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Illinois rates for HCPCS 21395

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

Facilitymedian $5,012 · 10th–90th $1,148–$14,1250%5%10th90th$5,012Professionalmedian $1,175 · 10th–90th $891–$2,5700%10%20%10th90th$1,175$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
$1,148.15 / $4,265.80 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,148.15 / $2,398.83
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $8,912.51 / $22,387.21
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,698.24 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,380.38 / $2,089.30
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,698.24 / $4,365.16
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,258.93 / $1,412.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,023.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $5,370.32 / $12,302.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,174.90 / $2,089.30