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Texas rates for HCPCS 21089

Unlisted maxillofacial prosthetic procedure

Facilitymedian $363 · 10th–90th $115–$2,0420%5%10th90th$363Professionalmedian $30 · 10th–90th $30–$910%50%90th$30$50.0$200.0$1.0K$5.0K

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
$588.84 / $4,168.69 / $6,456.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $338.84 / $724.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $56.23
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,187.76 / $2,187.76
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $4,168.69 / $6,456.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $870.96 / $2,290.87