|
CHG HGB GLYCOSYLATED A1C DEVICE CLEARED FDA HOME USE
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS 83037
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$21.05 |
| Rate for Payer: AlohaCare Medicare |
$9.71
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Devoted Health Medicare |
$10.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.71
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$21.05
|
| Rate for Payer: Health Management Network Commercial |
$14.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$11.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$11.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.71
|
|
|
CHG HYSTEROSALPINGOGRAPHY RS&I
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 74740
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$149.60 |
| Rate for Payer: AlohaCare Medicaid |
$63.00
|
| Rate for Payer: AlohaCare Medicare |
$100.29
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Devoted Health Medicare |
$110.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$100.29
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$77.76
|
| Rate for Payer: Health Management Network Commercial |
$149.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$120.35
|
| Rate for Payer: Kaiser Permanente Medicaid |
$120.35
|
| Rate for Payer: Kaiser Permanente Medicare |
$120.35
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$100.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$63.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$100.29
|
|
|
CHG HYSTEROSALPINGOGRAPHY RS&I
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 74740 26
|
| Min. Negotiated Rate |
$18.06 |
| Max. Negotiated Rate |
$77.76 |
| Rate for Payer: AlohaCare Medicaid |
$63.00
|
| Rate for Payer: AlohaCare Medicare |
$18.06
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Devoted Health Medicare |
$19.87
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$18.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$77.76
|
| Rate for Payer: Health Management Network Commercial |
$26.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$21.67
|
| Rate for Payer: Kaiser Permanente Medicaid |
$21.67
|
| Rate for Payer: Kaiser Permanente Medicare |
$21.67
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$18.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$63.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$18.06
|
|
|
CHG HYSTEROSALPINGOGRAPHY RS&I
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 74740 TC
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$123.25 |
| Rate for Payer: AlohaCare Medicaid |
$63.00
|
| Rate for Payer: AlohaCare Medicare |
$82.22
|
| Rate for Payer: Cash Price |
$87.00
|
| Rate for Payer: Cash Price |
$87.00
|
| Rate for Payer: Devoted Health Medicare |
$90.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$82.22
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$77.76
|
| Rate for Payer: Health Management Network Commercial |
$123.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$98.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$98.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$98.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$82.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$63.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$82.22
|
|
|
CHG IAADIADOO HIV1 ANTIGEN W/HIV1 & HIV2 ANTIBODIES
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 87806
|
| Min. Negotiated Rate |
$32.77 |
| Max. Negotiated Rate |
$48.45 |
| Rate for Payer: AlohaCare Medicare |
$32.77
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Devoted Health Medicare |
$36.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$32.77
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$33.03
|
| Rate for Payer: Health Management Network Commercial |
$48.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$39.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$39.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$39.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$32.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$32.77
|
|
|
CHG IAADIADOO INFLUENZA
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 87804
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$24.65 |
| Rate for Payer: AlohaCare Medicaid |
$16.58
|
| Rate for Payer: AlohaCare Medicare |
$16.55
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Devoted Health Medicare |
$18.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$16.55
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$16.58
|
| Rate for Payer: Health Management Network Commercial |
$24.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$19.86
|
| Rate for Payer: Kaiser Permanente Medicaid |
$19.86
|
| Rate for Payer: Kaiser Permanente Medicare |
$19.86
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$16.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$16.55
|
|
|
CHG IAADIADOO SEVERE AQT RESPIR SYND CORONAVIRUS
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 87811
|
| Min. Negotiated Rate |
$41.38 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: AlohaCare Medicaid |
$41.38
|
| Rate for Payer: AlohaCare Medicare |
$41.38
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Devoted Health Medicare |
$45.52
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$41.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$41.38
|
| Rate for Payer: Health Management Network Commercial |
$61.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$49.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$49.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$49.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$41.38
|
| Rate for Payer: Ohana Health Plan Medicare |
$41.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$41.38
|
| Rate for Payer: UnitedHealthcare Medicare |
$41.38
|
|
|
CHG IAADIADOO STREPTOCOCCUS GROUP A
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 87880
|
| Min. Negotiated Rate |
$16.53 |
| Max. Negotiated Rate |
$24.65 |
| Rate for Payer: AlohaCare Medicaid |
$16.58
|
| Rate for Payer: AlohaCare Medicare |
$16.53
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Devoted Health Medicare |
$18.18
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$16.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$19.08
|
| Rate for Payer: Health Management Network Commercial |
$24.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$19.84
|
| Rate for Payer: Kaiser Permanente Medicaid |
$19.84
|
| Rate for Payer: Kaiser Permanente Medicare |
$19.84
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$16.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$16.53
|
|
|
CHG IADNA DNA/RNA RSV AMPLIFIED PROBE TECHNIQUE
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 87634
|
| Min. Negotiated Rate |
$52.00 |
| Max. Negotiated Rate |
$104.55 |
| Rate for Payer: AlohaCare Medicaid |
$52.00
|
| Rate for Payer: AlohaCare Medicare |
$70.20
|
| Rate for Payer: Cash Price |
$73.80
|
| Rate for Payer: Cash Price |
$73.80
|
| Rate for Payer: Devoted Health Medicare |
$77.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$70.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$86.65
|
| Rate for Payer: Health Management Network Commercial |
$104.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$84.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$84.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$84.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$52.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$70.20
|
| Rate for Payer: UnitedHealthcare Medicaid |
$52.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$70.20
|
|
|
CHG IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ
|
Professional
|
Both
|
$430.00
|
|
|
Service Code
|
HCPCS 87635
|
| Min. Negotiated Rate |
$51.31 |
| Max. Negotiated Rate |
$365.50 |
| Rate for Payer: AlohaCare Medicaid |
$51.31
|
| Rate for Payer: AlohaCare Medicare |
$51.31
|
| Rate for Payer: Cash Price |
$258.00
|
| Rate for Payer: Cash Price |
$258.00
|
| Rate for Payer: Devoted Health Medicare |
$56.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$51.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$51.33
|
| Rate for Payer: Health Management Network Commercial |
$365.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$61.57
|
| Rate for Payer: Kaiser Permanente Medicaid |
$61.57
|
| Rate for Payer: Kaiser Permanente Medicare |
$61.57
|
| Rate for Payer: Ohana Health Plan Medicaid |
$51.31
|
| Rate for Payer: Ohana Health Plan Medicare |
$51.31
|
| Rate for Payer: UnitedHealthcare Medicaid |
$51.31
|
| Rate for Payer: UnitedHealthcare Medicare |
$51.31
|
|
|
CHG IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TQ
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 87651
|
| Min. Negotiated Rate |
$29.42 |
| Max. Negotiated Rate |
$51.85 |
| Rate for Payer: AlohaCare Medicaid |
$29.42
|
| Rate for Payer: AlohaCare Medicare |
$35.09
|
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Devoted Health Medicare |
$38.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$35.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$49.05
|
| Rate for Payer: Health Management Network Commercial |
$51.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$42.11
|
| Rate for Payer: Kaiser Permanente Medicaid |
$42.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$42.11
|
| Rate for Payer: Ohana Health Plan Medicaid |
$29.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$35.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$29.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$35.09
|
|
|
CHG IMHCHEM/IMCYTCHM 1ST SINGLE ANTB STAIN PROCEDURE
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 88342
|
| Min. Negotiated Rate |
$59.45 |
| Max. Negotiated Rate |
$300.90 |
| Rate for Payer: AlohaCare Medicaid |
$70.66
|
| Rate for Payer: AlohaCare Medicare |
$121.84
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Devoted Health Medicare |
$134.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$121.84
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$59.45
|
| Rate for Payer: Health Management Network Commercial |
$300.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$146.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$146.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$146.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$70.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$121.84
|
| Rate for Payer: UnitedHealthcare Medicaid |
$70.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$121.84
|
|
|
CHG IMHCHEM/IMCYTCHM 1ST SINGLE ANTB STAIN PROCEDURE
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 88342 26
|
| Min. Negotiated Rate |
$33.92 |
| Max. Negotiated Rate |
$70.66 |
| Rate for Payer: AlohaCare Medicaid |
$70.66
|
| Rate for Payer: AlohaCare Medicare |
$33.92
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Devoted Health Medicare |
$37.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$33.92
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$59.45
|
| Rate for Payer: Health Management Network Commercial |
$50.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$40.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$40.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$40.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$70.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$33.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$70.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$33.92
|
|
|
CHG IMHCHEM/IMCYTCHM 1ST SINGLE ANTB STAIN PROCEDURE
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 88342 TC
|
| Min. Negotiated Rate |
$59.45 |
| Max. Negotiated Rate |
$250.75 |
| Rate for Payer: AlohaCare Medicaid |
$70.66
|
| Rate for Payer: AlohaCare Medicare |
$87.92
|
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Devoted Health Medicare |
$96.71
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$87.92
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$59.45
|
| Rate for Payer: Health Management Network Commercial |
$250.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$105.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$105.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$105.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$70.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$87.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$70.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$87.92
|
|
|
CHG IMHCHEM/IMCYTCHM EA ADDL SINGLE ANTB STAIN PX
|
Professional
|
Both
|
$307.00
|
|
|
Service Code
|
HCPCS 88341
|
| Min. Negotiated Rate |
$60.64 |
| Max. Negotiated Rate |
$260.95 |
| Rate for Payer: AlohaCare Medicaid |
$60.64
|
| Rate for Payer: AlohaCare Medicare |
$104.39
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Devoted Health Medicare |
$114.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$104.39
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$75.75
|
| Rate for Payer: Health Management Network Commercial |
$260.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$125.27
|
| Rate for Payer: Kaiser Permanente Medicaid |
$125.27
|
| Rate for Payer: Kaiser Permanente Medicare |
$125.27
|
| Rate for Payer: Ohana Health Plan Medicaid |
$60.64
|
| Rate for Payer: Ohana Health Plan Medicare |
$104.39
|
| Rate for Payer: UnitedHealthcare Medicaid |
$60.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$104.39
|
|
|
CHG IMHCHEM/IMCYTCHM EA ADDL SINGLE ANTB STAIN PX
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 88341 26
|
| Min. Negotiated Rate |
$27.68 |
| Max. Negotiated Rate |
$75.75 |
| Rate for Payer: AlohaCare Medicaid |
$60.64
|
| Rate for Payer: AlohaCare Medicare |
$27.68
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Devoted Health Medicare |
$30.45
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$27.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$75.75
|
| Rate for Payer: Health Management Network Commercial |
$40.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$33.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$33.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$33.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$60.64
|
| Rate for Payer: Ohana Health Plan Medicare |
$27.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$60.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$27.68
|
|
|
CHG IMHCHEM/IMCYTCHM EA ADDL SINGLE ANTB STAIN PX
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 88341 TC
|
| Min. Negotiated Rate |
$60.64 |
| Max. Negotiated Rate |
$220.15 |
| Rate for Payer: AlohaCare Medicaid |
$60.64
|
| Rate for Payer: AlohaCare Medicare |
$76.71
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Devoted Health Medicare |
$84.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$76.71
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$75.75
|
| Rate for Payer: Health Management Network Commercial |
$220.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$92.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$92.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$92.05
|
| Rate for Payer: Ohana Health Plan Medicaid |
$60.64
|
| Rate for Payer: Ohana Health Plan Medicare |
$76.71
|
| Rate for Payer: UnitedHealthcare Medicaid |
$60.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$76.71
|
|
|
CHG IMHCHEM/IMCYTCHM EA MULTIPLEX ANTIBODY STAIN PX
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 88344
|
| Min. Negotiated Rate |
$116.58 |
| Max. Negotiated Rate |
$487.05 |
| Rate for Payer: AlohaCare Medicaid |
$116.58
|
| Rate for Payer: AlohaCare Medicare |
$193.30
|
| Rate for Payer: Cash Price |
$343.80
|
| Rate for Payer: Cash Price |
$343.80
|
| Rate for Payer: Devoted Health Medicare |
$212.63
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$193.30
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$131.10
|
| Rate for Payer: Health Management Network Commercial |
$487.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$231.96
|
| Rate for Payer: Kaiser Permanente Medicaid |
$231.96
|
| Rate for Payer: Kaiser Permanente Medicare |
$231.96
|
| Rate for Payer: Ohana Health Plan Medicaid |
$116.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$193.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$116.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$193.30
|
|
|
CHG IMHCHEM/IMCYTCHM EA MULTIPLEX ANTIBODY STAIN PX
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 88344 26
|
| Min. Negotiated Rate |
$37.40 |
| Max. Negotiated Rate |
$131.10 |
| Rate for Payer: AlohaCare Medicaid |
$116.58
|
| Rate for Payer: AlohaCare Medicare |
$37.40
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Devoted Health Medicare |
$41.14
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$37.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$131.10
|
| Rate for Payer: Health Management Network Commercial |
$56.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$44.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$44.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$44.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$116.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$37.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$116.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$37.40
|
|
|
CHG IMHCHEM/IMCYTCHM EA MULTIPLEX ANTIBODY STAIN PX
|
Professional
|
Both
|
$507.00
|
|
|
Service Code
|
HCPCS 88344 TC
|
| Min. Negotiated Rate |
$116.58 |
| Max. Negotiated Rate |
$430.95 |
| Rate for Payer: AlohaCare Medicaid |
$116.58
|
| Rate for Payer: AlohaCare Medicare |
$155.90
|
| Rate for Payer: Cash Price |
$304.20
|
| Rate for Payer: Cash Price |
$304.20
|
| Rate for Payer: Devoted Health Medicare |
$171.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$155.90
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$131.10
|
| Rate for Payer: Health Management Network Commercial |
$430.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$187.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$187.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$187.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$116.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$155.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$116.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$155.90
|
|
|
CHG IMMUNOFLUORESCENCE PER SPEC 1ST SINGLE ANTB STN
|
Professional
|
Both
|
$412.00
|
|
|
Service Code
|
HCPCS 88346 TC
|
| Min. Negotiated Rate |
$57.13 |
| Max. Negotiated Rate |
$350.20 |
| Rate for Payer: AlohaCare Medicaid |
$100.71
|
| Rate for Payer: AlohaCare Medicare |
$117.36
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Devoted Health Medicare |
$129.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$117.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$57.13
|
| Rate for Payer: Health Management Network Commercial |
$350.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$140.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$140.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$140.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$100.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$117.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$100.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$117.36
|
|
|
CHG IMMUNOFLUORESCENCE PER SPEC 1ST SINGLE ANTB STN
|
Professional
|
Both
|
$472.00
|
|
|
Service Code
|
HCPCS 88346
|
| Min. Negotiated Rate |
$57.13 |
| Max. Negotiated Rate |
$401.20 |
| Rate for Payer: AlohaCare Medicaid |
$100.71
|
| Rate for Payer: AlohaCare Medicare |
$151.85
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Devoted Health Medicare |
$167.03
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$151.85
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$57.13
|
| Rate for Payer: Health Management Network Commercial |
$401.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$182.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$182.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$182.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$100.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$151.85
|
| Rate for Payer: UnitedHealthcare Medicaid |
$100.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$151.85
|
|
|
CHG IMMUNOFLUORESCENCE PER SPEC 1ST SINGLE ANTB STN
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 88346 26
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$100.71 |
| Rate for Payer: AlohaCare Medicaid |
$100.71
|
| Rate for Payer: AlohaCare Medicare |
$34.50
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Devoted Health Medicare |
$37.95
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$34.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$57.13
|
| Rate for Payer: Health Management Network Commercial |
$51.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$41.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$41.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$41.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$100.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$34.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$100.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$34.50
|
|
|
CHG IMMUNOFLUORESCENCE PR SPEC EA ADD SINGL ANTB STN
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 88350
|
| Min. Negotiated Rate |
$76.49 |
| Max. Negotiated Rate |
$304.30 |
| Rate for Payer: AlohaCare Medicaid |
$76.49
|
| Rate for Payer: AlohaCare Medicare |
$118.50
|
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Devoted Health Medicare |
$130.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$118.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.65
|
| Rate for Payer: Health Management Network Commercial |
$304.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$142.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$142.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$142.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$76.49
|
| Rate for Payer: Ohana Health Plan Medicare |
$118.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$76.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$118.50
|
|
|
CHG IMMUNOFLUORESCENCE PR SPEC EA ADD SINGL ANTB STN
|
Professional
|
Both
|
$308.00
|
|
|
Service Code
|
HCPCS 88350 TC
|
| Min. Negotiated Rate |
$76.49 |
| Max. Negotiated Rate |
$261.80 |
| Rate for Payer: AlohaCare Medicaid |
$76.49
|
| Rate for Payer: AlohaCare Medicare |
$90.20
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Devoted Health Medicare |
$99.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$90.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.65
|
| Rate for Payer: Health Management Network Commercial |
$261.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$108.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$108.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$108.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$76.49
|
| Rate for Payer: Ohana Health Plan Medicare |
$90.20
|
| Rate for Payer: UnitedHealthcare Medicaid |
$76.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$90.20
|
|
