|
HC ASSAY, BLD/SERUM CHOLESTEROL - CHOLESTEROL TOTAL
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
HCPCS 82465
|
| Hospital Charge Code |
3018246502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$34.92 |
| Rate for Payer: AlohaCare Medicaid |
$4.35
|
| Rate for Payer: AlohaCare Medicare |
$4.35
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Devoted Health Medicare |
$4.79
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$6.02
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$5.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$4.35
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$6.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4.35
|
| Rate for Payer: Health Management Network Commercial |
$30.60
|
| Rate for Payer: Humana Medicare |
$4.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$22.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$18.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$4.35
|
| Rate for Payer: MDX Hawaii PPO |
$34.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$4.79
|
| Rate for Payer: Ohana Health Plan Medicare |
$4.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.02
|
| Rate for Payer: UnitedHealthcare Medicare |
$4.35
|
| Rate for Payer: University Health Alliance Commercial |
$11.25
|
|
|
HC ASSAY, DIHYDROXYVITAMIN D W/FRACTIONS, IF PERFORMED - VITAMIN D 1
|
Facility
|
IP
|
$323.00
|
|
|
Service Code
|
HCPCS 82652
|
| Hospital Charge Code |
3018265201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$274.55 |
| Max. Negotiated Rate |
$313.31 |
| Rate for Payer: Cash Price |
$193.80
|
| Rate for Payer: Health Management Network Commercial |
$274.55
|
| Rate for Payer: MDX Hawaii PPO |
$313.31
|
|
|
HC ASSAY, DIHYDROXYVITAMIN D W/FRACTIONS, IF PERFORMED - VITAMIN D 1
|
Facility
|
OP
|
$323.00
|
|
|
Service Code
|
HCPCS 82652
|
| Hospital Charge Code |
3018265201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.50 |
| Max. Negotiated Rate |
$313.31 |
| Rate for Payer: AlohaCare Medicaid |
$38.50
|
| Rate for Payer: AlohaCare Medicare |
$38.50
|
| Rate for Payer: Cash Price |
$193.80
|
| Rate for Payer: Cash Price |
$193.80
|
| Rate for Payer: Devoted Health Medicare |
$42.35
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$53.19
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$48.12
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$55.85
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$38.50
|
| Rate for Payer: Health Management Network Commercial |
$274.55
|
| Rate for Payer: Humana Medicare |
$38.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$203.49
|
| Rate for Payer: Kaiser Permanente Medicaid |
$164.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$38.50
|
| Rate for Payer: MDX Hawaii PPO |
$313.31
|
| Rate for Payer: Ohana Health Plan Medicaid |
$42.35
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$53.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.50
|
| Rate for Payer: University Health Alliance Commercial |
$99.49
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE 24 HOUR URINE
|
Facility
|
IP
|
$33.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3018294503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.05 |
| Max. Negotiated Rate |
$32.01 |
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Health Management Network Commercial |
$28.05
|
| Rate for Payer: MDX Hawaii PPO |
$32.01
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE 24 HOUR URINE
|
Facility
|
OP
|
$33.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3018294503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$32.01 |
| Rate for Payer: AlohaCare Medicaid |
$3.93
|
| Rate for Payer: AlohaCare Medicare |
$3.93
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Devoted Health Medicare |
$4.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$5.42
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$4.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3.93
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$5.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3.93
|
| Rate for Payer: Health Management Network Commercial |
$28.05
|
| Rate for Payer: Humana Medicare |
$3.93
|
| Rate for Payer: Kaiser Permanente Commercial |
$20.79
|
| Rate for Payer: Kaiser Permanente Medicaid |
$16.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$3.93
|
| Rate for Payer: MDX Hawaii PPO |
$32.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$4.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$3.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$5.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$3.93
|
| Rate for Payer: University Health Alliance Commercial |
$10.14
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE BODY FLUID
|
Facility
|
IP
|
$33.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3018294502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.05 |
| Max. Negotiated Rate |
$32.01 |
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Health Management Network Commercial |
$28.05
|
| Rate for Payer: MDX Hawaii PPO |
$32.01
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE BODY FLUID
|
Facility
|
OP
|
$33.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3018294502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$32.01 |
| Rate for Payer: AlohaCare Medicaid |
$3.93
|
| Rate for Payer: AlohaCare Medicare |
$3.93
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Devoted Health Medicare |
$4.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$5.42
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$4.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3.93
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$5.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3.93
|
| Rate for Payer: Health Management Network Commercial |
$28.05
|
| Rate for Payer: Humana Medicare |
$3.93
|
| Rate for Payer: Kaiser Permanente Commercial |
$20.79
|
| Rate for Payer: Kaiser Permanente Medicaid |
$16.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$3.93
|
| Rate for Payer: MDX Hawaii PPO |
$32.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$4.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$3.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$5.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$3.93
|
| Rate for Payer: University Health Alliance Commercial |
$10.14
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE CSF
|
Facility
|
OP
|
$33.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3018294501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$32.01 |
| Rate for Payer: AlohaCare Medicaid |
$3.93
|
| Rate for Payer: AlohaCare Medicare |
$3.93
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Devoted Health Medicare |
$4.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$5.42
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$4.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3.93
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$5.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3.93
|
| Rate for Payer: Health Management Network Commercial |
$28.05
|
| Rate for Payer: Humana Medicare |
$3.93
|
| Rate for Payer: Kaiser Permanente Commercial |
$20.79
|
| Rate for Payer: Kaiser Permanente Medicaid |
$16.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$3.93
|
| Rate for Payer: MDX Hawaii PPO |
$32.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$4.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$3.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$5.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$3.93
|
| Rate for Payer: University Health Alliance Commercial |
$10.14
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE CSF
|
Facility
|
IP
|
$33.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3018294501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.05 |
| Max. Negotiated Rate |
$32.01 |
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Health Management Network Commercial |
$28.05
|
| Rate for Payer: MDX Hawaii PPO |
$32.01
|
|
|
HC ASSAY, NON-ENDOCRINE RECEPTOR - SOLUBLE TRANSFERR RECP SO
|
Facility
|
OP
|
$307.00
|
|
|
Service Code
|
HCPCS 84238
|
| Hospital Charge Code |
3018423801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.57 |
| Max. Negotiated Rate |
$297.79 |
| Rate for Payer: AlohaCare Medicaid |
$36.57
|
| Rate for Payer: AlohaCare Medicare |
$36.57
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Devoted Health Medicare |
$40.23
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$50.53
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$45.71
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$36.57
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$53.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$36.57
|
| Rate for Payer: Health Management Network Commercial |
$260.95
|
| Rate for Payer: Humana Medicare |
$36.57
|
| Rate for Payer: Kaiser Permanente Commercial |
$193.41
|
| Rate for Payer: Kaiser Permanente Medicaid |
$156.57
|
| Rate for Payer: Kaiser Permanente Medicare |
$36.57
|
| Rate for Payer: MDX Hawaii PPO |
$297.79
|
| Rate for Payer: Ohana Health Plan Medicaid |
$40.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$36.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$50.53
|
| Rate for Payer: UnitedHealthcare Medicare |
$36.57
|
| Rate for Payer: University Health Alliance Commercial |
$94.52
|
|
|
HC ASSAY, NON-ENDOCRINE RECEPTOR - SOLUBLE TRANSFERR RECP SO
|
Facility
|
IP
|
$307.00
|
|
|
Service Code
|
HCPCS 84238
|
| Hospital Charge Code |
3018423801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$260.95 |
| Max. Negotiated Rate |
$297.79 |
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Health Management Network Commercial |
$260.95
|
| Rate for Payer: MDX Hawaii PPO |
$297.79
|
|
|
HC ASSAY OF ACTH - ACTH
|
Facility
|
IP
|
$324.00
|
|
|
Service Code
|
HCPCS 82024
|
| Hospital Charge Code |
3018202401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$275.40 |
| Max. Negotiated Rate |
$314.28 |
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Health Management Network Commercial |
$275.40
|
| Rate for Payer: MDX Hawaii PPO |
$314.28
|
|
|
HC ASSAY OF ACTH - ACTH
|
Facility
|
OP
|
$324.00
|
|
|
Service Code
|
HCPCS 82024
|
| Hospital Charge Code |
3018202401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.62 |
| Max. Negotiated Rate |
$314.28 |
| Rate for Payer: AlohaCare Medicaid |
$38.62
|
| Rate for Payer: AlohaCare Medicare |
$38.62
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Devoted Health Medicare |
$42.48
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$53.38
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$48.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.62
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$56.05
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$38.62
|
| Rate for Payer: Health Management Network Commercial |
$275.40
|
| Rate for Payer: Humana Medicare |
$38.62
|
| Rate for Payer: Kaiser Permanente Commercial |
$204.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$165.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$38.62
|
| Rate for Payer: MDX Hawaii PPO |
$314.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$42.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$53.38
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.62
|
| Rate for Payer: University Health Alliance Commercial |
$99.84
|
|
|
HC ASSAY OF ALDOLASE - ALDOLASE
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
HCPCS 82085
|
| Hospital Charge Code |
3018208501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.85 |
| Max. Negotiated Rate |
$78.57 |
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Health Management Network Commercial |
$68.85
|
| Rate for Payer: MDX Hawaii PPO |
$78.57
|
|
|
HC ASSAY OF ALDOLASE - ALDOLASE
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
HCPCS 82085
|
| Hospital Charge Code |
3018208501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$78.57 |
| Rate for Payer: AlohaCare Medicaid |
$9.71
|
| Rate for Payer: AlohaCare Medicare |
$9.71
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Devoted Health Medicare |
$10.68
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$13.42
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$12.14
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.71
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$14.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$9.71
|
| Rate for Payer: Health Management Network Commercial |
$68.85
|
| Rate for Payer: Humana Medicare |
$9.71
|
| Rate for Payer: Kaiser Permanente Commercial |
$51.03
|
| Rate for Payer: Kaiser Permanente Medicaid |
$41.31
|
| Rate for Payer: Kaiser Permanente Medicare |
$9.71
|
| Rate for Payer: MDX Hawaii PPO |
$78.57
|
| Rate for Payer: Ohana Health Plan Medicaid |
$10.68
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.71
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.71
|
| Rate for Payer: University Health Alliance Commercial |
$25.09
|
|
|
HC ASSAY OF ALDOSTERONE - ALDOSTERONE
|
Facility
|
OP
|
$342.00
|
|
|
Service Code
|
HCPCS 82088
|
| Hospital Charge Code |
3018208802
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.75 |
| Max. Negotiated Rate |
$331.74 |
| Rate for Payer: AlohaCare Medicaid |
$40.75
|
| Rate for Payer: AlohaCare Medicare |
$40.75
|
| Rate for Payer: Cash Price |
$205.20
|
| Rate for Payer: Cash Price |
$205.20
|
| Rate for Payer: Devoted Health Medicare |
$44.83
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$56.32
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$50.94
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$40.75
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$59.14
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$40.75
|
| Rate for Payer: Health Management Network Commercial |
$290.70
|
| Rate for Payer: Humana Medicare |
$40.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$215.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$174.42
|
| Rate for Payer: Kaiser Permanente Medicare |
$40.75
|
| Rate for Payer: MDX Hawaii PPO |
$331.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$44.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$40.75
|
| Rate for Payer: UnitedHealthcare Medicaid |
$56.32
|
| Rate for Payer: UnitedHealthcare Medicare |
$40.75
|
| Rate for Payer: University Health Alliance Commercial |
$105.34
|
|
|
HC ASSAY OF ALDOSTERONE - ALDOSTERONE
|
Facility
|
IP
|
$342.00
|
|
|
Service Code
|
HCPCS 82088
|
| Hospital Charge Code |
3018208802
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$290.70 |
| Max. Negotiated Rate |
$331.74 |
| Rate for Payer: Cash Price |
$205.20
|
| Rate for Payer: Health Management Network Commercial |
$290.70
|
| Rate for Payer: MDX Hawaii PPO |
$331.74
|
|
|
HC ASSAY OF AMIKACIN - AMIKACIN RANDOM
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
HCPCS 80150
|
| Hospital Charge Code |
3018015001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.08 |
| Max. Negotiated Rate |
$123.19 |
| Rate for Payer: AlohaCare Medicaid |
$15.08
|
| Rate for Payer: AlohaCare Medicare |
$15.08
|
| Rate for Payer: Cash Price |
$76.20
|
| Rate for Payer: Cash Price |
$76.20
|
| Rate for Payer: Devoted Health Medicare |
$16.59
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$20.83
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$18.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$15.08
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$21.87
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$15.08
|
| Rate for Payer: Health Management Network Commercial |
$107.95
|
| Rate for Payer: Humana Medicare |
$15.08
|
| Rate for Payer: Kaiser Permanente Commercial |
$80.01
|
| Rate for Payer: Kaiser Permanente Medicaid |
$64.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$15.08
|
| Rate for Payer: MDX Hawaii PPO |
$123.19
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16.59
|
| Rate for Payer: Ohana Health Plan Medicare |
$15.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$20.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$15.08
|
| Rate for Payer: University Health Alliance Commercial |
$38.96
|
|
|
HC ASSAY OF AMIKACIN - AMIKACIN RANDOM
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
HCPCS 80150
|
| Hospital Charge Code |
3018015001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$107.95 |
| Max. Negotiated Rate |
$123.19 |
| Rate for Payer: Cash Price |
$76.20
|
| Rate for Payer: Health Management Network Commercial |
$107.95
|
| Rate for Payer: MDX Hawaii PPO |
$123.19
|
|
|
HC ASSAY OF AMMONIA - AMMONIA
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
HCPCS 82140
|
| Hospital Charge Code |
3018214001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$103.70 |
| Max. Negotiated Rate |
$118.34 |
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
|
|
HC ASSAY OF AMMONIA - AMMONIA
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
HCPCS 82140
|
| Hospital Charge Code |
3018214001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.57 |
| Max. Negotiated Rate |
$118.34 |
| Rate for Payer: AlohaCare Medicaid |
$14.57
|
| Rate for Payer: AlohaCare Medicare |
$14.57
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Devoted Health Medicare |
$16.03
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$20.14
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$18.21
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$14.57
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$21.15
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$14.57
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Humana Medicare |
$14.57
|
| Rate for Payer: Kaiser Permanente Commercial |
$76.86
|
| Rate for Payer: Kaiser Permanente Medicaid |
$62.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$14.57
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16.03
|
| Rate for Payer: Ohana Health Plan Medicare |
$14.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$20.14
|
| Rate for Payer: UnitedHealthcare Medicare |
$14.57
|
| Rate for Payer: University Health Alliance Commercial |
$37.67
|
|
|
HC ASSAY OF AMYLASE - AMYLASE
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3018215005
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.48 |
| Max. Negotiated Rate |
$52.38 |
| Rate for Payer: AlohaCare Medicaid |
$6.48
|
| Rate for Payer: AlohaCare Medicare |
$6.48
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Devoted Health Medicare |
$7.13
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$8.96
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$8.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$6.48
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$9.41
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6.48
|
| Rate for Payer: Health Management Network Commercial |
$45.90
|
| Rate for Payer: Humana Medicare |
$6.48
|
| Rate for Payer: Kaiser Permanente Commercial |
$34.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$27.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$6.48
|
| Rate for Payer: MDX Hawaii PPO |
$52.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$7.13
|
| Rate for Payer: Ohana Health Plan Medicare |
$6.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.96
|
| Rate for Payer: UnitedHealthcare Medicare |
$6.48
|
| Rate for Payer: University Health Alliance Commercial |
$16.76
|
|
|
HC ASSAY OF AMYLASE - AMYLASE
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3018215005
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.90 |
| Max. Negotiated Rate |
$52.38 |
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Health Management Network Commercial |
$45.90
|
| Rate for Payer: MDX Hawaii PPO |
$52.38
|
|
|
HC ASSAY OF AMYLASE - AMYLASE BODY FLUID
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3018215001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.90 |
| Max. Negotiated Rate |
$52.38 |
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Health Management Network Commercial |
$45.90
|
| Rate for Payer: MDX Hawaii PPO |
$52.38
|
|
|
HC ASSAY OF AMYLASE - AMYLASE BODY FLUID
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3018215001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.48 |
| Max. Negotiated Rate |
$52.38 |
| Rate for Payer: AlohaCare Medicaid |
$6.48
|
| Rate for Payer: AlohaCare Medicare |
$6.48
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Devoted Health Medicare |
$7.13
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$8.96
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$8.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$6.48
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$9.41
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6.48
|
| Rate for Payer: Health Management Network Commercial |
$45.90
|
| Rate for Payer: Humana Medicare |
$6.48
|
| Rate for Payer: Kaiser Permanente Commercial |
$34.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$27.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$6.48
|
| Rate for Payer: MDX Hawaii PPO |
$52.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$7.13
|
| Rate for Payer: Ohana Health Plan Medicare |
$6.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.96
|
| Rate for Payer: UnitedHealthcare Medicare |
$6.48
|
| Rate for Payer: University Health Alliance Commercial |
$16.76
|
|
