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New Jersey rates for HCPCS 21076

Impression and custom preparation; surgical obturator prosthesis

Facilitymedian $3,236 · 10th–90th $977–$6,9180%10%10th90th$3,236Professionalmedian $891 · 10th–90th $661–$2,2390%10%10th90th$891$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
$776.25 / $1,174.90 / $1,513.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $870.96 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,230.27 / $2,630.27
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,122.02 / $1,548.82
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $4,786.30 / $7,585.78
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $831.76 / $2,691.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $5,128.61 / $8,511.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $933.25 / $2,187.76