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Unlisted Face or Jaw Prosthesis Service

Georgia 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?

$2,239

Typical facility fee. In Georgia, July 2026.

Insurers have agreed to pay about $2,239 for this service. Most negotiated rates run $1,259 to $3,388.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $2,239 · 10th to 90th $741 to $3,981Professionalmedian $275 · 10th to 90th $275 to $275
$500$1K$2K$5K$10Kfacility $2,239professional $275

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$2,344.23
Typical High
$4,168.69
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$2,511.89
Typical High
$2,511.89
United
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$1,318.26
Typical High
$2,454.71

Where Georgia 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.

Georgia· 11th of 49

$2,239

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.