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Delaware 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
$6,907.00 / $6,907.00 / $7,265.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$887.32 / $1,009.14 / $1,009.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$882.13 / $1,032.71 / $1,820.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,530.00 / $2,530.00 / $2,530.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$832.96 / $982.06 / $2,320.83