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West Virginia rates for HCPCS 21076

Impression and custom preparation; surgical obturator prosthesis

Facilitymedian $832 · 10th–90th $692–$1,2300%20%40%10th90th$832Professionalmedian $813 · 10th–90th $646–$1,5140%20%10th90th$813$50.0$100.0$200.0$500.0$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
$691.83 / $831.76 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $812.83 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,202.26 / $5,623.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $4,365.16
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,047.13 / $1,513.56