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Connecticut rates for HCPCS 21089

Unlisted maxillofacial prosthetic procedure

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $245.47 / $245.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $3,162.28 / $10,471.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $851.14 / $851.14
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $501.19 / $501.19
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54,954.09 / $54,954.09 / $54,954.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $3,467.37 / $6,760.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $50.12