|
PR INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>
|
Professional
|
Both
|
$1,511.68
|
|
|
Service Code
|
HCPCS 36558
|
| Min. Negotiated Rate |
$231.89 |
| Max. Negotiated Rate |
$1,284.93 |
| Rate for Payer: AlohaCare Medicaid |
$256.53
|
| Rate for Payer: AlohaCare Medicare |
$231.89
|
| Rate for Payer: Cash Price |
$907.01
|
| Rate for Payer: Cash Price |
$907.01
|
| Rate for Payer: Devoted Health Medicare |
$255.08
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$256.53
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$434.12
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$231.89
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$256.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,012.44
|
| Rate for Payer: Health Management Network Commercial |
$1,284.93
|
| Rate for Payer: Kaiser Permanente Commercial |
$278.27
|
| Rate for Payer: Kaiser Permanente Medicaid |
$278.27
|
| Rate for Payer: Kaiser Permanente Medicare |
$278.27
|
| Rate for Payer: Ohana Health Plan Medicaid |
$256.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$231.89
|
| Rate for Payer: UnitedHealthcare Medicaid |
$256.53
|
| Rate for Payer: UnitedHealthcare Medicare |
$231.89
|
|
|
PR INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$1,627.62
|
|
|
Service Code
|
HCPCS 36565
|
| Min. Negotiated Rate |
$307.25 |
| Max. Negotiated Rate |
$1,383.48 |
| Rate for Payer: AlohaCare Medicaid |
$328.52
|
| Rate for Payer: AlohaCare Medicare |
$307.25
|
| Rate for Payer: Cash Price |
$976.57
|
| Rate for Payer: Cash Price |
$976.57
|
| Rate for Payer: Devoted Health Medicare |
$337.98
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$328.52
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$556.59
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$307.25
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$328.52
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,198.60
|
| Rate for Payer: Health Management Network Commercial |
$1,383.48
|
| Rate for Payer: Kaiser Permanente Commercial |
$368.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$368.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$368.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$328.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$307.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$328.52
|
| Rate for Payer: UnitedHealthcare Medicare |
$307.25
|
|
|
PR INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL
|
Professional
|
Both
|
$763.00
|
|
|
Service Code
|
HCPCS 33206
|
| Min. Negotiated Rate |
$395.01 |
| Max. Negotiated Rate |
$648.55 |
| Rate for Payer: AlohaCare Medicaid |
$445.97
|
| Rate for Payer: AlohaCare Medicare |
$395.01
|
| Rate for Payer: Cash Price |
$457.80
|
| Rate for Payer: Cash Price |
$457.80
|
| Rate for Payer: Devoted Health Medicare |
$434.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$395.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$420.42
|
| Rate for Payer: Health Management Network Commercial |
$648.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$474.01
|
| Rate for Payer: Kaiser Permanente Medicaid |
$474.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$474.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$445.97
|
| Rate for Payer: Ohana Health Plan Medicare |
$395.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$445.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$395.01
|
|
|
PR INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT
|
Professional
|
Both
|
$860.00
|
|
|
Service Code
|
HCPCS 33208
|
| Min. Negotiated Rate |
$444.01 |
| Max. Negotiated Rate |
$731.00 |
| Rate for Payer: AlohaCare Medicaid |
$503.24
|
| Rate for Payer: AlohaCare Medicare |
$444.01
|
| Rate for Payer: Cash Price |
$516.00
|
| Rate for Payer: Cash Price |
$516.00
|
| Rate for Payer: Devoted Health Medicare |
$488.41
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$444.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$666.64
|
| Rate for Payer: Health Management Network Commercial |
$731.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$532.81
|
| Rate for Payer: Kaiser Permanente Medicaid |
$532.81
|
| Rate for Payer: Kaiser Permanente Medicare |
$532.81
|
| Rate for Payer: Ohana Health Plan Medicaid |
$503.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$444.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$503.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$444.01
|
|
|
PR INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR
|
Professional
|
Both
|
$797.00
|
|
|
Service Code
|
HCPCS 33207
|
| Min. Negotiated Rate |
$412.03 |
| Max. Negotiated Rate |
$677.45 |
| Rate for Payer: AlohaCare Medicaid |
$465.57
|
| Rate for Payer: AlohaCare Medicare |
$412.03
|
| Rate for Payer: Cash Price |
$478.20
|
| Rate for Payer: Cash Price |
$478.20
|
| Rate for Payer: Devoted Health Medicare |
$453.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$412.03
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$497.12
|
| Rate for Payer: Health Management Network Commercial |
$677.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$494.44
|
| Rate for Payer: Kaiser Permanente Medicaid |
$494.44
|
| Rate for Payer: Kaiser Permanente Medicare |
$494.44
|
| Rate for Payer: Ohana Health Plan Medicaid |
$465.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$412.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$465.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$412.03
|
|
|
PR INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS
|
Professional
|
Both
|
$530.78
|
|
|
Service Code
|
HCPCS 32560
|
| Min. Negotiated Rate |
$66.70 |
| Max. Negotiated Rate |
$451.16 |
| Rate for Payer: AlohaCare Medicaid |
$73.34
|
| Rate for Payer: AlohaCare Medicare |
$66.70
|
| Rate for Payer: Cash Price |
$318.47
|
| Rate for Payer: Cash Price |
$318.47
|
| Rate for Payer: Devoted Health Medicare |
$73.37
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$73.34
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$159.59
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$66.70
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$73.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$205.40
|
| Rate for Payer: Health Management Network Commercial |
$451.16
|
| Rate for Payer: Kaiser Permanente Commercial |
$80.04
|
| Rate for Payer: Kaiser Permanente Medicaid |
$80.04
|
| Rate for Payer: Kaiser Permanente Medicare |
$80.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$73.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$66.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$73.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$66.70
|
| Rate for Payer: University Health Alliance Commercial |
$99.59
|
|
|
PR INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY
|
Professional
|
Both
|
$185.59
|
|
|
Service Code
|
HCPCS 32561
|
| Min. Negotiated Rate |
$59.34 |
| Max. Negotiated Rate |
$157.75 |
| Rate for Payer: AlohaCare Medicaid |
$65.70
|
| Rate for Payer: AlohaCare Medicare |
$59.34
|
| Rate for Payer: Cash Price |
$111.35
|
| Rate for Payer: Cash Price |
$111.35
|
| Rate for Payer: Devoted Health Medicare |
$65.27
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$65.70
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$112.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$59.34
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$65.70
|
| Rate for Payer: Health Management Network Commercial |
$157.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$71.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$71.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$71.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$65.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$59.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$65.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$59.34
|
| Rate for Payer: University Health Alliance Commercial |
$88.85
|
|
|
PR INSTRUMENT BASED OCULAR SCR BI W/ONSITE ANALYSIS
|
Professional
|
Both
|
$9.00
|
|
|
Service Code
|
HCPCS 99177
|
| Min. Negotiated Rate |
$7.65 |
| Max. Negotiated Rate |
$30.01 |
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$30.01
|
| Rate for Payer: Health Management Network Commercial |
$7.65
|
|
|
PR INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM FAMILY
|
Professional
|
Both
|
$152.00
|
|
|
Service Code
|
HCPCS 90887
|
| Min. Negotiated Rate |
$68.69 |
| Max. Negotiated Rate |
$129.20 |
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$72.75
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$72.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$68.69
|
| Rate for Payer: Health Management Network Commercial |
$129.20
|
|
|
PR INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 93261 26
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$75.30 |
| Rate for Payer: AlohaCare Medicaid |
$75.30
|
| Rate for Payer: AlohaCare Medicare |
$36.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Devoted Health Medicare |
$40.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$36.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$65.19
|
| Rate for Payer: Health Management Network Commercial |
$54.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$43.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$43.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$43.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$75.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$36.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$75.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$36.40
|
|
|
PR INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 93261 TC
|
| Min. Negotiated Rate |
$38.93 |
| Max. Negotiated Rate |
$75.30 |
| Rate for Payer: AlohaCare Medicaid |
$75.30
|
| Rate for Payer: AlohaCare Medicare |
$38.93
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Devoted Health Medicare |
$42.82
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$65.19
|
| Rate for Payer: Health Management Network Commercial |
$57.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$46.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$46.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$46.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$75.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$75.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.93
|
|
|
PR INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 93261
|
| Min. Negotiated Rate |
$65.19 |
| Max. Negotiated Rate |
$112.20 |
| Rate for Payer: AlohaCare Medicaid |
$75.30
|
| Rate for Payer: AlohaCare Medicare |
$75.33
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Devoted Health Medicare |
$82.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$75.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$65.19
|
| Rate for Payer: Health Management Network Commercial |
$112.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$90.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$90.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$90.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$75.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$75.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$75.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$75.33
|
|
|
PR INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 93292 26
|
| Min. Negotiated Rate |
$21.06 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: AlohaCare Medicaid |
$55.80
|
| Rate for Payer: AlohaCare Medicare |
$21.06
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Devoted Health Medicare |
$23.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$21.06
|
| Rate for Payer: Health Management Network Commercial |
$31.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$25.27
|
| Rate for Payer: Kaiser Permanente Medicaid |
$25.27
|
| Rate for Payer: Kaiser Permanente Medicare |
$25.27
|
| Rate for Payer: Ohana Health Plan Medicaid |
$55.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$21.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$55.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$21.06
|
|
|
PR INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 93292
|
| Min. Negotiated Rate |
$55.80 |
| Max. Negotiated Rate |
$124.95 |
| Rate for Payer: AlohaCare Medicaid |
$55.80
|
| Rate for Payer: AlohaCare Medicare |
$56.19
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Devoted Health Medicare |
$61.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$56.19
|
| Rate for Payer: Health Management Network Commercial |
$124.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$67.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$67.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$67.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$55.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$56.19
|
| Rate for Payer: UnitedHealthcare Medicaid |
$55.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$56.19
|
|
|
PR INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR
|
Professional
|
Both
|
$110.00
|
|
|
Service Code
|
HCPCS 93292 TC
|
| Min. Negotiated Rate |
$35.13 |
| Max. Negotiated Rate |
$93.50 |
| Rate for Payer: AlohaCare Medicaid |
$55.80
|
| Rate for Payer: AlohaCare Medicare |
$35.13
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Devoted Health Medicare |
$38.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$35.13
|
| Rate for Payer: Health Management Network Commercial |
$93.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$42.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$42.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$42.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$55.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$35.13
|
| Rate for Payer: UnitedHealthcare Medicaid |
$55.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$35.13
|
|
|
PR INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB
|
Professional
|
Both
|
$64.38
|
|
|
Service Code
|
HCPCS 93295
|
| Min. Negotiated Rate |
$36.66 |
| Max. Negotiated Rate |
$63.33 |
| Rate for Payer: AlohaCare Medicaid |
$36.66
|
| Rate for Payer: AlohaCare Medicare |
$36.79
|
| Rate for Payer: Cash Price |
$38.63
|
| Rate for Payer: Cash Price |
$38.63
|
| Rate for Payer: Devoted Health Medicare |
$40.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$36.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$63.33
|
| Rate for Payer: Health Management Network Commercial |
$54.72
|
| Rate for Payer: Kaiser Permanente Commercial |
$44.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$44.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$44.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$36.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$36.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$36.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$36.79
|
|
|
PR INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 93290 TC
|
| Min. Negotiated Rate |
$30.69 |
| Max. Negotiated Rate |
$98.60 |
| Rate for Payer: AlohaCare Medicaid |
$58.09
|
| Rate for Payer: AlohaCare Medicare |
$36.27
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Devoted Health Medicare |
$39.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$36.27
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$30.69
|
| Rate for Payer: Health Management Network Commercial |
$98.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$43.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$43.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$43.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$58.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$36.27
|
| Rate for Payer: UnitedHealthcare Medicaid |
$58.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$36.27
|
|
|
PR INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 93290 26
|
| Min. Negotiated Rate |
$21.06 |
| Max. Negotiated Rate |
$58.09 |
| Rate for Payer: AlohaCare Medicaid |
$58.09
|
| Rate for Payer: AlohaCare Medicare |
$21.06
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Devoted Health Medicare |
$23.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$21.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$30.69
|
| Rate for Payer: Health Management Network Commercial |
$31.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$25.27
|
| Rate for Payer: Kaiser Permanente Medicaid |
$25.27
|
| Rate for Payer: Kaiser Permanente Medicare |
$25.27
|
| Rate for Payer: Ohana Health Plan Medicaid |
$58.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$21.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$58.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$21.06
|
|
|
PR INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 93290
|
| Min. Negotiated Rate |
$30.69 |
| Max. Negotiated Rate |
$130.05 |
| Rate for Payer: AlohaCare Medicaid |
$58.09
|
| Rate for Payer: AlohaCare Medicare |
$57.33
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Devoted Health Medicare |
$63.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$57.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$30.69
|
| Rate for Payer: Health Management Network Commercial |
$130.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$68.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$68.80
|
| Rate for Payer: Kaiser Permanente Medicare |
$68.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$58.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$57.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$58.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$57.33
|
|
|
PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS 93288 26
|
| Min. Negotiated Rate |
$20.68 |
| Max. Negotiated Rate |
$61.73 |
| Rate for Payer: AlohaCare Medicaid |
$61.73
|
| Rate for Payer: AlohaCare Medicare |
$20.68
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Devoted Health Medicare |
$22.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$20.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$42.68
|
| Rate for Payer: Health Management Network Commercial |
$29.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$24.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$24.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$24.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$61.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$20.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$61.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$20.68
|
|
|
PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 93288 TC
|
| Min. Negotiated Rate |
$40.07 |
| Max. Negotiated Rate |
$112.20 |
| Rate for Payer: AlohaCare Medicaid |
$61.73
|
| Rate for Payer: AlohaCare Medicare |
$40.07
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Devoted Health Medicare |
$44.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$40.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$42.68
|
| Rate for Payer: Health Management Network Commercial |
$112.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$48.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$48.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$48.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$61.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$40.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$61.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$40.07
|
|
|
PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 93288
|
| Min. Negotiated Rate |
$42.68 |
| Max. Negotiated Rate |
$141.95 |
| Rate for Payer: AlohaCare Medicaid |
$61.73
|
| Rate for Payer: AlohaCare Medicare |
$60.75
|
| Rate for Payer: Cash Price |
$100.20
|
| Rate for Payer: Cash Price |
$100.20
|
| Rate for Payer: Devoted Health Medicare |
$66.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$60.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$42.68
|
| Rate for Payer: Health Management Network Commercial |
$141.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$72.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$72.90
|
| Rate for Payer: Kaiser Permanente Medicare |
$72.90
|
| Rate for Payer: Ohana Health Plan Medicaid |
$61.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$60.75
|
| Rate for Payer: UnitedHealthcare Medicaid |
$61.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$60.75
|
|
|
PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 93291 26
|
| Min. Negotiated Rate |
$17.91 |
| Max. Negotiated Rate |
$53.61 |
| Rate for Payer: AlohaCare Medicaid |
$53.61
|
| Rate for Payer: AlohaCare Medicare |
$17.91
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Devoted Health Medicare |
$19.70
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$17.91
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$40.77
|
| Rate for Payer: Health Management Network Commercial |
$26.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$21.49
|
| Rate for Payer: Kaiser Permanente Medicaid |
$21.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$21.49
|
| Rate for Payer: Ohana Health Plan Medicaid |
$53.61
|
| Rate for Payer: Ohana Health Plan Medicare |
$17.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$53.61
|
| Rate for Payer: UnitedHealthcare Medicare |
$17.91
|
|
|
PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 93291 TC
|
| Min. Negotiated Rate |
$34.75 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: AlohaCare Medicaid |
$53.61
|
| Rate for Payer: AlohaCare Medicare |
$34.75
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Devoted Health Medicare |
$38.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$34.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$40.77
|
| Rate for Payer: Health Management Network Commercial |
$96.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$41.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$41.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$41.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$53.61
|
| Rate for Payer: Ohana Health Plan Medicare |
$34.75
|
| Rate for Payer: UnitedHealthcare Medicaid |
$53.61
|
| Rate for Payer: UnitedHealthcare Medicare |
$34.75
|
|
|
PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 93291
|
| Min. Negotiated Rate |
$40.77 |
| Max. Negotiated Rate |
$123.25 |
| Rate for Payer: AlohaCare Medicaid |
$53.61
|
| Rate for Payer: AlohaCare Medicare |
$52.67
|
| Rate for Payer: Cash Price |
$87.00
|
| Rate for Payer: Cash Price |
$87.00
|
| Rate for Payer: Devoted Health Medicare |
$57.94
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$52.67
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$40.77
|
| Rate for Payer: Health Management Network Commercial |
$123.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$63.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$63.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$63.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$53.61
|
| Rate for Payer: Ohana Health Plan Medicare |
$52.67
|
| Rate for Payer: UnitedHealthcare Medicaid |
$53.61
|
| Rate for Payer: UnitedHealthcare Medicare |
$52.67
|
|
