|
PR COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 45389
|
| Min. Negotiated Rate |
$253.67 |
| Max. Negotiated Rate |
$416.50 |
| Rate for Payer: AlohaCare Medicare |
$253.67
|
| Rate for Payer: Cash Price |
$294.00
|
| Rate for Payer: Cash Price |
$294.00
|
| Rate for Payer: Devoted Health Medicare |
$279.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$253.67
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$352.04
|
| Rate for Payer: Health Management Network Commercial |
$416.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$304.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$304.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$304.40
|
| Rate for Payer: Ohana Health Plan Medicare |
$253.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$253.67
|
|
|
PR COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)
|
Professional
|
Both
|
$904.00
|
|
|
Service Code
|
HCPCS 45379
|
| Min. Negotiated Rate |
$210.66 |
| Max. Negotiated Rate |
$768.40 |
| Rate for Payer: AlohaCare Medicaid |
$237.47
|
| Rate for Payer: AlohaCare Medicare |
$210.66
|
| Rate for Payer: Cash Price |
$542.40
|
| Rate for Payer: Cash Price |
$542.40
|
| Rate for Payer: Devoted Health Medicare |
$231.73
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$237.47
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$467.52
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$210.66
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$237.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$303.42
|
| Rate for Payer: Health Management Network Commercial |
$768.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$252.79
|
| Rate for Payer: Kaiser Permanente Medicaid |
$252.79
|
| Rate for Payer: Kaiser Permanente Medicare |
$252.79
|
| Rate for Payer: Ohana Health Plan Medicaid |
$237.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$210.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$237.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$210.66
|
| Rate for Payer: University Health Alliance Commercial |
$323.56
|
|
|
PR COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX
|
Professional
|
Both
|
$669.22
|
|
|
Service Code
|
HCPCS 44388
|
| Min. Negotiated Rate |
$105.24 |
| Max. Negotiated Rate |
$568.84 |
| Rate for Payer: AlohaCare Medicaid |
$155.19
|
| Rate for Payer: AlohaCare Medicare |
$140.49
|
| Rate for Payer: Cash Price |
$401.53
|
| Rate for Payer: Cash Price |
$401.53
|
| Rate for Payer: Devoted Health Medicare |
$154.54
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$155.19
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$261.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$140.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$155.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$203.58
|
| Rate for Payer: Health Management Network Commercial |
$568.84
|
| Rate for Payer: Kaiser Permanente Commercial |
$168.59
|
| Rate for Payer: Kaiser Permanente Medicaid |
$168.59
|
| Rate for Payer: Kaiser Permanente Medicare |
$168.59
|
| Rate for Payer: Ohana Health Plan Medicaid |
$155.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$140.49
|
| Rate for Payer: UnitedHealthcare Medicaid |
$155.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$140.49
|
| Rate for Payer: University Health Alliance Commercial |
$105.24
|
|
|
PR COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$873.90
|
|
|
Service Code
|
HCPCS 44389
|
| Min. Negotiated Rate |
$153.79 |
| Max. Negotiated Rate |
$742.82 |
| Rate for Payer: AlohaCare Medicaid |
$171.11
|
| Rate for Payer: AlohaCare Medicare |
$153.79
|
| Rate for Payer: Cash Price |
$524.34
|
| Rate for Payer: Cash Price |
$524.34
|
| Rate for Payer: Devoted Health Medicare |
$169.17
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$171.11
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$288.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$153.79
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$171.11
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$223.60
|
| Rate for Payer: Health Management Network Commercial |
$742.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$184.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$184.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$184.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$171.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$153.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$171.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$153.79
|
| Rate for Payer: University Health Alliance Commercial |
$227.00
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$914.20
|
|
|
Service Code
|
HCPCS 45380
|
| Min. Negotiated Rate |
$178.33 |
| Max. Negotiated Rate |
$777.07 |
| Rate for Payer: AlohaCare Medicaid |
$200.16
|
| Rate for Payer: AlohaCare Medicare |
$178.33
|
| Rate for Payer: Cash Price |
$548.52
|
| Rate for Payer: Cash Price |
$548.52
|
| Rate for Payer: Devoted Health Medicare |
$196.16
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$200.16
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$443.45
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$178.33
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$200.16
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$351.52
|
| Rate for Payer: Health Management Network Commercial |
$777.07
|
| Rate for Payer: Kaiser Permanente Commercial |
$214.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$214.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$214.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$200.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$178.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$200.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$178.33
|
| Rate for Payer: University Health Alliance Commercial |
$400.00
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Professional
|
Both
|
$713.48
|
|
|
Service Code
|
HCPCS G0105
|
| Min. Negotiated Rate |
$125.26 |
| Max. Negotiated Rate |
$713.46 |
| Rate for Payer: AlohaCare Medicaid |
$184.06
|
| Rate for Payer: AlohaCare Medicare |
$165.03
|
| Rate for Payer: Cash Price |
$428.09
|
| Rate for Payer: Cash Price |
$428.09
|
| Rate for Payer: Devoted Health Medicare |
$181.53
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$184.06
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$374.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$165.03
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$184.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$713.46
|
| Rate for Payer: Health Management Network Commercial |
$606.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$198.04
|
| Rate for Payer: Kaiser Permanente Medicaid |
$198.04
|
| Rate for Payer: Kaiser Permanente Medicare |
$198.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$184.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$165.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$184.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$165.03
|
| Rate for Payer: University Health Alliance Commercial |
$125.26
|
|
|
PR COLOSTOMY/SKIN LEVEL CECOSTOMY
|
Professional
|
Both
|
$2,036.00
|
|
|
Service Code
|
HCPCS 44320
|
| Min. Negotiated Rate |
$623.48 |
| Max. Negotiated Rate |
$1,730.60 |
| Rate for Payer: AlohaCare Medicaid |
$1,188.55
|
| Rate for Payer: AlohaCare Medicare |
$1,102.95
|
| Rate for Payer: Cash Price |
$1,221.60
|
| Rate for Payer: Cash Price |
$1,221.60
|
| Rate for Payer: Devoted Health Medicare |
$1,213.24
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,102.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$623.48
|
| Rate for Payer: Health Management Network Commercial |
$1,730.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,323.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,323.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,323.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,188.55
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,102.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,188.55
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,102.95
|
|
|
PR COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$1,661.00
|
|
|
Service Code
|
HCPCS 44025
|
| Min. Negotiated Rate |
$584.22 |
| Max. Negotiated Rate |
$1,411.85 |
| Rate for Payer: AlohaCare Medicaid |
$967.19
|
| Rate for Payer: AlohaCare Medicare |
$898.58
|
| Rate for Payer: Cash Price |
$996.60
|
| Rate for Payer: Cash Price |
$996.60
|
| Rate for Payer: Devoted Health Medicare |
$988.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$898.58
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$584.22
|
| Rate for Payer: Health Management Network Commercial |
$1,411.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,078.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,078.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,078.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$967.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$898.58
|
| Rate for Payer: UnitedHealthcare Medicaid |
$967.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$898.58
|
|
|
PR COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH
|
Professional
|
Both
|
$1,208.00
|
|
|
Service Code
|
HCPCS 57283
|
| Min. Negotiated Rate |
$615.34 |
| Max. Negotiated Rate |
$1,026.80 |
| Rate for Payer: AlohaCare Medicaid |
$710.85
|
| Rate for Payer: AlohaCare Medicare |
$615.34
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Devoted Health Medicare |
$676.87
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$615.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$623.22
|
| Rate for Payer: Health Management Network Commercial |
$1,026.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$738.41
|
| Rate for Payer: Kaiser Permanente Medicaid |
$738.41
|
| Rate for Payer: Kaiser Permanente Medicare |
$738.41
|
| Rate for Payer: Ohana Health Plan Medicaid |
$710.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$615.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$710.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$615.34
|
|
|
PR COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE
|
Professional
|
Both
|
$299.74
|
|
|
Service Code
|
HCPCS 57454
|
| Min. Negotiated Rate |
$104.78 |
| Max. Negotiated Rate |
$254.78 |
| Rate for Payer: AlohaCare Medicaid |
$134.18
|
| Rate for Payer: AlohaCare Medicare |
$117.36
|
| Rate for Payer: Cash Price |
$179.84
|
| Rate for Payer: Cash Price |
$179.84
|
| Rate for Payer: Devoted Health Medicare |
$129.10
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$134.18
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$224.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$117.36
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$134.18
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$104.78
|
| Rate for Payer: Health Management Network Commercial |
$254.78
|
| Rate for Payer: Kaiser Permanente Commercial |
$140.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$140.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$140.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$134.18
|
| Rate for Payer: Ohana Health Plan Medicare |
$117.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$134.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$117.36
|
| Rate for Payer: University Health Alliance Commercial |
$166.07
|
|
|
PR COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
HCPCS 57456
|
| Min. Negotiated Rate |
$87.01 |
| Max. Negotiated Rate |
$233.75 |
| Rate for Payer: AlohaCare Medicaid |
$100.65
|
| Rate for Payer: AlohaCare Medicare |
$87.01
|
| Rate for Payer: Cash Price |
$165.00
|
| Rate for Payer: Cash Price |
$165.00
|
| Rate for Payer: Devoted Health Medicare |
$95.71
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$100.65
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$168.76
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$87.01
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$100.65
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$129.74
|
| Rate for Payer: Health Management Network Commercial |
$233.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$104.41
|
| Rate for Payer: Kaiser Permanente Medicaid |
$104.41
|
| Rate for Payer: Kaiser Permanente Medicare |
$104.41
|
| Rate for Payer: Ohana Health Plan Medicaid |
$100.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$87.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$100.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$87.01
|
| Rate for Payer: University Health Alliance Commercial |
$123.75
|
|
|
PR COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA
|
Professional
|
Both
|
$229.72
|
|
|
Service Code
|
HCPCS 57452
|
| Min. Negotiated Rate |
$73.58 |
| Max. Negotiated Rate |
$195.26 |
| Rate for Payer: AlohaCare Medicaid |
$92.28
|
| Rate for Payer: AlohaCare Medicare |
$82.28
|
| Rate for Payer: Cash Price |
$137.83
|
| Rate for Payer: Cash Price |
$137.83
|
| Rate for Payer: Devoted Health Medicare |
$90.51
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$92.28
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$152.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$82.28
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$92.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$73.58
|
| Rate for Payer: Health Management Network Commercial |
$195.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$98.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$98.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$98.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$92.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$82.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$92.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$82.28
|
| Rate for Payer: University Health Alliance Commercial |
$114.35
|
|
|
PR COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX
|
Professional
|
Both
|
$293.06
|
|
|
Service Code
|
HCPCS 57455
|
| Min. Negotiated Rate |
$94.17 |
| Max. Negotiated Rate |
$249.10 |
| Rate for Payer: AlohaCare Medicaid |
$107.97
|
| Rate for Payer: AlohaCare Medicare |
$94.17
|
| Rate for Payer: Cash Price |
$175.84
|
| Rate for Payer: Cash Price |
$175.84
|
| Rate for Payer: Devoted Health Medicare |
$103.59
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$107.97
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$181.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$94.17
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$107.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$137.02
|
| Rate for Payer: Health Management Network Commercial |
$249.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$113.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$113.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$113.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$107.97
|
| Rate for Payer: Ohana Health Plan Medicare |
$94.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$107.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$94.17
|
| Rate for Payer: University Health Alliance Commercial |
$133.96
|
|
|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Professional
|
Both
|
$577.66
|
|
|
Service Code
|
HCPCS 57460
|
| Min. Negotiated Rate |
$139.45 |
| Max. Negotiated Rate |
$491.01 |
| Rate for Payer: AlohaCare Medicaid |
$159.59
|
| Rate for Payer: AlohaCare Medicare |
$139.45
|
| Rate for Payer: Cash Price |
$346.60
|
| Rate for Payer: Cash Price |
$346.60
|
| Rate for Payer: Devoted Health Medicare |
$153.40
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$159.59
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$266.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$139.45
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$159.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$191.88
|
| Rate for Payer: Health Management Network Commercial |
$491.01
|
| Rate for Payer: Kaiser Permanente Commercial |
$167.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$167.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$167.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$159.59
|
| Rate for Payer: Ohana Health Plan Medicare |
$139.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$159.59
|
| Rate for Payer: UnitedHealthcare Medicare |
$139.45
|
| Rate for Payer: University Health Alliance Commercial |
$197.88
|
|
|
PR COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX
|
Professional
|
Both
|
$331.29
|
|
|
Service Code
|
HCPCS 57421
|
| Min. Negotiated Rate |
$106.52 |
| Max. Negotiated Rate |
$281.60 |
| Rate for Payer: AlohaCare Medicaid |
$121.25
|
| Rate for Payer: AlohaCare Medicare |
$106.52
|
| Rate for Payer: Cash Price |
$198.77
|
| Rate for Payer: Cash Price |
$198.77
|
| Rate for Payer: Devoted Health Medicare |
$117.17
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$121.25
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$202.87
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$106.52
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$121.25
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$158.34
|
| Rate for Payer: Health Management Network Commercial |
$281.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$127.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$127.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$127.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$121.25
|
| Rate for Payer: Ohana Health Plan Medicare |
$106.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$121.25
|
| Rate for Payer: UnitedHealthcare Medicare |
$106.52
|
| Rate for Payer: University Health Alliance Commercial |
$159.78
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,400.80
|
|
|
Service Code
|
HCPCS 45382
|
| Min. Negotiated Rate |
$227.77 |
| Max. Negotiated Rate |
$1,190.68 |
| Rate for Payer: AlohaCare Medicaid |
$257.57
|
| Rate for Payer: AlohaCare Medicare |
$227.77
|
| Rate for Payer: Cash Price |
$840.48
|
| Rate for Payer: Cash Price |
$840.48
|
| Rate for Payer: Devoted Health Medicare |
$250.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$257.57
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$544.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$227.77
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$257.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$453.18
|
| Rate for Payer: Health Management Network Commercial |
$1,190.68
|
| Rate for Payer: Kaiser Permanente Commercial |
$273.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$273.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$273.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$257.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$227.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$257.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$227.77
|
| Rate for Payer: University Health Alliance Commercial |
$342.94
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Professional
|
Both
|
$934.13
|
|
|
Service Code
|
HCPCS 45381
|
| Min. Negotiated Rate |
$178.33 |
| Max. Negotiated Rate |
$794.01 |
| Rate for Payer: AlohaCare Medicaid |
$199.77
|
| Rate for Payer: AlohaCare Medicare |
$178.33
|
| Rate for Payer: Cash Price |
$560.48
|
| Rate for Payer: Cash Price |
$560.48
|
| Rate for Payer: Devoted Health Medicare |
$196.16
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$199.77
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$406.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$178.33
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$199.77
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$436.28
|
| Rate for Payer: Health Management Network Commercial |
$794.01
|
| Rate for Payer: Kaiser Permanente Commercial |
$214.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$214.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$214.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$199.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$178.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$199.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$178.33
|
| Rate for Payer: University Health Alliance Commercial |
$271.68
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Professional
|
Both
|
$1,021.63
|
|
|
Service Code
|
HCPCS 45384
|
| Min. Negotiated Rate |
$201.74 |
| Max. Negotiated Rate |
$868.39 |
| Rate for Payer: AlohaCare Medicaid |
$225.47
|
| Rate for Payer: AlohaCare Medicare |
$201.74
|
| Rate for Payer: Cash Price |
$612.98
|
| Rate for Payer: Cash Price |
$612.98
|
| Rate for Payer: Devoted Health Medicare |
$221.91
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$225.47
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$468.37
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$201.74
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$225.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$395.20
|
| Rate for Payer: Health Management Network Commercial |
$868.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$242.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$242.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$242.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$225.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$201.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$225.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$201.74
|
| Rate for Payer: University Health Alliance Commercial |
$495.00
|
|
|
PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ
|
Professional
|
Both
|
$943.22
|
|
|
Service Code
|
HCPCS 45385
|
| Min. Negotiated Rate |
$224.15 |
| Max. Negotiated Rate |
$801.74 |
| Rate for Payer: AlohaCare Medicaid |
$252.85
|
| Rate for Payer: AlohaCare Medicare |
$224.15
|
| Rate for Payer: Cash Price |
$565.93
|
| Rate for Payer: Cash Price |
$565.93
|
| Rate for Payer: Devoted Health Medicare |
$246.56
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$252.85
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$525.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$224.15
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$252.85
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$466.18
|
| Rate for Payer: Health Management Network Commercial |
$801.74
|
| Rate for Payer: Kaiser Permanente Commercial |
$268.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$268.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$268.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$252.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$224.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$252.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$224.15
|
| Rate for Payer: University Health Alliance Commercial |
$420.00
|
|
|
PR COMMUNITY SPORTS PHYSICAL
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 98388
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Health Management Network Commercial |
$51.00
|
|
|
PR COMP ASSES CARE PLAN CCM SVC
|
Professional
|
Both
|
$123.32
|
|
|
Service Code
|
HCPCS G0506
|
| Min. Negotiated Rate |
$38.57 |
| Max. Negotiated Rate |
$104.82 |
| Rate for Payer: AlohaCare Medicare |
$38.57
|
| Rate for Payer: Cash Price |
$73.99
|
| Rate for Payer: Cash Price |
$73.99
|
| Rate for Payer: Devoted Health Medicare |
$42.43
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$44.61
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$53.94
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.57
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$44.61
|
| Rate for Payer: Health Management Network Commercial |
$104.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$46.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$46.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$46.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.57
|
| Rate for Payer: University Health Alliance Commercial |
$42.80
|
|
|
PR COMPLETE REPLACEMENT PICC RS&I
|
Professional
|
Both
|
$599.15
|
|
|
Service Code
|
HCPCS 36584
|
| Min. Negotiated Rate |
$49.95 |
| Max. Negotiated Rate |
$509.28 |
| Rate for Payer: AlohaCare Medicaid |
$57.10
|
| Rate for Payer: AlohaCare Medicare |
$49.95
|
| Rate for Payer: Cash Price |
$359.49
|
| Rate for Payer: Cash Price |
$359.49
|
| Rate for Payer: Devoted Health Medicare |
$54.95
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$57.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$104.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$49.95
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$57.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$262.34
|
| Rate for Payer: Health Management Network Commercial |
$509.28
|
| Rate for Payer: Kaiser Permanente Commercial |
$59.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$59.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$59.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$57.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$49.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$57.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$49.95
|
| Rate for Payer: University Health Alliance Commercial |
$76.62
|
|
|
PR COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
HCPCS 93303 26
|
| Min. Negotiated Rate |
$61.80 |
| Max. Negotiated Rate |
$243.85 |
| Rate for Payer: AlohaCare Medicaid |
$243.85
|
| Rate for Payer: AlohaCare Medicare |
$61.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Devoted Health Medicare |
$67.98
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$61.80
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$204.57
|
| Rate for Payer: Health Management Network Commercial |
$91.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$74.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$74.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$74.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$243.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$61.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$243.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$61.80
|
|
|
PR COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY
|
Professional
|
Both
|
$577.00
|
|
|
Service Code
|
HCPCS 93303 TC
|
| Min. Negotiated Rate |
$181.73 |
| Max. Negotiated Rate |
$490.45 |
| Rate for Payer: AlohaCare Medicaid |
$243.85
|
| Rate for Payer: AlohaCare Medicare |
$181.73
|
| Rate for Payer: Cash Price |
$346.20
|
| Rate for Payer: Cash Price |
$346.20
|
| Rate for Payer: Devoted Health Medicare |
$199.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$204.57
|
| Rate for Payer: Health Management Network Commercial |
$490.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$218.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$218.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$218.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$243.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$181.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$243.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.73
|
|
|
PR COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY
|
Professional
|
Both
|
$685.00
|
|
|
Service Code
|
HCPCS 93303
|
| Min. Negotiated Rate |
$204.57 |
| Max. Negotiated Rate |
$582.25 |
| Rate for Payer: AlohaCare Medicaid |
$243.85
|
| Rate for Payer: AlohaCare Medicare |
$243.53
|
| Rate for Payer: Cash Price |
$411.00
|
| Rate for Payer: Cash Price |
$411.00
|
| Rate for Payer: Devoted Health Medicare |
$267.88
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$243.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$204.57
|
| Rate for Payer: Health Management Network Commercial |
$582.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$292.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$292.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$292.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$243.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$243.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$243.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$243.53
|
|
