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New York rates for HCPCS 21087

Impression and custom preparation; nasal prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,564.89 / $2,122.25 / $11,609.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,342.59 / $1,649.02 / $2,856.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,464.00 / $7,631.00 / $14,193.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,437.29 / $1,784.87 / $3,942.41
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,848.57 / $1,848.57 / $13,009.50
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,848.57 / $1,848.57 / $2,253.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,222.92 / $2,222.92 / $2,222.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,385.27 / $2,480.42 / $5,586.96
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$319.00 / $1,587.96 / $3,284.80
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,852.76 / $2,501.28 / $3,497.84
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,500.24 / $1,500.24 / $1,500.24
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,200.19 / $1,666.27 / $3,337.98
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $597.00 / $2,222.92
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,480.60 / $2,520.81 / $5,759.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,264.00 / $5,963.00 / $14,457.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,492.90 / $2,089.67 / $5,091.72
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,539.63 / $1,539.63 / $8,361.10
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,286.73 / $2,090.73 / $3,337.98