go back

Alabama rates for HCPCS 21085

Impression & Preparation Oral Surgical Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$777.58 / $1,251.00 / $2,250.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.91 / $653.46 / $1,064.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.25 / $93.75 / $126.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.20 / $755.20 / $841.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$490.94 / $768.83 / $1,967.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$241.00 / $850.00 / $1,323.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$543.24 / $694.79 / $1,158.91