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Utah rates for HCPCS 21089

Unlisted maxillofacial prosthetic procedure

Facilitymedian $479 · 10th–90th $331–$4,4670%10%20%10th90th$479Professionalmedian $603 · 10th–90th $603–$6030%50%$603$50.0$100.0$200.0$500.0$1.0K$2.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $457.09 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61