go back

Connecticut rates for HCPCS 21089

Unlisted Maxillofacial Prosthetic Procedure

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,410.00 / $6,763.00 / $10,432.00
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
$843.00 / $843.00 / $843.00
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $2,346.67 / $2,469.56
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,249.45 / $55,249.45 / $55,249.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.00 / $3,075.00 / $6,664.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $50.00 / $50.00