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California rates for HCPCS 21390

Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,843.00 / $10,195.62 / $23,163.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,585.00 / $11,216.00 / $21,514.00
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $15,290.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,445.00 / $5,729.24 / $10,261.32
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$590.47 / $941.64 / $1,271.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.12 / $1,046.88 / $1,909.02
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $5,906.32 / $16,547.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.69 / $1,039.23 / $1,513.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,416.00 / $12,267.00 / $26,109.00