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Indiana 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
$156.58 / $515.08 / $7,212.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.94 / $177.47 / $219.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,749.00 / $4,353.00 / $8,052.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.93 / $150.07 / $207.09
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$159.83 / $219.38 / $329.07
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.35 / $249.19 / $358.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$365.92 / $365.92 / $433.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.18 / $208.80 / $358.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.00 / $2,252.00 / $4,426.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.93 / $201.99 / $357.06