go back

Michigan rates for HCPCS 21083

Impression and custom preparation; palatal lift prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,316.29 / $1,366.92 / $1,770.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.38 / $1,341.24 / $1,770.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$266.33 / $266.33 / $266.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$266.33 / $930.20 / $1,742.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$982.39 / $1,516.25 / $2,388.84
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,316.29 / $1,480.45 / $1,705.18
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,316.29 / $1,480.45 / $2,211.62
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.00 / $920.81 / $1,560.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,986.00 / $7,800.00 / $10,351.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,452.85 / $1,761.39 / $2,497.71