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North Dakota rates for HCPCS 21085

Impression and custom preparation; oral surgical splint

Facilitymedian $708 · 10th–90th $479–$6,0260%20%10th90th$708Professionalmedian $851 · 10th–90th $513–$1,7380%10%20%10th90th$851$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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 / $707.95 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $707.95 / $1,621.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,258.93 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,230.27 / $1,862.09
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $831.76 / $1,202.26
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,288.25 / $5,128.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $2,398.83 / $3,388.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $1,047.13 / $1,584.89