go back

Pennsylvania rates for HCPCS 21088

Impression and custom preparation; facial prosthesis

Facilitymedian $3,548 · 10th–90th $2,188–$10,7150%20%10th90th$3,548Professionalmedian $2,884 · 10th–90th $955–$3,9810%10%20%10th90th$2,884$100.0$500.0$2.0K$10.0K$50.0K

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
$3,235.94 / $3,235.94 / $3,235.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $2,884.03 / $3,981.07
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $10,000.00 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $4,265.80 / $6,918.31
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $8,317.64 / $12,882.50
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,398.83 / $5,495.41
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,235.94 / $3,235.94
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $3,019.95 / $3,981.07
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,380.38
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $1,698.24
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $478.63 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $5,370.32 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,137.96 / $5,248.07