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Washington, DC rates for HCPCS 21395

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $7,244.36 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,023.29 / $2,691.53
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $5,495.41 / $11,748.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,318.26 / $2,818.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $2,041.74 / $2,290.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $16,218.10 / $33,884.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,288.25 / $2,754.23