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Nebraska rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $4,467 · 10th–90th $1,995–$8,9130%10%10th90th$4,467Professionalmedian $2,951 · 10th–90th $1,698–$6,6070%10%10th90th$2,951$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
$1,621.81 / $3,162.28 / $4,466.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,818.38 / $9,332.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $7,943.28 / $15,488.17
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,951.21 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,479.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,570.88 / $6,309.57
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,235.94 / $7,943.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,466.84 / $15,848.93
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $5,248.07 / $6,456.54
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,479.11
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,786.30 / $6,456.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $7,413.10 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $3,630.78 / $5,248.07