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Virginia 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
$899.18 / $6,010.54 / $14,798.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,153.00 / $7,363.00 / $9,410.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$903.02 / $903.02 / $1,200.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$763.83 / $977.70 / $1,144.29
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$822.13 / $1,052.04 / $1,565.79
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$743.87 / $1,004.42 / $3,477.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,423.00 / $11,475.00 / $21,639.00