go back

Hawaii rates for HCPCS Q4125

ArthroFlex, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $138.04 / $138.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $173.78 / $218.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $125.89 / $190.55