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Florida rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $9,550 · 10th–90th $1,862–$22,3870%10%10th90th$9,550Professionalmedian $2,188 · 10th–90th $1,698–$3,4670%20%10th90th$2,188$50.0$200.0$1.0K$5.0K$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
$1,778.28 / $2,041.74 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,187.76 / $3,388.44
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $6,165.95 / $12,302.69
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,187.76 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $891.25 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,691.53 / $4,466.84
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $13,489.63 / $23,988.33
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,737.80 / $2,818.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $1,348.96 / $3,019.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $9,549.93 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,238.72 / $3,981.07
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,659.59 / $2,290.87