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Hawaii rates for HCPCS 21183

Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 40 sq cm but less than 80 sq cm

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
$2,089.30 / $2,398.83 / $3,235.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,691.53 / $3,162.28
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,019.95 / $3,311.31 / $3,981.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,398.83 / $3,019.95
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
$1,862.09 / $2,754.23 / $3,715.35
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $2,041.74 / $3,890.45