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Connecticut rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $4,074 · 10th–90th $3,162–$16,2180%20%10th90th$4,074Professionalmedian $2,344 · 10th–90th $1,698–$5,2480%10%10th90th$2,344$1.0K$2.0K$5.0K$10.0K$20.0K

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
$3,162.28 / $3,311.31 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,238.72 / $5,248.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $15,135.61 / $16,595.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,715.35 / $5,495.41
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,890.45 / $5,623.41
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,548.13 / $4,365.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $10,232.93 / $16,218.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,090.30 / $5,495.41