|
TRAY REVERSED TI6AI4V DWF510
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
HCPCS C1776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$1,940.00 |
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,400.00
|
| Rate for Payer: Health Management Network Commercial |
$1,700.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,260.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,020.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,940.00
|
| Rate for Payer: University Health Alliance Commercial |
$1,120.00
|
|
|
TRAY REVERSED TI6AI4V DWF520
|
Facility
|
OP
|
$5,506.00
|
|
|
Service Code
|
HCPCS C1776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,808.06 |
| Max. Negotiated Rate |
$5,340.82 |
| Rate for Payer: Cash Price |
$3,303.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3,854.20
|
| Rate for Payer: Health Management Network Commercial |
$4,680.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,468.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,808.06
|
| Rate for Payer: MDX Hawaii PPO |
$5,340.82
|
| Rate for Payer: University Health Alliance Commercial |
$3,083.36
|
|
|
TRAY REVERSED TI6AI4V DWF520
|
Facility
|
IP
|
$5,506.00
|
|
|
Service Code
|
HCPCS C1776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,083.36 |
| Max. Negotiated Rate |
$5,340.82 |
| Rate for Payer: Cash Price |
$3,303.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3,854.20
|
| Rate for Payer: Health Management Network Commercial |
$4,680.10
|
| Rate for Payer: MDX Hawaii PPO |
$5,340.82
|
| Rate for Payer: University Health Alliance Commercial |
$3,083.36
|
|
|
TRAY TIBIAL RT SZ4 02.07.1204R
|
Facility
|
IP
|
$3,600.00
|
|
|
Service Code
|
HCPCS C1776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,016.00 |
| Max. Negotiated Rate |
$3,492.00 |
| Rate for Payer: Cash Price |
$2,160.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,520.00
|
| Rate for Payer: Health Management Network Commercial |
$3,060.00
|
| Rate for Payer: MDX Hawaii PPO |
$3,492.00
|
| Rate for Payer: University Health Alliance Commercial |
$2,016.00
|
|
|
TRAY TIBIAL RT SZ4 02.07.1204R
|
Facility
|
OP
|
$3,600.00
|
|
|
Service Code
|
HCPCS C1776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,836.00 |
| Max. Negotiated Rate |
$3,492.00 |
| Rate for Payer: Cash Price |
$2,160.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,520.00
|
| Rate for Payer: Health Management Network Commercial |
$3,060.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,268.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,836.00
|
| Rate for Payer: MDX Hawaii PPO |
$3,492.00
|
| Rate for Payer: University Health Alliance Commercial |
$2,016.00
|
|
|
TRAY TIBIAL SIZE A LF MEDIAL
|
Facility
|
IP
|
$3,800.00
|
|
|
Service Code
|
HCPCS C1776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,128.00 |
| Max. Negotiated Rate |
$3,686.00 |
| Rate for Payer: Cash Price |
$2,280.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,660.00
|
| Rate for Payer: Health Management Network Commercial |
$3,230.00
|
| Rate for Payer: MDX Hawaii PPO |
$3,686.00
|
| Rate for Payer: University Health Alliance Commercial |
$2,128.00
|
|
|
TRAY TIBIAL SIZE A LF MEDIAL
|
Facility
|
OP
|
$3,800.00
|
|
|
Service Code
|
HCPCS C1776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,938.00 |
| Max. Negotiated Rate |
$3,686.00 |
| Rate for Payer: Cash Price |
$2,280.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,660.00
|
| Rate for Payer: Health Management Network Commercial |
$3,230.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,394.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,938.00
|
| Rate for Payer: MDX Hawaii PPO |
$3,686.00
|
| Rate for Payer: University Health Alliance Commercial |
$2,128.00
|
|
|
TRAZODONE 100 MG TABLET [8083]
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
NDC 60687045411
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Health Management Network Commercial |
$0.85
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
|
|
TRAZODONE 100 MG TABLET [8083]
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
NDC 00904686961
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$0.95
|
| Rate for Payer: Health Management Network Commercial |
$0.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$0.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$0.51
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
| Rate for Payer: University Health Alliance Commercial |
$0.73
|
|
|
TRAZODONE 100 MG TABLET [8083]
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
NDC 60687045401
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Health Management Network Commercial |
$0.85
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
|
|
TRAZODONE 100 MG TABLET [8083]
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
NDC 60687045411
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$0.95
|
| Rate for Payer: Health Management Network Commercial |
$0.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$0.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$0.51
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
| Rate for Payer: University Health Alliance Commercial |
$0.73
|
|
|
TRAZODONE 100 MG TABLET [8083]
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
NDC 60687045401
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$0.95
|
| Rate for Payer: Health Management Network Commercial |
$0.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$0.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$0.51
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
| Rate for Payer: University Health Alliance Commercial |
$0.73
|
|
|
TRAZODONE 100 MG TABLET [8083]
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
NDC 00904686961
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Health Management Network Commercial |
$0.85
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
|
|
TRAZODONE 50 MG TABLET [8085]
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
NDC 00904686861
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Health Management Network Commercial |
$0.85
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
|
|
TRAZODONE 50 MG TABLET [8085]
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
NDC 00904686861
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$0.95
|
| Rate for Payer: Health Management Network Commercial |
$0.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$0.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$0.51
|
| Rate for Payer: MDX Hawaii PPO |
$0.97
|
| Rate for Payer: University Health Alliance Commercial |
$0.73
|
|
|
TREATMENT OF HUMERAL SHAFT FRACTURE, WITH INSERTION OF INTRAMEDULLARY IMPLANT, WITH OR WITHOUT CERCLAGE AND/OR LOCKING SCREWS
|
Facility
|
OP
|
$16,683.60
|
|
|
Service Code
|
CPT 24516
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$521.33 |
| Max. Negotiated Rate |
$16,683.60 |
| Rate for Payer: AlohaCare Medicaid |
$15,166.91
|
| Rate for Payer: AlohaCare Medicare |
$15,166.91
|
| Rate for Payer: Devoted Health Medicare |
$16,683.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$1,149.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$13,778.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$15,166.91
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$2,294.85
|
| Rate for Payer: Humana Medicare |
$15,166.91
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,837.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$15,166.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16,683.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$15,166.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$521.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$15,166.91
|
| Rate for Payer: University Health Alliance Commercial |
$10,679.55
|
|
|
TREATMENT OF INCOMPLETE ABORTION, ANY TRIMESTER, COMPLETED SURGICALLY
|
Facility
|
OP
|
$11,157.19
|
|
|
Service Code
|
CPT 59812
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$11,157.19 |
| Rate for Payer: AlohaCare Medicaid |
$3,824.16
|
| Rate for Payer: AlohaCare Medicare |
$3,824.16
|
| Rate for Payer: Devoted Health Medicare |
$4,206.58
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$695.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$5,509.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3,824.16
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$1,028.67
|
| Rate for Payer: Humana Medicare |
$3,824.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,837.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,824.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$4,206.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,824.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,824.16
|
| Rate for Payer: University Health Alliance Commercial |
$11,157.19
|
|
|
TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST TRIMESTER
|
Facility
|
OP
|
$11,157.19
|
|
|
Service Code
|
CPT 59820
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$11,157.19 |
| Rate for Payer: AlohaCare Medicaid |
$3,824.16
|
| Rate for Payer: AlohaCare Medicare |
$3,824.16
|
| Rate for Payer: Devoted Health Medicare |
$4,206.58
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$695.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$5,509.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3,824.16
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$1,028.67
|
| Rate for Payer: Humana Medicare |
$3,824.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,837.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,824.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$4,206.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,824.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,824.16
|
| Rate for Payer: University Health Alliance Commercial |
$11,157.19
|
|
|
TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; SECOND TRIMESTER
|
Facility
|
OP
|
$11,157.19
|
|
|
Service Code
|
CPT 59821
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$11,157.19 |
| Rate for Payer: AlohaCare Medicaid |
$3,824.16
|
| Rate for Payer: AlohaCare Medicare |
$3,824.16
|
| Rate for Payer: Devoted Health Medicare |
$4,206.58
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$695.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$5,509.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3,824.16
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$1,028.67
|
| Rate for Payer: Humana Medicare |
$3,824.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,837.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,824.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$4,206.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,824.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,824.16
|
| Rate for Payer: University Health Alliance Commercial |
$11,157.19
|
|
|
TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) BY INTRAMEDULLARY IMPLANT, WITH OR WITHOUT INTERLOCKING SCREWS AND/OR CERCLAGE
|
Facility
|
OP
|
$16,683.60
|
|
|
Service Code
|
CPT 27759
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$521.33 |
| Max. Negotiated Rate |
$16,683.60 |
| Rate for Payer: AlohaCare Medicaid |
$15,166.91
|
| Rate for Payer: AlohaCare Medicare |
$15,166.91
|
| Rate for Payer: Devoted Health Medicare |
$16,683.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$1,149.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$13,778.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$15,166.91
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$2,294.85
|
| Rate for Payer: Humana Medicare |
$15,166.91
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,837.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$15,166.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16,683.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$15,166.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$521.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$15,166.91
|
| Rate for Payer: University Health Alliance Commercial |
$10,679.55
|
|
|
TREK RX 3.5X30
|
Facility
|
IP
|
$380.00
|
|
|
Service Code
|
HCPCS C1725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$323.00 |
| Max. Negotiated Rate |
$368.60 |
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Health Management Network Commercial |
$323.00
|
| Rate for Payer: MDX Hawaii PPO |
$368.60
|
|
|
TREK RX 3.5X30
|
Facility
|
OP
|
$380.00
|
|
|
Service Code
|
HCPCS C1725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$193.80 |
| Max. Negotiated Rate |
$368.60 |
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$361.00
|
| Rate for Payer: Health Management Network Commercial |
$323.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$193.80
|
| Rate for Payer: MDX Hawaii PPO |
$368.60
|
| Rate for Payer: University Health Alliance Commercial |
$276.98
|
|
|
TREK RX 4X30
|
Facility
|
OP
|
$380.00
|
|
|
Service Code
|
HCPCS C1725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$193.80 |
| Max. Negotiated Rate |
$368.60 |
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$361.00
|
| Rate for Payer: Health Management Network Commercial |
$323.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$193.80
|
| Rate for Payer: MDX Hawaii PPO |
$368.60
|
| Rate for Payer: University Health Alliance Commercial |
$276.98
|
|
|
TREK RX 4X30
|
Facility
|
IP
|
$380.00
|
|
|
Service Code
|
HCPCS C1725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$323.00 |
| Max. Negotiated Rate |
$368.60 |
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Health Management Network Commercial |
$323.00
|
| Rate for Payer: MDX Hawaii PPO |
$368.60
|
|
|
TREMELIMUMAB-ACTL 20 MG/ML INTRAVENOUS SOLUTION [188830]
|
Facility
|
OP
|
$50,165.00
|
|
|
Service Code
|
HCPCS J9347
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$141.17 |
| Max. Negotiated Rate |
$48,660.05 |
| Rate for Payer: AlohaCare Medicaid |
$143.23
|
| Rate for Payer: AlohaCare Medicaid |
$143.23
|
| Rate for Payer: AlohaCare Medicaid |
$143.23
|
| Rate for Payer: AlohaCare Medicare |
$143.23
|
| Rate for Payer: AlohaCare Medicare |
$143.23
|
| Rate for Payer: AlohaCare Medicare |
$143.23
|
| Rate for Payer: Cash Price |
$30,099.00
|
| Rate for Payer: Cash Price |
$7,750.20
|
| Rate for Payer: Cash Price |
$4,571.40
|
| Rate for Payer: Cash Price |
$4,571.40
|
| Rate for Payer: Cash Price |
$7,750.20
|
| Rate for Payer: Cash Price |
$30,099.00
|
| Rate for Payer: Devoted Health Medicare |
$157.55
|
| Rate for Payer: Devoted Health Medicare |
$157.55
|
| Rate for Payer: Devoted Health Medicare |
$157.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$141.17
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$141.17
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$141.17
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$179.04
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$179.04
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$179.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$143.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$143.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$143.23
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$141.17
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$141.17
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$141.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$7,238.05
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$12,271.15
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$47,656.75
|
| Rate for Payer: Health Management Network Commercial |
$42,640.25
|
| Rate for Payer: Health Management Network Commercial |
$6,476.15
|
| Rate for Payer: Health Management Network Commercial |
$10,979.45
|
| Rate for Payer: Humana Medicare |
$143.23
|
| Rate for Payer: Humana Medicare |
$143.23
|
| Rate for Payer: Humana Medicare |
$143.23
|
| Rate for Payer: Kaiser Permanente Commercial |
$31,603.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$8,137.71
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,799.97
|
| Rate for Payer: Kaiser Permanente Medicaid |
$6,587.67
|
| Rate for Payer: Kaiser Permanente Medicaid |
$25,584.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$3,885.69
|
| Rate for Payer: Kaiser Permanente Medicare |
$143.23
|
| Rate for Payer: Kaiser Permanente Medicare |
$143.23
|
| Rate for Payer: Kaiser Permanente Medicare |
$143.23
|
| Rate for Payer: MDX Hawaii PPO |
$48,660.05
|
| Rate for Payer: MDX Hawaii PPO |
$12,529.49
|
| Rate for Payer: MDX Hawaii PPO |
$7,390.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$157.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$157.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$157.55
|
| Rate for Payer: Ohana Health Plan Medicare |
$143.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$143.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$143.23
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7,750.20
|
| Rate for Payer: UnitedHealthcare Medicaid |
$30,099.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4,571.40
|
| Rate for Payer: UnitedHealthcare Medicare |
$143.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$143.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$143.23
|
| Rate for Payer: University Health Alliance Commercial |
$36,565.27
|
| Rate for Payer: University Health Alliance Commercial |
$5,553.49
|
| Rate for Payer: University Health Alliance Commercial |
$9,415.20
|
|
