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Hawaii rates for HCPCS 90997

Hemoperfusion (eg, with activated charcoal or resin)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.44 / $84.29 / $93.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.71 / $117.43 / $368.32
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.16 / $160.88 / $181.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.22 / $103.46 / $120.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.87 / $107.78 / $155.47
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.81 / $78.70 / $107.40