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Oklahoma 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
$916.00 / $3,683.00 / $8,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.94 / $174.09 / $216.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,175.22 / $6,632.94 / $10,479.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.27 / $242.92 / $266.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$440.17 / $440.17 / $440.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.79 / $211.11 / $310.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.54 / $226.94 / $1,213.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.19 / $209.70 / $1,625.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.00 / $610.00 / $1,883.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.19 / $195.83 / $293.62