|
PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS
|
Professional
|
Both
|
$187.76
|
|
|
Service Code
|
HCPCS 90846
|
| Min. Negotiated Rate |
$97.86 |
| Max. Negotiated Rate |
$159.60 |
| Rate for Payer: AlohaCare Medicaid |
$97.86
|
| Rate for Payer: AlohaCare Medicare |
$99.69
|
| Rate for Payer: Cash Price |
$112.66
|
| Rate for Payer: Cash Price |
$112.66
|
| Rate for Payer: Devoted Health Medicare |
$109.66
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$97.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$99.69
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$97.86
|
| Rate for Payer: Health Management Network Commercial |
$159.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$119.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$119.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$119.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$97.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$99.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$97.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$99.69
|
| Rate for Payer: University Health Alliance Commercial |
$113.90
|
|
|
PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS
|
Professional
|
Both
|
$194.42
|
|
|
Service Code
|
HCPCS 90847
|
| Min. Negotiated Rate |
$102.29 |
| Max. Negotiated Rate |
$165.26 |
| Rate for Payer: AlohaCare Medicaid |
$102.29
|
| Rate for Payer: AlohaCare Medicare |
$103.51
|
| Rate for Payer: Cash Price |
$116.65
|
| Rate for Payer: Cash Price |
$116.65
|
| Rate for Payer: Devoted Health Medicare |
$113.86
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$102.29
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$103.51
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$102.29
|
| Rate for Payer: Health Management Network Commercial |
$165.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$124.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$124.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$124.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$102.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$103.51
|
| Rate for Payer: UnitedHealthcare Medicaid |
$102.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$103.51
|
| Rate for Payer: University Health Alliance Commercial |
$124.35
|
|
|
PR FASCIA LATA GRAFT INCISION & AREA EXPOSURE
|
Professional
|
Both
|
$1,204.54
|
|
|
Service Code
|
HCPCS 20922
|
| Min. Negotiated Rate |
$323.96 |
| Max. Negotiated Rate |
$1,023.86 |
| Rate for Payer: AlohaCare Medicaid |
$512.82
|
| Rate for Payer: AlohaCare Medicare |
$476.02
|
| Rate for Payer: Cash Price |
$722.72
|
| Rate for Payer: Cash Price |
$722.72
|
| Rate for Payer: Devoted Health Medicare |
$523.62
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$512.82
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$833.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$476.02
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$512.82
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$323.96
|
| Rate for Payer: Health Management Network Commercial |
$1,023.86
|
| Rate for Payer: Kaiser Permanente Commercial |
$571.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$571.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$571.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$512.82
|
| Rate for Payer: Ohana Health Plan Medicare |
$476.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$512.82
|
| Rate for Payer: UnitedHealthcare Medicare |
$476.02
|
| Rate for Payer: University Health Alliance Commercial |
$656.70
|
|
|
PR FASCIOTOMY ILIOTIBIAL OPEN
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
HCPCS 27305
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$745.45 |
| Rate for Payer: AlohaCare Medicaid |
$510.37
|
| Rate for Payer: AlohaCare Medicare |
$476.99
|
| Rate for Payer: Cash Price |
$526.20
|
| Rate for Payer: Cash Price |
$526.20
|
| Rate for Payer: Devoted Health Medicare |
$524.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$476.99
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$57.20
|
| Rate for Payer: Health Management Network Commercial |
$745.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$572.39
|
| Rate for Payer: Kaiser Permanente Medicaid |
$572.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$572.39
|
| Rate for Payer: Ohana Health Plan Medicaid |
$510.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$476.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$510.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$476.99
|
|
|
PR FASCIOTOMY PALMAR PERCUTANEOUS
|
Professional
|
Both
|
$592.00
|
|
|
Service Code
|
HCPCS 26040
|
| Min. Negotiated Rate |
$323.93 |
| Max. Negotiated Rate |
$503.20 |
| Rate for Payer: AlohaCare Medicaid |
$343.61
|
| Rate for Payer: AlohaCare Medicare |
$323.93
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Devoted Health Medicare |
$356.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$323.93
|
| Rate for Payer: Health Management Network Commercial |
$503.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$388.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$388.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$388.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$343.61
|
| Rate for Payer: Ohana Health Plan Medicare |
$323.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$343.61
|
| Rate for Payer: UnitedHealthcare Medicare |
$323.93
|
|
|
PR FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT
|
Professional
|
Both
|
$1,091.00
|
|
|
Service Code
|
HCPCS 26121
|
| Min. Negotiated Rate |
$577.43 |
| Max. Negotiated Rate |
$927.35 |
| Rate for Payer: AlohaCare Medicaid |
$633.77
|
| Rate for Payer: AlohaCare Medicare |
$577.43
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Devoted Health Medicare |
$635.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$577.43
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$687.70
|
| Rate for Payer: Health Management Network Commercial |
$927.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$692.92
|
| Rate for Payer: Kaiser Permanente Medicaid |
$692.92
|
| Rate for Payer: Kaiser Permanente Medicare |
$692.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$633.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$577.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$633.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$577.43
|
|
|
PR FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR
|
Professional
|
Both
|
$1,520.00
|
|
|
Service Code
|
HCPCS 26123
|
| Min. Negotiated Rate |
$781.04 |
| Max. Negotiated Rate |
$1,292.00 |
| Rate for Payer: AlohaCare Medicaid |
$882.75
|
| Rate for Payer: AlohaCare Medicare |
$802.08
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Devoted Health Medicare |
$882.29
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$802.08
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$781.04
|
| Rate for Payer: Health Management Network Commercial |
$1,292.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$962.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$962.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$962.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$882.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$802.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$882.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$802.08
|
|
|
PR FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR
|
Professional
|
Both
|
$457.00
|
|
|
Service Code
|
HCPCS 26125
|
| Min. Negotiated Rate |
$222.81 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: AlohaCare Medicaid |
$266.13
|
| Rate for Payer: AlohaCare Medicare |
$222.81
|
| Rate for Payer: Cash Price |
$274.20
|
| Rate for Payer: Cash Price |
$274.20
|
| Rate for Payer: Devoted Health Medicare |
$245.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$222.81
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$247.26
|
| Rate for Payer: Health Management Network Commercial |
$388.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$267.37
|
| Rate for Payer: Kaiser Permanente Medicaid |
$267.37
|
| Rate for Payer: Kaiser Permanente Medicare |
$267.37
|
| Rate for Payer: Ohana Health Plan Medicaid |
$266.13
|
| Rate for Payer: Ohana Health Plan Medicare |
$222.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$266.13
|
| Rate for Payer: UnitedHealthcare Medicare |
$222.81
|
|
|
PR FETAL NONSTRESS TEST
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 59025 26
|
| Min. Negotiated Rate |
$28.62 |
| Max. Negotiated Rate |
$51.24 |
| Rate for Payer: AlohaCare Medicaid |
$51.24
|
| Rate for Payer: AlohaCare Medicare |
$28.62
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Devoted Health Medicare |
$31.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$28.62
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$44.98
|
| Rate for Payer: Health Management Network Commercial |
$42.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$34.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$34.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$34.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$51.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$28.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$51.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$28.62
|
|
|
PR FETAL NONSTRESS TEST
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 59025 TC
|
| Min. Negotiated Rate |
$23.74 |
| Max. Negotiated Rate |
$62.90 |
| Rate for Payer: AlohaCare Medicaid |
$51.24
|
| Rate for Payer: AlohaCare Medicare |
$23.74
|
| Rate for Payer: Cash Price |
$44.40
|
| Rate for Payer: Cash Price |
$44.40
|
| Rate for Payer: Devoted Health Medicare |
$26.11
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$23.74
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$44.98
|
| Rate for Payer: Health Management Network Commercial |
$62.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$28.49
|
| Rate for Payer: Kaiser Permanente Medicaid |
$28.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$28.49
|
| Rate for Payer: Ohana Health Plan Medicaid |
$51.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$23.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$51.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$23.74
|
|
|
PR FETAL NONSTRESS TEST
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 59025
|
| Min. Negotiated Rate |
$44.98 |
| Max. Negotiated Rate |
$105.40 |
| Rate for Payer: AlohaCare Medicaid |
$51.24
|
| Rate for Payer: AlohaCare Medicare |
$52.36
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Devoted Health Medicare |
$57.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$52.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$44.98
|
| Rate for Payer: Health Management Network Commercial |
$105.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$62.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$62.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$62.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$51.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$52.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$51.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$52.36
|
|
|
PR FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION
|
Professional
|
Both
|
$796.32
|
|
|
Service Code
|
HCPCS 10009
|
| Min. Negotiated Rate |
$91.60 |
| Max. Negotiated Rate |
$676.87 |
| Rate for Payer: AlohaCare Medicaid |
$106.88
|
| Rate for Payer: AlohaCare Medicare |
$91.60
|
| Rate for Payer: Cash Price |
$477.79
|
| Rate for Payer: Cash Price |
$477.79
|
| Rate for Payer: Devoted Health Medicare |
$100.76
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$106.88
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$184.78
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$91.60
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$106.88
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$530.92
|
| Rate for Payer: Health Management Network Commercial |
$676.87
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.92
|
| Rate for Payer: Kaiser Permanente Medicaid |
$109.92
|
| Rate for Payer: Kaiser Permanente Medicare |
$109.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$106.88
|
| Rate for Payer: Ohana Health Plan Medicare |
$91.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$106.88
|
| Rate for Payer: UnitedHealthcare Medicare |
$91.60
|
| Rate for Payer: University Health Alliance Commercial |
$115.70
|
|
|
PR FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL
|
Professional
|
Both
|
$448.14
|
|
|
Service Code
|
HCPCS 10010
|
| Min. Negotiated Rate |
$63.53 |
| Max. Negotiated Rate |
$380.92 |
| Rate for Payer: AlohaCare Medicaid |
$69.17
|
| Rate for Payer: AlohaCare Medicare |
$63.53
|
| Rate for Payer: Cash Price |
$268.88
|
| Rate for Payer: Cash Price |
$268.88
|
| Rate for Payer: Devoted Health Medicare |
$69.88
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$69.17
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$134.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$63.53
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$69.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$317.98
|
| Rate for Payer: Health Management Network Commercial |
$380.92
|
| Rate for Payer: Kaiser Permanente Commercial |
$76.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$76.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$76.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$69.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$63.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$69.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$63.53
|
| Rate for Payer: University Health Alliance Commercial |
$91.35
|
|
|
PR FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1ST LESION
|
Professional
|
Both
|
$662.30
|
|
|
Service Code
|
HCPCS 10007
|
| Min. Negotiated Rate |
$78.06 |
| Max. Negotiated Rate |
$562.96 |
| Rate for Payer: AlohaCare Medicaid |
$88.07
|
| Rate for Payer: AlohaCare Medicare |
$78.06
|
| Rate for Payer: Cash Price |
$397.38
|
| Rate for Payer: Cash Price |
$397.38
|
| Rate for Payer: Devoted Health Medicare |
$85.87
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$88.07
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$151.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$78.06
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$88.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$321.10
|
| Rate for Payer: Health Management Network Commercial |
$562.96
|
| Rate for Payer: Kaiser Permanente Commercial |
$93.67
|
| Rate for Payer: Kaiser Permanente Medicaid |
$93.67
|
| Rate for Payer: Kaiser Permanente Medicare |
$93.67
|
| Rate for Payer: Ohana Health Plan Medicaid |
$88.07
|
| Rate for Payer: Ohana Health Plan Medicare |
$78.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$88.07
|
| Rate for Payer: UnitedHealthcare Medicare |
$78.06
|
| Rate for Payer: University Health Alliance Commercial |
$104.38
|
|
|
PR FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL
|
Professional
|
Both
|
$267.02
|
|
|
Service Code
|
HCPCS 10008
|
| Min. Negotiated Rate |
$45.49 |
| Max. Negotiated Rate |
$226.97 |
| Rate for Payer: AlohaCare Medicaid |
$49.35
|
| Rate for Payer: AlohaCare Medicare |
$45.49
|
| Rate for Payer: Cash Price |
$160.21
|
| Rate for Payer: Cash Price |
$160.21
|
| Rate for Payer: Devoted Health Medicare |
$50.04
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$49.35
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$98.96
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$45.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$49.35
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$179.92
|
| Rate for Payer: Health Management Network Commercial |
$226.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$54.59
|
| Rate for Payer: Kaiser Permanente Medicaid |
$54.59
|
| Rate for Payer: Kaiser Permanente Medicare |
$54.59
|
| Rate for Payer: Ohana Health Plan Medicaid |
$49.35
|
| Rate for Payer: Ohana Health Plan Medicare |
$45.49
|
| Rate for Payer: UnitedHealthcare Medicaid |
$49.35
|
| Rate for Payer: UnitedHealthcare Medicare |
$45.49
|
| Rate for Payer: University Health Alliance Commercial |
$65.76
|
|
|
PR FINE NEEDLE ASPIRATION BX W/MR GDN 1ST LESION
|
Professional
|
Both
|
$862.00
|
|
|
Service Code
|
HCPCS 10011
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$732.70 |
| Rate for Payer: Cash Price |
$517.20
|
| Rate for Payer: Cash Price |
$517.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$102.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$102.00
|
| Rate for Payer: Health Management Network Commercial |
$732.70
|
|
|
PR FINE NEEDLE ASPIRATION BX W/MR GDN EA ADDL
|
Professional
|
Both
|
$467.00
|
|
|
Service Code
|
HCPCS 10012
|
| Min. Negotiated Rate |
$66.56 |
| Max. Negotiated Rate |
$396.95 |
| Rate for Payer: Cash Price |
$280.20
|
| Rate for Payer: Cash Price |
$280.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$66.56
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$66.56
|
| Rate for Payer: Health Management Network Commercial |
$396.95
|
|
|
PR FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION
|
Professional
|
Both
|
$188.79
|
|
|
Service Code
|
HCPCS 10021
|
| Min. Negotiated Rate |
$45.22 |
| Max. Negotiated Rate |
$160.47 |
| Rate for Payer: AlohaCare Medicaid |
$54.49
|
| Rate for Payer: AlohaCare Medicare |
$45.22
|
| Rate for Payer: Cash Price |
$113.27
|
| Rate for Payer: Cash Price |
$113.27
|
| Rate for Payer: Devoted Health Medicare |
$49.74
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$54.49
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$97.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$45.22
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$54.49
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$83.72
|
| Rate for Payer: Health Management Network Commercial |
$160.47
|
| Rate for Payer: Kaiser Permanente Commercial |
$54.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$54.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$54.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$54.49
|
| Rate for Payer: Ohana Health Plan Medicare |
$45.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$54.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$45.22
|
| Rate for Payer: University Health Alliance Commercial |
$59.40
|
|
|
PR FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL
|
Professional
|
Both
|
$95.18
|
|
|
Service Code
|
HCPCS 10004
|
| Min. Negotiated Rate |
$35.78 |
| Max. Negotiated Rate |
$80.90 |
| Rate for Payer: AlohaCare Medicaid |
$42.83
|
| Rate for Payer: AlohaCare Medicare |
$35.78
|
| Rate for Payer: Cash Price |
$57.11
|
| Rate for Payer: Cash Price |
$57.11
|
| Rate for Payer: Devoted Health Medicare |
$39.36
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$42.83
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$71.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$35.78
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$42.83
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$55.38
|
| Rate for Payer: Health Management Network Commercial |
$80.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$42.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$42.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$42.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$42.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$35.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$42.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$35.78
|
| Rate for Payer: University Health Alliance Commercial |
$49.26
|
|
|
PR FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION
|
Professional
|
Both
|
$246.26
|
|
|
Service Code
|
HCPCS 10005
|
| Min. Negotiated Rate |
$61.35 |
| Max. Negotiated Rate |
$209.32 |
| Rate for Payer: AlohaCare Medicaid |
$72.24
|
| Rate for Payer: AlohaCare Medicare |
$61.35
|
| Rate for Payer: Cash Price |
$147.76
|
| Rate for Payer: Cash Price |
$147.76
|
| Rate for Payer: Devoted Health Medicare |
$67.48
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$72.24
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$123.13
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$61.35
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$72.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$137.80
|
| Rate for Payer: Health Management Network Commercial |
$209.32
|
| Rate for Payer: Kaiser Permanente Commercial |
$73.62
|
| Rate for Payer: Kaiser Permanente Medicaid |
$73.62
|
| Rate for Payer: Kaiser Permanente Medicare |
$73.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$72.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$61.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$72.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$61.35
|
| Rate for Payer: University Health Alliance Commercial |
$78.33
|
|
|
PR FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL
|
Professional
|
Both
|
$108.18
|
|
|
Service Code
|
HCPCS 10006
|
| Min. Negotiated Rate |
$42.46 |
| Max. Negotiated Rate |
$91.95 |
| Rate for Payer: AlohaCare Medicaid |
$49.69
|
| Rate for Payer: AlohaCare Medicare |
$42.46
|
| Rate for Payer: Cash Price |
$64.91
|
| Rate for Payer: Cash Price |
$64.91
|
| Rate for Payer: Devoted Health Medicare |
$46.71
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$49.69
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$84.37
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$42.46
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$49.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$63.44
|
| Rate for Payer: Health Management Network Commercial |
$91.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$50.95
|
| Rate for Payer: Kaiser Permanente Medicaid |
$50.95
|
| Rate for Payer: Kaiser Permanente Medicare |
$50.95
|
| Rate for Payer: Ohana Health Plan Medicaid |
$49.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$42.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$49.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$42.46
|
| Rate for Payer: University Health Alliance Commercial |
$53.59
|
|
|
PR FINGER SPLINT, STATIC
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS Q4049
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$4.25 |
| Rate for Payer: AlohaCare Medicaid |
$1.50
|
| Rate for Payer: AlohaCare Medicare |
$2.68
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Devoted Health Medicare |
$2.95
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2.09
|
| Rate for Payer: Health Management Network Commercial |
$4.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$3.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$3.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$3.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$2.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$2.68
|
|
|
PR FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 57160
|
| Min. Negotiated Rate |
$39.18 |
| Max. Negotiated Rate |
$113.05 |
| Rate for Payer: AlohaCare Medicaid |
$45.24
|
| Rate for Payer: AlohaCare Medicare |
$39.18
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: Devoted Health Medicare |
$43.10
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$45.24
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$75.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$39.18
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$45.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$43.94
|
| Rate for Payer: Health Management Network Commercial |
$113.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$47.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$47.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$47.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$45.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$39.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$45.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$39.18
|
| Rate for Payer: University Health Alliance Commercial |
$56.07
|
|
|
PR FLUORESCEIN&ICG ANGRPH MULTIFRAME IMG I&R UNI/BI
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 92242 26
|
| Min. Negotiated Rate |
$56.33 |
| Max. Negotiated Rate |
$316.93 |
| Rate for Payer: AlohaCare Medicaid |
$316.93
|
| Rate for Payer: AlohaCare Medicare |
$56.33
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Devoted Health Medicare |
$61.96
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$56.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$259.30
|
| Rate for Payer: Health Management Network Commercial |
$84.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$67.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$67.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$67.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$316.93
|
| Rate for Payer: Ohana Health Plan Medicare |
$56.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$316.93
|
| Rate for Payer: UnitedHealthcare Medicare |
$56.33
|
|
|
PR FLUORESCEIN&ICG ANGRPH MULTIFRAME IMG I&R UNI/BI
|
Professional
|
Both
|
$1,012.00
|
|
|
Service Code
|
HCPCS 92242 TC
|
| Min. Negotiated Rate |
$259.30 |
| Max. Negotiated Rate |
$860.20 |
| Rate for Payer: AlohaCare Medicaid |
$316.93
|
| Rate for Payer: AlohaCare Medicare |
$321.10
|
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Devoted Health Medicare |
$353.21
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$321.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$259.30
|
| Rate for Payer: Health Management Network Commercial |
$860.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$385.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$385.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$385.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$316.93
|
| Rate for Payer: Ohana Health Plan Medicare |
$321.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$316.93
|
| Rate for Payer: UnitedHealthcare Medicare |
$321.10
|
|
