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Washington, DC rates for HCPCS 21085

Impression & Preparation Oral Surgical Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$488.82 / $1,614.00 / $7,727.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.82 / $702.82 / $702.82
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$532.64 / $573.00 / $1,575.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$594.69 / $1,073.63 / $1,861.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,082.70 / $1,563.39 / $1,563.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.00 / $442.00 / $5,940.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.89 / $1,103.95 / $1,892.84