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Illinois rates for HCPCS 21089

Unlisted maxillofacial prosthetic procedure

Facilitymedian $407 · 10th–90th $204–$1,9950%10%10th90th$407Professionalmedian $245 · 10th–90th $200–$3470%50%10th90th$245$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $338.84 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $10,000.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $199.53 / $346.74
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $691.83 / $2,089.30