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Montana rates for HCPCS 21087

Impression and custom preparation; nasal prosthesis

Facilitymedian $2,630 · 10th–90th $2,188–$3,1620%20%10th90th$2,630Professionalmedian $2,239 · 10th–90th $1,288–$3,9810%10%10th90th$2,239$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$1,288.25 / $2,041.74 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,089.30 / $2,630.27
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,691.53 / $3,090.30
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,691.53 / $3,090.30
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,290.87 / $3,235.94
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $2,137.96 / $3,162.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,570.40 / $3,311.31