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New Mexico rates for HCPCS 21395

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

Facilitymedian $1,514 · 10th–90th $1,023–$8,9130%20%10th90th$1,514Professionalmedian $1,023 · 10th–90th $912–$1,7780%20%10th90th$1,023$50.0$200.0$1.0K$5.0K$20.0K

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
$1,412.54 / $2,089.30 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,023.29 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,380.38 / $3,388.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $288.40
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,288.25 / $2,041.74
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,445.44 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $11,748.98 / $25,703.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,445.44 / $2,041.74