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New Mexico 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
$820.83 / $7,838.38 / $8,942.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,345.93 / $15,935.67 / $25,966.96
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$742.29 / $943.56 / $1,581.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$899.00 / $11,259.00 / $16,897.00