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Hawaii rates for HCPCS 67912

Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)

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
$543.02 / $930.36 / $1,162.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,981.00 / $1,981.00 / $1,981.00