go back

Wisconsin rates for HCPCS 21087

Impression and custom preparation; nasal prosthesis

Facilitymedian $9,772 · 10th–90th $2,399$16,9820%5%10%10th90th$9,772Professionalmedian $2,042 · 10th–90th $1,259$6,3100%10%10th90th$2,042$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
$1,258.93 / $2,691.53 / $3,311.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,548.82 / $3,467.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,511.89 / $7,079.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,786.30 / $7,762.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,890.45 / $7,413.10
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,398.83 / $3,801.89
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,311.31 / $5,011.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,691.53 / $13,182.57
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $3,630.78 / $11,748.98
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,995.26
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $4,265.80 / $6,165.95
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,630.78 / $5,623.41
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $3,388.44 / $7,943.28
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $8,128.31 / $11,748.98
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $5,128.61
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $8,128.31 / $10,232.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,511.89 / $6,309.57