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New Jersey 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
$972.81 / $6,922.00 / $13,413.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$856.75 / $973.96 / $1,698.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$974.79 / $1,389.72 / $2,986.35
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$923.55 / $1,351.15 / $1,594.78
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,989.59 / $14,382.16 / $29,209.37
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$838.22 / $1,203.09 / $2,562.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,682.00 / $9,969.00 / $19,696.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$789.32 / $1,218.18 / $2,963.39