go back

Maine rates for HCPCS 21085

Impression and custom preparation; oral surgical splint

Professionalmedian $741 · 10th–90th $513$1,5140%10%10th90th$741$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $724.44 / $1,548.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $707.95 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $933.25 / $1,380.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $870.96 / $1,513.56
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $691.83 / $977.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $831.76 / $1,380.38