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Unlisted Face or Jaw Prosthesis Service

Kentucky 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?

$10,715

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $10,715 for this service. The price depends on where it is billed: about $2,188 from a physician practice, and about $10,715 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 5 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$2,188$44.67 to $79,433
FacilityA hospital or hospital-owned outpatient department$10,715$3,802 to $11,220

How much rates vary

Facilitymedian $10,715 · 10th to 90th $724 to $66,069Professionalmedian $2,188 · 10th to 90th $0 to $85,114
$0.1$1$10$100$1K$10K$100Kfacility $10,715professional $2,188

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
$3,801.89
Median
$10,715.19
Typical High
$11,220.18
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.02
Typical High
$0.02
CareSource
Setting
Facility
Modifier
Global
Typical Low
$66,069.34
Median
$85,113.80
Typical High
$114,815.36
CareSource
Setting
Professional
Modifier
Global
Typical Low
$63,095.73
Median
$79,432.82
Typical High
$97,723.72
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,187.76
Median
$2,187.76
Typical High
$2,187.76
Molina
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$44.67
Typical High
$67.61
United
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$724.44
Typical High
$1,949.84

Where Kentucky 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.

Kentucky· 2nd of 49

$10,715

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.