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Iowa rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $4,571 · 10th–90th $2,818–$13,1830%10%10th90th$4,571Professionalmedian $2,399 · 10th–90th $1,738–$5,2480%10%20%10th90th$2,399$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$2,818.38 / $2,818.38 / $3,388.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,238.72 / $3,801.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $4,897.79 / $6,309.57
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,691.53 / $7,244.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,677.35 / $12,589.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $4,677.35 / $15,488.17
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,897.79 / $5,888.44
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $4,677.35 / $5,623.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $10,964.78 / $15,488.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,090.30 / $5,888.44
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,981.07 / $4,897.79