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Michigan 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
$1,122.02 / $6,760.83 / $6,918.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $1,819.70 / $1,819.70
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $4,897.79 / $6,918.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $7,413.10 / $12,882.50