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Hawaii rates for HCPCS 26502

Reconstruction of tendon pulley, each tendon; with tendon or fascial graft (includes obtaining graft) (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $724.44 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $851.14 / $1,096.48
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,148.15 / $1,412.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $954.99 / $1,174.90
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
$562.34 / $870.96 / $1,202.26
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $4,073.80 / $7,943.28