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Unlisted Face or Jaw Prosthesis Service

Florida rates for HCPCS 21089

Covers the making or fitting of an artificial replacement for a missing or damaged part of the face, jaw or mouth when no standard named service applies. These custom devices restore appearance and function after cancer surgery, injury, or a condition present from birth. Because each one is built for a single person, the specialist records exactly what was designed and fitted.

Rates data updated July 2026.

How much does Unlisted Face or Jaw Prosthesis Service cost?

$2,089

Typical negotiated rate. In Florida, July 2026.

Insurers have agreed to pay about $2,089 for this service. The price depends on where it is billed: about $1,349 from a physician practice, and about $2,399 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,349$1,175 to $1,698
FacilityA hospital or hospital-owned outpatient department$2,399$1,738 to $3,548

How much rates vary

Facilitymedian $2,399 · 10th to 90th $1,000 to $5,248Professionalmedian $1,349 · 10th to 90th $1,072 to $1,995
$50$200$1K$5Kfacility $2,399professional $1,349

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$588.84
Typical High
$812.83
AvMed
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$4,897.79
Typical High
$12,302.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$398.11
Typical High
$10,000.00
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$1,548.82
Median
$2,511.89
Typical High
$4,365.16
Molina
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,412.54
Typical High
$1,995.26
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$1,445.44
Typical High
$4,168.69
United
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$39.81
Typical High
$60.26
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,071.52

Where Florida sits

The same service costs 1148.2 times more in Pennsylvania than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Florida· 12th of 49

$2,089

PA $54,954MD $47.86

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.