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Nevada rates for HCPCS 21085

Impression and custom preparation; oral surgical splint

Facilitymedian $3,467 · 10th–90th $457–$5,8880%10%10th90th$3,467Professionalmedian $692 · 10th–90th $468–$1,2300%10%10th90th$692$10.0$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
$457.09 / $4,365.16 / $10,232.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $691.83 / $1,258.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $3,467.37 / $4,466.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $724.44 / $1,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $812.83 / $1,258.93
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $660.69 / $1,122.02
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $630.96 / $1,047.13
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $707.95 / $1,258.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $977.24 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $741.31 / $1,202.26