go back

Missouri 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
$1,045.80 / $4,908.00 / $12,154.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$738.05 / $1,215.56 / $4,813.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,044.49 / $4,000.00 / $10,781.00