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Hawaii rates for HCPCS 21172

Rcnstj Superior-Lateral Orbital Rim & Lower Fhd

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,528.00 / $2,747.00 / $6,084.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,652.75 / $1,886.41 / $3,152.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,001.95 / $2,543.88 / $3,052.65
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,725.62 / $3,062.31 / $3,560.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.61 / $2,442.12 / $2,849.14
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
$2,048.84 / $2,543.88 / $3,239.18
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.27 / $1,862.59 / $2,882.68