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Hawaii rates for HCPCS 14301

Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm

Facilitymedian $2,138 · 10th–90th $1,413–$4,4670%20%10th90th$2,138Professionalmedian $1,096 · 10th–90th $457–$2,2910%5%10%10th90th$1,096$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
$1,412.54 / $2,089.30 / $4,466.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,096.48 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$257.04 / $269.15 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,380.38 / $1,659.59
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,778.28 / $7,079.46
HMSA
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$234.42 / $269.15 / $295.12
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,288.25 / $1,513.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,202.26 / $1,412.54
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $1,000.00 / $2,630.27