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Nebraska 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
$198.92 / $4,778.89 / $13,841.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.99 / $198.92 / $852.97
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,350.61 / $4,406.97 / $8,524.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.91 / $294.44 / $412.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$409.56 / $409.56 / $409.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.50 / $423.66 / $643.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.24 / $293.70 / $633.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.48 / $394.76 / $1,271.59
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$362.27 / $453.98 / $641.64
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.66 / $406.71 / $558.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,031.00 / $1,775.00 / $4,406.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.25 / $404.33 / $514.36