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Hawaii rates for HCPCS 35103

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving iliac vessels (common, hypogastric, external)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $2,818.38 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $2,630.27 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,884.03
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $3,311.31 / $3,981.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,187.76 / $2,570.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,454.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $2,630.27 / $3,388.44
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $2,691.53 / $3,981.07