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Alaska rates for HCPCS 21387

Open treatment of orbital floor blowout fracture; combined approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,236.00 / $9,577.00 / $14,552.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.00 / $3,705.28 / $3,705.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,891.35 / $2,547.66 / $3,290.23
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$719.71 / $3,705.28 / $5,187.39
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,876.90 / $2,252.28 / $4,572.37
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,822.50 / $3,830.10 / $4,604.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$719.71 / $3,705.28 / $5,187.39
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,126.90 / $3,594.50 / $5,042.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,038.14 / $3,493.23 / $4,483.91