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Hawaii rates for HCPCS 65290

Repair of wound, extraocular muscle, tendon and/or Tenon's capsule

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,324.03 / $2,747.00 / $4,456.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$551.41 / $551.41 / $551.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.55 / $622.17 / $746.61
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$641.39 / $731.63 / $4,765.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$547.51 / $597.29 / $696.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $2,155.00 / $2,155.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.03 / $605.41 / $799.05
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$513.96 / $2,582.96 / $6,124.00