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Indiana rates for HCPCS 21089

Unlisted Maxillofacial Prosthetic Procedure

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$856.00 / $4,320.00 / $8,230.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,999.73 / $29,999.70 / $60,749.39
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26,999.73 / $32,399.68 / $40,499.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.00 / $2,252.00 / $4,426.00