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Hawaii rates for HCPCS 21210

Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,583.13 / $3,107.00 / $8,431.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$836.57 / $836.57 / $2,149.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,853.84 / $2,336.15 / $2,803.38
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,212.99 / $1,434.34 / $3,245.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.22 / $1,981.06 / $2,336.15
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
$1,906.30 / $2,295.44 / $3,385.61
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$921.87 / $4,682.00 / $11,157.30