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North Dakota rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $2,138 · 10th–90th $1,738–$3,5480%20%10th90th$2,138Professionalmedian $3,162 · 10th–90th $1,862–$5,3700%10%10th90th$3,162$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
$1,737.80 / $1,862.09 / $2,238.72
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,238.72 / $4,570.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,365.16 / $5,495.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $4,168.69 / $5,888.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,951.21 / $5,623.41
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $4,265.80 / $15,848.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $8,912.51 / $11,748.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,715.35 / $5,011.87