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Connecticut rates for HCPCS 21088

Impression & Preparation Facial Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.20 / $1,122.20 / $1,122.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.45 / $1,386.41 / $3,876.75
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,217.00 / $8,931.00 / $11,908.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,303.89 / $1,477.74 / $1,955.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$843.00 / $3,820.70 / $3,820.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,035.94 / $6,488.34 / $9,700.95
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,330.14 / $4,873.00 / $4,974.00
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,489.68 / $5,489.68 / $13,183.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,644.00 / $8,468.00 / $13,943.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.94 / $10,047.50 / $17,627.21