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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 October 2026.

How much does Unlisted Face or Jaw Prosthesis Service cost?

$1,230

Typical negotiated rate. In Florida, October 2026.

Insurers have agreed to pay about $1,230 for this service. The price depends on where it is billed: about $1,122 from a physician practice, and about $1,479 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,122$1,122 to $1,349
FacilityA hospital or hospital-owned outpatient department$1,479$417 to $2,692

How much rates vary

Facilitymedian $1,479 · 10th to 90th $115 to $4,467Professionalmedian $1,122 · 10th to 90th $759 to $1,820
$50$200$1K$5Kfacility $1,479professional $1,122

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$426.58
Median
$588.84
Typical High
$812.83
AvMed
Setting
Facility
Modifier
None
Typical Low
$512.86
Median
$4,265.80
Typical High
$12,882.50
Cigna
Setting
Facility
Modifier
None
Typical Low
$398.11
Median
$501.19
Typical High
$2,691.53
Florida Blue
Setting
Facility
Modifier
None
Typical Low
$1,380.38
Median
$2,398.83
Typical High
$4,265.80
Molina
Setting
Professional
Modifier
None
Typical Low
$1,174.90
Median
$1,348.96
Typical High
$1,819.70
United
Setting
Facility
Modifier
None
Typical Low
$81.28
Median
$302.00
Typical High
$2,818.38
United
Setting
Professional
Modifier
None
Typical Low
$34.67
Median
$39.81
Typical High
$60.26
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$1,122.02
Median
$1,122.02
Typical High
$1,122.02

Where Florida sits

The same service costs 38.0 times more in New York than in Montana. 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· 9th of 51

$1,230

NY $3,020MT $79.43

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.