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New York rates for HCPCS 21395

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

Facilitymedian $5,888 · 10th–90th $1,549$13,1830%10%10th90th$5,888Professionalmedian $1,148 · 10th–90th $871$2,8180%20%10th90th$1,148$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
$1,380.38 / $5,248.07 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,148.15 / $2,630.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $7,762.47 / $13,803.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,047.13 / $2,454.71
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $13,489.63
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,412.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $1,698.24 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,513.56 / $4,570.88
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,380.38 / $3,467.37
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,445.44 / $2,041.74
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $933.25
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,318.26 / $2,137.96
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $1,348.96 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $5,495.41 / $12,589.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,348.96 / $4,265.80
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $1,202.26 / $4,073.80
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,230.27 / $2,818.38