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Hawaii rates for HCPCS 42815

Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,528.00 / $5,625.00 / $6,084.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,749.74 / $1,749.74 / $1,749.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$603.79 / $658.68 / $768.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,912.00 / $2,912.00 / $2,912.00