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Open Repair Of Orbital Floor Fracture Through The Sinus

New Jersey rates for HCPCS 21385

Repairs a broken floor of the eye socket by working through the cheek sinus below it. The surgeon reaches the fracture from inside the sinus and lifts the bone and tissue back into place. The break treated is a blowout type, where the socket floor gives way.

Rates data updated July 2026.

How much does Open Repair Of Orbital Floor Fracture Through The Sinus cost?

$933

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $933 for this service. The price depends on where it is billed: about $759 from a physician practice, and about $8,511 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$759$692 to $1,288
FacilityA hospital or hospital-owned outpatient department$8,511$6,026 to $11,482

How much rates vary

Facilitymedian $8,511 · 10th to 90th $4,365 to $13,490Professionalmedian $759 · 10th to 90th $617 to $4,266
$1K$2K$5K$10K$20Kfacility $8,511professional $759

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
$4,365.16
Median
$8,511.38
Typical High
$13,489.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$724.44
Typical High
$8,511.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,000.00
Typical High
$2,238.72
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$851.14
Typical High
$1,148.15
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$11,748.98
Median
$18,197.01
Typical High
$30,199.52
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$891.25
Typical High
$3,630.78
United
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$8,709.64
Typical High
$19,498.45
United
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$758.58
Typical High
$1,819.70

Where New Jersey sits

The same service costs 9.1 times more in California than in Kentucky. 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.

New Jersey· 33rd of 51

$933

CA $6,607KY $724

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.