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Alaska rates for HCPCS 21088

Impression & Preparation Facial Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,887.37 / $14,978.19 / $14,978.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,633.41 / $9,321.81 / $13,253.10
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,887.37 / $14,978.19 / $20,969.47
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,782.69 / $2,782.69 / $3,975.28
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,461.25 / $16,183.75 / $20,584.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,999.55 / $14,978.19 / $20,969.47
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,276.75 / $14,645.75 / $18,411.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,201.60 / $14,352.80 / $18,043.52