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Missouri rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $3,981 · 10th–90th $1,820–$7,7620%10%10th90th$3,981Professionalmedian $2,291 · 10th–90th $1,660–$4,1690%10%10th90th$2,291$100.0$500.0$2.0K$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
$1,479.11 / $1,819.70 / $2,691.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,187.76 / $4,073.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $4,570.88 / $8,912.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,511.89 / $3,981.07
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,290.87 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,884.03 / $4,570.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,818.38 / $5,888.44
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,548.13 / $15,848.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,548.13 / $6,165.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,454.71 / $3,715.35