go back

Hawaii rates for HCPCS A5113

Leg Strap; Latex Replacement Only Per Set (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.21 / $3.21 / $3.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.13 / $4.13 / $4.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.53 / $4.53 / $5.73
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.21 / $5.46 / $5.46
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.65 / $5.21 / $7.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.72 / $4.66 / $5.73
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $4.34 / $4.96