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New Mexico rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $2,951 · 10th–90th $2,138–$5,3700%10%10th90th$2,951Professionalmedian $2,239 · 10th–90th $1,660–$3,8900%10%10th90th$2,239$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
$2,398.83 / $2,511.89 / $3,548.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,187.76 / $3,801.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,951.21 / $6,918.31
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,819.70
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,818.38 / $4,073.80
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,090.30 / $4,365.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $11,748.98 / $25,703.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,090.30 / $4,466.84