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Oklahoma rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $2,884 · 10th–90th $1,862–$8,7100%10%10th90th$2,884Professionalmedian $2,138 · 10th–90th $1,622–$3,1620%10%20%10th90th$2,138$100.0$200.0$500.0$1.0K$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
$1,862.09 / $1,862.09 / $2,238.72
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,995.26 / $3,019.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,818.38 / $3,801.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,884.03 / $7,943.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,691.53 / $15,848.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $5,011.87 / $10,715.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,137.96 / $2,884.03