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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
$1,324.03 / $2,747.00 / $4,456.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$717.25 / $717.25 / $717.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$745.03 / $965.90 / $1,159.08
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,077.75 / $1,210.88 / $5,851.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$849.99 / $927.26 / $1,081.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $2,155.00 / $2,155.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$788.17 / $965.90 / $1,212.61
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$919.30 / $2,582.96 / $6,124.00