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Washington, DC rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $2,188 · 10th–90th $1,738–$26,3030%20%10th90th$2,188Professionalmedian $2,188 · 10th–90th $1,698–$4,6770%10%20%10th90th$2,188$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
$1,737.80 / $1,737.80 / $2,187.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,187.76 / $4,677.35
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,344.23 / $9,549.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,162.28 / $5,495.41
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $3,890.45 / $4,897.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $13,182.57 / $33,113.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,691.53 / $5,370.32