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North Carolina rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $3,311 · 10th–90th $1,862–$9,3330%10%10th90th$3,311Professionalmedian $2,570 · 10th–90th $1,698–$5,4950%10%10th90th$2,570$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
$2,041.74 / $3,890.45 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,187.76 / $4,365.16
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,235.94 / $6,165.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,090.30 / $4,897.79
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,365.16 / $4,897.79
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,754.23 / $4,677.35
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,168.69 / $5,370.32
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $11,748.98 / $19,498.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,454.71 / $4,466.84
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $10,715.19 / $10,715.19
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,848.93 / $15,848.93 / $17,782.79