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Service Code HCPCS 87206
Hospital Charge Code 3068720601
Hospital Revenue Code 306
Min. Negotiated Rate $38.25
Max. Negotiated Rate $43.65
Rate for Payer: Cash Price $27.00
Rate for Payer: Health Management Network Commercial $38.25
Rate for Payer: MDX Hawaii PPO $43.65
Service Code HCPCS 87207
Hospital Charge Code 3068720702
Hospital Revenue Code 306
Min. Negotiated Rate $42.50
Max. Negotiated Rate $48.50
Rate for Payer: Cash Price $30.00
Rate for Payer: Health Management Network Commercial $42.50
Rate for Payer: MDX Hawaii PPO $48.50
Service Code HCPCS 87207
Hospital Charge Code 3068720702
Hospital Revenue Code 306
Min. Negotiated Rate $5.99
Max. Negotiated Rate $48.50
Rate for Payer: AlohaCare Medicaid $5.99
Rate for Payer: AlohaCare Medicare $5.99
Rate for Payer: Cash Price $30.00
Rate for Payer: Cash Price $30.00
Rate for Payer: Devoted Health Medicare $6.59
Rate for Payer: Hawaii Medical Service Association ABD $8.37
Rate for Payer: Hawaii Medical Service Association Commercial $7.49
Rate for Payer: Hawaii Medical Service Association Medicare $5.99
Rate for Payer: Hawaii Medical Service Association Non-ABD $8.79
Rate for Payer: Hawaii Western Management Group Commercial $5.99
Rate for Payer: Health Management Network Commercial $42.50
Rate for Payer: Humana Medicare $5.99
Rate for Payer: Kaiser Permanente Commercial $31.50
Rate for Payer: Kaiser Permanente Medicaid $25.50
Rate for Payer: Kaiser Permanente Medicare $5.99
Rate for Payer: MDX Hawaii PPO $48.50
Rate for Payer: Ohana Health Plan Medicaid $6.59
Rate for Payer: Ohana Health Plan Medicare $5.99
Rate for Payer: UnitedHealthcare Medicaid $8.37
Rate for Payer: UnitedHealthcare Medicare $5.99
Rate for Payer: University Health Alliance Commercial $15.48
Service Code HCPCS 87207
Hospital Charge Code 3068720701
Hospital Revenue Code 306
Min. Negotiated Rate $42.50
Max. Negotiated Rate $48.50
Rate for Payer: Cash Price $30.00
Rate for Payer: Health Management Network Commercial $42.50
Rate for Payer: MDX Hawaii PPO $48.50
Service Code HCPCS 87207
Hospital Charge Code 3068720701
Hospital Revenue Code 306
Min. Negotiated Rate $5.99
Max. Negotiated Rate $48.50
Rate for Payer: AlohaCare Medicaid $5.99
Rate for Payer: AlohaCare Medicare $5.99
Rate for Payer: Cash Price $30.00
Rate for Payer: Cash Price $30.00
Rate for Payer: Devoted Health Medicare $6.59
Rate for Payer: Hawaii Medical Service Association ABD $8.37
Rate for Payer: Hawaii Medical Service Association Commercial $7.49
Rate for Payer: Hawaii Medical Service Association Medicare $5.99
Rate for Payer: Hawaii Medical Service Association Non-ABD $8.79
Rate for Payer: Hawaii Western Management Group Commercial $5.99
Rate for Payer: Health Management Network Commercial $42.50
Rate for Payer: Humana Medicare $5.99
Rate for Payer: Kaiser Permanente Commercial $31.50
Rate for Payer: Kaiser Permanente Medicaid $25.50
Rate for Payer: Kaiser Permanente Medicare $5.99
Rate for Payer: MDX Hawaii PPO $48.50
Rate for Payer: Ohana Health Plan Medicaid $6.59
Rate for Payer: Ohana Health Plan Medicare $5.99
Rate for Payer: UnitedHealthcare Medicaid $8.37
Rate for Payer: UnitedHealthcare Medicare $5.99
Rate for Payer: University Health Alliance Commercial $15.48
Service Code HCPCS 87210
Hospital Charge Code 3068721001
Hospital Revenue Code 306
Min. Negotiated Rate $5.82
Max. Negotiated Rate $47.53
Rate for Payer: AlohaCare Medicaid $5.82
Rate for Payer: AlohaCare Medicare $5.82
Rate for Payer: Cash Price $29.40
Rate for Payer: Cash Price $29.40
Rate for Payer: Devoted Health Medicare $6.40
Rate for Payer: Hawaii Medical Service Association ABD $5.90
Rate for Payer: Hawaii Medical Service Association Commercial $7.28
Rate for Payer: Hawaii Medical Service Association Medicare $5.82
Rate for Payer: Hawaii Medical Service Association Non-ABD $6.20
Rate for Payer: Hawaii Western Management Group Commercial $5.82
Rate for Payer: Health Management Network Commercial $41.65
Rate for Payer: Humana Medicare $5.82
Rate for Payer: Kaiser Permanente Commercial $30.87
Rate for Payer: Kaiser Permanente Medicaid $24.99
Rate for Payer: Kaiser Permanente Medicare $5.82
Rate for Payer: MDX Hawaii PPO $47.53
Rate for Payer: Ohana Health Plan Medicaid $6.40
Rate for Payer: Ohana Health Plan Medicare $5.82
Rate for Payer: UnitedHealthcare Medicaid $5.90
Rate for Payer: UnitedHealthcare Medicare $5.82
Rate for Payer: University Health Alliance Commercial $11.03
Service Code HCPCS 87210
Hospital Charge Code 3068721001
Hospital Revenue Code 306
Min. Negotiated Rate $41.65
Max. Negotiated Rate $47.53
Rate for Payer: Cash Price $29.40
Rate for Payer: Health Management Network Commercial $41.65
Rate for Payer: MDX Hawaii PPO $47.53
Hospital Charge Code 1200000003
Hospital Revenue Code 120
Min. Negotiated Rate $486.76
Max. Negotiated Rate $7,250.00
Rate for Payer: AlohaCare Medicaid $486.76
Rate for Payer: Cash Price $1,500.00
Rate for Payer: Cash Price $1,500.00
Rate for Payer: Hawaii Medical Service Association ABD $486.76
Rate for Payer: Hawaii Medical Service Association Non-ABD $486.76
Rate for Payer: Hawaii Western Management Group Commercial $7,250.00
Rate for Payer: Health Management Network Commercial $2,125.00
Rate for Payer: Kaiser Permanente Medicaid $486.76
Rate for Payer: MDX Hawaii PPO $2,425.00
Rate for Payer: Ohana Health Plan Medicaid $486.76
Rate for Payer: UnitedHealthcare Medicaid $486.76
Rate for Payer: University Health Alliance Commercial $2,320.00
Service Code HCPCS 76857
Hospital Charge Code 4027685703
Hospital Revenue Code 402
Min. Negotiated Rate $44.29
Max. Negotiated Rate $513.13
Rate for Payer: AlohaCare Medicaid $123.50
Rate for Payer: AlohaCare Medicare $123.50
Rate for Payer: Cash Price $317.40
Rate for Payer: Cash Price $317.40
Rate for Payer: Devoted Health Medicare $135.85
Rate for Payer: Hawaii Medical Service Association ABD $44.29
Rate for Payer: Hawaii Medical Service Association Commercial $154.38
Rate for Payer: Hawaii Medical Service Association Medicare $123.50
Rate for Payer: Hawaii Medical Service Association Non-ABD $69.53
Rate for Payer: Hawaii Western Management Group Commercial $123.50
Rate for Payer: Health Management Network Commercial $449.65
Rate for Payer: Humana Medicare $123.50
Rate for Payer: Kaiser Permanente Commercial $333.27
Rate for Payer: Kaiser Permanente Medicaid $269.79
Rate for Payer: Kaiser Permanente Medicare $123.50
Rate for Payer: MDX Hawaii PPO $513.13
Rate for Payer: Ohana Health Plan Medicaid $135.85
Rate for Payer: Ohana Health Plan Medicare $123.50
Rate for Payer: UnitedHealthcare Medicaid $44.29
Rate for Payer: UnitedHealthcare Medicare $123.50
Rate for Payer: University Health Alliance Commercial $161.45
Service Code HCPCS 76857
Hospital Charge Code 4027685703
Hospital Revenue Code 402
Min. Negotiated Rate $449.65
Max. Negotiated Rate $513.13
Rate for Payer: Cash Price $317.40
Rate for Payer: Health Management Network Commercial $449.65
Rate for Payer: MDX Hawaii PPO $513.13
Service Code HCPCS 76857
Hospital Charge Code 4027685701
Hospital Revenue Code 402
Min. Negotiated Rate $44.29
Max. Negotiated Rate $513.13
Rate for Payer: AlohaCare Medicaid $123.50
Rate for Payer: AlohaCare Medicare $123.50
Rate for Payer: Cash Price $317.40
Rate for Payer: Cash Price $317.40
Rate for Payer: Devoted Health Medicare $135.85
Rate for Payer: Hawaii Medical Service Association ABD $44.29
Rate for Payer: Hawaii Medical Service Association Commercial $154.38
Rate for Payer: Hawaii Medical Service Association Medicare $123.50
Rate for Payer: Hawaii Medical Service Association Non-ABD $69.53
Rate for Payer: Hawaii Western Management Group Commercial $123.50
Rate for Payer: Health Management Network Commercial $449.65
Rate for Payer: Humana Medicare $123.50
Rate for Payer: Kaiser Permanente Commercial $333.27
Rate for Payer: Kaiser Permanente Medicaid $269.79
Rate for Payer: Kaiser Permanente Medicare $123.50
Rate for Payer: MDX Hawaii PPO $513.13
Rate for Payer: Ohana Health Plan Medicaid $135.85
Rate for Payer: Ohana Health Plan Medicare $123.50
Rate for Payer: UnitedHealthcare Medicaid $44.29
Rate for Payer: UnitedHealthcare Medicare $123.50
Rate for Payer: University Health Alliance Commercial $161.45
Service Code HCPCS 76857
Hospital Charge Code 4027685701
Hospital Revenue Code 402
Min. Negotiated Rate $449.65
Max. Negotiated Rate $513.13
Rate for Payer: Cash Price $317.40
Rate for Payer: Health Management Network Commercial $449.65
Rate for Payer: MDX Hawaii PPO $513.13
Service Code HCPCS 77370
Hospital Charge Code 3337737001
Hospital Revenue Code 333
Min. Negotiated Rate $448.80
Max. Negotiated Rate $512.16
Rate for Payer: Cash Price $316.80
Rate for Payer: Health Management Network Commercial $448.80
Rate for Payer: MDX Hawaii PPO $512.16
Service Code HCPCS 77370
Hospital Charge Code 3337737001
Hospital Revenue Code 333
Min. Negotiated Rate $123.30
Max. Negotiated Rate $512.16
Rate for Payer: AlohaCare Medicaid $158.78
Rate for Payer: AlohaCare Medicare $158.78
Rate for Payer: Cash Price $316.80
Rate for Payer: Cash Price $316.80
Rate for Payer: Devoted Health Medicare $174.66
Rate for Payer: Hawaii Medical Service Association ABD $123.30
Rate for Payer: Hawaii Medical Service Association Commercial $198.47
Rate for Payer: Hawaii Medical Service Association Medicare $158.78
Rate for Payer: Hawaii Medical Service Association Non-ABD $129.47
Rate for Payer: Hawaii Western Management Group Commercial $158.78
Rate for Payer: Health Management Network Commercial $448.80
Rate for Payer: Humana Medicare $158.78
Rate for Payer: Kaiser Permanente Commercial $332.64
Rate for Payer: Kaiser Permanente Medicaid $269.28
Rate for Payer: Kaiser Permanente Medicare $158.78
Rate for Payer: MDX Hawaii PPO $512.16
Rate for Payer: Ohana Health Plan Medicaid $174.66
Rate for Payer: Ohana Health Plan Medicare $158.78
Rate for Payer: UnitedHealthcare Medicaid $123.30
Rate for Payer: UnitedHealthcare Medicare $158.78
Rate for Payer: University Health Alliance Commercial $271.17
Service Code HCPCS 77331
Hospital Charge Code 3337733101
Hospital Revenue Code 333
Min. Negotiated Rate $18.05
Max. Negotiated Rate $512.16
Rate for Payer: AlohaCare Medicaid $158.78
Rate for Payer: AlohaCare Medicare $158.78
Rate for Payer: Cash Price $316.80
Rate for Payer: Cash Price $316.80
Rate for Payer: Devoted Health Medicare $174.66
Rate for Payer: Hawaii Medical Service Association ABD $18.05
Rate for Payer: Hawaii Medical Service Association Commercial $198.47
Rate for Payer: Hawaii Medical Service Association Medicare $158.78
Rate for Payer: Hawaii Medical Service Association Non-ABD $18.95
Rate for Payer: Hawaii Western Management Group Commercial $158.78
Rate for Payer: Health Management Network Commercial $448.80
Rate for Payer: Humana Medicare $158.78
Rate for Payer: Kaiser Permanente Commercial $332.64
Rate for Payer: Kaiser Permanente Medicaid $269.28
Rate for Payer: Kaiser Permanente Medicare $158.78
Rate for Payer: MDX Hawaii PPO $512.16
Rate for Payer: Ohana Health Plan Medicaid $174.66
Rate for Payer: Ohana Health Plan Medicare $158.78
Rate for Payer: UnitedHealthcare Medicaid $18.05
Rate for Payer: UnitedHealthcare Medicare $158.78
Rate for Payer: University Health Alliance Commercial $120.68
Service Code HCPCS 77331
Hospital Charge Code 3337733101
Hospital Revenue Code 333
Min. Negotiated Rate $448.80
Max. Negotiated Rate $512.16
Rate for Payer: Cash Price $316.80
Rate for Payer: Health Management Network Commercial $448.80
Rate for Payer: MDX Hawaii PPO $512.16
Service Code HCPCS 88313
Hospital Charge Code 3108831302
Hospital Revenue Code 310
Min. Negotiated Rate $37.18
Max. Negotiated Rate $1,238.69
Rate for Payer: AlohaCare Medicaid $157.18
Rate for Payer: AlohaCare Medicare $157.18
Rate for Payer: Cash Price $766.20
Rate for Payer: Cash Price $766.20
Rate for Payer: Devoted Health Medicare $172.90
Rate for Payer: Hawaii Medical Service Association ABD $37.43
Rate for Payer: Hawaii Medical Service Association Commercial $196.47
Rate for Payer: Hawaii Medical Service Association Medicare $157.18
Rate for Payer: Hawaii Medical Service Association Non-ABD $37.18
Rate for Payer: Hawaii Western Management Group Commercial $157.18
Rate for Payer: Health Management Network Commercial $1,085.45
Rate for Payer: Humana Medicare $157.18
Rate for Payer: Kaiser Permanente Commercial $804.51
Rate for Payer: Kaiser Permanente Medicaid $651.27
Rate for Payer: Kaiser Permanente Medicare $157.18
Rate for Payer: MDX Hawaii PPO $1,238.69
Rate for Payer: Ohana Health Plan Medicaid $172.90
Rate for Payer: Ohana Health Plan Medicare $157.18
Rate for Payer: UnitedHealthcare Medicaid $37.43
Rate for Payer: UnitedHealthcare Medicare $157.18
Rate for Payer: University Health Alliance Commercial $144.02
Service Code HCPCS 88313
Hospital Charge Code 3108831302
Hospital Revenue Code 310
Min. Negotiated Rate $1,085.45
Max. Negotiated Rate $1,238.69
Rate for Payer: Cash Price $766.20
Rate for Payer: Health Management Network Commercial $1,085.45
Rate for Payer: MDX Hawaii PPO $1,238.69
Service Code HCPCS 88312
Hospital Charge Code 3108831202
Hospital Revenue Code 310
Min. Negotiated Rate $449.65
Max. Negotiated Rate $513.13
Rate for Payer: Cash Price $317.40
Rate for Payer: Health Management Network Commercial $449.65
Rate for Payer: MDX Hawaii PPO $513.13
Service Code HCPCS 88312
Hospital Charge Code 3108831202
Hospital Revenue Code 310
Min. Negotiated Rate $32.77
Max. Negotiated Rate $513.13
Rate for Payer: AlohaCare Medicaid $61.56
Rate for Payer: AlohaCare Medicare $61.56
Rate for Payer: Cash Price $317.40
Rate for Payer: Cash Price $317.40
Rate for Payer: Devoted Health Medicare $67.72
Rate for Payer: Hawaii Medical Service Association ABD $32.77
Rate for Payer: Hawaii Medical Service Association Commercial $76.95
Rate for Payer: Hawaii Medical Service Association Medicare $61.56
Rate for Payer: Hawaii Medical Service Association Non-ABD $41.86
Rate for Payer: Hawaii Western Management Group Commercial $61.56
Rate for Payer: Health Management Network Commercial $449.65
Rate for Payer: Humana Medicare $61.56
Rate for Payer: Kaiser Permanente Commercial $333.27
Rate for Payer: Kaiser Permanente Medicaid $269.79
Rate for Payer: Kaiser Permanente Medicare $61.56
Rate for Payer: MDX Hawaii PPO $513.13
Rate for Payer: Ohana Health Plan Medicaid $67.72
Rate for Payer: Ohana Health Plan Medicare $61.56
Rate for Payer: UnitedHealthcare Medicaid $32.77
Rate for Payer: UnitedHealthcare Medicare $61.56
Rate for Payer: University Health Alliance Commercial $187.61
Service Code HCPCS 77470
Hospital Charge Code 3337747001
Hospital Revenue Code 333
Min. Negotiated Rate $393.73
Max. Negotiated Rate $2,232.94
Rate for Payer: AlohaCare Medicaid $652.74
Rate for Payer: AlohaCare Medicare $652.74
Rate for Payer: Cash Price $1,381.20
Rate for Payer: Cash Price $1,381.20
Rate for Payer: Devoted Health Medicare $718.01
Rate for Payer: Hawaii Medical Service Association ABD $393.73
Rate for Payer: Hawaii Medical Service Association Commercial $815.92
Rate for Payer: Hawaii Medical Service Association Medicare $652.74
Rate for Payer: Hawaii Medical Service Association Non-ABD $404.84
Rate for Payer: Hawaii Western Management Group Commercial $652.74
Rate for Payer: Health Management Network Commercial $1,956.70
Rate for Payer: Humana Medicare $652.74
Rate for Payer: Kaiser Permanente Commercial $1,450.26
Rate for Payer: Kaiser Permanente Medicaid $1,174.02
Rate for Payer: Kaiser Permanente Medicare $652.74
Rate for Payer: MDX Hawaii PPO $2,232.94
Rate for Payer: Ohana Health Plan Medicaid $718.01
Rate for Payer: Ohana Health Plan Medicare $652.74
Rate for Payer: UnitedHealthcare Medicaid $393.73
Rate for Payer: UnitedHealthcare Medicare $652.74
Rate for Payer: University Health Alliance Commercial $716.76
Service Code HCPCS 77470
Hospital Charge Code 3337747001
Hospital Revenue Code 333
Min. Negotiated Rate $1,956.70
Max. Negotiated Rate $2,232.94
Rate for Payer: Cash Price $1,381.20
Rate for Payer: Health Management Network Commercial $1,956.70
Rate for Payer: MDX Hawaii PPO $2,232.94
Service Code HCPCS 84311
Hospital Charge Code 3018431101
Hospital Revenue Code 301
Min. Negotiated Rate $57.80
Max. Negotiated Rate $65.96
Rate for Payer: Cash Price $40.80
Rate for Payer: Health Management Network Commercial $57.80
Rate for Payer: MDX Hawaii PPO $65.96
Service Code HCPCS 84311
Hospital Charge Code 3018431101
Hospital Revenue Code 301
Min. Negotiated Rate $8.10
Max. Negotiated Rate $65.96
Rate for Payer: AlohaCare Medicaid $8.10
Rate for Payer: AlohaCare Medicare $8.10
Rate for Payer: Cash Price $40.80
Rate for Payer: Cash Price $40.80
Rate for Payer: Devoted Health Medicare $8.91
Rate for Payer: Hawaii Medical Service Association ABD $9.66
Rate for Payer: Hawaii Medical Service Association Commercial $10.12
Rate for Payer: Hawaii Medical Service Association Medicare $8.10
Rate for Payer: Hawaii Medical Service Association Non-ABD $10.14
Rate for Payer: Hawaii Western Management Group Commercial $8.10
Rate for Payer: Health Management Network Commercial $57.80
Rate for Payer: Humana Medicare $8.10
Rate for Payer: Kaiser Permanente Commercial $42.84
Rate for Payer: Kaiser Permanente Medicaid $34.68
Rate for Payer: Kaiser Permanente Medicare $8.10
Rate for Payer: MDX Hawaii PPO $65.96
Rate for Payer: Ohana Health Plan Medicaid $8.91
Rate for Payer: Ohana Health Plan Medicare $8.10
Rate for Payer: UnitedHealthcare Medicaid $9.66
Rate for Payer: UnitedHealthcare Medicare $8.10
Rate for Payer: University Health Alliance Commercial $18.07
Service Code HCPCS 84311
Hospital Charge Code 3018431102
Hospital Revenue Code 301
Min. Negotiated Rate $57.80
Max. Negotiated Rate $65.96
Rate for Payer: Cash Price $40.80
Rate for Payer: Health Management Network Commercial $57.80
Rate for Payer: MDX Hawaii PPO $65.96