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Arizona rates for HCPCS 21088

Impression and custom preparation; facial prosthesis

Facilitymedian $3,548 · 10th–90th $832–$7,9430%5%10th90th$3,548Professionalmedian $3,020 · 10th–90th $955–$5,0120%10%10th90th$3,020$100.0$500.0$2.0K$10.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $3,090.30 / $5,011.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $1,862.09 / $3,388.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,041.74 / $4,168.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,890.45 / $7,079.46
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $5,623.41 / $8,912.51
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,090.30 / $25,118.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $5,495.41 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,754.23 / $5,495.41