|
PR EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Professional
|
Both
|
$755.00
|
|
|
Service Code
|
HCPCS 25071
|
| Min. Negotiated Rate |
$409.69 |
| Max. Negotiated Rate |
$641.75 |
| Rate for Payer: AlohaCare Medicaid |
$439.60
|
| Rate for Payer: AlohaCare Medicare |
$409.69
|
| Rate for Payer: Cash Price |
$453.00
|
| Rate for Payer: Cash Price |
$453.00
|
| Rate for Payer: Devoted Health Medicare |
$450.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$409.69
|
| Rate for Payer: Health Management Network Commercial |
$641.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$491.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$491.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$491.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$439.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$409.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$439.60
|
| Rate for Payer: UnitedHealthcare Medicare |
$409.69
|
|
|
PR EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 25076
|
| Min. Negotiated Rate |
$307.84 |
| Max. Negotiated Rate |
$799.85 |
| Rate for Payer: AlohaCare Medicaid |
$546.77
|
| Rate for Payer: AlohaCare Medicare |
$503.97
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Devoted Health Medicare |
$554.37
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$503.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$307.84
|
| Rate for Payer: Health Management Network Commercial |
$799.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$604.76
|
| Rate for Payer: Kaiser Permanente Medicaid |
$604.76
|
| Rate for Payer: Kaiser Permanente Medicare |
$604.76
|
| Rate for Payer: Ohana Health Plan Medicaid |
$546.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$503.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$546.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$503.97
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$936.00
|
|
|
Service Code
|
HCPCS 21556
|
| Min. Negotiated Rate |
$359.32 |
| Max. Negotiated Rate |
$795.60 |
| Rate for Payer: AlohaCare Medicaid |
$546.14
|
| Rate for Payer: AlohaCare Medicare |
$496.87
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Devoted Health Medicare |
$546.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$496.87
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$359.32
|
| Rate for Payer: Health Management Network Commercial |
$795.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$596.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$596.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$596.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$546.14
|
| Rate for Payer: Ohana Health Plan Medicare |
$496.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$546.14
|
| Rate for Payer: UnitedHealthcare Medicare |
$496.87
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$971.00
|
|
|
Service Code
|
HCPCS 23076
|
| Min. Negotiated Rate |
$345.80 |
| Max. Negotiated Rate |
$825.35 |
| Rate for Payer: AlohaCare Medicaid |
$562.61
|
| Rate for Payer: AlohaCare Medicare |
$531.68
|
| Rate for Payer: Cash Price |
$582.60
|
| Rate for Payer: Cash Price |
$582.60
|
| Rate for Payer: Devoted Health Medicare |
$584.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$531.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$345.80
|
| Rate for Payer: Health Management Network Commercial |
$825.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$638.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$638.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$638.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$562.61
|
| Rate for Payer: Ohana Health Plan Medicare |
$531.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$562.61
|
| Rate for Payer: UnitedHealthcare Medicare |
$531.68
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$991.00
|
|
|
Service Code
|
HCPCS 22900
|
| Min. Negotiated Rate |
$351.52 |
| Max. Negotiated Rate |
$842.35 |
| Rate for Payer: AlohaCare Medicaid |
$576.51
|
| Rate for Payer: AlohaCare Medicare |
$548.43
|
| Rate for Payer: Cash Price |
$594.60
|
| Rate for Payer: Cash Price |
$594.60
|
| Rate for Payer: Devoted Health Medicare |
$603.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$548.43
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$351.52
|
| Rate for Payer: Health Management Network Commercial |
$842.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$658.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$658.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$658.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$576.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$548.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$576.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$548.43
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Professional
|
Both
|
$1,156.00
|
|
|
Service Code
|
HCPCS 22901
|
| Min. Negotiated Rate |
$638.38 |
| Max. Negotiated Rate |
$982.60 |
| Rate for Payer: AlohaCare Medicaid |
$673.37
|
| Rate for Payer: AlohaCare Medicare |
$638.38
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Devoted Health Medicare |
$702.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$638.38
|
| Rate for Payer: Health Management Network Commercial |
$982.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$766.06
|
| Rate for Payer: Kaiser Permanente Medicaid |
$766.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$766.06
|
| Rate for Payer: Ohana Health Plan Medicaid |
$673.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$638.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$673.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$638.38
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$770.00
|
|
|
Service Code
|
HCPCS 22903
|
| Min. Negotiated Rate |
$423.02 |
| Max. Negotiated Rate |
$654.50 |
| Rate for Payer: AlohaCare Medicaid |
$448.37
|
| Rate for Payer: AlohaCare Medicare |
$430.04
|
| Rate for Payer: Cash Price |
$462.00
|
| Rate for Payer: Cash Price |
$462.00
|
| Rate for Payer: Devoted Health Medicare |
$473.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$430.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$423.02
|
| Rate for Payer: Health Management Network Commercial |
$654.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$516.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$516.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$516.05
|
| Rate for Payer: Ohana Health Plan Medicaid |
$448.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$448.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$430.04
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM
|
Professional
|
Both
|
$959.70
|
|
|
Service Code
|
HCPCS 22902
|
| Min. Negotiated Rate |
$337.07 |
| Max. Negotiated Rate |
$815.75 |
| Rate for Payer: AlohaCare Medicaid |
$345.92
|
| Rate for Payer: AlohaCare Medicare |
$337.07
|
| Rate for Payer: Cash Price |
$575.82
|
| Rate for Payer: Cash Price |
$575.82
|
| Rate for Payer: Devoted Health Medicare |
$370.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$345.92
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$574.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$337.07
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$345.92
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$408.20
|
| Rate for Payer: Health Management Network Commercial |
$815.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$404.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$404.48
|
| Rate for Payer: Kaiser Permanente Medicare |
$404.48
|
| Rate for Payer: Ohana Health Plan Medicaid |
$345.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$337.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$345.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$337.07
|
| Rate for Payer: University Health Alliance Commercial |
$452.60
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$1,041.92
|
|
|
Service Code
|
HCPCS 25075
|
| Min. Negotiated Rate |
$95.16 |
| Max. Negotiated Rate |
$885.63 |
| Rate for Payer: AlohaCare Medicaid |
$333.98
|
| Rate for Payer: AlohaCare Medicare |
$315.87
|
| Rate for Payer: Cash Price |
$625.15
|
| Rate for Payer: Cash Price |
$625.15
|
| Rate for Payer: Devoted Health Medicare |
$347.46
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$333.98
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$549.80
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$315.87
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$333.98
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.16
|
| Rate for Payer: Health Management Network Commercial |
$885.63
|
| Rate for Payer: Kaiser Permanente Commercial |
$379.04
|
| Rate for Payer: Kaiser Permanente Medicaid |
$379.04
|
| Rate for Payer: Kaiser Permanente Medicare |
$379.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$333.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$315.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$333.98
|
| Rate for Payer: UnitedHealthcare Medicare |
$315.87
|
| Rate for Payer: University Health Alliance Commercial |
$433.02
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM
|
Professional
|
Both
|
$830.00
|
|
|
Service Code
|
HCPCS 27619
|
| Min. Negotiated Rate |
$404.04 |
| Max. Negotiated Rate |
$705.50 |
| Rate for Payer: AlohaCare Medicaid |
$488.99
|
| Rate for Payer: AlohaCare Medicare |
$444.07
|
| Rate for Payer: Cash Price |
$498.00
|
| Rate for Payer: Cash Price |
$498.00
|
| Rate for Payer: Devoted Health Medicare |
$488.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$444.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$404.04
|
| Rate for Payer: Health Management Network Commercial |
$705.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$532.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$532.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$532.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$488.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$444.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$488.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$444.07
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$975.10
|
|
|
Service Code
|
HCPCS 27618
|
| Min. Negotiated Rate |
$205.92 |
| Max. Negotiated Rate |
$828.84 |
| Rate for Payer: AlohaCare Medicaid |
$321.95
|
| Rate for Payer: AlohaCare Medicare |
$306.93
|
| Rate for Payer: Cash Price |
$585.06
|
| Rate for Payer: Cash Price |
$585.06
|
| Rate for Payer: Devoted Health Medicare |
$337.62
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$321.95
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$533.94
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$306.93
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$321.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$205.92
|
| Rate for Payer: Health Management Network Commercial |
$828.84
|
| Rate for Payer: Kaiser Permanente Commercial |
$368.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$368.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$368.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$321.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$306.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$321.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$306.93
|
| Rate for Payer: University Health Alliance Commercial |
$418.15
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$863.00
|
|
|
Service Code
|
HCPCS 21555
|
| Min. Negotiated Rate |
$238.42 |
| Max. Negotiated Rate |
$733.55 |
| Rate for Payer: AlohaCare Medicaid |
$321.74
|
| Rate for Payer: AlohaCare Medicare |
$305.43
|
| Rate for Payer: Cash Price |
$517.80
|
| Rate for Payer: Cash Price |
$517.80
|
| Rate for Payer: Devoted Health Medicare |
$335.97
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$321.74
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$531.67
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$305.43
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$321.74
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$238.42
|
| Rate for Payer: Health Management Network Commercial |
$733.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$366.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$366.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$366.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$321.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$305.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$321.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$305.43
|
| Rate for Payer: University Health Alliance Commercial |
$418.74
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$1,273.00
|
|
|
Service Code
|
HCPCS 21554
|
| Min. Negotiated Rate |
$679.77 |
| Max. Negotiated Rate |
$1,082.05 |
| Rate for Payer: AlohaCare Medicaid |
$743.28
|
| Rate for Payer: AlohaCare Medicare |
$679.77
|
| Rate for Payer: Cash Price |
$763.80
|
| Rate for Payer: Cash Price |
$763.80
|
| Rate for Payer: Devoted Health Medicare |
$747.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$679.77
|
| Rate for Payer: Health Management Network Commercial |
$1,082.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$815.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$815.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$815.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$743.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$679.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$743.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$679.77
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>
|
Professional
|
Both
|
$1,281.00
|
|
|
Service Code
|
HCPCS 27045
|
| Min. Negotiated Rate |
$691.56 |
| Max. Negotiated Rate |
$1,088.85 |
| Rate for Payer: AlohaCare Medicaid |
$745.77
|
| Rate for Payer: AlohaCare Medicare |
$691.56
|
| Rate for Payer: Cash Price |
$768.60
|
| Rate for Payer: Cash Price |
$768.60
|
| Rate for Payer: Devoted Health Medicare |
$760.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$691.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$696.54
|
| Rate for Payer: Health Management Network Commercial |
$1,088.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$829.87
|
| Rate for Payer: Kaiser Permanente Medicaid |
$829.87
|
| Rate for Payer: Kaiser Permanente Medicare |
$829.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$745.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$691.56
|
| Rate for Payer: UnitedHealthcare Medicaid |
$745.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$691.56
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM
|
Professional
|
Both
|
$988.56
|
|
|
Service Code
|
HCPCS 27047
|
| Min. Negotiated Rate |
$297.18 |
| Max. Negotiated Rate |
$840.28 |
| Rate for Payer: AlohaCare Medicaid |
$374.68
|
| Rate for Payer: AlohaCare Medicare |
$356.78
|
| Rate for Payer: Cash Price |
$593.14
|
| Rate for Payer: Cash Price |
$593.14
|
| Rate for Payer: Devoted Health Medicare |
$392.46
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$374.68
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$716.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$356.78
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$374.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$297.18
|
| Rate for Payer: Health Management Network Commercial |
$840.28
|
| Rate for Payer: Kaiser Permanente Commercial |
$428.14
|
| Rate for Payer: Kaiser Permanente Medicaid |
$428.14
|
| Rate for Payer: Kaiser Permanente Medicare |
$428.14
|
| Rate for Payer: Ohana Health Plan Medicaid |
$374.68
|
| Rate for Payer: Ohana Health Plan Medicare |
$356.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$374.68
|
| Rate for Payer: UnitedHealthcare Medicare |
$356.78
|
| Rate for Payer: University Health Alliance Commercial |
$489.14
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,223.00
|
|
|
Service Code
|
HCPCS 23073
|
| Min. Negotiated Rate |
$661.39 |
| Max. Negotiated Rate |
$1,039.55 |
| Rate for Payer: AlohaCare Medicaid |
$712.34
|
| Rate for Payer: AlohaCare Medicare |
$661.39
|
| Rate for Payer: Cash Price |
$733.80
|
| Rate for Payer: Cash Price |
$733.80
|
| Rate for Payer: Devoted Health Medicare |
$727.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$661.39
|
| Rate for Payer: Health Management Network Commercial |
$1,039.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$793.67
|
| Rate for Payer: Kaiser Permanente Medicaid |
$793.67
|
| Rate for Payer: Kaiser Permanente Medicare |
$793.67
|
| Rate for Payer: Ohana Health Plan Medicaid |
$712.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$661.39
|
| Rate for Payer: UnitedHealthcare Medicaid |
$712.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$661.39
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$1,099.00
|
|
|
Service Code
|
HCPCS 27328
|
| Min. Negotiated Rate |
$266.76 |
| Max. Negotiated Rate |
$934.15 |
| Rate for Payer: AlohaCare Medicaid |
$641.76
|
| Rate for Payer: AlohaCare Medicare |
$595.03
|
| Rate for Payer: Cash Price |
$659.40
|
| Rate for Payer: Cash Price |
$659.40
|
| Rate for Payer: Devoted Health Medicare |
$654.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$595.03
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$266.76
|
| Rate for Payer: Health Management Network Commercial |
$934.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$714.04
|
| Rate for Payer: Kaiser Permanente Medicaid |
$714.04
|
| Rate for Payer: Kaiser Permanente Medicare |
$714.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$641.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$595.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$641.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$595.03
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$717.00
|
|
|
Service Code
|
HCPCS 24071
|
| Min. Negotiated Rate |
$395.61 |
| Max. Negotiated Rate |
$609.45 |
| Rate for Payer: AlohaCare Medicaid |
$417.69
|
| Rate for Payer: AlohaCare Medicare |
$395.61
|
| Rate for Payer: Cash Price |
$430.20
|
| Rate for Payer: Cash Price |
$430.20
|
| Rate for Payer: Devoted Health Medicare |
$435.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$395.61
|
| Rate for Payer: Health Management Network Commercial |
$609.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$474.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$474.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$474.73
|
| Rate for Payer: Ohana Health Plan Medicaid |
$417.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$395.61
|
| Rate for Payer: UnitedHealthcare Medicaid |
$417.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$395.61
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,070.70
|
|
|
Service Code
|
HCPCS 24075
|
| Min. Negotiated Rate |
$216.58 |
| Max. Negotiated Rate |
$910.10 |
| Rate for Payer: AlohaCare Medicaid |
$345.74
|
| Rate for Payer: AlohaCare Medicare |
$328.91
|
| Rate for Payer: Cash Price |
$642.42
|
| Rate for Payer: Cash Price |
$642.42
|
| Rate for Payer: Devoted Health Medicare |
$361.80
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$345.74
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$572.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$328.91
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$345.74
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$216.58
|
| Rate for Payer: Health Management Network Commercial |
$910.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$394.69
|
| Rate for Payer: Kaiser Permanente Medicaid |
$394.69
|
| Rate for Payer: Kaiser Permanente Medicare |
$394.69
|
| Rate for Payer: Ohana Health Plan Medicaid |
$345.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$328.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$345.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$328.91
|
| Rate for Payer: University Health Alliance Commercial |
$449.80
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,218.00
|
|
|
Service Code
|
HCPCS 24073
|
| Min. Negotiated Rate |
$655.68 |
| Max. Negotiated Rate |
$1,035.30 |
| Rate for Payer: AlohaCare Medicaid |
$708.34
|
| Rate for Payer: AlohaCare Medicare |
$655.68
|
| Rate for Payer: Cash Price |
$730.80
|
| Rate for Payer: Cash Price |
$730.80
|
| Rate for Payer: Devoted Health Medicare |
$721.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$655.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$686.92
|
| Rate for Payer: Health Management Network Commercial |
$1,035.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$786.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$786.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$786.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$708.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$655.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$708.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$655.68
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$979.00
|
|
|
Service Code
|
HCPCS 24076
|
| Min. Negotiated Rate |
$405.86 |
| Max. Negotiated Rate |
$832.15 |
| Rate for Payer: AlohaCare Medicaid |
$569.35
|
| Rate for Payer: AlohaCare Medicare |
$530.33
|
| Rate for Payer: Cash Price |
$587.40
|
| Rate for Payer: Cash Price |
$587.40
|
| Rate for Payer: Devoted Health Medicare |
$583.36
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$530.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$405.86
|
| Rate for Payer: Health Management Network Commercial |
$832.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$636.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$636.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$636.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$569.35
|
| Rate for Payer: Ohana Health Plan Medicare |
$530.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$569.35
|
| Rate for Payer: UnitedHealthcare Medicare |
$530.33
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,115.64
|
|
|
Service Code
|
HCPCS 26115
|
| Min. Negotiated Rate |
$263.64 |
| Max. Negotiated Rate |
$948.29 |
| Rate for Payer: AlohaCare Medicaid |
$355.80
|
| Rate for Payer: AlohaCare Medicare |
$333.70
|
| Rate for Payer: Cash Price |
$669.38
|
| Rate for Payer: Cash Price |
$669.38
|
| Rate for Payer: Devoted Health Medicare |
$367.07
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$355.80
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$579.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$333.70
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$355.80
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$263.64
|
| Rate for Payer: Health Management Network Commercial |
$948.29
|
| Rate for Payer: Kaiser Permanente Commercial |
$400.44
|
| Rate for Payer: Kaiser Permanente Medicaid |
$400.44
|
| Rate for Payer: Kaiser Permanente Medicare |
$400.44
|
| Rate for Payer: Ohana Health Plan Medicaid |
$355.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$333.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$355.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$333.70
|
| Rate for Payer: University Health Alliance Commercial |
$500.00
|
|
|
PR EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM
|
Professional
|
Both
|
$958.00
|
|
|
Service Code
|
HCPCS 26116
|
| Min. Negotiated Rate |
$427.70 |
| Max. Negotiated Rate |
$814.30 |
| Rate for Payer: AlohaCare Medicaid |
$555.78
|
| Rate for Payer: AlohaCare Medicare |
$508.32
|
| Rate for Payer: Cash Price |
$574.80
|
| Rate for Payer: Cash Price |
$574.80
|
| Rate for Payer: Devoted Health Medicare |
$559.15
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$508.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$427.70
|
| Rate for Payer: Health Management Network Commercial |
$814.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$609.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$609.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$609.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$555.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$508.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$555.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$508.32
|
|
|
PR EXC URETHRAL DIVERTICULUM SPX FEMALE
|
Professional
|
Both
|
$1,061.00
|
|
|
Service Code
|
HCPCS 53230
|
| Min. Negotiated Rate |
$501.54 |
| Max. Negotiated Rate |
$901.85 |
| Rate for Payer: AlohaCare Medicaid |
$620.16
|
| Rate for Payer: AlohaCare Medicare |
$556.06
|
| Rate for Payer: Cash Price |
$636.60
|
| Rate for Payer: Cash Price |
$636.60
|
| Rate for Payer: Devoted Health Medicare |
$611.67
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$556.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$501.54
|
| Rate for Payer: Health Management Network Commercial |
$901.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$667.27
|
| Rate for Payer: Kaiser Permanente Medicaid |
$667.27
|
| Rate for Payer: Kaiser Permanente Medicare |
$667.27
|
| Rate for Payer: Ohana Health Plan Medicaid |
$620.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$556.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$620.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$556.06
|
|
|
PR EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX
|
Professional
|
Both
|
$623.00
|
|
|
Service Code
|
HCPCS 55530
|
| Min. Negotiated Rate |
$332.14 |
| Max. Negotiated Rate |
$529.55 |
| Rate for Payer: AlohaCare Medicaid |
$363.00
|
| Rate for Payer: AlohaCare Medicare |
$332.14
|
| Rate for Payer: Cash Price |
$373.80
|
| Rate for Payer: Cash Price |
$373.80
|
| Rate for Payer: Devoted Health Medicare |
$365.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$332.14
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$410.80
|
| Rate for Payer: Health Management Network Commercial |
$529.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$398.57
|
| Rate for Payer: Kaiser Permanente Medicaid |
$398.57
|
| Rate for Payer: Kaiser Permanente Medicare |
$398.57
|
| Rate for Payer: Ohana Health Plan Medicaid |
$363.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$332.14
|
| Rate for Payer: UnitedHealthcare Medicaid |
$363.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$332.14
|
|
