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New Hampshire rates for HCPCS 21087

Impression and custom preparation; nasal prosthesis

Facilitymedian $5,623 · 10th–90th $5,012–$6,1660%20%40%10th90th$5,623Professionalmedian $2,042 · 10th–90th $1,445–$3,6310%10%10th90th$2,042$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $5,495.41 / $6,165.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,905.46 / $3,235.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,623.41 / $9,120.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $2,137.96 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,630.27 / $4,786.30
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,290.87 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,454.71 / $4,265.80
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,096.48 / $1,905.46