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Hawaii rates for HCPCS 21206

Osteotomy, maxilla, segmental (eg, Wassmund or Schuchard)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.46 / $1,148.46 / $1,148.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$955.32 / $1,239.05 / $1,486.86
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,469.09 / $1,650.57 / $2,072.80
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,090.35 / $1,189.49 / $1,387.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,011.06 / $1,239.05 / $1,883.55
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,181.90 / $3,692.19 / $9,324.00