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Texas rates for HCPCS 21087

Impression & Preparation Nasal Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,076.18 / $1,441.38 / $2,038.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,216.19 / $1,558.73 / $2,518.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$670.40 / $1,184.38 / $3,549.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,219.38 / $1,957.58 / $3,082.86
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $1,111.76 / $1,132.16
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
$1,421.41 / $2,079.98 / $3,256.13
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $55.00 / $6,389.32
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,538.00 / $11,734.30 / $13,273.73
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,324.59 / $2,032.09 / $3,062.29
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,639.96 / $2,099.55 / $2,799.40
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,239.69 / $2,239.69 / $2,239.69
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,324.59 / $2,048.50 / $3,119.98
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,439.00 / $2,192.54 / $3,309.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,093.00 / $6,000.00 / $13,134.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,381.20 / $1,871.79 / $2,910.89
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,327.33 / $1,513.10 / $2,105.08