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Custom Artificial Nose Prosthesis

New Hampshire rates for HCPCS 21087

Taking an impression and custom-building an artificial nose for someone who has lost part or all of the nose to injury, disease, or surgery. The prosthesis is sculpted and colored to blend with the surrounding face and is made to be put on and taken off by the wearer.

Rates data updated July 2026.

How much does Custom Artificial Nose Prosthesis cost?

$2,089

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $2,089 for this service. The price depends on where it is billed: about $2,089 from a physician practice, and about $5,623 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2,089$1,738 to $2,692
FacilityA hospital or hospital-owned outpatient department$5,623$5,495 to $6,166

How much rates vary

Facilitymedian $5,623 · 10th to 90th $5,012 to $8,913Professionalmedian $2,089 · 10th to 90th $1,413 to $3,631
$1K$2K$5K$10Kfacility $5,623professional $2,089

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$5,495.41
Median
$5,495.41
Typical High
$6,165.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,778.28
Typical High
$2,137.96
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,623.41
Typical High
$8,912.51
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$2,187.76
Typical High
$3,090.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,659.59
Median
$2,630.27
Typical High
$4,786.30
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$11,220.18
Median
$11,220.18
Typical High
$11,220.18
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$2,290.87
Typical High
$3,715.35
United
Setting
Facility
Modifier
Global
Typical Low
$11,220.18
Median
$11,220.18
Typical High
$11,220.18
United
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$2,454.71
Typical High
$4,265.80
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$1,096.48
Typical High
$1,905.46

Where New Hampshire sits

The same service costs 2.6 times more in Alaska than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Hampshire· 15th of 51

$2,089

AK $3,981DE $1,514

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.