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Kansas 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
$3,131.00 / $7,655.00 / $14,450.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.44 / $1,018.80 / $1,593.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$792.00 / $792.00 / $792.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,241.21 / $1,460.25 / $1,460.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$624.00 / $624.00 / $624.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.57 / $1,306.93 / $1,993.04
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,018.80 / $1,593.92 / $5,323.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,013.35 / $1,217.29 / $8,440.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,967.00 / $4,960.00 / $11,732.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,013.35 / $1,194.85 / $1,642.67