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Colorado rates for HCPCS 21085

Impression and custom preparation; oral surgical splint

Facilitymedian $3,388 · 10th–90th $1,905$8,7100%10%10th90th$3,388Professionalmedian $708 · 10th–90th $490$1,5850%10%10th90th$708$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$691.83 / $5,370.32 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $691.83 / $1,737.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,467.37 / $8,511.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $676.08 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $562.34 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $851.14 / $1,412.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $724.44 / $3,548.13
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $691.83 / $776.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,479.11 / $2,691.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $870.96 / $1,380.38