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Hawaii rates for HCPCS 25265

Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $4,466.84 / $4,466.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $776.25 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $870.96 / $1,047.13
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,258.93 / $7,762.47
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $851.14 / $1,047.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $2,137.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $954.99 / $1,202.26
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $3,235.94 / $6,165.95