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Rhode Island rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $7,413 · 10th–90th $3,236–$13,1830%10%10th90th$7,413Professionalmedian $2,188 · 10th–90th $1,585–$4,3650%10%20%10th90th$2,188$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,187.76 / $4,365.16
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,089.30 / $4,265.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,548.13 / $4,365.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $7,413.10 / $13,182.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,818.38 / $4,677.35