|
PR EXC XTRPARENCHYMAL LESION TESTIS
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 54512
|
| Min. Negotiated Rate |
$493.68 |
| Max. Negotiated Rate |
$799.85 |
| Rate for Payer: AlohaCare Medicaid |
$547.56
|
| Rate for Payer: AlohaCare Medicare |
$493.68
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Devoted Health Medicare |
$543.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$493.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$499.20
|
| Rate for Payer: Health Management Network Commercial |
$799.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$592.42
|
| Rate for Payer: Kaiser Permanente Medicaid |
$592.42
|
| Rate for Payer: Kaiser Permanente Medicare |
$592.42
|
| Rate for Payer: Ohana Health Plan Medicaid |
$547.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$493.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$547.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$493.68
|
|
|
PR EXISION OF SUBLINGUAL GLAND
|
Professional
|
Both
|
$881.21
|
|
|
Service Code
|
HCPCS 42450
|
| Min. Negotiated Rate |
$241.02 |
| Max. Negotiated Rate |
$749.03 |
| Rate for Payer: AlohaCare Medicaid |
$385.23
|
| Rate for Payer: AlohaCare Medicare |
$341.01
|
| Rate for Payer: Cash Price |
$528.73
|
| Rate for Payer: Cash Price |
$528.73
|
| Rate for Payer: Devoted Health Medicare |
$375.11
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$385.23
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$637.45
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$341.01
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$385.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$241.02
|
| Rate for Payer: Health Management Network Commercial |
$749.03
|
| Rate for Payer: Kaiser Permanente Commercial |
$409.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$409.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$409.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$385.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$341.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$385.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$341.01
|
| Rate for Payer: University Health Alliance Commercial |
$502.06
|
|
|
PR EXPLORATION N/FLWD SURG LOWER EXTREMITY ARTERY
|
Professional
|
Both
|
$681.00
|
|
|
Service Code
|
HCPCS 35703
|
| Min. Negotiated Rate |
$365.54 |
| Max. Negotiated Rate |
$578.85 |
| Rate for Payer: AlohaCare Medicaid |
$395.91
|
| Rate for Payer: AlohaCare Medicare |
$365.54
|
| Rate for Payer: Cash Price |
$408.60
|
| Rate for Payer: Cash Price |
$408.60
|
| Rate for Payer: Devoted Health Medicare |
$402.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$365.54
|
| Rate for Payer: Health Management Network Commercial |
$578.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$438.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$438.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$438.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$395.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$365.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$395.91
|
| Rate for Payer: UnitedHealthcare Medicare |
$365.54
|
|
|
PR EXPLORATION N/FLWD SURG UPPER EXTREMITY ARTERY
|
Professional
|
Both
|
$677.00
|
|
|
Service Code
|
HCPCS 35702
|
| Min. Negotiated Rate |
$360.55 |
| Max. Negotiated Rate |
$575.45 |
| Rate for Payer: AlohaCare Medicaid |
$394.79
|
| Rate for Payer: AlohaCare Medicare |
$360.55
|
| Rate for Payer: Cash Price |
$406.20
|
| Rate for Payer: Cash Price |
$406.20
|
| Rate for Payer: Devoted Health Medicare |
$396.61
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$360.55
|
| Rate for Payer: Health Management Network Commercial |
$575.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$432.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$432.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$432.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$394.79
|
| Rate for Payer: Ohana Health Plan Medicare |
$360.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$394.79
|
| Rate for Payer: UnitedHealthcare Medicare |
$360.55
|
|
|
PR EXPLORATION PENETRATING WOUND SPX CHEST
|
Professional
|
Both
|
$1,194.16
|
|
|
Service Code
|
HCPCS 20101
|
| Min. Negotiated Rate |
$145.08 |
| Max. Negotiated Rate |
$1,015.04 |
| Rate for Payer: AlohaCare Medicaid |
$208.69
|
| Rate for Payer: AlohaCare Medicare |
$199.31
|
| Rate for Payer: Cash Price |
$716.50
|
| Rate for Payer: Cash Price |
$716.50
|
| Rate for Payer: Devoted Health Medicare |
$219.24
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$208.69
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$355.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$199.31
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$208.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$145.08
|
| Rate for Payer: Health Management Network Commercial |
$1,015.04
|
| Rate for Payer: Kaiser Permanente Commercial |
$239.17
|
| Rate for Payer: Kaiser Permanente Medicaid |
$239.17
|
| Rate for Payer: Kaiser Permanente Medicare |
$239.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$208.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$199.31
|
| Rate for Payer: UnitedHealthcare Medicaid |
$208.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$199.31
|
| Rate for Payer: University Health Alliance Commercial |
$281.32
|
|
|
PR EXPLORATION PENETRATING WOUND SPX EXTREMITY
|
Professional
|
Both
|
$1,103.01
|
|
|
Service Code
|
HCPCS 20103
|
| Min. Negotiated Rate |
$315.38 |
| Max. Negotiated Rate |
$937.56 |
| Rate for Payer: AlohaCare Medicaid |
$350.36
|
| Rate for Payer: AlohaCare Medicare |
$316.98
|
| Rate for Payer: Cash Price |
$661.81
|
| Rate for Payer: Cash Price |
$661.81
|
| Rate for Payer: Devoted Health Medicare |
$348.68
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$350.36
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$585.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$316.98
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$350.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$315.38
|
| Rate for Payer: Health Management Network Commercial |
$937.56
|
| Rate for Payer: Kaiser Permanente Commercial |
$380.38
|
| Rate for Payer: Kaiser Permanente Medicaid |
$380.38
|
| Rate for Payer: Kaiser Permanente Medicare |
$380.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$350.36
|
| Rate for Payer: Ohana Health Plan Medicare |
$316.98
|
| Rate for Payer: UnitedHealthcare Medicaid |
$350.36
|
| Rate for Payer: UnitedHealthcare Medicare |
$316.98
|
| Rate for Payer: University Health Alliance Commercial |
$460.82
|
|
|
PR EXPLORATION PENETRATING WOUND SPX NECK
|
Professional
|
Both
|
$1,016.00
|
|
|
Service Code
|
HCPCS 20100
|
| Min. Negotiated Rate |
$532.86 |
| Max. Negotiated Rate |
$863.60 |
| Rate for Payer: AlohaCare Medicaid |
$593.33
|
| Rate for Payer: AlohaCare Medicare |
$532.86
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Devoted Health Medicare |
$586.15
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$532.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$583.44
|
| Rate for Payer: Health Management Network Commercial |
$863.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$639.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$639.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$639.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$593.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$532.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$593.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$532.86
|
|
|
PR EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX
|
Professional
|
Both
|
$1,309.00
|
|
|
Service Code
|
HCPCS 49000
|
| Min. Negotiated Rate |
$711.88 |
| Max. Negotiated Rate |
$1,112.65 |
| Rate for Payer: AlohaCare Medicaid |
$763.58
|
| Rate for Payer: AlohaCare Medicare |
$716.59
|
| Rate for Payer: Cash Price |
$785.40
|
| Rate for Payer: Cash Price |
$785.40
|
| Rate for Payer: Devoted Health Medicare |
$788.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$716.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$711.88
|
| Rate for Payer: Health Management Network Commercial |
$1,112.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$859.91
|
| Rate for Payer: Kaiser Permanente Medicaid |
$859.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$859.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$763.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$716.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$763.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$716.59
|
|
|
PR EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK
|
Professional
|
Both
|
$1,254.52
|
|
|
Service Code
|
HCPCS 20102
|
| Min. Negotiated Rate |
$178.62 |
| Max. Negotiated Rate |
$1,066.34 |
| Rate for Payer: AlohaCare Medicaid |
$256.16
|
| Rate for Payer: AlohaCare Medicare |
$242.54
|
| Rate for Payer: Cash Price |
$752.71
|
| Rate for Payer: Cash Price |
$752.71
|
| Rate for Payer: Devoted Health Medicare |
$266.79
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$256.16
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$431.30
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$242.54
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$256.16
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$178.62
|
| Rate for Payer: Health Management Network Commercial |
$1,066.34
|
| Rate for Payer: Kaiser Permanente Commercial |
$291.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$291.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$291.05
|
| Rate for Payer: Ohana Health Plan Medicaid |
$256.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$242.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$256.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$242.54
|
| Rate for Payer: University Health Alliance Commercial |
$343.79
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD
|
Professional
|
Both
|
$2,032.00
|
|
|
Service Code
|
HCPCS 35840
|
| Min. Negotiated Rate |
$507.78 |
| Max. Negotiated Rate |
$1,727.20 |
| Rate for Payer: AlohaCare Medicaid |
$1,182.99
|
| Rate for Payer: AlohaCare Medicare |
$1,091.03
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Devoted Health Medicare |
$1,200.13
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,091.03
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$507.78
|
| Rate for Payer: Health Management Network Commercial |
$1,727.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,309.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,309.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,309.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,182.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,091.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,182.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,091.03
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ CH
|
Professional
|
Both
|
$3,147.00
|
|
|
Service Code
|
HCPCS 35820
|
| Min. Negotiated Rate |
$631.02 |
| Max. Negotiated Rate |
$2,674.95 |
| Rate for Payer: AlohaCare Medicaid |
$1,909.22
|
| Rate for Payer: AlohaCare Medicare |
$1,798.10
|
| Rate for Payer: Cash Price |
$1,888.20
|
| Rate for Payer: Cash Price |
$1,888.20
|
| Rate for Payer: Devoted Health Medicare |
$1,977.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,798.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$631.02
|
| Rate for Payer: Health Management Network Commercial |
$2,674.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,157.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,157.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,157.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,909.22
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,798.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,909.22
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,798.10
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK
|
Professional
|
Both
|
$1,253.00
|
|
|
Service Code
|
HCPCS 35800
|
| Min. Negotiated Rate |
$362.96 |
| Max. Negotiated Rate |
$1,065.05 |
| Rate for Payer: AlohaCare Medicaid |
$730.77
|
| Rate for Payer: AlohaCare Medicare |
$654.79
|
| Rate for Payer: Cash Price |
$751.80
|
| Rate for Payer: Cash Price |
$751.80
|
| Rate for Payer: Devoted Health Medicare |
$720.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$654.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$362.96
|
| Rate for Payer: Health Management Network Commercial |
$1,065.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$785.75
|
| Rate for Payer: Kaiser Permanente Medicaid |
$785.75
|
| Rate for Payer: Kaiser Permanente Medicare |
$785.75
|
| Rate for Payer: Ohana Health Plan Medicaid |
$730.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$654.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$730.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$654.79
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR
|
Professional
|
Both
|
$1,372.00
|
|
|
Service Code
|
HCPCS 35860
|
| Min. Negotiated Rate |
$339.04 |
| Max. Negotiated Rate |
$1,166.20 |
| Rate for Payer: AlohaCare Medicaid |
$800.08
|
| Rate for Payer: AlohaCare Medicare |
$745.00
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Devoted Health Medicare |
$819.50
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$745.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$339.04
|
| Rate for Payer: Health Management Network Commercial |
$1,166.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$894.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$894.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$894.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$800.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$745.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$800.08
|
| Rate for Payer: UnitedHealthcare Medicare |
$745.00
|
|
|
PR EXPL RETROPERITONEUM W/WO BX SPX
|
Professional
|
Both
|
$1,551.00
|
|
|
Service Code
|
HCPCS 49010
|
| Min. Negotiated Rate |
$741.26 |
| Max. Negotiated Rate |
$1,318.35 |
| Rate for Payer: AlohaCare Medicaid |
$902.96
|
| Rate for Payer: AlohaCare Medicare |
$838.87
|
| Rate for Payer: Cash Price |
$930.60
|
| Rate for Payer: Cash Price |
$930.60
|
| Rate for Payer: Devoted Health Medicare |
$922.76
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$838.87
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$741.26
|
| Rate for Payer: Health Management Network Commercial |
$1,318.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,006.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,006.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,006.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$902.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$838.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$902.96
|
| Rate for Payer: UnitedHealthcare Medicare |
$838.87
|
|
|
PR EXPL RPR & PRESACRAL DRG RECTAL INJURY
|
Professional
|
Both
|
$1,997.00
|
|
|
Service Code
|
HCPCS 45562
|
| Min. Negotiated Rate |
$593.06 |
| Max. Negotiated Rate |
$1,697.45 |
| Rate for Payer: AlohaCare Medicaid |
$1,163.64
|
| Rate for Payer: AlohaCare Medicare |
$1,109.53
|
| Rate for Payer: Cash Price |
$1,198.20
|
| Rate for Payer: Cash Price |
$1,198.20
|
| Rate for Payer: Devoted Health Medicare |
$1,220.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,109.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$593.06
|
| Rate for Payer: Health Management Network Commercial |
$1,697.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,331.44
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,331.44
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,331.44
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,163.64
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,109.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,163.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,109.53
|
|
|
PR EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST
|
Professional
|
Both
|
$758.00
|
|
|
Service Code
|
HCPCS 25248
|
| Min. Negotiated Rate |
$256.36 |
| Max. Negotiated Rate |
$644.30 |
| Rate for Payer: AlohaCare Medicaid |
$449.33
|
| Rate for Payer: AlohaCare Medicare |
$419.50
|
| Rate for Payer: Cash Price |
$454.80
|
| Rate for Payer: Cash Price |
$454.80
|
| Rate for Payer: Devoted Health Medicare |
$461.45
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$419.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$256.36
|
| Rate for Payer: Health Management Network Commercial |
$644.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$503.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$503.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$503.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$449.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$419.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$449.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$419.50
|
|
|
PR EXTERNAL ECG REC>48HR<7D RECORDING
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 93242
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$19.55 |
| Rate for Payer: AlohaCare Medicaid |
$13.57
|
| Rate for Payer: AlohaCare Medicare |
$13.11
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Devoted Health Medicare |
$14.42
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$13.11
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$17.39
|
| Rate for Payer: Health Management Network Commercial |
$19.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$15.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$15.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$15.73
|
| Rate for Payer: Ohana Health Plan Medicaid |
$13.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$13.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$13.11
|
|
|
PR EXTERNAL ECG REC>48HR<7D REVIEW & INTERPRETATION
|
Professional
|
Both
|
$40.62
|
|
|
Service Code
|
HCPCS 93244
|
| Min. Negotiated Rate |
$23.14 |
| Max. Negotiated Rate |
$34.53 |
| Rate for Payer: AlohaCare Medicaid |
$23.14
|
| Rate for Payer: AlohaCare Medicare |
$23.21
|
| Rate for Payer: Cash Price |
$24.37
|
| Rate for Payer: Cash Price |
$24.37
|
| Rate for Payer: Devoted Health Medicare |
$25.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$23.21
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$25.66
|
| Rate for Payer: Health Management Network Commercial |
$34.53
|
| Rate for Payer: Kaiser Permanente Commercial |
$27.85
|
| Rate for Payer: Kaiser Permanente Medicaid |
$27.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$27.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$23.14
|
| Rate for Payer: Ohana Health Plan Medicare |
$23.21
|
| Rate for Payer: UnitedHealthcare Medicaid |
$23.14
|
| Rate for Payer: UnitedHealthcare Medicare |
$23.21
|
|
|
PR EXTERNAL ECG REC>48HR<7D SCANNING ALYS W/REPORT
|
Professional
|
Both
|
$487.00
|
|
|
Service Code
|
HCPCS 93243
|
| Min. Negotiated Rate |
$43.55 |
| Max. Negotiated Rate |
$413.95 |
| Rate for Payer: AlohaCare Medicaid |
$256.44
|
| Rate for Payer: AlohaCare Medicare |
$278.18
|
| Rate for Payer: Cash Price |
$292.20
|
| Rate for Payer: Cash Price |
$292.20
|
| Rate for Payer: Devoted Health Medicare |
$306.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$278.18
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$43.55
|
| Rate for Payer: Health Management Network Commercial |
$413.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$333.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$333.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$333.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$256.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$278.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$256.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$278.18
|
|
|
PR EXTERNAL ECG REC>7D<15D RECORDING
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 93246
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$19.55 |
| Rate for Payer: AlohaCare Medicaid |
$13.57
|
| Rate for Payer: AlohaCare Medicare |
$13.11
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Devoted Health Medicare |
$14.42
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$13.11
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$17.39
|
| Rate for Payer: Health Management Network Commercial |
$19.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$15.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$15.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$15.73
|
| Rate for Payer: Ohana Health Plan Medicaid |
$13.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$13.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$13.11
|
|
|
PR EXTERNAL ECG REC>7D<15D REVIEW & INTERPRETATION
|
Professional
|
Both
|
$44.20
|
|
|
Service Code
|
HCPCS 93248
|
| Min. Negotiated Rate |
$25.26 |
| Max. Negotiated Rate |
$37.57 |
| Rate for Payer: AlohaCare Medicaid |
$25.57
|
| Rate for Payer: AlohaCare Medicare |
$25.26
|
| Rate for Payer: Cash Price |
$26.52
|
| Rate for Payer: Cash Price |
$26.52
|
| Rate for Payer: Devoted Health Medicare |
$27.79
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$25.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$28.22
|
| Rate for Payer: Health Management Network Commercial |
$37.57
|
| Rate for Payer: Kaiser Permanente Commercial |
$30.31
|
| Rate for Payer: Kaiser Permanente Medicaid |
$30.31
|
| Rate for Payer: Kaiser Permanente Medicare |
$30.31
|
| Rate for Payer: Ohana Health Plan Medicaid |
$25.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$25.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$25.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$25.26
|
|
|
PR EXTERNAL ECG REC>7D<15D SCAN ALYS REPORT R&I
|
Professional
|
Both
|
$571.24
|
|
|
Service Code
|
HCPCS 93245
|
| Min. Negotiated Rate |
$97.22 |
| Max. Negotiated Rate |
$485.55 |
| Rate for Payer: AlohaCare Medicaid |
$308.20
|
| Rate for Payer: AlohaCare Medicare |
$326.04
|
| Rate for Payer: Cash Price |
$342.74
|
| Rate for Payer: Cash Price |
$342.74
|
| Rate for Payer: Devoted Health Medicare |
$358.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$326.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$97.22
|
| Rate for Payer: Health Management Network Commercial |
$485.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$391.25
|
| Rate for Payer: Kaiser Permanente Medicaid |
$391.25
|
| Rate for Payer: Kaiser Permanente Medicare |
$391.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$308.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$326.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$308.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$326.04
|
|
|
PR EXTERNAL ECG REC>7D<15D SCANNING ALYS W/REPORT
|
Professional
|
Both
|
$504.10
|
|
|
Service Code
|
HCPCS 93247
|
| Min. Negotiated Rate |
$43.66 |
| Max. Negotiated Rate |
$428.49 |
| Rate for Payer: AlohaCare Medicaid |
$269.07
|
| Rate for Payer: AlohaCare Medicare |
$287.68
|
| Rate for Payer: Cash Price |
$302.46
|
| Rate for Payer: Cash Price |
$302.46
|
| Rate for Payer: Devoted Health Medicare |
$316.45
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$287.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$43.66
|
| Rate for Payer: Health Management Network Commercial |
$428.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$345.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$345.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$345.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$269.07
|
| Rate for Payer: Ohana Health Plan Medicare |
$287.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$269.07
|
| Rate for Payer: UnitedHealthcare Medicare |
$287.68
|
|
|
PR EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 26111
|
| Min. Negotiated Rate |
$308.10 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: AlohaCare Medicaid |
$438.69
|
| Rate for Payer: AlohaCare Medicare |
$403.44
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Devoted Health Medicare |
$443.78
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$403.44
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$308.10
|
| Rate for Payer: Health Management Network Commercial |
$642.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$484.13
|
| Rate for Payer: Kaiser Permanente Medicaid |
$484.13
|
| Rate for Payer: Kaiser Permanente Medicare |
$484.13
|
| Rate for Payer: Ohana Health Plan Medicaid |
$438.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$403.44
|
| Rate for Payer: UnitedHealthcare Medicaid |
$438.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$403.44
|
|
|
PR EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5CM/>
|
Professional
|
Both
|
$995.00
|
|
|
Service Code
|
HCPCS 26113
|
| Min. Negotiated Rate |
$525.97 |
| Max. Negotiated Rate |
$845.75 |
| Rate for Payer: AlohaCare Medicaid |
$577.52
|
| Rate for Payer: AlohaCare Medicare |
$525.97
|
| Rate for Payer: Cash Price |
$597.00
|
| Rate for Payer: Cash Price |
$597.00
|
| Rate for Payer: Devoted Health Medicare |
$578.57
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$525.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$527.80
|
| Rate for Payer: Health Management Network Commercial |
$845.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$631.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$631.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$631.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$577.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$525.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$577.52
|
| Rate for Payer: UnitedHealthcare Medicare |
$525.97
|
|
