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North Carolina rates for HCPCS 21089

Unlisted maxillofacial prosthetic procedure

Facilitymedian $724 · 10th–90th $174–$1,9500%10%10th90th$724Professionalmedian $1,380 · 10th–90th $724–$1,5490%50%10th90th$1,380$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,380.38 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $724.44 / $1,949.84
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $56.23 / $56.23
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $2,187.76