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Indiana rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $17,378 · 10th–90th $3,020–$25,7040%10%10th90th$17,378Professionalmedian $2,138 · 10th–90th $1,660–$3,9810%10%20%10th90th$2,138$1.0K$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
$1,995.26 / $2,511.89 / $3,548.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,089.30 / $3,890.45
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $19,054.61 / $27,542.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,884.03 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,311.31 / $5,128.61
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,570.40 / $4,677.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $9,549.93 / $18,197.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,398.83 / $4,073.80