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Tennessee rates for HCPCS 21085

Impression and custom preparation; oral surgical splint

Facilitymedian $1,820 · 10th–90th $372–$4,2660%10%10th90th$1,820Professionalmedian $692 · 10th–90th $468–$1,3800%10%10th90th$692$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
$1,819.70 / $2,691.53 / $7,585.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $660.69 / $1,348.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,513.56 / $2,187.76
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $954.99 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $851.14 / $1,348.96
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $3,019.95 / $3,019.95
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,754.40 / $5,754.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $812.83 / $2,344.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $758.58 / $1,288.25