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Indiana rates for HCPCS 21088

Impression and custom preparation; facial prosthesis

Facilitymedian $8,913 · 10th–90th $3,802–$11,2200%10%20%10th90th$8,913Professionalmedian $2,951 · 10th–90th $708–$4,0740%10%20%10th90th$2,951$500.0$1.0K$2.0K$5.0K$10.0K$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
$954.99 / $1,174.90 / $2,951.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $3,019.95 / $4,073.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $8,912.51 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $537.03 / $954.99
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,623.41 / $6,309.57
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $3,715.35 / $6,165.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $9,549.93 / $18,197.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,951.21 / $5,754.40