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Missouri rates for HCPCS 21087

Impression & Preparation Nasal Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,081.33 / $1,324.30 / $1,643.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,172.51 / $1,441.38 / $2,463.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,501.03 / $1,845.79 / $2,946.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,461.86 / $2,115.31 / $3,373.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,242.82 / $2,115.60 / $4,600.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,719.67 / $2,579.51 / $11,810.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,156.00 / $4,000.00 / $10,781.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,555.22 / $2,149.59 / $3,557.10