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Connecticut rates for HCPCS 21088

Impression and custom preparation; facial prosthesis

Facilitymedian $4,365 · 10th–90th $1,122–$12,0230%20%10th90th$4,365Professionalmedian $3,020 · 10th–90th $955–$5,0120%20%10th90th$3,020$0.0$0.2$2.0$20.0$200.0$2.0K$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
$1,122.02 / $1,122.02 / $1,122.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $2,951.21 / $4,365.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,168.69 / $12,022.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.03 / $1,479.11 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $6,165.95 / $10,232.93
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $7,943.28 / $13,182.57
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $10,232.93 / $16,218.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $7,943.28 / $16,218.10