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Rebuilding The Eye Socket With Bone Grafts

New Jersey 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 July 2026.

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

$1,318

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $1,318 for this service. The price depends on where it is billed: about $1,288 from a physician practice, and about $7,762 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,288$1,148 to $1,862
FacilityA hospital or hospital-owned outpatient department$7,762$5,129 to $10,471

How much rates vary

Facilitymedian $7,762 · 10th to 90th $2,138 to $14,791Professionalmedian $1,288 · 10th to 90th $1,023 to $4,677
$100.0$500.0$2.0K$10.0Kfacility $7,762professional $1,288

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$6,918.31
Typical High
$12,302.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,202.26
Typical High
$5,888.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$1,659.59
Typical High
$3,801.89
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,380.38
Typical High
$1,905.46
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$11,748.98
Median
$19,952.62
Typical High
$30,199.52
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,479.11
Typical High
$6,309.57
United
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$8,709.64
Typical High
$19,498.45
United
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,258.93
Typical High
$2,951.21

Where New Jersey sits

The same service costs 5.9 times more in California than in Kentucky. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

New Jersey $1,318 · 42nd of 51
CA $7,079KY $1,202

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.