go back

Tennessee 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
$1,500.00 / $4,069.00 / $10,746.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,013.00 / $6,038.00 / $9,272.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $16,547.20 / $16,547.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,905.00 / $6,073.00 / $10,287.00