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Minnesota rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $8,710 · 10th–90th $2,138–$21,8780%5%10%10th90th$8,710Professionalmedian $4,266 · 10th–90th $2,042–$7,7620%5%10th90th$4,266$50.0$200.0$1.0K$5.0K$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
$1,737.80 / $2,137.96 / $2,137.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,187.76 / $3,388.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $14,454.40 / $42,657.95
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $4,786.30 / $7,762.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $7,762.47 / $18,620.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $5,888.44 / $9,120.11
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $7,585.78 / $14,791.08
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $5,370.32 / $8,511.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,548.13 / $6,165.95
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $4,570.88 / $13,182.57
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $8,709.64 / $15,135.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,981.07 / $7,244.36