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Pennsylvania rates for HCPCS 21079

Impression and custom preparation; interim obturator prosthesis

Professionalmedian $1,479 · 10th–90th $1,122–$2,5700%20%10th90th$1,479$10.0$50.0$200.0$1.0K$5.0K

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
$1,122.02 / $1,445.44 / $2,344.23
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,137.96 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,778.28 / $2,951.21
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,454.71 / $3,090.30
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,995.26 / $3,235.94
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,412.54 / $2,454.71
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,570.40 / $3,630.78
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $1,202.26 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,621.81 / $2,754.23