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Tennessee rates for HCPCS 21088

Impression & Preparation Facial Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,764.98 / $6,014.27 / $8,242.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.45 / $3,090.39 / $4,802.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,676.00 / $3,611.00 / $5,774.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.49 / $2,353.46 / $3,736.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,111.95 / $4,093.79 / $6,943.62
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $14,212.24 / $21,368.21
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25,045.36 / $36,897.44 / $39,483.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,905.00 / $6,073.00 / $10,287.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,661.99 / $2,775.58 / $4,715.63