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North Dakota 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
$1,010.37 / $1,010.37 / $10,000.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$905.91 / $999.92 / $1,025.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,999.53 / $2,199.59 / $2,579.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,219.05 / $2,435.50 / $3,244.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,010.37 / $1,229.58 / $1,717.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,058.51 / $1,861.62 / $2,616.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,058.51 / $1,853.52 / $2,328.71