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Arizona rates for HCPCS 21089

Unlisted maxillofacial prosthetic procedure

Facilitymedian $1,445 · 10th–90th $417–$2,7540%5%10%10th90th$1,445Professionalmedian $398 · 10th–90th $245–$7940%20%10th90th$398$100.0$200.0$500.0$1.0K$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $1,862.09 / $3,388.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $457.09 / $870.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,412.54 / $2,238.72
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,137.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $933.25 / $2,137.96