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Vermont rates for HCPCS 21077

Impression and custom preparation; orbital prosthesis

Professionalmedian $2,630 · 10th–90th $1,905$5,3700%10%10th90th$2,630$2.0K$5.0K$10.0K$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
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,570.40 / $5,370.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,162.28 / $4,265.80
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $3,090.30 / $3,548.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,162.28 / $5,495.41