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North Carolina rates for HCPCS 21088

Impression and custom preparation; facial prosthesis

Facilitymedian $3,631 · 10th–90th $2,042–$15,4880%10%20%10th90th$3,631Professionalmedian $3,236 · 10th–90th $1,380–$7,0790%10%10th90th$3,236$100.0$500.0$2.0K$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
$3,019.95 / $3,019.95 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $3,019.95 / $3,981.07
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $3,467.37 / $3,548.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $6,309.57 / $10,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $4,786.30 / $8,317.64
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $3,235.94 / $6,456.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $10,964.78 / $19,498.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,951.21 / $6,025.60
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $25,118.86 / $25,118.86
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37,153.52 / $37,153.52 / $39,810.72