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Illinois rates for HCPCS 21387

Open Tx Orbital Floor Blowout Fx Combined Appr

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$825.00 / $2,784.00 / $6,661.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$646.82 / $774.81 / $1,474.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,070.62 / $9,928.21 / $18,117.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$986.47 / $1,356.46 / $1,356.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $875.00 / $908.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$725.10 / $1,099.44 / $1,637.73
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$864.13 / $1,265.84 / $3,391.98
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$903.08 / $964.39 / $1,069.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $1,209.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,100.00 / $5,820.00 / $12,241.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.24 / $971.03 / $1,721.31