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Hawaii rates for HCPCS 21088

Impression & Preparation Facial Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.45 / $961.45 / $961.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,695.16 / $1,695.16 / $2,393.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,912.00 / $2,912.00 / $2,912.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,695.16 / $4,487.99 / $5,038.34