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Rhode Island rates for HCPCS 21088

Impression & Preparation Facial Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.45 / $1,122.20 / $3,876.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,034.18 / $5,536.09 / $6,340.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,219.00 / $7,228.00 / $12,680.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,741.73 / $3,780.79 / $5,859.12