|
CHG RADIOLOGIC EXAM ABDOMEN 1 VIEW
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 74018
|
| Min. Negotiated Rate |
$20.11 |
| Max. Negotiated Rate |
$49.30 |
| Rate for Payer: AlohaCare Medicaid |
$20.11
|
| Rate for Payer: AlohaCare Medicare |
$32.60
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Devoted Health Medicare |
$35.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$32.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$32.81
|
| Rate for Payer: Health Management Network Commercial |
$49.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$39.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$39.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$39.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$20.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$32.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$20.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$32.60
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 3+ VIEWS
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 74021
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: AlohaCare Medicaid |
$28.57
|
| Rate for Payer: AlohaCare Medicare |
$46.29
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Devoted Health Medicare |
$50.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$46.29
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$49.40
|
| Rate for Payer: Health Management Network Commercial |
$68.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$55.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$55.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$55.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$28.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$46.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$28.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$46.29
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 3+ VIEWS
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 74021 TC
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$50.15 |
| Rate for Payer: AlohaCare Medicaid |
$28.57
|
| Rate for Payer: AlohaCare Medicare |
$33.61
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Devoted Health Medicare |
$36.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$33.61
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$49.40
|
| Rate for Payer: Health Management Network Commercial |
$50.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$40.33
|
| Rate for Payer: Kaiser Permanente Medicaid |
$40.33
|
| Rate for Payer: Kaiser Permanente Medicare |
$40.33
|
| Rate for Payer: Ohana Health Plan Medicaid |
$28.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$33.61
|
| Rate for Payer: UnitedHealthcare Medicaid |
$28.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$33.61
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 3+ VIEWS
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS 74021 26
|
| Min. Negotiated Rate |
$12.68 |
| Max. Negotiated Rate |
$49.40 |
| Rate for Payer: AlohaCare Medicaid |
$28.57
|
| Rate for Payer: AlohaCare Medicare |
$12.68
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Devoted Health Medicare |
$13.95
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$12.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$49.40
|
| Rate for Payer: Health Management Network Commercial |
$18.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$15.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$15.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$15.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$28.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$12.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$28.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$12.68
|
|
|
CHG RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 73565 TC
|
| Min. Negotiated Rate |
$26.83 |
| Max. Negotiated Rate |
$56.95 |
| Rate for Payer: AlohaCare Medicaid |
$26.83
|
| Rate for Payer: AlohaCare Medicare |
$38.17
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Devoted Health Medicare |
$41.99
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$30.81
|
| Rate for Payer: Health Management Network Commercial |
$56.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$45.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$45.80
|
| Rate for Payer: Kaiser Permanente Medicare |
$45.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$26.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$26.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.17
|
|
|
CHG RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 73565
|
| Min. Negotiated Rate |
$26.83 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: AlohaCare Medicaid |
$26.83
|
| Rate for Payer: AlohaCare Medicare |
$46.75
|
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Cash Price |
$49.20
|
| Rate for Payer: Devoted Health Medicare |
$51.42
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$46.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$30.81
|
| Rate for Payer: Health Management Network Commercial |
$69.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$56.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$56.10
|
| Rate for Payer: Kaiser Permanente Medicare |
$56.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$26.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$46.75
|
| Rate for Payer: UnitedHealthcare Medicaid |
$26.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$46.75
|
|
|
CHG RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 73565 26
|
| Min. Negotiated Rate |
$8.58 |
| Max. Negotiated Rate |
$30.81 |
| Rate for Payer: AlohaCare Medicaid |
$26.83
|
| Rate for Payer: AlohaCare Medicare |
$8.58
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Devoted Health Medicare |
$9.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$8.58
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$30.81
|
| Rate for Payer: Health Management Network Commercial |
$12.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$10.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$10.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$10.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$26.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$8.58
|
| Rate for Payer: UnitedHealthcare Medicaid |
$26.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$8.58
|
|
|
CHG RADIOLOGIC EXAM CHEST 2 VIEWS
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 71046
|
| Min. Negotiated Rate |
$22.29 |
| Max. Negotiated Rate |
$89.25 |
| Rate for Payer: AlohaCare Medicaid |
$22.29
|
| Rate for Payer: AlohaCare Medicare |
$36.26
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Devoted Health Medicare |
$39.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$36.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$39.25
|
| Rate for Payer: Health Management Network Commercial |
$89.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$43.51
|
| Rate for Payer: Kaiser Permanente Medicaid |
$43.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$43.51
|
| Rate for Payer: Ohana Health Plan Medicaid |
$22.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$36.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$36.26
|
|
|
CHG RADIOLOGIC EXAM CHEST 2 VIEWS
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 71046 26
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$39.25 |
| Rate for Payer: AlohaCare Medicaid |
$22.29
|
| Rate for Payer: AlohaCare Medicare |
$10.25
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Devoted Health Medicare |
$11.28
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$10.25
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$39.25
|
| Rate for Payer: Health Management Network Commercial |
$15.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$12.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$12.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$12.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$22.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$10.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$10.25
|
|
|
CHG RADIOLOGIC EXAM CHEST 2 VIEWS
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 71046 TC
|
| Min. Negotiated Rate |
$22.29 |
| Max. Negotiated Rate |
$73.95 |
| Rate for Payer: AlohaCare Medicaid |
$22.29
|
| Rate for Payer: AlohaCare Medicare |
$26.02
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Devoted Health Medicare |
$28.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$26.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$39.25
|
| Rate for Payer: Health Management Network Commercial |
$73.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$31.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$31.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$31.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$22.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$26.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$26.02
|
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 71045
|
| Min. Negotiated Rate |
$16.90 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: AlohaCare Medicaid |
$16.90
|
| Rate for Payer: AlohaCare Medicare |
$27.67
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Devoted Health Medicare |
$30.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$27.67
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.57
|
| Rate for Payer: Health Management Network Commercial |
$68.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$33.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$33.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$33.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$27.67
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$27.67
|
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 71045 TC
|
| Min. Negotiated Rate |
$16.90 |
| Max. Negotiated Rate |
$55.25 |
| Rate for Payer: AlohaCare Medicaid |
$16.90
|
| Rate for Payer: AlohaCare Medicare |
$19.18
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Devoted Health Medicare |
$21.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$19.18
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.57
|
| Rate for Payer: Health Management Network Commercial |
$55.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$23.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$23.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$23.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$19.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$19.18
|
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 71045 26
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$34.57 |
| Rate for Payer: AlohaCare Medicaid |
$16.90
|
| Rate for Payer: AlohaCare Medicare |
$8.48
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Devoted Health Medicare |
$9.33
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$8.48
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.57
|
| Rate for Payer: Health Management Network Commercial |
$12.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$10.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$10.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$10.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$8.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$8.48
|
|
|
CHG RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY
|
Professional
|
Both
|
$687.00
|
|
|
Service Code
|
HCPCS 74280
|
| Min. Negotiated Rate |
$146.42 |
| Max. Negotiated Rate |
$583.95 |
| Rate for Payer: AlohaCare Medicaid |
$146.42
|
| Rate for Payer: AlohaCare Medicare |
$233.09
|
| Rate for Payer: Cash Price |
$412.20
|
| Rate for Payer: Cash Price |
$412.20
|
| Rate for Payer: Devoted Health Medicare |
$256.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$233.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network Commercial |
$583.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$279.71
|
| Rate for Payer: Kaiser Permanente Medicaid |
$279.71
|
| Rate for Payer: Kaiser Permanente Medicare |
$279.71
|
| Rate for Payer: Ohana Health Plan Medicaid |
$146.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$233.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$146.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$233.09
|
|
|
CHG RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 74280 26
|
| Min. Negotiated Rate |
$58.77 |
| Max. Negotiated Rate |
$152.40 |
| Rate for Payer: AlohaCare Medicaid |
$146.42
|
| Rate for Payer: AlohaCare Medicare |
$58.77
|
| Rate for Payer: Cash Price |
$61.80
|
| Rate for Payer: Cash Price |
$61.80
|
| Rate for Payer: Devoted Health Medicare |
$64.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$58.77
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network Commercial |
$87.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$70.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$70.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$70.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$146.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$58.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$146.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$58.77
|
|
|
CHG RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY
|
Professional
|
Both
|
$584.00
|
|
|
Service Code
|
HCPCS 74280 TC
|
| Min. Negotiated Rate |
$146.42 |
| Max. Negotiated Rate |
$496.40 |
| Rate for Payer: AlohaCare Medicaid |
$146.42
|
| Rate for Payer: AlohaCare Medicare |
$174.32
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Devoted Health Medicare |
$191.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$174.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network Commercial |
$496.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$209.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$146.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$174.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$146.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$174.32
|
|
|
CHG RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 74270 TC
|
| Min. Negotiated Rate |
$101.76 |
| Max. Negotiated Rate |
$325.55 |
| Rate for Payer: AlohaCare Medicaid |
$101.76
|
| Rate for Payer: AlohaCare Medicare |
$114.50
|
| Rate for Payer: Cash Price |
$229.80
|
| Rate for Payer: Cash Price |
$229.80
|
| Rate for Payer: Devoted Health Medicare |
$125.95
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$114.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$113.38
|
| Rate for Payer: Health Management Network Commercial |
$325.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$137.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$137.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$137.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$101.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$114.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$101.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$114.50
|
|
|
CHG RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 74270 26
|
| Min. Negotiated Rate |
$48.57 |
| Max. Negotiated Rate |
$113.38 |
| Rate for Payer: AlohaCare Medicaid |
$101.76
|
| Rate for Payer: AlohaCare Medicare |
$48.57
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Devoted Health Medicare |
$53.43
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$48.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$113.38
|
| Rate for Payer: Health Management Network Commercial |
$72.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$58.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$58.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$58.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$101.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$48.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$101.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$48.57
|
|
|
CHG RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$468.00
|
|
|
Service Code
|
HCPCS 74270
|
| Min. Negotiated Rate |
$101.76 |
| Max. Negotiated Rate |
$397.80 |
| Rate for Payer: AlohaCare Medicaid |
$101.76
|
| Rate for Payer: AlohaCare Medicare |
$163.07
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Devoted Health Medicare |
$179.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$163.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$113.38
|
| Rate for Payer: Health Management Network Commercial |
$397.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$195.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$195.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$195.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$101.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$163.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$101.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$163.07
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 74022 TC
|
| Min. Negotiated Rate |
$33.12 |
| Max. Negotiated Rate |
$57.80 |
| Rate for Payer: AlohaCare Medicaid |
$33.12
|
| Rate for Payer: AlohaCare Medicare |
$38.93
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Devoted Health Medicare |
$42.82
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$49.96
|
| Rate for Payer: Health Management Network Commercial |
$57.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$46.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$46.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$46.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$33.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$33.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.93
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 74022
|
| Min. Negotiated Rate |
$33.12 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: AlohaCare Medicaid |
$33.12
|
| Rate for Payer: AlohaCare Medicare |
$54.23
|
| Rate for Payer: Cash Price |
$57.00
|
| Rate for Payer: Cash Price |
$57.00
|
| Rate for Payer: Devoted Health Medicare |
$59.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$54.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$49.96
|
| Rate for Payer: Health Management Network Commercial |
$80.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$65.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$65.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$65.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$33.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$54.23
|
| Rate for Payer: UnitedHealthcare Medicaid |
$33.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$54.23
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 74022 26
|
| Min. Negotiated Rate |
$15.30 |
| Max. Negotiated Rate |
$49.96 |
| Rate for Payer: AlohaCare Medicaid |
$33.12
|
| Rate for Payer: AlohaCare Medicare |
$15.30
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Devoted Health Medicare |
$16.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$15.30
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$49.96
|
| Rate for Payer: Health Management Network Commercial |
$22.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$18.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$18.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$18.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$33.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$15.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$33.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$15.30
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 74221
|
| Min. Negotiated Rate |
$72.83 |
| Max. Negotiated Rate |
$287.30 |
| Rate for Payer: AlohaCare Medicaid |
$72.83
|
| Rate for Payer: AlohaCare Medicare |
$115.96
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Devoted Health Medicare |
$127.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$115.96
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$122.12
|
| Rate for Payer: Health Management Network Commercial |
$287.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$139.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$139.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$139.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$72.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$115.96
|
| Rate for Payer: UnitedHealthcare Medicaid |
$72.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$115.96
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 74221 26
|
| Min. Negotiated Rate |
$32.60 |
| Max. Negotiated Rate |
$122.12 |
| Rate for Payer: AlohaCare Medicaid |
$72.83
|
| Rate for Payer: AlohaCare Medicare |
$32.60
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Devoted Health Medicare |
$35.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$32.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$122.12
|
| Rate for Payer: Health Management Network Commercial |
$48.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$39.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$39.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$39.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$72.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$32.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$72.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$32.60
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
HCPCS 74221 TC
|
| Min. Negotiated Rate |
$72.83 |
| Max. Negotiated Rate |
$238.85 |
| Rate for Payer: AlohaCare Medicaid |
$72.83
|
| Rate for Payer: AlohaCare Medicare |
$83.36
|
| Rate for Payer: Cash Price |
$168.60
|
| Rate for Payer: Cash Price |
$168.60
|
| Rate for Payer: Devoted Health Medicare |
$91.70
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$83.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$122.12
|
| Rate for Payer: Health Management Network Commercial |
$238.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$100.03
|
| Rate for Payer: Kaiser Permanente Medicaid |
$100.03
|
| Rate for Payer: Kaiser Permanente Medicare |
$100.03
|
| Rate for Payer: Ohana Health Plan Medicaid |
$72.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$83.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$72.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$83.36
|
|
