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Oregon rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $4,266 · 10th–90th $2,455–$5,3700%20%40%10th90th$4,266Professionalmedian $3,388 · 10th–90th $1,820–$5,4950%10%20%10th90th$3,388$20.0$200.0$2.0K$20.0K$200.0K

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
$3,019.95 / $4,365.16 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,238.72 / $5,370.32
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,801.89 / $5,623.41
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $4,168.69 / $5,248.07
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,388.44 / $5,128.61
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,981.07 / $5,495.41
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $4,265.80 / $4,786.30
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,388.44 / $5,128.61
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $3,981.07 / $5,495.41
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,803.84 / $19,054.61 / $22,908.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $4,265.80 / $6,025.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $17,782.79 / $25,703.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,981.07 / $5,495.41