|
PR CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ
|
Professional
|
Both
|
$1,078.12
|
|
|
Service Code
|
HCPCS 24505
|
| Min. Negotiated Rate |
$286.00 |
| Max. Negotiated Rate |
$916.40 |
| Rate for Payer: AlohaCare Medicaid |
$487.76
|
| Rate for Payer: AlohaCare Medicare |
$492.26
|
| Rate for Payer: Cash Price |
$646.87
|
| Rate for Payer: Cash Price |
$646.87
|
| Rate for Payer: Devoted Health Medicare |
$541.49
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$487.76
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$492.26
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$487.76
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$286.00
|
| Rate for Payer: Health Management Network Commercial |
$916.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$590.71
|
| Rate for Payer: Kaiser Permanente Medicaid |
$590.71
|
| Rate for Payer: Kaiser Permanente Medicare |
$590.71
|
| Rate for Payer: Ohana Health Plan Medicaid |
$487.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$492.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$487.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$492.26
|
| Rate for Payer: University Health Alliance Commercial |
$628.56
|
|
|
PR CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ
|
Professional
|
Both
|
$857.00
|
|
|
Service Code
|
HCPCS 27238
|
| Min. Negotiated Rate |
$318.76 |
| Max. Negotiated Rate |
$728.45 |
| Rate for Payer: AlohaCare Medicaid |
$498.57
|
| Rate for Payer: AlohaCare Medicare |
$472.06
|
| Rate for Payer: Cash Price |
$514.20
|
| Rate for Payer: Cash Price |
$514.20
|
| Rate for Payer: Devoted Health Medicare |
$519.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$472.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$318.76
|
| Rate for Payer: Health Management Network Commercial |
$728.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$566.47
|
| Rate for Payer: Kaiser Permanente Medicaid |
$566.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$566.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$498.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$472.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$498.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$472.06
|
|
|
PR CLTX IPHAL JT DISLC W/MANJ W/O ANES
|
Professional
|
Both
|
$672.66
|
|
|
Service Code
|
HCPCS 26770
|
| Min. Negotiated Rate |
$142.74 |
| Max. Negotiated Rate |
$571.76 |
| Rate for Payer: AlohaCare Medicaid |
$287.78
|
| Rate for Payer: AlohaCare Medicare |
$322.86
|
| Rate for Payer: Cash Price |
$403.60
|
| Rate for Payer: Cash Price |
$403.60
|
| Rate for Payer: Devoted Health Medicare |
$355.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$287.78
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$322.86
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$287.78
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$142.74
|
| Rate for Payer: Health Management Network Commercial |
$571.76
|
| Rate for Payer: Kaiser Permanente Commercial |
$387.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$387.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$387.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$287.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$322.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$287.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$322.86
|
| Rate for Payer: University Health Alliance Commercial |
$361.87
|
|
|
PR CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION
|
Professional
|
Both
|
$705.36
|
|
|
Service Code
|
HCPCS 27760
|
| Min. Negotiated Rate |
$259.22 |
| Max. Negotiated Rate |
$599.56 |
| Rate for Payer: AlohaCare Medicaid |
$340.86
|
| Rate for Payer: AlohaCare Medicare |
$338.12
|
| Rate for Payer: Cash Price |
$423.22
|
| Rate for Payer: Cash Price |
$423.22
|
| Rate for Payer: Devoted Health Medicare |
$371.93
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$340.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$338.12
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$340.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$259.22
|
| Rate for Payer: Health Management Network Commercial |
$599.56
|
| Rate for Payer: Kaiser Permanente Commercial |
$405.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$405.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$405.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$340.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$338.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$338.12
|
| Rate for Payer: University Health Alliance Commercial |
$433.68
|
|
|
PR CLTX METACARPAL FX W/MANIPULATION EACH BONE
|
Professional
|
Both
|
$706.14
|
|
|
Service Code
|
HCPCS 26605
|
| Min. Negotiated Rate |
$238.42 |
| Max. Negotiated Rate |
$600.22 |
| Rate for Payer: AlohaCare Medicaid |
$329.51
|
| Rate for Payer: AlohaCare Medicare |
$329.84
|
| Rate for Payer: Cash Price |
$423.68
|
| Rate for Payer: Cash Price |
$423.68
|
| Rate for Payer: Devoted Health Medicare |
$362.82
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$329.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$329.84
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$329.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$238.42
|
| Rate for Payer: Health Management Network Commercial |
$600.22
|
| Rate for Payer: Kaiser Permanente Commercial |
$395.81
|
| Rate for Payer: Kaiser Permanente Medicaid |
$395.81
|
| Rate for Payer: Kaiser Permanente Medicare |
$395.81
|
| Rate for Payer: Ohana Health Plan Medicaid |
$329.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$329.84
|
| Rate for Payer: UnitedHealthcare Medicaid |
$329.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$329.84
|
| Rate for Payer: University Health Alliance Commercial |
$421.06
|
|
|
PR CLTX METACARPAL FX W/O MANIPULATION EACH BONE
|
Professional
|
Both
|
$644.23
|
|
|
Service Code
|
HCPCS 26600
|
| Min. Negotiated Rate |
$166.92 |
| Max. Negotiated Rate |
$547.60 |
| Rate for Payer: AlohaCare Medicaid |
$322.31
|
| Rate for Payer: AlohaCare Medicare |
$321.04
|
| Rate for Payer: Cash Price |
$386.54
|
| Rate for Payer: Cash Price |
$386.54
|
| Rate for Payer: Devoted Health Medicare |
$353.14
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$322.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$321.04
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$322.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$166.92
|
| Rate for Payer: Health Management Network Commercial |
$547.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$385.25
|
| Rate for Payer: Kaiser Permanente Medicaid |
$385.25
|
| Rate for Payer: Kaiser Permanente Medicare |
$385.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$322.31
|
| Rate for Payer: Ohana Health Plan Medicare |
$321.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$322.31
|
| Rate for Payer: UnitedHealthcare Medicare |
$321.04
|
| Rate for Payer: University Health Alliance Commercial |
$407.54
|
|
|
PR CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES
|
Professional
|
Both
|
$908.42
|
|
|
Service Code
|
HCPCS 26705
|
| Min. Negotiated Rate |
$209.04 |
| Max. Negotiated Rate |
$772.16 |
| Rate for Payer: AlohaCare Medicaid |
$432.82
|
| Rate for Payer: AlohaCare Medicare |
$414.29
|
| Rate for Payer: Cash Price |
$545.05
|
| Rate for Payer: Cash Price |
$545.05
|
| Rate for Payer: Devoted Health Medicare |
$455.72
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$432.82
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$414.29
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$432.82
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$209.04
|
| Rate for Payer: Health Management Network Commercial |
$772.16
|
| Rate for Payer: Kaiser Permanente Commercial |
$497.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$497.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$497.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$432.82
|
| Rate for Payer: Ohana Health Plan Medicare |
$414.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$432.82
|
| Rate for Payer: UnitedHealthcare Medicare |
$414.29
|
| Rate for Payer: University Health Alliance Commercial |
$538.86
|
|
|
PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA
|
Professional
|
Both
|
$736.91
|
|
|
Service Code
|
HCPCS 26725
|
| Min. Negotiated Rate |
$170.82 |
| Max. Negotiated Rate |
$626.37 |
| Rate for Payer: AlohaCare Medicaid |
$333.73
|
| Rate for Payer: AlohaCare Medicare |
$337.17
|
| Rate for Payer: Cash Price |
$442.15
|
| Rate for Payer: Cash Price |
$442.15
|
| Rate for Payer: Devoted Health Medicare |
$370.89
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$333.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$337.17
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$333.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$170.82
|
| Rate for Payer: Health Management Network Commercial |
$626.37
|
| Rate for Payer: Kaiser Permanente Commercial |
$404.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$404.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$404.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$333.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$337.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$333.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$337.17
|
| Rate for Payer: University Health Alliance Commercial |
$426.02
|
|
|
PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA
|
Professional
|
Both
|
$443.03
|
|
|
Service Code
|
HCPCS 26720
|
| Min. Negotiated Rate |
$118.30 |
| Max. Negotiated Rate |
$376.58 |
| Rate for Payer: AlohaCare Medicaid |
$212.76
|
| Rate for Payer: AlohaCare Medicare |
$218.60
|
| Rate for Payer: Cash Price |
$265.82
|
| Rate for Payer: Cash Price |
$265.82
|
| Rate for Payer: Devoted Health Medicare |
$240.46
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$212.76
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$218.60
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$212.76
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$118.30
|
| Rate for Payer: Health Management Network Commercial |
$376.58
|
| Rate for Payer: Kaiser Permanente Commercial |
$262.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$262.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$262.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$212.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$218.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$212.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$218.60
|
| Rate for Payer: University Health Alliance Commercial |
$275.00
|
|
|
PR CLTX POST HIP ARTHRP DISLC REQ ANES
|
Professional
|
Both
|
$1,044.00
|
|
|
Service Code
|
HCPCS 27266
|
| Min. Negotiated Rate |
$366.86 |
| Max. Negotiated Rate |
$887.40 |
| Rate for Payer: AlohaCare Medicaid |
$610.71
|
| Rate for Payer: AlohaCare Medicare |
$569.29
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Devoted Health Medicare |
$626.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$569.29
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$366.86
|
| Rate for Payer: Health Management Network Commercial |
$887.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$683.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$683.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$683.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$610.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$569.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$610.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$569.29
|
|
|
PR CLTX POST HIP ARTHRP DISLC W/O ANES
|
Professional
|
Both
|
$901.23
|
|
|
Service Code
|
HCPCS 27265
|
| Min. Negotiated Rate |
$263.64 |
| Max. Negotiated Rate |
$766.05 |
| Rate for Payer: AlohaCare Medicaid |
$445.68
|
| Rate for Payer: AlohaCare Medicare |
$514.61
|
| Rate for Payer: Cash Price |
$540.74
|
| Rate for Payer: Cash Price |
$540.74
|
| Rate for Payer: Devoted Health Medicare |
$566.07
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$514.61
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$263.64
|
| Rate for Payer: Health Management Network Commercial |
$766.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$617.53
|
| Rate for Payer: Kaiser Permanente Medicaid |
$617.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$617.53
|
| Rate for Payer: Ohana Health Plan Medicaid |
$445.68
|
| Rate for Payer: Ohana Health Plan Medicare |
$514.61
|
| Rate for Payer: UnitedHealthcare Medicaid |
$445.68
|
| Rate for Payer: UnitedHealthcare Medicare |
$514.61
|
|
|
PR CLTX PROX FIBULA/SHFT FX W/O MANJ
|
Professional
|
Both
|
$663.44
|
|
|
Service Code
|
HCPCS 27780
|
| Min. Negotiated Rate |
$154.18 |
| Max. Negotiated Rate |
$563.92 |
| Rate for Payer: AlohaCare Medicaid |
$316.56
|
| Rate for Payer: AlohaCare Medicare |
$315.69
|
| Rate for Payer: Cash Price |
$398.06
|
| Rate for Payer: Cash Price |
$398.06
|
| Rate for Payer: Devoted Health Medicare |
$347.26
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$316.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$315.69
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$316.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$154.18
|
| Rate for Payer: Health Management Network Commercial |
$563.92
|
| Rate for Payer: Kaiser Permanente Commercial |
$378.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$378.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$378.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$316.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$315.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$316.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$315.69
|
| Rate for Payer: University Health Alliance Commercial |
$403.45
|
|
|
PR CLTX PROX HUMRL FX W/MNPJ W/WO SKELETAL TRACJ
|
Professional
|
Both
|
$989.31
|
|
|
Service Code
|
HCPCS 23605
|
| Min. Negotiated Rate |
$309.66 |
| Max. Negotiated Rate |
$840.91 |
| Rate for Payer: AlohaCare Medicaid |
$461.51
|
| Rate for Payer: AlohaCare Medicare |
$458.61
|
| Rate for Payer: Cash Price |
$593.59
|
| Rate for Payer: Cash Price |
$593.59
|
| Rate for Payer: Devoted Health Medicare |
$504.47
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$461.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$458.61
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$461.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$309.66
|
| Rate for Payer: Health Management Network Commercial |
$840.91
|
| Rate for Payer: Kaiser Permanente Commercial |
$550.33
|
| Rate for Payer: Kaiser Permanente Medicaid |
$550.33
|
| Rate for Payer: Kaiser Permanente Medicare |
$550.33
|
| Rate for Payer: Ohana Health Plan Medicaid |
$461.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$458.61
|
| Rate for Payer: UnitedHealthcare Medicaid |
$461.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$458.61
|
| Rate for Payer: University Health Alliance Commercial |
$593.45
|
|
|
PR CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$714.94
|
|
|
Service Code
|
HCPCS 23600
|
| Min. Negotiated Rate |
$173.16 |
| Max. Negotiated Rate |
$607.70 |
| Rate for Payer: AlohaCare Medicaid |
$352.60
|
| Rate for Payer: AlohaCare Medicare |
$352.71
|
| Rate for Payer: Cash Price |
$428.96
|
| Rate for Payer: Cash Price |
$428.96
|
| Rate for Payer: Devoted Health Medicare |
$387.98
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$352.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$352.71
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$352.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$173.16
|
| Rate for Payer: Health Management Network Commercial |
$607.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$423.25
|
| Rate for Payer: Kaiser Permanente Medicaid |
$423.25
|
| Rate for Payer: Kaiser Permanente Medicare |
$423.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$352.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$352.71
|
| Rate for Payer: UnitedHealthcare Medicaid |
$352.60
|
| Rate for Payer: UnitedHealthcare Medicare |
$352.71
|
| Rate for Payer: University Health Alliance Commercial |
$447.85
|
|
|
PR CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ
|
Professional
|
Both
|
$195.96
|
|
|
Service Code
|
HCPCS 24640
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$202.00 |
| Rate for Payer: AlohaCare Medicaid |
$84.60
|
| Rate for Payer: AlohaCare Medicare |
$74.38
|
| Rate for Payer: Cash Price |
$117.58
|
| Rate for Payer: Cash Price |
$117.58
|
| Rate for Payer: Devoted Health Medicare |
$81.82
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$84.60
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$140.18
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$74.38
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$84.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$93.60
|
| Rate for Payer: Health Management Network Commercial |
$166.57
|
| Rate for Payer: Kaiser Permanente Commercial |
$89.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$89.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$89.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$84.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$74.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$84.60
|
| Rate for Payer: UnitedHealthcare Medicare |
$74.38
|
| Rate for Payer: University Health Alliance Commercial |
$202.00
|
|
|
PR CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT
|
Professional
|
Both
|
$1,172.24
|
|
|
Service Code
|
HCPCS 25520
|
| Min. Negotiated Rate |
$381.42 |
| Max. Negotiated Rate |
$996.40 |
| Rate for Payer: AlohaCare Medicaid |
$585.62
|
| Rate for Payer: AlohaCare Medicare |
$550.98
|
| Rate for Payer: Cash Price |
$703.34
|
| Rate for Payer: Cash Price |
$703.34
|
| Rate for Payer: Devoted Health Medicare |
$606.08
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$585.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$550.98
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$585.62
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$381.42
|
| Rate for Payer: Health Management Network Commercial |
$996.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$661.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$661.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$661.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$585.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$550.98
|
| Rate for Payer: UnitedHealthcare Medicaid |
$585.62
|
| Rate for Payer: UnitedHealthcare Medicare |
$550.98
|
| Rate for Payer: University Health Alliance Commercial |
$754.98
|
|
|
PR CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MNPJ
|
Professional
|
Both
|
$923.26
|
|
|
Service Code
|
HCPCS 23665
|
| Min. Negotiated Rate |
$228.80 |
| Max. Negotiated Rate |
$784.77 |
| Rate for Payer: AlohaCare Medicaid |
$434.46
|
| Rate for Payer: AlohaCare Medicare |
$434.16
|
| Rate for Payer: Cash Price |
$553.96
|
| Rate for Payer: Cash Price |
$553.96
|
| Rate for Payer: Devoted Health Medicare |
$477.58
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$434.16
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.46
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$228.80
|
| Rate for Payer: Health Management Network Commercial |
$784.77
|
| Rate for Payer: Kaiser Permanente Commercial |
$520.99
|
| Rate for Payer: Kaiser Permanente Medicaid |
$520.99
|
| Rate for Payer: Kaiser Permanente Medicare |
$520.99
|
| Rate for Payer: Ohana Health Plan Medicaid |
$434.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$434.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$434.16
|
| Rate for Payer: University Health Alliance Commercial |
$556.54
|
|
|
PR CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ
|
Professional
|
Both
|
$1,269.61
|
|
|
Service Code
|
HCPCS 24535
|
| Min. Negotiated Rate |
$384.80 |
| Max. Negotiated Rate |
$1,079.17 |
| Rate for Payer: AlohaCare Medicaid |
$612.37
|
| Rate for Payer: AlohaCare Medicare |
$583.08
|
| Rate for Payer: Cash Price |
$761.77
|
| Rate for Payer: Cash Price |
$761.77
|
| Rate for Payer: Devoted Health Medicare |
$641.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$612.37
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$583.08
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$612.37
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$384.80
|
| Rate for Payer: Health Management Network Commercial |
$1,079.17
|
| Rate for Payer: Kaiser Permanente Commercial |
$699.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$699.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$699.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$612.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$583.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$612.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$583.08
|
| Rate for Payer: University Health Alliance Commercial |
$784.53
|
|
|
PR CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ
|
Professional
|
Both
|
$810.69
|
|
|
Service Code
|
HCPCS 24530
|
| Min. Negotiated Rate |
$220.48 |
| Max. Negotiated Rate |
$689.09 |
| Rate for Payer: AlohaCare Medicaid |
$387.55
|
| Rate for Payer: AlohaCare Medicare |
$378.18
|
| Rate for Payer: Cash Price |
$486.41
|
| Rate for Payer: Cash Price |
$486.41
|
| Rate for Payer: Devoted Health Medicare |
$416.00
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$387.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$378.18
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$387.55
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$220.48
|
| Rate for Payer: Health Management Network Commercial |
$689.09
|
| Rate for Payer: Kaiser Permanente Commercial |
$453.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$453.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$453.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$387.55
|
| Rate for Payer: Ohana Health Plan Medicare |
$378.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$387.55
|
| Rate for Payer: UnitedHealthcare Medicare |
$378.18
|
| Rate for Payer: University Health Alliance Commercial |
$493.89
|
|
|
PR CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ
|
Professional
|
Both
|
$1,423.00
|
|
|
Service Code
|
HCPCS 27503
|
| Min. Negotiated Rate |
$559.52 |
| Max. Negotiated Rate |
$1,209.55 |
| Rate for Payer: AlohaCare Medicaid |
$827.54
|
| Rate for Payer: AlohaCare Medicare |
$759.06
|
| Rate for Payer: Cash Price |
$853.80
|
| Rate for Payer: Cash Price |
$853.80
|
| Rate for Payer: Devoted Health Medicare |
$834.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$759.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$559.52
|
| Rate for Payer: Health Management Network Commercial |
$1,209.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$910.87
|
| Rate for Payer: Kaiser Permanente Medicaid |
$910.87
|
| Rate for Payer: Kaiser Permanente Medicare |
$910.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$827.54
|
| Rate for Payer: Ohana Health Plan Medicare |
$759.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$827.54
|
| Rate for Payer: UnitedHealthcare Medicare |
$759.06
|
|
|
PR CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES
|
Professional
|
Both
|
$373.08
|
|
|
Service Code
|
HCPCS 28540
|
| Min. Negotiated Rate |
$60.84 |
| Max. Negotiated Rate |
$317.12 |
| Rate for Payer: AlohaCare Medicaid |
$193.49
|
| Rate for Payer: AlohaCare Medicare |
$181.29
|
| Rate for Payer: Cash Price |
$223.85
|
| Rate for Payer: Cash Price |
$223.85
|
| Rate for Payer: Devoted Health Medicare |
$199.42
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$193.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.29
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$193.49
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$60.84
|
| Rate for Payer: Health Management Network Commercial |
$317.12
|
| Rate for Payer: Kaiser Permanente Commercial |
$217.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$217.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$217.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$193.49
|
| Rate for Payer: Ohana Health Plan Medicare |
$181.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$193.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.29
|
| Rate for Payer: University Health Alliance Commercial |
$243.51
|
|
|
PR CLTX TIBIAL FX PROXIMAL W/O MANIPULATION
|
Professional
|
Both
|
$656.55
|
|
|
Service Code
|
HCPCS 27530
|
| Min. Negotiated Rate |
$245.70 |
| Max. Negotiated Rate |
$558.07 |
| Rate for Payer: AlohaCare Medicaid |
$323.20
|
| Rate for Payer: AlohaCare Medicare |
$320.49
|
| Rate for Payer: Cash Price |
$393.93
|
| Rate for Payer: Cash Price |
$393.93
|
| Rate for Payer: Devoted Health Medicare |
$352.54
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$323.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$320.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$323.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$245.70
|
| Rate for Payer: Health Management Network Commercial |
$558.07
|
| Rate for Payer: Kaiser Permanente Commercial |
$384.59
|
| Rate for Payer: Kaiser Permanente Medicaid |
$384.59
|
| Rate for Payer: Kaiser Permanente Medicare |
$384.59
|
| Rate for Payer: Ohana Health Plan Medicaid |
$323.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$320.49
|
| Rate for Payer: UnitedHealthcare Medicaid |
$323.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$320.49
|
| Rate for Payer: University Health Alliance Commercial |
$411.45
|
|
|
PR CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ
|
Professional
|
Both
|
$1,241.96
|
|
|
Service Code
|
HCPCS 27532
|
| Min. Negotiated Rate |
$395.20 |
| Max. Negotiated Rate |
$1,055.67 |
| Rate for Payer: AlohaCare Medicaid |
$612.25
|
| Rate for Payer: AlohaCare Medicare |
$569.55
|
| Rate for Payer: Cash Price |
$745.18
|
| Rate for Payer: Cash Price |
$745.18
|
| Rate for Payer: Devoted Health Medicare |
$626.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$612.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$569.55
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$612.25
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$395.20
|
| Rate for Payer: Health Management Network Commercial |
$1,055.67
|
| Rate for Payer: Kaiser Permanente Commercial |
$683.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$683.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$683.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$612.25
|
| Rate for Payer: Ohana Health Plan Medicare |
$569.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$612.25
|
| Rate for Payer: UnitedHealthcare Medicare |
$569.55
|
| Rate for Payer: University Health Alliance Commercial |
$793.75
|
|
|
PR CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$1,118.25
|
|
|
Service Code
|
HCPCS 27752
|
| Min. Negotiated Rate |
$472.68 |
| Max. Negotiated Rate |
$950.51 |
| Rate for Payer: AlohaCare Medicaid |
$521.19
|
| Rate for Payer: AlohaCare Medicare |
$516.34
|
| Rate for Payer: Cash Price |
$670.95
|
| Rate for Payer: Cash Price |
$670.95
|
| Rate for Payer: Devoted Health Medicare |
$567.97
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$521.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$516.34
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$521.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$472.68
|
| Rate for Payer: Health Management Network Commercial |
$950.51
|
| Rate for Payer: Kaiser Permanente Commercial |
$619.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$619.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$619.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$521.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$516.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$521.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$516.34
|
| Rate for Payer: University Health Alliance Commercial |
$675.47
|
|
|
PR CLTX TIBIAL SHAFT FX W/O MANIPULATION
|
Professional
|
Both
|
$738.36
|
|
|
Service Code
|
HCPCS 27750
|
| Min. Negotiated Rate |
$299.78 |
| Max. Negotiated Rate |
$627.61 |
| Rate for Payer: AlohaCare Medicaid |
$356.47
|
| Rate for Payer: AlohaCare Medicare |
$351.66
|
| Rate for Payer: Cash Price |
$443.02
|
| Rate for Payer: Cash Price |
$443.02
|
| Rate for Payer: Devoted Health Medicare |
$386.83
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$356.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$351.66
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$356.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$299.78
|
| Rate for Payer: Health Management Network Commercial |
$627.61
|
| Rate for Payer: Kaiser Permanente Commercial |
$421.99
|
| Rate for Payer: Kaiser Permanente Medicaid |
$421.99
|
| Rate for Payer: Kaiser Permanente Medicare |
$421.99
|
| Rate for Payer: Ohana Health Plan Medicaid |
$356.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$351.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$356.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$351.66
|
| Rate for Payer: University Health Alliance Commercial |
$475.00
|
|
