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Rhode Island rates for HCPCS 21085

Impression and custom preparation; oral surgical splint

Facilitymedian $1,479 · 10th–90th $490–$3,9810%10%10th90th$1,479Professionalmedian $661 · 10th–90th $437–$2,1380%10%10th90th$661$500.0$1.0K$2.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,981.07 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $645.65 / $2,137.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $616.60 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $977.24 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $1,230.27 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $812.83 / $1,412.54