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Maryland rates for HCPCS 21087

Impression & Preparation Nasal Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,244.01 / $1,537.31 / $1,929.22
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,402.01 / $1,456.84 / $1,711.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.00 / $635.80 / $641.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,286.08 / $2,097.09 / $3,769.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,647.63 / $2,125.44 / $2,838.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.00 / $847.00 / $1,560.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,375.74 / $1,949.58 / $3,288.34
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,331.02 / $1,894.77 / $2,360.36