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Oklahoma rates for HCPCS 21088

Impression & Preparation Facial Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,253.45 / $3,253.45 / $3,253.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,675.87 / $3,253.45 / $3,253.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,248.01 / $2,248.01 / $2,248.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,508.66 / $3,763.00 / $6,575.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,481.00 / $3,416.12 / $8,753.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,844.72 / $3,165.40 / $5,851.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,481.00 / $5,524.00 / $9,232.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,969.66 / $2,938.85 / $4,604.49