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Eye Socket Floor Fracture Repair With Graft

New Jersey 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.

How much does Eye Socket Floor Fracture Repair With Graft cost?

$1,259

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $1,259 for this service. The price depends on where it is billed: about $1,047 from a physician practice, and about $9,772 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,047$977 to $1,698
FacilityA hospital or hospital-owned outpatient department$9,772$6,026 to $11,749

How much rates vary

Facilitymedian $9,772 · 10th to 90th $4,365 to $14,454Professionalmedian $1,047 · 10th to 90th $851 to $5,623
$1K$2K$5K$10K$20Kfacility $9,772professional $1,047

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$4,365.16
Median
$9,772.37
Typical High
$14,125.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,023.29
Typical High
$9,332.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,380.38
Typical High
$3,162.28
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,122.02
Typical High
$1,548.82
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$18,197.01
Typical High
$27,542.29
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,202.26
Typical High
$5,128.61
United
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$8,709.64
Typical High
$19,498.45
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,000.00
Typical High
$2,398.83

Where New Jersey sits

The same service costs 8.1 times more in California than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Jersey· 38th of 51

$1,259

CA $7,943KY $977

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.