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Vermont rates for HCPCS 21085

Impression and custom preparation; oral surgical splint

Professionalmedian $794 · 10th–90th $513$1,7380%10%10th90th$794$500.0$1.0K$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $794.33 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $912.01 / $1,288.25
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $954.99 / $1,148.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $891.25 / $1,737.80