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Wyoming rates for HCPCS 21087

Impression and custom preparation; nasal prosthesis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,287.51 / $1,599.87 / $2,033.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,006.39 / $5,006.39 / $5,006.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,439.00 / $3,009.00 / $4,553.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,099.85 / $2,731.13 / $4,390.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,188.00 / $5,188.00 / $18,767.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,059.61 / $3,318.96 / $5,777.19