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Nonstandard Size or Width

Hawaii rates for HCPCS L3254

Nonstandard size or width

Rates data updated October 2026.

How much does Nonstandard Size or Width cost?

$85.11

Typical negotiated rate. In Hawaii, October 2026.

Insurers have agreed to pay about $85.11 for this service. Most negotiated rates run $85.11 to $89.13.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $11 · 10th to 90th $11 to $11Professionalmedian $85 · 10th to 90th $85 to $89
$10$20$50$100facility $11professional $85

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$14.13
Typical High
$14.13
Cigna
Setting
Facility
Modifier
None
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
Cigna
Setting
Professional
Modifier
None
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
HMSA
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$89.13
HMSA
Setting
Professional
Modifier
RR · Rental
Typical Low
$8.51
Median
$8.51
Typical High
$8.91
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$8.51
Median
$8.51
Typical High
$8.51
United
Setting
Professional
Modifier
None
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
University Health Alliance
Setting
Professional
Modifier
None
Typical Low
$323.59
Median
$323.59
Typical High
$323.59

Where Hawaii sits

The same service costs 27.5 times more in Kansas than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Hawaii· 2nd of 51

$85.11

KS $138SC $5.01

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.