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Hawaii rates for HCPCS 61790

Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,324.03 / $2,747.00 / $4,456.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.24 / $1,040.99 / $1,214.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,981.00 / $1,981.00 / $1,981.00