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South Carolina rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Facilitymedian $4,074 · 10th–90th $2,042–$15,8490%10%20%10th90th$4,074Professionalmedian $2,239 · 10th–90th $1,698–$4,3650%20%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
$1,995.26 / $2,454.71 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,238.72 / $4,466.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,623.41 / $9,772.37 / $17,378.01
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,187.76 / $3,890.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $1,479.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $3,090.30 / $4,677.35
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,951.21 / $4,786.30
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $15,488.17 / $25,703.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,290.87 / $3,801.89