go back

Nebraska rates for HCPCS 21089

Unlisted Maxillofacial Prosthetic Procedure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$370.50 / $370.50 / $740.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,271.26 / $4,302.59 / $8,322.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$289.08 / $1,242.00 / $4,406.00
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
$1,031.00 / $1,775.00 / $4,406.00