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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
$1,924.00 / $2,747.00 / $5,484.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,326.81 / $2,326.81 / $2,326.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,223.21 / $2,847.80 / $3,417.36
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,012.43 / $3,296.78 / $3,892.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,506.06 / $2,733.89 / $3,189.54
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
$2,323.80 / $2,847.80 / $3,723.84
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.27 / $2,058.59 / $3,894.18