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New York rates for HCPCS 21088

Impression and custom preparation; facial prosthesis

Facilitymedian $5,370 · 10th–90th $2,630–$12,8820%20%10th90th$5,370Professionalmedian $3,236 · 10th–90th $955–$9,7720%20%10th90th$3,236$0.0$0.2$2.0$20.0$200.0$2.0K$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
$812.83 / $954.99 / $977.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $2,884.03 / $3,981.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $5,495.41 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.03 / $11,748.98
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $4,786.30
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $4,786.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $9,549.93 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $6,309.57 / $24,547.09
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,819.70 / $4,168.69
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,760.83 / $10,471.29 / $14,791.08
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $6,165.95 / $6,165.95
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $8,709.64 / $13,803.84
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $5,495.41 / $12,302.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $7,413.10 / $17,782.79
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,230.27 / $16,595.87
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $7,079.46 / $15,135.61