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Eye Socket Floor Fracture Repair With Graft

Montana 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.

Facilitymedian $1,738 · 10th–90th $1,318$2,0890%20%40%10th90th$1,738Professionalmedian $1,413 · 10th–90th $933$2,6920%10%20%10th90th$1,413$100.0$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
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,380.38
Typical High
$5,495.41
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,584.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,380.38
Typical High
$1,698.24
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$1,737.80
Typical High
$2,089.30
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$1,659.59
Median
$1,737.80
Typical High
$2,089.30
Providence
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,412.54
Typical High
$2,041.74
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$1,380.38
Typical High
$2,089.30
United
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$12,022.64
United
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,659.59
Typical High
$1,949.84