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Pennsylvania rates for HCPCS 21386

Open treatment of orbital floor blowout fracture; periorbital approach

Facilitymedian $6,026 · 10th–90th $1,318–$10,4710%10%10th90th$6,026Professionalmedian $708 · 10th–90th $617–$1,2880%20%40%10th90th$708$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $6,025.60 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $707.95 / $1,258.93
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $10,000.00 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $724.44 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $812.83 / $1,380.38
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,000.00 / $1,288.25
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $812.83 / $1,148.15
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19,498.45 / $19,498.45 / $19,498.45
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $4,786.30 / $8,709.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $707.95 / $1,584.89
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,071.52 / $1,513.56
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $691.83 / $758.58
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $691.83 / $758.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $5,754.40 / $19,054.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $758.58 / $1,318.26