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Hawaii rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$744.93 / $744.93 / $762.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.88 / $762.88 / $859.78
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$821.73 / $902.02 / $1,086.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.10 / $584.10 / $584.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$859.78 / $1,869.66 / $2,996.25
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.21 / $226.21 / $235.64