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Delaware rates for HCPCS 21077

Impression & Preparation Orbital Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,588.50 / $1,721.55 / $2,099.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$989.43 / $989.43 / $989.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,601.17 / $2,305.17 / $4,171.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,530.00 / $2,530.00 / $2,530.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,877.86 / $2,664.53 / $5,064.25