go back

California rates for HCPCS 21400

Closed treatment of fracture of orbit, except blowout; without manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$462.00 / $5,505.00 / $16,713.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.88 / $176.68 / $852.97
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,759.00 / $4,464.00 / $8,976.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.73 / $211.32 / $425.20
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $7,100.20
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.61 / $170.11 / $382.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$536.21 / $537.16 / $1,992.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.54 / $226.37 / $455.05
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.28 / $270.69 / $380.96
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.31 / $267.69 / $444.33
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,196.76 / $1,213.26 / $16,394.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,253.59 / $1,594.80 / $1,888.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.51 / $252.34 / $354.62
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.22 / $242.07 / $479.59
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.26 / $529.26 / $671.11
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.84 / $256.57 / $365.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$548.00 / $1,523.00 / $6,323.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.13 / $196.18 / $467.14