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California rates for HCPCS 21395

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

Facilitymedian $11,749 · 10th–90th $3,715$22,3870%10%10th90th$11,749Professionalmedian $1,202 · 10th–90th $891$4,6770%20%10th90th$1,202$50.0$200.0$1.0K$5.0K$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
$4,466.84 / $10,232.93 / $23,988.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,071.52 / $5,495.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $13,489.63 / $22,387.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,445.44 / $2,884.03
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $4,466.84 / $8,128.31
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,288.25 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,258.93 / $2,630.27
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,023.29 / $1,380.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,096.48 / $2,238.72
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $16,982.44
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,230.27 / $1,995.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,258.93 / $2,630.27
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,311.31 / $3,311.31
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,071.52 / $1,513.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,760.83 / $11,748.98 / $25,118.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,047.13 / $2,290.87