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New Mexico rates for HCPCS 21088

Impression and custom preparation; facial prosthesis

Facilitymedian $5,370 · 10th–90th $891–$12,8820%10%10th90th$5,370Professionalmedian $3,090 · 10th–90th $955–$4,5710%20%10th90th$3,090$100.0$200.0$500.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,162.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $3,090.30 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $4,570.88 / $8,128.31
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $331.13 / $2,951.21
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $3,890.45 / $6,760.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $4,365.16 / $6,456.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $9,120.11 / $16,982.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,715.35 / $5,623.41