|
PR BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$425.51
|
|
|
Service Code
|
HCPCS 20220
|
| Min. Negotiated Rate |
$76.43 |
| Max. Negotiated Rate |
$361.68 |
| Rate for Payer: AlohaCare Medicaid |
$86.98
|
| Rate for Payer: AlohaCare Medicare |
$76.43
|
| Rate for Payer: Cash Price |
$255.31
|
| Rate for Payer: Cash Price |
$255.31
|
| Rate for Payer: Devoted Health Medicare |
$84.07
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$86.98
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$143.37
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$76.43
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$86.98
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$89.18
|
| Rate for Payer: Health Management Network Commercial |
$361.68
|
| Rate for Payer: Kaiser Permanente Commercial |
$91.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$91.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$91.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$86.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$76.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$86.98
|
| Rate for Payer: UnitedHealthcare Medicare |
$76.43
|
| Rate for Payer: University Health Alliance Commercial |
$115.07
|
|
|
PR BIOPSY BREAST OPEN INCISIONAL
|
Professional
|
Both
|
$646.17
|
|
|
Service Code
|
HCPCS 19101
|
| Min. Negotiated Rate |
$216.95 |
| Max. Negotiated Rate |
$549.24 |
| Rate for Payer: AlohaCare Medicaid |
$226.30
|
| Rate for Payer: AlohaCare Medicare |
$216.95
|
| Rate for Payer: Cash Price |
$387.70
|
| Rate for Payer: Cash Price |
$387.70
|
| Rate for Payer: Devoted Health Medicare |
$238.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$226.30
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$381.99
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$216.95
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$226.30
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$268.58
|
| Rate for Payer: Health Management Network Commercial |
$549.24
|
| Rate for Payer: Kaiser Permanente Commercial |
$260.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$260.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$260.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$226.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$216.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$226.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$216.95
|
| Rate for Payer: University Health Alliance Commercial |
$262.95
|
|
|
PR BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX
|
Professional
|
Both
|
$285.51
|
|
|
Service Code
|
HCPCS 57500
|
| Min. Negotiated Rate |
$67.34 |
| Max. Negotiated Rate |
$242.68 |
| Rate for Payer: AlohaCare Medicaid |
$76.57
|
| Rate for Payer: AlohaCare Medicare |
$68.58
|
| Rate for Payer: Cash Price |
$171.31
|
| Rate for Payer: Cash Price |
$171.31
|
| Rate for Payer: Devoted Health Medicare |
$75.44
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$76.57
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$126.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$68.58
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$76.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$67.34
|
| Rate for Payer: Health Management Network Commercial |
$242.68
|
| Rate for Payer: Kaiser Permanente Commercial |
$82.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$82.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$82.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$76.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$68.58
|
| Rate for Payer: UnitedHealthcare Medicaid |
$76.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$68.58
|
| Rate for Payer: University Health Alliance Commercial |
$94.97
|
|
|
PR BIOPSY EXTERNAL EAR
|
Professional
|
Both
|
$175.49
|
|
|
Service Code
|
HCPCS 69100
|
| Min. Negotiated Rate |
$37.61 |
| Max. Negotiated Rate |
$149.17 |
| Rate for Payer: AlohaCare Medicaid |
$47.00
|
| Rate for Payer: AlohaCare Medicare |
$37.61
|
| Rate for Payer: Cash Price |
$105.29
|
| Rate for Payer: Cash Price |
$105.29
|
| Rate for Payer: Devoted Health Medicare |
$41.37
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$47.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$78.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$37.61
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$47.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$62.66
|
| Rate for Payer: Health Management Network Commercial |
$149.17
|
| Rate for Payer: Kaiser Permanente Commercial |
$45.13
|
| Rate for Payer: Kaiser Permanente Medicaid |
$45.13
|
| Rate for Payer: Kaiser Permanente Medicare |
$45.13
|
| Rate for Payer: Ohana Health Plan Medicaid |
$47.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$37.61
|
| Rate for Payer: UnitedHealthcare Medicaid |
$47.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$37.61
|
| Rate for Payer: University Health Alliance Commercial |
$64.64
|
|
|
PR BIOPSY FLOOR MOUTH
|
Professional
|
Both
|
$324.82
|
|
|
Service Code
|
HCPCS 41108
|
| Min. Negotiated Rate |
$63.70 |
| Max. Negotiated Rate |
$276.10 |
| Rate for Payer: AlohaCare Medicaid |
$97.17
|
| Rate for Payer: AlohaCare Medicare |
$88.01
|
| Rate for Payer: Cash Price |
$194.89
|
| Rate for Payer: Cash Price |
$194.89
|
| Rate for Payer: Devoted Health Medicare |
$96.81
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$97.17
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$157.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$88.01
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$97.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$63.70
|
| Rate for Payer: Health Management Network Commercial |
$276.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$105.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$105.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$105.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$97.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$88.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$97.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$88.01
|
| Rate for Payer: University Health Alliance Commercial |
$124.32
|
|
|
PR BIOPSY INTRANASAL
|
Professional
|
Both
|
$269.52
|
|
|
Service Code
|
HCPCS 30100
|
| Min. Negotiated Rate |
$50.96 |
| Max. Negotiated Rate |
$229.09 |
| Rate for Payer: AlohaCare Medicaid |
$71.58
|
| Rate for Payer: AlohaCare Medicare |
$62.86
|
| Rate for Payer: Cash Price |
$161.71
|
| Rate for Payer: Cash Price |
$161.71
|
| Rate for Payer: Devoted Health Medicare |
$69.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$71.58
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$116.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$62.86
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$71.58
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$50.96
|
| Rate for Payer: Health Management Network Commercial |
$229.09
|
| Rate for Payer: Kaiser Permanente Commercial |
$75.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$75.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$75.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$71.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$62.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$71.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$62.86
|
| Rate for Payer: University Health Alliance Commercial |
$89.28
|
|
|
PR BIOPSY LIVER NEEDLE PERCUTANEOUS
|
Professional
|
Both
|
$554.43
|
|
|
Service Code
|
HCPCS 47000
|
| Min. Negotiated Rate |
$76.43 |
| Max. Negotiated Rate |
$471.27 |
| Rate for Payer: AlohaCare Medicaid |
$87.17
|
| Rate for Payer: AlohaCare Medicare |
$76.43
|
| Rate for Payer: Cash Price |
$332.66
|
| Rate for Payer: Cash Price |
$332.66
|
| Rate for Payer: Devoted Health Medicare |
$84.07
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$87.17
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$146.74
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$76.43
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$87.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$184.86
|
| Rate for Payer: Health Management Network Commercial |
$471.27
|
| Rate for Payer: Kaiser Permanente Commercial |
$91.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$91.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$91.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$87.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$76.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$87.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$76.43
|
| Rate for Payer: University Health Alliance Commercial |
$115.57
|
|
|
PR BIOPSY LIVER WEDGE
|
Professional
|
Both
|
$1,457.00
|
|
|
Service Code
|
HCPCS 47100
|
| Min. Negotiated Rate |
$324.74 |
| Max. Negotiated Rate |
$1,238.45 |
| Rate for Payer: AlohaCare Medicaid |
$852.08
|
| Rate for Payer: AlohaCare Medicare |
$809.38
|
| Rate for Payer: Cash Price |
$874.20
|
| Rate for Payer: Cash Price |
$874.20
|
| Rate for Payer: Devoted Health Medicare |
$890.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$809.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$324.74
|
| Rate for Payer: Health Management Network Commercial |
$1,238.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$971.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$971.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$971.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$852.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$809.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$852.08
|
| Rate for Payer: UnitedHealthcare Medicare |
$809.38
|
|
|
PR BIOPSY MUSCLE DEEP
|
Professional
|
Both
|
$634.36
|
|
|
Service Code
|
HCPCS 20205
|
| Min. Negotiated Rate |
$141.18 |
| Max. Negotiated Rate |
$539.21 |
| Rate for Payer: AlohaCare Medicaid |
$153.66
|
| Rate for Payer: AlohaCare Medicare |
$144.50
|
| Rate for Payer: Cash Price |
$380.62
|
| Rate for Payer: Cash Price |
$380.62
|
| Rate for Payer: Devoted Health Medicare |
$158.95
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$153.66
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$256.58
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$144.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$153.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$141.18
|
| Rate for Payer: Health Management Network Commercial |
$539.21
|
| Rate for Payer: Kaiser Permanente Commercial |
$173.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$173.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$173.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$153.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$144.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$153.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$144.50
|
| Rate for Payer: University Health Alliance Commercial |
$202.08
|
|
|
PR BIOPSY MUSCLE PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$406.02
|
|
|
Service Code
|
HCPCS 20206
|
| Min. Negotiated Rate |
$51.62 |
| Max. Negotiated Rate |
$345.12 |
| Rate for Payer: AlohaCare Medicaid |
$57.77
|
| Rate for Payer: AlohaCare Medicare |
$51.62
|
| Rate for Payer: Cash Price |
$243.61
|
| Rate for Payer: Cash Price |
$243.61
|
| Rate for Payer: Devoted Health Medicare |
$56.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$57.77
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$96.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$51.62
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$57.77
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.68
|
| Rate for Payer: Health Management Network Commercial |
$345.12
|
| Rate for Payer: Kaiser Permanente Commercial |
$61.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$61.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$61.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$57.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$51.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$57.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$51.62
|
| Rate for Payer: University Health Alliance Commercial |
$76.25
|
|
|
PR BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE
|
Professional
|
Both
|
$412.70
|
|
|
Service Code
|
HCPCS 42804
|
| Min. Negotiated Rate |
$102.96 |
| Max. Negotiated Rate |
$350.80 |
| Rate for Payer: AlohaCare Medicaid |
$132.93
|
| Rate for Payer: AlohaCare Medicare |
$119.24
|
| Rate for Payer: Cash Price |
$247.62
|
| Rate for Payer: Cash Price |
$247.62
|
| Rate for Payer: Devoted Health Medicare |
$131.16
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$132.93
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$208.94
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$119.24
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$132.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$102.96
|
| Rate for Payer: Health Management Network Commercial |
$350.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$143.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$143.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$143.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$132.93
|
| Rate for Payer: Ohana Health Plan Medicare |
$119.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$132.93
|
| Rate for Payer: UnitedHealthcare Medicare |
$119.24
|
| Rate for Payer: University Health Alliance Commercial |
$170.70
|
|
|
PR BIOPSY NERVE
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 64795
|
| Min. Negotiated Rate |
$157.56 |
| Max. Negotiated Rate |
$284.75 |
| Rate for Payer: AlohaCare Medicaid |
$192.17
|
| Rate for Payer: AlohaCare Medicare |
$182.10
|
| Rate for Payer: Cash Price |
$201.00
|
| Rate for Payer: Cash Price |
$201.00
|
| Rate for Payer: Devoted Health Medicare |
$200.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$182.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$157.56
|
| Rate for Payer: Health Management Network Commercial |
$284.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$218.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$218.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$218.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$192.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$182.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$192.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$182.10
|
|
|
PR BIOPSY OF LIP
|
Professional
|
Both
|
$225.80
|
|
|
Service Code
|
HCPCS 40490
|
| Min. Negotiated Rate |
$56.12 |
| Max. Negotiated Rate |
$191.93 |
| Rate for Payer: AlohaCare Medicaid |
$70.19
|
| Rate for Payer: AlohaCare Medicare |
$56.12
|
| Rate for Payer: Cash Price |
$135.48
|
| Rate for Payer: Cash Price |
$135.48
|
| Rate for Payer: Devoted Health Medicare |
$61.73
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$70.19
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$116.28
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$56.12
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$70.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.08
|
| Rate for Payer: Health Management Network Commercial |
$191.93
|
| Rate for Payer: Kaiser Permanente Commercial |
$67.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$67.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$67.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$70.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$56.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$70.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$56.12
|
| Rate for Payer: University Health Alliance Commercial |
$91.58
|
|
|
PR BIOPSY OROPHARYNX
|
Professional
|
Both
|
$300.28
|
|
|
Service Code
|
HCPCS 42800
|
| Min. Negotiated Rate |
$73.06 |
| Max. Negotiated Rate |
$255.24 |
| Rate for Payer: AlohaCare Medicaid |
$124.53
|
| Rate for Payer: AlohaCare Medicare |
$110.45
|
| Rate for Payer: Cash Price |
$180.17
|
| Rate for Payer: Cash Price |
$180.17
|
| Rate for Payer: Devoted Health Medicare |
$121.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$124.53
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$202.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$110.45
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$124.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$73.06
|
| Rate for Payer: Health Management Network Commercial |
$255.24
|
| Rate for Payer: Kaiser Permanente Commercial |
$132.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$132.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$132.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$124.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$110.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$124.53
|
| Rate for Payer: UnitedHealthcare Medicare |
$110.45
|
| Rate for Payer: University Health Alliance Commercial |
$159.27
|
|
|
PR BIOPSY PALATE UVULA
|
Professional
|
Both
|
$281.89
|
|
|
Service Code
|
HCPCS 42100
|
| Min. Negotiated Rate |
$91.26 |
| Max. Negotiated Rate |
$239.61 |
| Rate for Payer: AlohaCare Medicaid |
$117.10
|
| Rate for Payer: AlohaCare Medicare |
$106.01
|
| Rate for Payer: Cash Price |
$169.13
|
| Rate for Payer: Cash Price |
$169.13
|
| Rate for Payer: Devoted Health Medicare |
$116.61
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$117.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$191.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$106.01
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$117.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$91.26
|
| Rate for Payer: Health Management Network Commercial |
$239.61
|
| Rate for Payer: Kaiser Permanente Commercial |
$127.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$127.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$127.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$117.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$106.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$117.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$106.01
|
| Rate for Payer: University Health Alliance Commercial |
$150.61
|
|
|
PR BIOPSY PANCREA PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$927.62
|
|
|
Service Code
|
HCPCS 48102
|
| Min. Negotiated Rate |
$201.57 |
| Max. Negotiated Rate |
$788.48 |
| Rate for Payer: AlohaCare Medicaid |
$231.78
|
| Rate for Payer: AlohaCare Medicare |
$201.57
|
| Rate for Payer: Cash Price |
$556.57
|
| Rate for Payer: Cash Price |
$556.57
|
| Rate for Payer: Devoted Health Medicare |
$221.73
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$231.78
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$391.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$201.57
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$231.78
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$228.80
|
| Rate for Payer: Health Management Network Commercial |
$788.48
|
| Rate for Payer: Kaiser Permanente Commercial |
$241.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$241.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$241.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$231.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$201.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$231.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$201.57
|
| Rate for Payer: University Health Alliance Commercial |
$308.20
|
|
|
PR BIOPSY PENIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$382.74
|
|
|
Service Code
|
HCPCS 54100
|
| Min. Negotiated Rate |
$71.50 |
| Max. Negotiated Rate |
$325.33 |
| Rate for Payer: AlohaCare Medicaid |
$125.30
|
| Rate for Payer: AlohaCare Medicare |
$105.91
|
| Rate for Payer: Cash Price |
$229.64
|
| Rate for Payer: Cash Price |
$229.64
|
| Rate for Payer: Devoted Health Medicare |
$116.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$125.30
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$204.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$105.91
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$125.30
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.50
|
| Rate for Payer: Health Management Network Commercial |
$325.33
|
| Rate for Payer: Kaiser Permanente Commercial |
$127.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$127.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$127.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$125.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$105.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$125.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$105.91
|
| Rate for Payer: University Health Alliance Commercial |
$161.10
|
|
|
PR BIOPSY PLEURA PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$311.32
|
|
|
Service Code
|
HCPCS 32400
|
| Min. Negotiated Rate |
$71.18 |
| Max. Negotiated Rate |
$264.62 |
| Rate for Payer: AlohaCare Medicaid |
$81.84
|
| Rate for Payer: AlohaCare Medicare |
$71.18
|
| Rate for Payer: Cash Price |
$186.79
|
| Rate for Payer: Cash Price |
$186.79
|
| Rate for Payer: Devoted Health Medicare |
$78.30
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$81.84
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$140.67
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$71.18
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$81.84
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.16
|
| Rate for Payer: Health Management Network Commercial |
$264.62
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.42
|
| Rate for Payer: Kaiser Permanente Medicaid |
$85.42
|
| Rate for Payer: Kaiser Permanente Medicare |
$85.42
|
| Rate for Payer: Ohana Health Plan Medicaid |
$81.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$71.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$81.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$71.18
|
| Rate for Payer: University Health Alliance Commercial |
$110.79
|
|
|
PR BIOPSY PROSTATE INCISIONAL ANY APPROACH
|
Professional
|
Both
|
$442.00
|
|
|
Service Code
|
HCPCS 55705
|
| Min. Negotiated Rate |
$100.66 |
| Max. Negotiated Rate |
$375.70 |
| Rate for Payer: AlohaCare Medicaid |
$269.09
|
| Rate for Payer: AlohaCare Medicare |
$100.66
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Devoted Health Medicare |
$110.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$100.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$233.48
|
| Rate for Payer: Health Management Network Commercial |
$375.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$120.79
|
| Rate for Payer: Kaiser Permanente Medicaid |
$120.79
|
| Rate for Payer: Kaiser Permanente Medicare |
$120.79
|
| Rate for Payer: Ohana Health Plan Medicaid |
$269.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$100.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$269.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$100.66
|
|
|
PR BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED
|
Professional
|
Both
|
$649.00
|
|
|
Service Code
|
HCPCS 55707
|
| Min. Negotiated Rate |
$136.39 |
| Max. Negotiated Rate |
$551.65 |
| Rate for Payer: AlohaCare Medicare |
$136.39
|
| Rate for Payer: Cash Price |
$389.40
|
| Rate for Payer: Cash Price |
$389.40
|
| Rate for Payer: Devoted Health Medicare |
$150.03
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$136.39
|
| Rate for Payer: Health Management Network Commercial |
$551.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$163.67
|
| Rate for Payer: Kaiser Permanente Medicaid |
$163.67
|
| Rate for Payer: Kaiser Permanente Medicare |
$163.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$136.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$136.39
|
|
|
PR BIOPSY SALIVARY GLAND NEEDLE
|
Professional
|
Both
|
$180.06
|
|
|
Service Code
|
HCPCS 42400
|
| Min. Negotiated Rate |
$49.34 |
| Max. Negotiated Rate |
$153.05 |
| Rate for Payer: AlohaCare Medicaid |
$55.00
|
| Rate for Payer: AlohaCare Medicare |
$49.34
|
| Rate for Payer: Cash Price |
$108.04
|
| Rate for Payer: Cash Price |
$108.04
|
| Rate for Payer: Devoted Health Medicare |
$54.27
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$55.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$90.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$49.34
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$55.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$76.96
|
| Rate for Payer: Health Management Network Commercial |
$153.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$59.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$59.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$59.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$55.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$49.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$55.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$49.34
|
| Rate for Payer: University Health Alliance Commercial |
$68.58
|
|
|
PR BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL
|
Professional
|
Both
|
$498.75
|
|
|
Service Code
|
HCPCS 21920
|
| Min. Negotiated Rate |
$89.70 |
| Max. Negotiated Rate |
$423.94 |
| Rate for Payer: AlohaCare Medicaid |
$161.69
|
| Rate for Payer: AlohaCare Medicare |
$146.76
|
| Rate for Payer: Cash Price |
$299.25
|
| Rate for Payer: Cash Price |
$299.25
|
| Rate for Payer: Devoted Health Medicare |
$161.44
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$161.69
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$269.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$146.76
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$161.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$89.70
|
| Rate for Payer: Health Management Network Commercial |
$423.94
|
| Rate for Payer: Kaiser Permanente Commercial |
$176.11
|
| Rate for Payer: Kaiser Permanente Medicaid |
$176.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$176.11
|
| Rate for Payer: Ohana Health Plan Medicaid |
$161.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$146.76
|
| Rate for Payer: UnitedHealthcare Medicaid |
$161.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$146.76
|
| Rate for Payer: University Health Alliance Commercial |
$212.28
|
|
|
PR BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP
|
Professional
|
Both
|
$686.00
|
|
|
Service Code
|
HCPCS 25066
|
| Min. Negotiated Rate |
$190.84 |
| Max. Negotiated Rate |
$583.10 |
| Rate for Payer: AlohaCare Medicaid |
$394.20
|
| Rate for Payer: AlohaCare Medicare |
$373.17
|
| Rate for Payer: Cash Price |
$411.60
|
| Rate for Payer: Cash Price |
$411.60
|
| Rate for Payer: Devoted Health Medicare |
$410.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$373.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$190.84
|
| Rate for Payer: Health Management Network Commercial |
$583.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$447.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$447.80
|
| Rate for Payer: Kaiser Permanente Medicare |
$447.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$394.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$373.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$394.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$373.17
|
|
|
PR BIOPSY SOFT TISSUE NECK/THORAX
|
Professional
|
Both
|
$515.00
|
|
|
Service Code
|
HCPCS 21550
|
| Min. Negotiated Rate |
$90.74 |
| Max. Negotiated Rate |
$437.75 |
| Rate for Payer: AlohaCare Medicaid |
$163.23
|
| Rate for Payer: AlohaCare Medicare |
$148.28
|
| Rate for Payer: Cash Price |
$309.00
|
| Rate for Payer: Cash Price |
$309.00
|
| Rate for Payer: Devoted Health Medicare |
$163.11
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$163.23
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$270.16
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$148.28
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$163.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$90.74
|
| Rate for Payer: Health Management Network Commercial |
$437.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$177.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$177.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$177.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$163.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$148.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$163.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$148.28
|
| Rate for Payer: University Health Alliance Commercial |
$212.78
|
|
|
PR BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP
|
Professional
|
Both
|
$744.00
|
|
|
Service Code
|
HCPCS 27324
|
| Min. Negotiated Rate |
$190.84 |
| Max. Negotiated Rate |
$632.40 |
| Rate for Payer: AlohaCare Medicaid |
$432.30
|
| Rate for Payer: AlohaCare Medicare |
$414.09
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Devoted Health Medicare |
$455.50
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$414.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$190.84
|
| Rate for Payer: Health Management Network Commercial |
$632.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$496.91
|
| Rate for Payer: Kaiser Permanente Medicaid |
$496.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$496.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$432.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$414.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$432.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$414.09
|
|
