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Wisconsin rates for HCPCS 21079

Impression and custom preparation; interim obturator prosthesis

Professionalmedian $1,862 · 10th–90th $1,148–$5,7540%10%10th90th$1,862$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 / $3,162.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,398.83 / $6,309.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $3,548.13 / $6,760.83
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,090.30 / $4,570.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,311.31 / $10,964.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,819.70
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,981.07 / $5,623.41
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,388.44 / $5,248.07
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $7,413.10 / $10,964.78
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $4,786.30
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $7,413.10 / $9,332.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,290.87 / $5,754.40