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Hawaii rates for HCPCS 35121

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, renal, or mesenteric artery

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,747.00 / $2,747.00 / $2,747.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,623.02 / $1,623.02 / $1,623.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,781.01 / $1,781.01 / $2,112.52
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,231.58 / $2,442.23 / $3,019.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,567.29 / $1,709.77 / $1,994.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,446.00 / $2,446.00 / $2,446.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,453.31 / $1,869.02 / $2,404.41
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.27 / $1,979.24 / $2,961.47