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Mississippi rates for HCPCS 21085

Impression & Preparation Oral Surgical Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$443.31 / $993.00 / $1,831.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$443.31 / $679.53 / $1,293.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.76 / $133.76 / $133.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,268.00 / $1,268.00 / $1,268.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.71 / $128.41 / $1,124.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$582.89 / $939.51 / $1,446.43
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.00 / $491.00 / $1,650.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$590.80 / $818.57 / $1,576.56