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Arizona rates for HCPCS 21387

Open treatment of orbital floor blowout fracture; combined approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $4,521.00 / $7,963.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.17 / $737.42 / $4,123.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,763.75 / $6,640.00 / $10,860.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$797.30 / $911.20 / $1,139.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$670.00 / $906.46 / $1,492.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$732.85 / $993.06 / $7,140.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$641.77 / $823.18 / $8,296.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,637.00 / $6,477.00 / $9,010.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$640.90 / $767.52 / $1,529.91