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Eye Socket Floor Fracture Repair With Graft

Pennsylvania 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?

$1,148

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $1,148 for this service. The price depends on where it is billed: about $1,023 from a physician practice, and about $6,607 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 9 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$1,023$933 to $1,288
FacilityA hospital or hospital-owned outpatient department$6,607$3,802 to $8,511

How much rates vary

Facilitymedian $6,607 · 10th to 90th $1,413 to $11,220Professionalmedian $1,023 · 10th to 90th $912 to $1,585
$1K$2K$5K$10Kfacility $6,607professional $1,023

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
$1,412.54
Median
$7,244.36
Typical High
$10,964.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,023.29
Typical High
$1,513.56
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$20,417.38
Median
$21,379.62
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,047.13
Typical High
$1,862.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,584.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,174.90
Typical High
$1,995.26
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,445.44
Typical High
$1,819.70
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,174.90
Typical High
$1,905.46
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$5,754.40
Typical High
$11,220.18
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,047.13
Typical High
$5,248.07
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$1,047.13
Typical High
$1,096.48
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$1,698.24
Median
$3,801.89
Typical High
$6,456.54
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,000.00
Typical High
$1,047.13
United
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$5,370.32
Typical High
$17,378.01
United
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,122.02
Typical High
$2,041.74

Where Pennsylvania 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.

Pennsylvania· 42nd of 51

$1,148

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.