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Indiana rates for HCPCS 21087

Impression & Preparation Nasal Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,215.58 / $1,485.71 / $2,472.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,190.59 / $1,442.09 / $1,976.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,310.00 / $10,338.00 / $26,304.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,293.53 / $2,232.02 / $3,222.70
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,192.25 / $1,549.93 / $1,960.48
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,463.04 / $1,616.66 / $2,194.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$902.54 / $902.54 / $1,069.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,439.00 / $1,998.16 / $3,423.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,472.00 / $10,113.00 / $15,750.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,439.91 / $1,948.11 / $3,439.34