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Kentucky 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
$841.39 / $1,194.00 / $8,229.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$841.39 / $971.28 / $1,132.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,212.00 / $9,015.00 / $11,253.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.93 / $937.46 / $1,310.69
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.29 / $1,293.98 / $1,617.47
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,016.70 / $1,293.98 / $1,848.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$985.03 / $1,135.13 / $1,135.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$967.18 / $1,323.13 / $1,917.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $1,201.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$842.00 / $4,539.00 / $10,113.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.16 / $1,222.77 / $1,914.20