go back

New Jersey rates for HCPCS 21085

Impression & Preparation Oral Surgical Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$580.41 / $4,174.00 / $10,692.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.82 / $653.46 / $963.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$523.54 / $920.65 / $1,892.86
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.95 / $1,064.80 / $1,089.30
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.66 / $564.57 / $1,076.70
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$409.85 / $688.87 / $1,679.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,529.00 / $3,352.00 / $10,536.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.40 / $847.88 / $2,096.92