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Kansas rates for HCPCS 21077

Impression & Preparation Orbital Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,108.09 / $2,555.94 / $3,394.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,756.74 / $2,129.96 / $3,394.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,549.09 / $2,998.93 / $3,568.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$624.00 / $624.00 / $624.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,168.06 / $2,827.18 / $4,520.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,756.74 / $2,887.08 / $6,791.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,486.02 / $3,289.08 / $15,904.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,967.00 / $4,960.00 / $11,732.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.08 / $2,653.95 / $3,674.69