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Maryland 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
$4,311.95 / $4,764.71 / $9,653.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$990.00 / $1,012.17 / $2,754.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.17 / $1,072.21 / $1,408.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.00 / $847.00 / $1,560.00