|
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 INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 87502
|
| Min. Negotiated Rate |
$95.80 |
| Max. Negotiated Rate |
$142.80 |
| Rate for Payer: AlohaCare Medicaid |
$119.75
|
| Rate for Payer: AlohaCare Medicare |
$95.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Devoted Health Medicare |
$105.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$95.80
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$119.75
|
| Rate for Payer: Health Management Network Commercial |
$142.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$114.96
|
| Rate for Payer: Kaiser Permanente Medicaid |
$114.96
|
| Rate for Payer: Kaiser Permanente Medicare |
$114.96
|
| Rate for Payer: Ohana Health Plan Medicaid |
$119.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$95.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$119.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$95.80
|
|
|
CHG IN SITU HYBRIDIZATION 1ST PROBE STAIN
|
Professional
|
Both
|
$497.00
|
|
|
Service Code
|
HCPCS 88365 TC
|
| Min. Negotiated Rate |
$66.53 |
| Max. Negotiated Rate |
$422.45 |
| Rate for Payer: AlohaCare Medicaid |
$119.11
|
| Rate for Payer: AlohaCare Medicare |
$145.84
|
| Rate for Payer: Cash Price |
$298.20
|
| Rate for Payer: Cash Price |
$298.20
|
| Rate for Payer: Devoted Health Medicare |
$160.42
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$145.84
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$66.53
|
| Rate for Payer: Health Management Network Commercial |
$422.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$175.01
|
| Rate for Payer: Kaiser Permanente Medicaid |
$175.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$175.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$119.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$145.84
|
| Rate for Payer: UnitedHealthcare Medicaid |
$119.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$145.84
|
|
|
CHG IN SITU HYBRIDIZATION 1ST PROBE STAIN
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 88365
|
| Min. Negotiated Rate |
$66.53 |
| Max. Negotiated Rate |
$484.50 |
| Rate for Payer: AlohaCare Medicaid |
$119.11
|
| Rate for Payer: AlohaCare Medicare |
$187.67
|
| Rate for Payer: Cash Price |
$342.00
|
| Rate for Payer: Cash Price |
$342.00
|
| Rate for Payer: Devoted Health Medicare |
$206.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$187.67
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$66.53
|
| Rate for Payer: Health Management Network Commercial |
$484.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$225.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$225.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$225.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$119.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$187.67
|
| Rate for Payer: UnitedHealthcare Medicaid |
$119.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$187.67
|
|
|
CHG IN SITU HYBRIDIZATION 1ST PROBE STAIN
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 88365 26
|
| Min. Negotiated Rate |
$41.83 |
| Max. Negotiated Rate |
$119.11 |
| Rate for Payer: AlohaCare Medicaid |
$119.11
|
| Rate for Payer: AlohaCare Medicare |
$41.83
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Devoted Health Medicare |
$46.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$41.83
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$66.53
|
| Rate for Payer: Health Management Network Commercial |
$62.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$50.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$50.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$50.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$119.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$41.83
|
| Rate for Payer: UnitedHealthcare Medicaid |
$119.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$41.83
|
|
|
CHG IN SITU HYBRIDIZATION EA ADDL PROBE STAIN
|
Professional
|
Both
|
$361.00
|
|
|
Service Code
|
HCPCS 88364 TC
|
| Min. Negotiated Rate |
$89.48 |
| Max. Negotiated Rate |
$306.85 |
| Rate for Payer: AlohaCare Medicaid |
$89.48
|
| Rate for Payer: AlohaCare Medicare |
$107.67
|
| Rate for Payer: Cash Price |
$216.60
|
| Rate for Payer: Cash Price |
$216.60
|
| Rate for Payer: Devoted Health Medicare |
$118.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$107.67
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$109.60
|
| Rate for Payer: Health Management Network Commercial |
$306.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$129.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$129.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$129.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$89.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$107.67
|
| Rate for Payer: UnitedHealthcare Medicaid |
$89.48
|
| Rate for Payer: UnitedHealthcare Medicare |
$107.67
|
|
|
CHG IN SITU HYBRIDIZATION EA ADDL PROBE STAIN
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 88364 26
|
| Min. Negotiated Rate |
$32.78 |
| Max. Negotiated Rate |
$109.60 |
| Rate for Payer: AlohaCare Medicaid |
$89.48
|
| Rate for Payer: AlohaCare Medicare |
$32.78
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Devoted Health Medicare |
$36.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$32.78
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$109.60
|
| Rate for Payer: Health Management Network Commercial |
$48.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$39.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$39.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$39.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$89.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$32.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$89.48
|
| Rate for Payer: UnitedHealthcare Medicare |
$32.78
|
|
|
CHG IN SITU HYBRIDIZATION EA ADDL PROBE STAIN
|
Professional
|
Both
|
$418.00
|
|
|
Service Code
|
HCPCS 88364
|
| Min. Negotiated Rate |
$89.48 |
| Max. Negotiated Rate |
$355.30 |
| Rate for Payer: AlohaCare Medicaid |
$89.48
|
| Rate for Payer: AlohaCare Medicare |
$140.45
|
| Rate for Payer: Cash Price |
$250.80
|
| Rate for Payer: Cash Price |
$250.80
|
| Rate for Payer: Devoted Health Medicare |
$154.50
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$140.45
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$109.60
|
| Rate for Payer: Health Management Network Commercial |
$355.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$168.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$168.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$168.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$89.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$140.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$89.48
|
| Rate for Payer: UnitedHealthcare Medicare |
$140.45
|
|
|
CHG LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 88304
|
| Min. Negotiated Rate |
$28.71 |
| Max. Negotiated Rate |
$116.45 |
| Rate for Payer: AlohaCare Medicaid |
$28.71
|
| Rate for Payer: AlohaCare Medicare |
$45.38
|
| Rate for Payer: Cash Price |
$82.20
|
| Rate for Payer: Cash Price |
$82.20
|
| Rate for Payer: Devoted Health Medicare |
$49.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$45.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$32.68
|
| Rate for Payer: Health Management Network Commercial |
$116.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$54.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$54.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$54.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$28.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$45.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$28.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$45.38
|
|
|
CHG LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 88304 TC
|
| Min. Negotiated Rate |
$28.71 |
| Max. Negotiated Rate |
$100.30 |
| Rate for Payer: AlohaCare Medicaid |
$28.71
|
| Rate for Payer: AlohaCare Medicare |
$34.75
|
| Rate for Payer: Cash Price |
$70.80
|
| Rate for Payer: Cash Price |
$70.80
|
| Rate for Payer: Devoted Health Medicare |
$38.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$34.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$32.68
|
| Rate for Payer: Health Management Network Commercial |
$100.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$41.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$41.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$41.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$28.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$34.75
|
| Rate for Payer: UnitedHealthcare Medicaid |
$28.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$34.75
|
|
|
CHG LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 88304 26
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$32.68 |
| Rate for Payer: AlohaCare Medicaid |
$28.71
|
| Rate for Payer: AlohaCare Medicare |
$10.63
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Devoted Health Medicare |
$11.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$10.63
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$32.68
|
| Rate for Payer: Health Management Network Commercial |
$16.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$12.76
|
| Rate for Payer: Kaiser Permanente Medicaid |
$12.76
|
| Rate for Payer: Kaiser Permanente Medicare |
$12.76
|
| Rate for Payer: Ohana Health Plan Medicaid |
$28.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$10.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$28.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$10.63
|
|
|
CHG LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 88302
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$95.20 |
| Rate for Payer: AlohaCare Medicaid |
$22.33
|
| Rate for Payer: AlohaCare Medicare |
$35.87
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Devoted Health Medicare |
$39.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$35.87
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$22.15
|
| Rate for Payer: Health Management Network Commercial |
$95.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$43.04
|
| Rate for Payer: Kaiser Permanente Medicaid |
$43.04
|
| Rate for Payer: Kaiser Permanente Medicare |
$43.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$22.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$35.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$35.87
|
|
|
CHG LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 88302 26
|
| Min. Negotiated Rate |
$6.81 |
| Max. Negotiated Rate |
$22.33 |
| Rate for Payer: AlohaCare Medicaid |
$22.33
|
| Rate for Payer: AlohaCare Medicare |
$6.81
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Devoted Health Medicare |
$7.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$6.81
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$22.15
|
| Rate for Payer: Health Management Network Commercial |
$10.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$8.17
|
| Rate for Payer: Kaiser Permanente Medicaid |
$8.17
|
| Rate for Payer: Kaiser Permanente Medicare |
$8.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$22.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$6.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$6.81
|
|
|
CHG LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 88302 TC
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: AlohaCare Medicaid |
$22.33
|
| Rate for Payer: AlohaCare Medicare |
$29.06
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Devoted Health Medicare |
$31.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$29.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$22.15
|
| Rate for Payer: Health Management Network Commercial |
$85.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$34.87
|
| Rate for Payer: Kaiser Permanente Medicaid |
$34.87
|
| Rate for Payer: Kaiser Permanente Medicare |
$34.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$22.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$29.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$29.06
|
|
|
CHG LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 88305 26
|
| Min. Negotiated Rate |
$36.35 |
| Max. Negotiated Rate |
$71.43 |
| Rate for Payer: AlohaCare Medicaid |
$46.87
|
| Rate for Payer: AlohaCare Medicare |
$36.35
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Devoted Health Medicare |
$39.98
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$36.35
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.43
|
| Rate for Payer: Health Management Network Commercial |
$54.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$43.62
|
| Rate for Payer: Kaiser Permanente Medicaid |
$43.62
|
| Rate for Payer: Kaiser Permanente Medicare |
$43.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$46.87
|
| Rate for Payer: Ohana Health Plan Medicare |
$36.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$46.87
|
| Rate for Payer: UnitedHealthcare Medicare |
$36.35
|
|
|
CHG LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 88305 TC
|
| Min. Negotiated Rate |
$39.69 |
| Max. Negotiated Rate |
$113.05 |
| Rate for Payer: AlohaCare Medicaid |
$46.87
|
| Rate for Payer: AlohaCare Medicare |
$39.69
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: Devoted Health Medicare |
$43.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$39.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.43
|
| Rate for Payer: Health Management Network Commercial |
$113.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$47.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$47.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$47.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$46.87
|
| Rate for Payer: Ohana Health Plan Medicare |
$39.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$46.87
|
| Rate for Payer: UnitedHealthcare Medicare |
$39.69
|
|
|
CHG LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 88305
|
| Min. Negotiated Rate |
$46.87 |
| Max. Negotiated Rate |
$167.45 |
| Rate for Payer: AlohaCare Medicaid |
$46.87
|
| Rate for Payer: AlohaCare Medicare |
$76.04
|
| Rate for Payer: Cash Price |
$118.20
|
| Rate for Payer: Cash Price |
$118.20
|
| Rate for Payer: Devoted Health Medicare |
$83.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$76.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.43
|
| Rate for Payer: Health Management Network Commercial |
$167.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$91.25
|
| Rate for Payer: Kaiser Permanente Medicaid |
$91.25
|
| Rate for Payer: Kaiser Permanente Medicare |
$91.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$46.87
|
| Rate for Payer: Ohana Health Plan Medicare |
$76.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$46.87
|
| Rate for Payer: UnitedHealthcare Medicare |
$76.04
|
|
|
CHG LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM
|
Professional
|
Both
|
$1,085.00
|
|
|
Service Code
|
HCPCS 88309 TC
|
| Min. Negotiated Rate |
$166.48 |
| Max. Negotiated Rate |
$922.25 |
| Rate for Payer: AlohaCare Medicaid |
$288.48
|
| Rate for Payer: AlohaCare Medicare |
$316.17
|
| Rate for Payer: Cash Price |
$651.00
|
| Rate for Payer: Cash Price |
$651.00
|
| Rate for Payer: Devoted Health Medicare |
$347.79
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$316.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$166.48
|
| Rate for Payer: Health Management Network Commercial |
$922.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$379.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$379.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$379.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$288.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$316.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$288.48
|
| Rate for Payer: UnitedHealthcare Medicare |
$316.17
|
|
|
CHG LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 88309 26
|
| Min. Negotiated Rate |
$139.62 |
| Max. Negotiated Rate |
$288.48 |
| Rate for Payer: AlohaCare Medicaid |
$288.48
|
| Rate for Payer: AlohaCare Medicare |
$139.62
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Devoted Health Medicare |
$153.58
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$139.62
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$166.48
|
| Rate for Payer: Health Management Network Commercial |
$207.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$167.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$167.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$167.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$288.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$139.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$288.48
|
| Rate for Payer: UnitedHealthcare Medicare |
$139.62
|
|
|
CHG LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM
|
Professional
|
Both
|
$1,329.00
|
|
|
Service Code
|
HCPCS 88309
|
| Min. Negotiated Rate |
$166.48 |
| Max. Negotiated Rate |
$1,129.65 |
| Rate for Payer: AlohaCare Medicaid |
$288.48
|
| Rate for Payer: AlohaCare Medicare |
$455.80
|
| Rate for Payer: Cash Price |
$797.40
|
| Rate for Payer: Cash Price |
$797.40
|
| Rate for Payer: Devoted Health Medicare |
$501.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$455.80
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$166.48
|
| Rate for Payer: Health Management Network Commercial |
$1,129.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$546.96
|
| Rate for Payer: Kaiser Permanente Medicaid |
$546.96
|
| Rate for Payer: Kaiser Permanente Medicare |
$546.96
|
| Rate for Payer: Ohana Health Plan Medicaid |
$288.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$455.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$288.48
|
| Rate for Payer: UnitedHealthcare Medicare |
$455.80
|
|
|
CHG LIPID PANEL
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 80061
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$19.55 |
| Rate for Payer: AlohaCare Medicaid |
$18.51
|
| Rate for Payer: AlohaCare Medicare |
$13.39
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Devoted Health Medicare |
$14.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$13.39
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$18.50
|
| Rate for Payer: Health Management Network Commercial |
$19.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$16.07
|
| Rate for Payer: Kaiser Permanente Medicaid |
$16.07
|
| Rate for Payer: Kaiser Permanente Medicare |
$16.07
|
| Rate for Payer: Ohana Health Plan Medicaid |
$18.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$13.39
|
| Rate for Payer: UnitedHealthcare Medicaid |
$18.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$13.39
|
|
|
CHG LYMPHANGIOGRAPHY EXTREMITY ONLY UNILATERAL RS&I
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 75801 26
|
| Min. Negotiated Rate |
$43.90 |
| Max. Negotiated Rate |
$283.00 |
| Rate for Payer: AlohaCare Medicaid |
$210.73
|
| Rate for Payer: AlohaCare Medicare |
$43.90
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Devoted Health Medicare |
$48.29
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$43.90
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$283.00
|
| Rate for Payer: Health Management Network Commercial |
$61.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$52.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$52.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$52.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$210.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$43.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$210.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$43.90
|
|
|
CHG LYMPHANGIOGRAPHY EXTREMITY ONLY UNILATERAL RS&I
|
Professional
|
Both
|
$1,280.00
|
|
|
Service Code
|
HCPCS 75801 TC
|
| Min. Negotiated Rate |
$210.73 |
| Max. Negotiated Rate |
$1,088.00 |
| Rate for Payer: AlohaCare Medicaid |
$210.73
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$283.00
|
| Rate for Payer: Health Management Network Commercial |
$1,088.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$210.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$210.73
|
|
|
CHG LYMPHANGIOGRAPHY EXTREMITY ONLY UNILATERAL RS&I
|
Professional
|
Both
|
$1,352.00
|
|
|
Service Code
|
HCPCS 75801
|
| Min. Negotiated Rate |
$210.73 |
| Max. Negotiated Rate |
$1,149.20 |
| Rate for Payer: AlohaCare Medicaid |
$210.73
|
| Rate for Payer: Cash Price |
$811.20
|
| Rate for Payer: Cash Price |
$811.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$283.00
|
| Rate for Payer: Health Management Network Commercial |
$1,149.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$210.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$210.73
|
|
|
CHG LYMPHATICS & LYMPH NODES IMAGING
|
Professional
|
Both
|
$1,078.00
|
|
|
Service Code
|
HCPCS 78195
|
| Min. Negotiated Rate |
$217.85 |
| Max. Negotiated Rate |
$916.30 |
| Rate for Payer: AlohaCare Medicaid |
$217.85
|
| Rate for Payer: AlohaCare Medicare |
$346.92
|
| Rate for Payer: Cash Price |
$646.80
|
| Rate for Payer: Cash Price |
$646.80
|
| Rate for Payer: Devoted Health Medicare |
$381.61
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$346.92
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$236.90
|
| Rate for Payer: Health Management Network Commercial |
$916.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$416.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$416.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$416.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$217.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$346.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$217.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$346.92
|
|
