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Eye Socket Floor Fracture Repair With Graft

Utah 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 $6,026 · 10th–90th $1,380$12,0230%10%10th90th$6,026Professionalmedian $1,380 · 10th–90th $891$5,4950%10%10th90th$1,380$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
Setting
Facility
Modifier
Global
Typical Low
$1,380.38
Median
$4,570.88
Typical High
$10,232.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,380.38
Typical High
$5,495.41
Cigna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,348.96
Typical High
$2,137.96
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,949.84
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$8,511.38
Median
$11,481.54
Typical High
$17,782.79
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,548.82
Typical High
$2,570.40
Select Health
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$1,778.28
Typical High
$1,778.28
Select Health
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,621.81
Typical High
$1,862.09
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,445.44
Typical High
$2,187.76
United
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$5,128.61
Typical High
$13,803.84
United
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,047.13
Typical High
$1,698.24