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Ohio rates for HCPCS 21089

Unlisted maxillofacial prosthetic procedure

Facilitymedian $1,549 · 10th–90th $178$3,5480%20%10th90th$1,549Professionalmedian $0 · 10th–90th $0$500%50%90th$0$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $117.49 / $218.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $2,137.96 / $3,981.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.03
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72,443.60 / $72,443.60 / $72,443.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $50.12 / $60.26
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $144.54
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $70.79 / $75.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $851.14 / $2,951.21