go back

Idaho rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $3,890 · 10th–90th $1,950–$14,1250%5%10th90th$3,890Professionalmedian $3,020 · 10th–90th $1,905–$4,3650%10%10th90th$3,020$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
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,754.23 / $4,365.16
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $7,244.36 / $15,135.61
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,548.13 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,818.38 / $3,801.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $3,235.94 / $5,128.61
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,630.78 / $4,466.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $13,182.57 / $18,620.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,630.78 / $4,570.88
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,162.28 / $9,332.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $12,022.64 / $27,542.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $3,090.30 / $4,570.88