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Eye Socket Floor Fracture Repair With Graft

South Dakota 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.

Facilitymedian $1,698 · 10th–90th $1,202$6,9180%20%10th90th$1,698Professionalmedian $1,738 · 10th–90th $832$2,8840%10%10th90th$1,738$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$4,365.16
Typical High
$6,918.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,000.00
Typical High
$2,041.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$2,290.87
Typical High
$2,884.03
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,659.59
Typical High
$2,630.27
Medica
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,819.70
Typical High
$8,511.38
Midlands
Setting
Professional
Modifier
Global
Typical Low
$2,041.74
Median
$2,290.87
Typical High
$2,290.87
Midlands
Setting
Professional
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,238.72
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,659.59
Typical High
$1,949.84
United
Setting
Facility
Modifier
Global
Typical Low
$4,466.84
Median
$4,466.84
Typical High
$12,022.64
United
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,659.59
Typical High
$2,818.38
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,862.09
Median
$1,949.84
Typical High
$2,290.87