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Georgia rates for HCPCS 21085

Impression and custom preparation; oral surgical splint

Facilitymedian $2,754 · 10th–90th $794$7,4130%5%10%10th90th$2,754Professionalmedian $724 · 10th–90th $490$1,4790%10%10th90th$724$50.0$200.0$1.0K$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
$831.76 / $5,370.32 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $707.95 / $1,513.56
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $1,174.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $2,344.23 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $912.01 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $933.25 / $1,584.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $794.33 / $1,698.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $1,318.26 / $2,344.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $831.76 / $1,380.38