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Kentucky rates for HCPCS 21089

Unlisted maxillofacial prosthetic procedure

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $245.47 / $245.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,801.89 / $10,715.19 / $11,220.18
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
$66,069.34 / $85,113.80 / $114,815.36
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63,095.73 / $79,432.82 / $97,723.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $34.67 / $34.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $2,187.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $44.67 / $67.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $602.56 / $3,162.28