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New York rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $5,495 · 10th–90th $2,512$13,4900%10%10th90th$5,495Professionalmedian $2,455 · 10th–90th $1,738$5,3700%20%10th90th$2,455$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
$2,187.76 / $3,019.95 / $12,302.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,290.87 / $4,570.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $8,317.64 / $16,595.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,511.89 / $5,623.41
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $12,882.50
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $3,019.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $3,019.95 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,548.13 / $8,128.31
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,630.27 / $6,309.57
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,548.13 / $4,897.79
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $2,041.74
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,818.38 / $4,466.84
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $2,951.21 / $4,786.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $5,495.41 / $12,589.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,691.53 / $6,165.95
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,089.30 / $11,220.18
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,630.27 / $6,025.60