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Hawaii rates for HCPCS 21146

Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral alveolar cleft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,659.59 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $1,949.84 / $2,238.72
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,570.40 / $2,818.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,778.28 / $2,238.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $2,884.03 / $2,884.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,819.70 / $2,630.27
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $1,513.56 / $2,511.89