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Tennessee rates for HCPCS 21387

Open treatment of orbital floor blowout fracture; combined approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,150.00 / $2,940.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.75 / $763.13 / $1,220.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,984.00 / $5,500.00 / $9,419.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$722.08 / $985.92 / $1,537.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$779.29 / $1,024.77 / $1,595.31
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $13,960.05 / $13,960.05
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,296.79 / $8,296.79 / $8,296.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,905.00 / $6,073.00 / $10,287.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$674.21 / $856.61 / $1,595.32