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Eye Socket Floor Fracture Repair With Graft

Illinois rates for HCPCS 21395

Repairs a break in the thin floor of the eye socket through an incision made around the eye, rebuilding the missing bone with a graft of the patient's own bone. This kind of break happens when a blow to the eye pushes the socket floor downward, letting tissue drop into the sinus below and causing double vision or a sunken-looking eye. Restoring the floor lifts the eye back into position.

Rates data updated July 2026.

How much does Eye Socket Floor Fracture Repair With Graft cost?

$1,622

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $1,622 for this service. The price depends on where it is billed: about $1,259 from a physician practice, and about $3,802 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,259$977 to $1,905
FacilityA hospital or hospital-owned outpatient department$3,802$1,862 to $7,586

How much rates vary

Facilitymedian $3,802 · 10th to 90th $1,148 to $14,125Professionalmedian $1,259 · 10th to 90th $891 to $2,951
$200$500$1K$2K$5K$10K$20Kfacility $3,802professional $1,259

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$3,235.94
Typical High
$12,882.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,047.13
Typical High
$2,398.83
BCBS
Setting
Facility
Modifier
Global
Typical Low
$7,413.10
Median
$8,912.51
Typical High
$22,387.21
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,148.15
Typical High
$1,621.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,380.38
Typical High
$2,089.30
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,698.24
Typical High
$4,365.16
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$1,258.93
Typical High
$1,412.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$107.15
Typical High
$1,258.93
United
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$5,370.32
Typical High
$12,882.50
United
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,202.26
Typical High
$2,137.96

Where Illinois sits

The same service costs 8.1 times more in California than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 18th of 51

$1,622

CA $7,943KY $977

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.