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Utah rates for HCPCS 21401

Closed treatment of fracture of orbit, except blowout; with manipulation

Facilitymedian $4,571 · 10th–90th $661–$7,9430%10%10th90th$4,571Professionalmedian $575 · 10th–90th $316–$2,1380%5%10%10th90th$575$50.0$200.0$1.0K$5.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,570.88 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $575.44 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $512.86 / $851.14
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $549.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,884.03 / $4,466.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $676.08 / $1,148.15
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $645.65 / $1,071.52
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $691.83 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $446.68 / $724.44