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Michigan rates for HCPCS 21088

Impression and custom preparation; facial prosthesis

Facilitymedian $4,266 · 10th–90th $2,630–$9,7720%20%10th90th$4,266Professionalmedian $3,090 · 10th–90th $955–$4,2660%10%20%10th90th$3,090$1.0K$2.0K$5.0K$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
$4,073.80 / $4,073.80 / $4,265.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $3,090.30 / $4,265.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,630.78 / $7,762.47
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $4,168.69 / $4,677.35
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,089.30 / $4,073.80
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,548.13 / $5,623.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $6,025.60 / $10,715.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,951.21 / $4,365.16