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Delaware rates for HCPCS 21085

Impression and custom preparation; oral surgical splint

Facilitymedian $7,244 · 10th–90th $145–$7,2440%50%10th$7,244Professionalmedian $661 · 10th–90th $468–$1,5850%10%10th90th$661$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,244.36 / $7,244.36 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $645.65 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $707.95 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $691.83 / $1,096.48