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Hawaii rates for HCPCS 21245

Rcnstj Mndbl/Maxl Subpriosteal Implant Partial

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
$927.02 / $927.02 / $1,153.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,255.23 / $1,584.10 / $1,900.92
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.48 / $1,675.09 / $1,885.57
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,065.72 / $1,394.01 / $1,584.10
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
$1,195.33 / $1,584.10 / $2,010.50
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,035.64 / $4,635.00 / $11,157.00