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Hawaii rates for HCPCS 42500

Plastic repair of salivary duct, sialodochoplasty; primary or simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $4,466.84 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $1,258.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $489.78 / $676.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26