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Arizona rates for HCPCS 21395

Open treatment of orbital floor blowout fracture; periorbital approach with bone graft (includes obtaining graft)

Facilitymedian $5,129 · 10th–90th $1,820–$9,7720%10%10th90th$5,129Professionalmedian $1,072 · 10th–90th $891–$2,6300%20%10th90th$1,072$1.0K$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $5,128.61 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,047.13 / $2,630.27
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $7,413.10 / $13,489.63
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,380.38 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,148.15 / $1,995.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,348.96 / $7,413.10
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,174.90 / $8,511.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $5,495.41 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,023.29 / $1,819.70