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Eye Socket Floor Fracture Repair With Graft

Washington 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 $2,455 · 10th–90th $1,202$20,8930%10%10th90th$2,455Professionalmedian $1,514 · 10th–90th $912$2,9510%20%10th90th$1,514$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
$1,548.82
Median
$7,079.46
Typical High
$22,908.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,412.54
Typical High
$2,884.03
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$10,715.19
Median
$18,197.01
Typical High
$32,359.37
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,995.26
Typical High
$2,818.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$870.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,659.59
Typical High
$3,019.95
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$2,041.74
Typical High
$7,762.47
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,905.46
Typical High
$5,248.07
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$407.38
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$1,949.84
Typical High
$2,041.74
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$1,380.38
Typical High
$1,778.28
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$2,041.74
Typical High
$2,630.27
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$10,964.78
Median
$17,378.01
Typical High
$31,622.78
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,995.26
Typical High
$2,754.23
United
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$17,782.79
Typical High
$33,884.42
United
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,513.56
Typical High
$2,818.38
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$977.24
Typical High
$1,862.09