go back

Minnesota rates for HCPCS 21085

Impression and custom preparation; oral surgical splint

Facilitymedian $1,660 · 10th–90th $457–$4,7860%5%10%10th90th$1,660Professionalmedian $1,259 · 10th–90th $617–$2,5120%5%10th90th$1,259$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
$478.63 / $691.83 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $691.83 / $1,513.56
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $794.33 / $4,365.16
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,479.11 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,511.89 / $6,025.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,698.24 / $2,951.21
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,398.83 / $4,786.30
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,584.89 / $2,754.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $977.24 / $1,905.46
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,412.54 / $3,630.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $1,862.09 / $2,951.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,174.90 / $2,187.76