go back

North Dakota rates for HCPCS 21088

Impression & Preparation Facial Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.36 / $2,818.36 / $2,818.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.45 / $2,818.36 / $3,166.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,466.29 / $3,941.86 / $5,250.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.36 / $6,291.99 / $8,644.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,283.94 / $3,513.76 / $8,015.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,986.70 / $5,138.93 / $7,183.86