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Maryland rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $851 · 10th–90th $646$2,8840%10%20%10th90th$851Professionalmedian $2,188 · 10th–90th $1,698$3,7150%10%10th90th$2,188$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,187.76 / $3,467.37
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,905.46 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $645.65 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,754.23 / $4,786.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,630.27 / $3,890.45
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,548.82 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,454.71 / $4,265.80
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,754.23 / $3,311.31