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Hawaii rates for HCPCS G0415

Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,747.00 / $6,966.00 / $8,499.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,498.50 / $1,634.72 / $1,907.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,028.00 / $3,028.00 / $3,028.00