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Nebraska rates for HCPCS 21088

Impression and custom preparation; facial prosthesis

Facilitymedian $4,898 · 10th–90th $2,884–$8,9130%10%10th90th$4,898Professionalmedian $4,074 · 10th–90th $2,344–$6,9180%10%20%10th90th$4,074$1.0K$2.0K$5.0K$10.0K$20.0K

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
$2,884.03 / $2,884.03 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $2,884.03 / $5,011.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $4,265.80 / $8,317.64
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $4,786.30 / $6,606.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,238.72 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $4,677.35 / $8,511.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $5,128.61 / $8,912.51
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $4,677.35 / $25,118.86
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,165.95 / $6,606.93 / $10,000.00
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,238.72 / $2,238.72
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,456.54 / $9,120.11 / $9,549.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $6,309.57 / $7,585.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $4,677.35 / $7,943.28