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Illinois rates for HCPCS 21088

Impression and custom preparation; facial prosthesis

Facilitymedian $4,786 · 10th–90th $2,818–$10,7150%10%20%10th90th$4,786Professionalmedian $2,884 · 10th–90th $832–$5,6230%10%10th90th$2,884$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
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,311.31 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $3,019.95 / $5,495.41
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $5,011.87 / $11,220.18
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $831.76 / $1,047.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $5,495.41 / $7,762.47
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $870.96 / $5,888.44
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $645.65 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $5,370.32 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,235.94 / $6,309.57