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Utah rates for HCPCS 21406

Open treatment of fracture of orbit, except blowout; without implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $6,025.60 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $776.25 / $3,235.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $741.31 / $1,258.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $912.01
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $10,000.00 / $22,387.21
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,000.00 / $1,479.11
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $1,000.00 / $1,380.38
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $933.25 / $1,380.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $588.84 / $912.01