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Alabama rates for HCPCS 21085

Impression and custom preparation; oral surgical splint

Facilitymedian $447 · 10th–90th $87–$1,4450%10%10th90th$447Professionalmedian $724 · 10th–90th $479–$1,6980%10%10th90th$724$50.0$100.0$200.0$500.0$1.0K$2.0K$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
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,445.44 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $724.44 / $1,698.24
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $95.50 / $128.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $758.58 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $776.25 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $512.86 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $660.69 / $1,148.15