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New Jersey rates for HCPCS 21085

Impression and custom preparation; oral surgical splint

Facilitymedian $6,026 · 10th–90th $1,175–$11,2200%10%10th90th$6,026Professionalmedian $692 · 10th–90th $447–$1,8200%10%10th90th$692$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
$1,174.90 / $6,918.31 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $691.83 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $912.01 / $1,905.46
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $870.96 / $1,202.26
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $741.31 / $1,174.90
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $645.65 / $2,137.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,630.27 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $691.83 / $1,659.59