go back

Maine rates for HCPCS 21088

Impression & Preparation Facial Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.45 / $3,252.88 / $3,590.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,604.39 / $1,604.39 / $1,738.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,862.20 / $5,871.86 / $8,137.67
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,336.75 / $6,174.62 / $9,472.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.45 / $2,675.87 / $3,590.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,416.69 / $3,159.02 / $6,783.29