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Maine rates for HCPCS 21088

Impression and custom preparation; facial prosthesis

Facilitymedian $6,761 · 10th–90th $6,761–$6,7610%50%100%$6,761Professionalmedian $3,311 · 10th–90th $955–$8,5110%10%10th90th$3,311$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $2,884.03 / $4,365.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,621.81 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $6,309.57 / $9,549.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $7,943.28 / $14,791.08
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $3,235.94 / $4,365.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,760.83 / $6,760.83 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $4,073.80 / $11,481.54