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Washington rates for HCPCS 21087

Impression and custom preparation; nasal prosthesis

Facilitymedian $2,884 · 10th–90th $1,622–$5,0120%10%20%10th90th$2,884Professionalmedian $2,138 · 10th–90th $1,288–$3,8020%10%20%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
$2,041.74 / $2,951.21 / $4,466.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,778.28 / $3,548.13
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,715.19 / $15,488.17 / $31,622.78
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,754.23 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $870.96 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,570.40 / $4,365.16
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,454.71 / $4,466.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,454.71 / $3,890.45
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $676.08
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,162.28 / $3,548.13
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,089.30 / $2,137.96
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,570.40 / $3,890.45
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,715.19 / $16,218.10 / $31,622.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,754.23 / $3,890.45
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $17,378.01 / $33,884.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,344.23 / $3,981.07
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,819.70 / $2,344.23