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Michigan rates for HCPCS 21395

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

Facilitymedian $6,918 · 10th–90th $4,266–$7,9430%20%10th90th$6,918Professionalmedian $1,122 · 10th–90th $912–$2,2910%10%20%10th90th$1,122$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$4,897.79 / $4,897.79 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,023.29 / $1,905.46
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,290.87 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,202.26 / $1,819.70
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $4,897.79 / $6,918.31
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,202.26 / $2,089.30
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,202.26 / $1,659.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $7,762.47 / $14,791.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,148.15 / $1,548.82