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Hawaii rates for HCPCS L3265

Plastazote sandal, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.92 / $12.92 / $12.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.62 / $16.62 / $16.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.65 / $28.65 / $28.65
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.28 / $21.24 / $21.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.27 / $2.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.67 / $14.44 / $21.82