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Rebuilding The Eye Socket With Bone Grafts

Arizona rates for HCPCS 21256

Reshapes and enlarges the bony eye socket by cutting the surrounding bone and adding grafts of the patient's own bone, working from outside the skull rather than through it. It is used when a socket is underdeveloped or misshapen, for example when the eye itself did not grow to full size, so the socket can properly hold and support the eye or an artificial eye. The work rebuilds the walls of the socket rather than shifting the whole socket to a new position.

Rates data updated October 2026.

How much does Rebuilding The Eye Socket With Bone Grafts cost?

$1,349

Typical negotiated rate. In Arizona, October 2026.

Insurers have agreed to pay about $1,349 for this service. The price depends on where it is billed: about $1,175 from a physician practice, and about $4,074 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,175$1,122 to $1,585
FacilityA hospital or hospital-owned outpatient department$4,074$2,138 to $6,457

How much rates vary

Facilitymedian $4,074 · 10th to 90th $1,096 to $8,511Professionalmedian $1,175 · 10th to 90th $1,023 to $14,791
$1K$2K$5K$10Kfacility $4,074professional $1,175

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$977.24
Median
$3,715.35
Typical High
$7,585.78
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,122.02
Median
$1,122.02
Typical High
$1,122.02
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$1,659.59
Median
$3,981.07
Typical High
$10,232.93
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$2,137.96
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,548.82
Median
$4,168.69
Typical High
$7,943.28
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,023.29
Median
$1,174.90
Typical High
$1,862.09
Medica
Setting
Facility
Modifier
None
Typical Low
$891.25
Median
$3,715.35
Typical High
$13,803.84
Medica
Setting
Professional
Modifier
None
Typical Low
$1,023.29
Median
$1,412.54
Typical High
$14,791.08
United
Setting
Facility
Modifier
None
Typical Low
$977.24
Median
$4,168.69
Typical High
$8,317.64
United
Setting
Professional
Modifier
None
Typical Low
$1,000.00
Median
$1,122.02
Typical High
$1,819.70
6 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$223.87
Median
$223.87
Typical High
$223.87
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$851.14
Median
$851.14
Typical High
$851.14
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$169.82
Median
$169.82
Typical High
$169.82
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$794.33
Median
$794.33
Typical High
$794.33

Where Arizona sits

The same service costs 16.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Arizona· 39th of 51

$1,349

AK $5,012TX $309

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.