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Kentucky rates for HCPCS 21085

Impression and custom preparation; oral surgical splint

Facilitymedian $851 · 10th–90th $457–$11,2200%10%10th90th$851Professionalmedian $631 · 10th–90th $457–$1,0720%10%10th90th$631$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
$457.09 / $707.95 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $630.96 / $1,071.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $10,715.19 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $602.56 / $776.25
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $562.34 / $741.31
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $588.84 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $831.76 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $912.01 / $3,715.35
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $812.83 / $1,949.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $758.58 / $1,202.26