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Washington, DC rates for HCPCS 21081

Impression and custom preparation; mandibular resection prosthesis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,225.77 / $1,461.98 / $1,590.28
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,327.93 / $1,480.58 / $9,276.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,316.35 / $2,710.49 / $4,205.75
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,699.28 / $3,494.54 / $3,494.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,301.46 / $2,283.69 / $4,230.93