facilitymedian $2,951 · 10th–90th $1,585–$3,3880%20%10th90th$2,951Professionalmedian $1,148 · 10th–90th $776–$1,9950%10%10th90th$1,148$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
$2,951.21 / $2,951.21 / $3,388.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,023.29 / $1,778.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,737.80 / $3,890.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,174.90 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,479.11 / $2,570.40
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,288.25 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,348.96 / $2,398.83
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $1,047.13