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Utah rates for HCPCS 21087

Impression and custom preparation; nasal prosthesis

Facilitymedian $2,512 · 10th–90th $2,138–$14,1250%20%10th90th$2,512Professionalmedian $2,138 · 10th–90th $1,259–$7,5860%10%10th90th$2,138$50.0$200.0$1.0K$5.0K$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
$2,137.96 / $2,137.96 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,137.96 / $7,585.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,041.74 / $2,884.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $2,818.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,511.38 / $11,481.54 / $17,782.79
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,398.83 / $4,265.80
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,630.27 / $3,388.44
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,187.76 / $3,090.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,698.24 / $2,691.53