CPT 21077
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Prepare face/oral prosthesis
Low
$1.5k
Average
$6.1k
Median
$5.5k
High
$16.5k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
62 payers; the 90th percentile is 3.8× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare case rate · outpatient · +22 other terms | 428 | $9.3k | $9.1k | $4.7k | 51% | — | $1 – $36.5k |
| 2 | Aetna fee schedule · outpatient · +22 other terms | 406 | $6.1k | $7.1k | $5.1k | 72% | — | $1 – $57.5k |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +20 other terms | 319 | $7.5k | $9.1k | $6.1k | 68% | — | $1 – $58.9k |
| 4 | Humana fee schedule · outpatient · +21 other terms | 285 | $5.9k | $5.2k | $2.6k | 50% | — | $1 – $19.6k |
| 5 | Cigna case rate · outpatient · +17 other terms | 223 | $6.8k | $11.7k | $8.3k | 71% | — | $1 – $40.7k |
| 6 | WellCare fee schedule · outpatient · +8 other terms | 149 | $6.0k | $6.1k | $2.4k | 40% | — | $864 – $13.9k |
| 7 | Oscar case rate · outpatient · +16 other terms | 130 | $9.4k | $8.9k | $3.1k | 34% | — | $3.5k – $17.8k |
| 8 | Molina fee schedule · outpatient · +15 other terms | 126 | $6.2k | $6.5k | $3.4k | 53% | — | $1 – $13.7k |
| 9 | Anthem fee schedule · outpatient · +17 other terms | 120 | $7.5k | $7.2k | $7.1k | 98% | — | $851 – $43.3k |
| 10 | Kaiser fee schedule · outpatient · +11 other terms | 91 | $8.1k | $10.7k | $7.0k | 65% | — | $1.6k – $42.0k |
| 11 | Healthcare Highways case rate · outpatient · +1 other terms | 76 | $6.4k | $7.0k | $1.1k | 16% | — | $3.4k – $8.6k |
| 12 | Devoted fee schedule · outpatient · +6 other terms | 68 | $6.0k | $5.6k | $1.4k | 25% | — | $1.7k – $6.7k |
| 13 | Ambetter fee schedule · outpatient · +6 other terms | 62 | $10.2k | $7.8k | $5.1k | 65% | — | $760 – $14.3k |
| 14 | Caresource fee schedule · outpatient · +10 other terms | 40 | $5.8k | $3.5k | $3.2k | 92% | — | $1 – $10.1k |
| 15 | Superior Healthplan case rate · outpatient · +3 other terms | 38 | $948 | $1.2k | $1.4k | 116% | — | $929 – $8.9k |
| 16 | Optum fee schedule · outpatient · +11 other terms | 35 | $5.7k | $6.8k | $5.0k | 73% | — | $1.7k – $21.9k |
| 17 | Bcbs Tx fee schedule · outpatient · +2 other terms | 32 | $2.2k | $2.1k | $1.6k | 73% | — | $773 – $6.1k |
| 18 | Clover fee schedule · outpatient · +6 other terms | 31 | $6.5k | $6.3k | $402 | 6% | — | $5.3k – $7.0k |
| 19 | Medica case rate · outpatient · +10 other terms | 28 | $4.0k | $5.0k | $2.2k | 45% | — | $1.6k – $10.6k |
| 20 | Tricare fee schedule · outpatient · +10 other terms | 27 | $5.4k | $5.1k | $947 | 19% | — | $3.8k – $7.0k |
| 21 | Bcbs La fee schedule · outpatient · +2 other terms | 25 | $10.0k | $9.7k | $2.2k | 22% | — | $1.5k – $13.7k |
| 22 | Medicare fee schedule · outpatient · +9 other terms | 24 | $1.7k | $2.5k | $1.7k | 66% | — | $1.6k – $5.9k |
| 23 | MultiPlan fee schedule · outpatient · +13 other terms | 22 | $9.4k | $9.3k | $530 | 6% | — | $5.6k – $9.4k |
| 24 | Regence professional · fee schedule · outpatient · +7 other terms | 20 | $2.1k | $2.1k | $827 | 39% | — | $1.2k – $4.2k |
| 25 | Highmark fee schedule · outpatient · +9 other terms | 17 | $5.9k | $5.5k | $3.7k | 67% | — | $1.0k – $17.4k |
← Hospitals reporting CPT 21077 · Snapshot 20261113T090226Z-3ce6c0b8