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Michigan rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $4,266 · 10th–90th $2,239–$10,2330%10%20%10th90th$4,266Professionalmedian $2,239 · 10th–90th $1,698–$3,9810%10%10th90th$2,239$500.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,290.87 / $2,691.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,137.96 / $3,630.78
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,981.07 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,570.40 / $3,467.37
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $6,165.95 / $7,244.36
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,691.53 / $4,677.35
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,511.89 / $3,467.37
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $7,762.47 / $14,791.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,570.40 / $3,467.37