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Minnesota rates for HCPCS 21087

Impression and custom preparation; nasal prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $1,584.89 / $1,584.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,584.89 / $2,511.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,943.28 / $13,803.84 / $33,113.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $3,388.44 / $5,495.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $5,754.40 / $13,803.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $4,265.80 / $6,760.83
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $5,495.41 / $10,964.78
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $3,981.07 / $6,309.57
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $2,630.27 / $4,570.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $3,467.37 / $9,549.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,168.69 / $7,943.28 / $12,589.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,818.38 / $5,248.07