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Hawaii rates for HCPCS Q4247

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,054.40 / $3,054.40 / $3,128.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.60 / $3,128.00 / $3,128.00
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$667.21 / $766.91 / $881.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$495.55 / $2,880.00 / $4,800.00