|
HC ASSAY OF HAPTOGLOBIN, QUANT - HAPTOGLOBIN
|
Facility
|
OP
|
$106.00
|
|
|
Service Code
|
HCPCS 83010
|
| Hospital Charge Code |
3018301001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.58 |
| Max. Negotiated Rate |
$102.82 |
| Rate for Payer: AlohaCare Medicaid |
$12.58
|
| Rate for Payer: AlohaCare Medicare |
$12.58
|
| Rate for Payer: Cash Price |
$63.60
|
| Rate for Payer: Cash Price |
$63.60
|
| Rate for Payer: Devoted Health Medicare |
$13.84
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$17.38
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$15.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$12.58
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$18.25
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$12.58
|
| Rate for Payer: Health Management Network Commercial |
$90.10
|
| Rate for Payer: Humana Medicare |
$12.58
|
| Rate for Payer: Kaiser Permanente Commercial |
$66.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$54.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$12.58
|
| Rate for Payer: MDX Hawaii PPO |
$102.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$13.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$12.58
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.38
|
| Rate for Payer: UnitedHealthcare Medicare |
$12.58
|
| Rate for Payer: University Health Alliance Commercial |
$32.52
|
|
|
HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
HCPCS 83090
|
| Hospital Charge Code |
3018309002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.92 |
| Max. Negotiated Rate |
$145.50 |
| Rate for Payer: AlohaCare Medicaid |
$17.92
|
| Rate for Payer: AlohaCare Medicare |
$17.92
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Devoted Health Medicare |
$19.71
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$23.31
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$22.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$17.92
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$24.48
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$17.92
|
| Rate for Payer: Health Management Network Commercial |
$127.50
|
| Rate for Payer: Humana Medicare |
$17.92
|
| Rate for Payer: Kaiser Permanente Commercial |
$94.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$76.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$17.92
|
| Rate for Payer: MDX Hawaii PPO |
$145.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$19.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$17.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$23.31
|
| Rate for Payer: UnitedHealthcare Medicare |
$17.92
|
| Rate for Payer: University Health Alliance Commercial |
$43.60
|
|
|
HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
HCPCS 83090
|
| Hospital Charge Code |
3018309002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$127.50 |
| Max. Negotiated Rate |
$145.50 |
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Health Management Network Commercial |
$127.50
|
| Rate for Payer: MDX Hawaii PPO |
$145.50
|
|
|
HC ASSAY OF INORGANIC PHOSPHORUS - PHOSPHORUS BLOOD
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
HCPCS 84100
|
| Hospital Charge Code |
3018410001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$38.80 |
| Rate for Payer: AlohaCare Medicaid |
$4.74
|
| Rate for Payer: AlohaCare Medicare |
$4.74
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Devoted Health Medicare |
$5.21
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$6.56
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$5.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$4.74
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$6.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4.74
|
| Rate for Payer: Health Management Network Commercial |
$34.00
|
| Rate for Payer: Humana Medicare |
$4.74
|
| Rate for Payer: Kaiser Permanente Commercial |
$25.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$20.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$4.74
|
| Rate for Payer: MDX Hawaii PPO |
$38.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$5.21
|
| Rate for Payer: Ohana Health Plan Medicare |
$4.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$4.74
|
| Rate for Payer: University Health Alliance Commercial |
$12.27
|
|
|
HC ASSAY OF INORGANIC PHOSPHORUS - PHOSPHORUS BLOOD
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
HCPCS 84100
|
| Hospital Charge Code |
3018410001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$38.80 |
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Health Management Network Commercial |
$34.00
|
| Rate for Payer: MDX Hawaii PPO |
$38.80
|
|
|
HC ASSAY OF INSULIN,TOTAL - INSULIN, TOTAL
|
Facility
|
OP
|
$96.00
|
|
|
Service Code
|
HCPCS 83525
|
| Hospital Charge Code |
3018352503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.43 |
| Max. Negotiated Rate |
$93.12 |
| Rate for Payer: AlohaCare Medicaid |
$11.43
|
| Rate for Payer: AlohaCare Medicare |
$11.43
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Devoted Health Medicare |
$12.57
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$15.81
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$14.29
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$11.43
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$16.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$11.43
|
| Rate for Payer: Health Management Network Commercial |
$81.60
|
| Rate for Payer: Humana Medicare |
$11.43
|
| Rate for Payer: Kaiser Permanente Commercial |
$60.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$48.96
|
| Rate for Payer: Kaiser Permanente Medicare |
$11.43
|
| Rate for Payer: MDX Hawaii PPO |
$93.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$12.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$11.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$11.43
|
| Rate for Payer: University Health Alliance Commercial |
$29.56
|
|
|
HC ASSAY OF INSULIN,TOTAL - INSULIN, TOTAL
|
Facility
|
IP
|
$96.00
|
|
|
Service Code
|
HCPCS 83525
|
| Hospital Charge Code |
3018352503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$93.12 |
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Health Management Network Commercial |
$81.60
|
| Rate for Payer: MDX Hawaii PPO |
$93.12
|
|
|
HC ASSAY OF IRON - IRON BLOOD
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
HCPCS 83540
|
| Hospital Charge Code |
3018354001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.47 |
| Max. Negotiated Rate |
$52.38 |
| Rate for Payer: AlohaCare Medicaid |
$6.47
|
| Rate for Payer: AlohaCare Medicare |
$6.47
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Devoted Health Medicare |
$7.12
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$8.95
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$8.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$6.47
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$9.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6.47
|
| Rate for Payer: Health Management Network Commercial |
$45.90
|
| Rate for Payer: Humana Medicare |
$6.47
|
| Rate for Payer: Kaiser Permanente Commercial |
$34.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$27.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$6.47
|
| Rate for Payer: MDX Hawaii PPO |
$52.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$7.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$6.47
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$6.47
|
| Rate for Payer: University Health Alliance Commercial |
$16.74
|
|
|
HC ASSAY OF IRON - IRON BLOOD
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
HCPCS 83540
|
| Hospital Charge Code |
3018354001
|
|
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 LACTIC ACID - LACTATE
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
HCPCS 83605
|
| Hospital Charge Code |
3018360502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$82.45 |
| Max. Negotiated Rate |
$94.09 |
| Rate for Payer: Cash Price |
$58.20
|
| Rate for Payer: Health Management Network Commercial |
$82.45
|
| Rate for Payer: MDX Hawaii PPO |
$94.09
|
|
|
HC ASSAY OF LACTIC ACID - LACTATE
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
HCPCS 83605
|
| Hospital Charge Code |
3018360502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.57 |
| Max. Negotiated Rate |
$94.09 |
| Rate for Payer: AlohaCare Medicaid |
$11.57
|
| Rate for Payer: AlohaCare Medicare |
$11.57
|
| Rate for Payer: Cash Price |
$58.20
|
| Rate for Payer: Cash Price |
$58.20
|
| Rate for Payer: Devoted Health Medicare |
$12.73
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$14.76
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$14.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$11.57
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$15.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$11.57
|
| Rate for Payer: Health Management Network Commercial |
$82.45
|
| Rate for Payer: Humana Medicare |
$11.57
|
| Rate for Payer: Kaiser Permanente Commercial |
$61.11
|
| Rate for Payer: Kaiser Permanente Medicaid |
$49.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$11.57
|
| Rate for Payer: MDX Hawaii PPO |
$94.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$12.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$11.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$14.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$11.57
|
| Rate for Payer: University Health Alliance Commercial |
$27.60
|
|
|
HC ASSAY OF LEAD - EC LEAD WHOLE BLOOD SO
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
HCPCS 83655
|
| Hospital Charge Code |
3018365501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$86.70 |
| Max. Negotiated Rate |
$98.94 |
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Health Management Network Commercial |
$86.70
|
| Rate for Payer: MDX Hawaii PPO |
$98.94
|
|
|
HC ASSAY OF LEAD - EC LEAD WHOLE BLOOD SO
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
HCPCS 83655
|
| Hospital Charge Code |
3018365501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$98.94 |
| Rate for Payer: AlohaCare Medicaid |
$12.11
|
| Rate for Payer: AlohaCare Medicare |
$12.11
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Devoted Health Medicare |
$13.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$16.72
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$15.14
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$12.11
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$17.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$12.11
|
| Rate for Payer: Health Management Network Commercial |
$86.70
|
| Rate for Payer: Humana Medicare |
$12.11
|
| Rate for Payer: Kaiser Permanente Commercial |
$64.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$52.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$12.11
|
| Rate for Payer: MDX Hawaii PPO |
$98.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$13.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$12.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$12.11
|
| Rate for Payer: University Health Alliance Commercial |
$31.28
|
|
|
HC ASSAY OF LEAD - LEAD WHOLE BLOOD
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
HCPCS 83655
|
| Hospital Charge Code |
3018365502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$98.94 |
| Rate for Payer: AlohaCare Medicaid |
$12.11
|
| Rate for Payer: AlohaCare Medicare |
$12.11
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Devoted Health Medicare |
$13.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$16.72
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$15.14
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$12.11
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$17.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$12.11
|
| Rate for Payer: Health Management Network Commercial |
$86.70
|
| Rate for Payer: Humana Medicare |
$12.11
|
| Rate for Payer: Kaiser Permanente Commercial |
$64.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$52.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$12.11
|
| Rate for Payer: MDX Hawaii PPO |
$98.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$13.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$12.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$12.11
|
| Rate for Payer: University Health Alliance Commercial |
$31.28
|
|
|
HC ASSAY OF LEAD - LEAD WHOLE BLOOD
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
HCPCS 83655
|
| Hospital Charge Code |
3018365502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$86.70 |
| Max. Negotiated Rate |
$98.94 |
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Health Management Network Commercial |
$86.70
|
| Rate for Payer: MDX Hawaii PPO |
$98.94
|
|
|
HC ASSAY OF LIPASE - LIPASE
|
Facility
|
OP
|
$58.00
|
|
|
Service Code
|
HCPCS 83690
|
| Hospital Charge Code |
3018369001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$56.26 |
| Rate for Payer: AlohaCare Medicaid |
$6.89
|
| Rate for Payer: AlohaCare Medicare |
$6.89
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Devoted Health Medicare |
$7.58
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$9.52
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$8.61
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$6.89
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$10.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6.89
|
| Rate for Payer: Health Management Network Commercial |
$49.30
|
| Rate for Payer: Humana Medicare |
$6.89
|
| Rate for Payer: Kaiser Permanente Commercial |
$36.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$29.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$6.89
|
| Rate for Payer: MDX Hawaii PPO |
$56.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$7.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$6.89
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.52
|
| Rate for Payer: UnitedHealthcare Medicare |
$6.89
|
| Rate for Payer: University Health Alliance Commercial |
$17.80
|
|
|
HC ASSAY OF LIPASE - LIPASE
|
Facility
|
IP
|
$58.00
|
|
|
Service Code
|
HCPCS 83690
|
| Hospital Charge Code |
3018369001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.30 |
| Max. Negotiated Rate |
$56.26 |
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Health Management Network Commercial |
$49.30
|
| Rate for Payer: MDX Hawaii PPO |
$56.26
|
|
|
HC ASSAY OF LITHIUM - LITHIUM
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
HCPCS 80178
|
| Hospital Charge Code |
3018017801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.61 |
| Max. Negotiated Rate |
$53.35 |
| Rate for Payer: AlohaCare Medicaid |
$6.61
|
| Rate for Payer: AlohaCare Medicare |
$6.61
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Devoted Health Medicare |
$7.27
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$9.13
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$8.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$6.61
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$9.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6.61
|
| Rate for Payer: Health Management Network Commercial |
$46.75
|
| Rate for Payer: Humana Medicare |
$6.61
|
| Rate for Payer: Kaiser Permanente Commercial |
$34.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$28.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$6.61
|
| Rate for Payer: MDX Hawaii PPO |
$53.35
|
| Rate for Payer: Ohana Health Plan Medicaid |
$7.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$6.61
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.13
|
| Rate for Payer: UnitedHealthcare Medicare |
$6.61
|
| Rate for Payer: University Health Alliance Commercial |
$17.09
|
|
|
HC ASSAY OF LITHIUM - LITHIUM
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
HCPCS 80178
|
| Hospital Charge Code |
3018017801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.75 |
| Max. Negotiated Rate |
$53.35 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Health Management Network Commercial |
$46.75
|
| Rate for Payer: MDX Hawaii PPO |
$53.35
|
|
|
HC ASSAY OF MAGNESIUM - MAGNESIUM
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
HCPCS 83735
|
| Hospital Charge Code |
3018373501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$54.32 |
| Rate for Payer: AlohaCare Medicaid |
$6.70
|
| Rate for Payer: AlohaCare Medicare |
$6.70
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Devoted Health Medicare |
$7.37
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$9.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$8.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$6.70
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$9.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6.70
|
| Rate for Payer: Health Management Network Commercial |
$47.60
|
| Rate for Payer: Humana Medicare |
$6.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$35.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$28.56
|
| Rate for Payer: Kaiser Permanente Medicare |
$6.70
|
| Rate for Payer: MDX Hawaii PPO |
$54.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$7.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$6.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$6.70
|
| Rate for Payer: University Health Alliance Commercial |
$17.32
|
|
|
HC ASSAY OF MAGNESIUM - MAGNESIUM
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
HCPCS 83735
|
| Hospital Charge Code |
3018373501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$54.32 |
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Health Management Network Commercial |
$47.60
|
| Rate for Payer: MDX Hawaii PPO |
$54.32
|
|
|
HC ASSAY OF MAGNESIUM - MAGNESIUM URINE
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
HCPCS 83735
|
| Hospital Charge Code |
3018373502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$54.32 |
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Health Management Network Commercial |
$47.60
|
| Rate for Payer: MDX Hawaii PPO |
$54.32
|
|
|
HC ASSAY OF MAGNESIUM - MAGNESIUM URINE
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
HCPCS 83735
|
| Hospital Charge Code |
3018373502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$54.32 |
| Rate for Payer: AlohaCare Medicaid |
$6.70
|
| Rate for Payer: AlohaCare Medicare |
$6.70
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Devoted Health Medicare |
$7.37
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$9.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$8.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$6.70
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$9.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6.70
|
| Rate for Payer: Health Management Network Commercial |
$47.60
|
| Rate for Payer: Humana Medicare |
$6.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$35.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$28.56
|
| Rate for Payer: Kaiser Permanente Medicare |
$6.70
|
| Rate for Payer: MDX Hawaii PPO |
$54.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$7.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$6.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$6.70
|
| Rate for Payer: University Health Alliance Commercial |
$17.32
|
|
|
HC ASSAY OF MERCURY - MERCURY, BLOOD
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
HCPCS 83825
|
| Hospital Charge Code |
3018382503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.26 |
| Max. Negotiated Rate |
$131.92 |
| Rate for Payer: AlohaCare Medicaid |
$16.26
|
| Rate for Payer: AlohaCare Medicare |
$16.26
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Devoted Health Medicare |
$17.89
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$22.47
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$20.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$16.26
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$23.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$16.26
|
| Rate for Payer: Health Management Network Commercial |
$115.60
|
| Rate for Payer: Humana Medicare |
$16.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$69.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$16.26
|
| Rate for Payer: MDX Hawaii PPO |
$131.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$17.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$16.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$16.26
|
| Rate for Payer: University Health Alliance Commercial |
$42.03
|
|
|
HC ASSAY OF MERCURY - MERCURY, BLOOD
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
HCPCS 83825
|
| Hospital Charge Code |
3018382503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$115.60 |
| Max. Negotiated Rate |
$131.92 |
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Health Management Network Commercial |
$115.60
|
| Rate for Payer: MDX Hawaii PPO |
$131.92
|
|
