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
Devils Lake, ND
See all hospitals reporting CPT 21089 →Price type
Altru Hospital Devils Lake’s median price of $421 is 38% above the median hospital's median price ($305), higher than 59% of the 1,372 hospitals reporting CPT 21089. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 10 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield medicaid managed care plan facility · fee schedule · outpatient | $87 | $87 | — | — | — | $87 – $87 |
| 2 | Aetna medicare managed care plan facility · fee schedule · outpatient | $242 | $242 | — | — | — | $242 – $242 |
| 3 | Sanford Health Plan all commercial plans facility · fee schedule · outpatient | $331 | $331 | $48 | 15% | — | $283 – $379 |
| 4 | Medica medicaid managed care plan facility · fee schedule · outpatient | $365 | $365 | — | — | — | $365 – $365 |
| 5 | Medica medicaid managed care plan – hmo facility · fee schedule · outpatient | $365 | $365 | — | — | — | $365 – $365 |
| 6 | Blue Cross Blue Shield all commercial plans facility · fee schedule · outpatient | $421 | $421 | — | — | — | $421 – $421 |
| 7 | Medica medicare managed care plan facility · fee schedule · outpatient | $455 | $455 | — | — | — | $455 – $455 |
| 8 | UnitedHealthcare all commercial plans facility · fee schedule · outpatient | $474 | $474 | — | — | — | $474 – $474 |
| 9 | Medica all commercial plans facility · fee schedule · outpatient | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 10 | Aetna all commercial plans facility · fee schedule · outpatient | $436 | $3.1k | $3.8k | 126% | — | $254 – $8.5k |
Last updated: Mar 1, 2026
See Unlisted facial prosthetic procedure pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.