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Maryland 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
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,380.38 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $645.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $40.74 / $128.82