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Hawaii rates for HCPCS Q4188

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $489.78 / $489.78
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $524.81 / $575.44
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
$125.89 / $354.81 / $977.24