go back

Hawaii rates for HCPCS 21125

Augmentation, mandibular body or angle; prosthetic material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,583.13 / $3,107.00 / $8,431.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$752.66 / $752.66 / $3,192.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,800.89 / $3,449.59 / $4,139.51
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,066.46 / $1,242.48 / $4,474.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$753.97 / $2,925.25 / $3,449.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,981.00 / $1,981.00 / $1,981.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,814.86 / $3,440.03 / $4,904.18
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$810.51 / $4,635.00 / $11,157.00