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Minnesota rates for HCPCS 21088

Impression & Preparation Facial Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,166.32 / $3,166.32 / $3,166.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,103.45 / $3,166.32 / $5,023.97
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,143.94 / $5,064.68 / $11,441.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.25 / $301.64 / $301.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,932.19 / $5,579.21 / $13,421.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,083.02 / $4,805.06 / $6,913.35
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,574.72 / $5,100.72 / $10,568.14
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,645.65 / $4,194.67 / $6,339.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,166.32 / $7,872.00 / $10,533.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,459.63 / $5,551.16 / $12,358.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,940.00 / $7,872.00 / $11,531.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,389.36 / $5,061.35 / $11,918.67