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Texas rates for HCPCS 21395

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

Facilitymedian $4,365 · 10th–90th $1,096$13,8040%5%10th90th$4,365Professionalmedian $1,072 · 10th–90th $891$1,9050%20%10th90th$1,072$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
$1,096.48 / $4,073.80 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,047.13 / $1,778.28
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $7,762.47 / $14,791.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,122.02 / $1,584.89
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $870.96 / $891.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,318.26 / $2,089.30
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $16,982.44
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,412.54 / $5,248.07
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,288.25 / $2,089.30
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $128.82 / $851.14
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,202.26 / $2,137.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,318.26 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $6,165.95 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,047.13 / $1,659.59
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $891.25 / $933.25