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Massachusetts rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $2,344 · 10th–90th $1,950–$6,1660%20%10th90th$2,344Professionalmedian $2,630 · 10th–90th $1,738–$5,4950%5%10%10th90th$2,630$100.0$500.0$2.0K$10.0K$50.0K

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
$1,949.84 / $2,344.23 / $2,344.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,238.72 / $4,570.88
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $5,011.87 / $12,882.50
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,162.28 / $7,244.36
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $4,570.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,162.28 / $5,888.44
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,137.96 / $4,168.69
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,019.95 / $4,265.80
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $6,165.95 / $13,182.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,162.28 / $5,754.40
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $5,011.87 / $12,882.50
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,162.28 / $7,244.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $5,888.44 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,311.31 / $6,025.60