go back

Missouri rates for HCPCS 21089

Unlisted maxillofacial prosthetic procedure

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$727.00 / $727.00 / $727.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $692.74 / $1,351.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,117.16 / $2,117.16 / $2,117.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.00 / $815.00 / $1,351.00