|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 95867 TC
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$117.11 |
| Rate for Payer: AlohaCare Medicaid |
$117.11
|
| Rate for Payer: AlohaCare Medicare |
$75.01
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Devoted Health Medicare |
$82.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$75.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$73.88
|
| Rate for Payer: Health Management Network Commercial |
$63.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$90.01
|
| Rate for Payer: Kaiser Permanente Medicaid |
$90.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$90.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$117.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$75.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$117.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$75.01
|
|
|
PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 95866
|
| Min. Negotiated Rate |
$132.99 |
| Max. Negotiated Rate |
$221.00 |
| Rate for Payer: AlohaCare Medicaid |
$132.99
|
| Rate for Payer: AlohaCare Medicare |
$148.43
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Devoted Health Medicare |
$163.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$148.43
|
| Rate for Payer: Health Management Network Commercial |
$221.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$178.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$178.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$178.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$132.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$148.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$132.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$148.43
|
|
|
PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 95866 TC
|
| Min. Negotiated Rate |
$79.19 |
| Max. Negotiated Rate |
$132.99 |
| Rate for Payer: AlohaCare Medicaid |
$132.99
|
| Rate for Payer: AlohaCare Medicare |
$79.19
|
| Rate for Payer: Cash Price |
$83.40
|
| Rate for Payer: Cash Price |
$83.40
|
| Rate for Payer: Devoted Health Medicare |
$87.11
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$79.19
|
| Rate for Payer: Health Management Network Commercial |
$118.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$95.03
|
| Rate for Payer: Kaiser Permanente Medicaid |
$95.03
|
| Rate for Payer: Kaiser Permanente Medicare |
$95.03
|
| Rate for Payer: Ohana Health Plan Medicaid |
$132.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$79.19
|
| Rate for Payer: UnitedHealthcare Medicaid |
$132.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$79.19
|
|
|
PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 95866 26
|
| Min. Negotiated Rate |
$69.25 |
| Max. Negotiated Rate |
$132.99 |
| Rate for Payer: AlohaCare Medicaid |
$132.99
|
| Rate for Payer: AlohaCare Medicare |
$69.25
|
| Rate for Payer: Cash Price |
$72.60
|
| Rate for Payer: Cash Price |
$72.60
|
| Rate for Payer: Devoted Health Medicare |
$76.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.25
|
| Rate for Payer: Health Management Network Commercial |
$102.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$83.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$83.10
|
| Rate for Payer: Kaiser Permanente Medicare |
$83.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$132.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$132.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.25
|
|
|
PR NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 95885 26
|
| Min. Negotiated Rate |
$19.15 |
| Max. Negotiated Rate |
$68.83 |
| Rate for Payer: AlohaCare Medicaid |
$68.83
|
| Rate for Payer: AlohaCare Medicare |
$19.15
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Devoted Health Medicare |
$21.07
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$19.15
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$68.53
|
| Rate for Payer: Health Management Network Commercial |
$28.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$22.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$22.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$22.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$68.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$19.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$68.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$19.15
|
|
|
PR NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED
|
Professional
|
Both
|
$189.00
|
|
|
Service Code
|
HCPCS 95885
|
| Min. Negotiated Rate |
$68.53 |
| Max. Negotiated Rate |
$160.65 |
| Rate for Payer: AlohaCare Medicaid |
$68.83
|
| Rate for Payer: AlohaCare Medicare |
$71.55
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Devoted Health Medicare |
$78.70
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$71.55
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$68.53
|
| Rate for Payer: Health Management Network Commercial |
$160.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.86
|
| Rate for Payer: Kaiser Permanente Medicaid |
$85.86
|
| Rate for Payer: Kaiser Permanente Medicare |
$85.86
|
| Rate for Payer: Ohana Health Plan Medicaid |
$68.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$71.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$68.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$71.55
|
|
|
PR NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 95885 TC
|
| Min. Negotiated Rate |
$52.41 |
| Max. Negotiated Rate |
$131.75 |
| Rate for Payer: AlohaCare Medicaid |
$68.83
|
| Rate for Payer: AlohaCare Medicare |
$52.41
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Devoted Health Medicare |
$57.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$52.41
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$68.53
|
| Rate for Payer: Health Management Network Commercial |
$131.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$62.89
|
| Rate for Payer: Kaiser Permanente Medicaid |
$62.89
|
| Rate for Payer: Kaiser Permanente Medicare |
$62.89
|
| Rate for Payer: Ohana Health Plan Medicaid |
$68.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$52.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$68.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$52.41
|
|
|
PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 95886 TC
|
| Min. Negotiated Rate |
$61.90 |
| Max. Negotiated Rate |
$152.15 |
| Rate for Payer: AlohaCare Medicaid |
$105.30
|
| Rate for Payer: AlohaCare Medicare |
$61.90
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Devoted Health Medicare |
$68.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$61.90
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$93.62
|
| Rate for Payer: Health Management Network Commercial |
$152.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$74.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$74.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$74.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$105.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$61.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$105.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$61.90
|
|
|
PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
HCPCS 95886 26
|
| Min. Negotiated Rate |
$47.25 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: AlohaCare Medicaid |
$105.30
|
| Rate for Payer: AlohaCare Medicare |
$47.25
|
| Rate for Payer: Cash Price |
$49.80
|
| Rate for Payer: Cash Price |
$49.80
|
| Rate for Payer: Devoted Health Medicare |
$51.98
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$47.25
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$93.62
|
| Rate for Payer: Health Management Network Commercial |
$70.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$56.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$56.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$56.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$105.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$47.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$105.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$47.25
|
|
|
PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE
|
Professional
|
Both
|
$262.00
|
|
|
Service Code
|
HCPCS 95886
|
| Min. Negotiated Rate |
$93.62 |
| Max. Negotiated Rate |
$222.70 |
| Rate for Payer: AlohaCare Medicaid |
$105.30
|
| Rate for Payer: AlohaCare Medicare |
$109.15
|
| Rate for Payer: Cash Price |
$157.20
|
| Rate for Payer: Cash Price |
$157.20
|
| Rate for Payer: Devoted Health Medicare |
$120.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$109.15
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$93.62
|
| Rate for Payer: Health Management Network Commercial |
$222.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$130.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$130.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$130.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$105.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$109.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$105.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$109.15
|
|
|
PR NEEDLE EMG GUID W/CHEMODENERVATION
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 95874
|
| Min. Negotiated Rate |
$85.17 |
| Max. Negotiated Rate |
$202.30 |
| Rate for Payer: AlohaCare Medicaid |
$85.17
|
| Rate for Payer: AlohaCare Medicare |
$89.69
|
| Rate for Payer: Cash Price |
$142.80
|
| Rate for Payer: Cash Price |
$142.80
|
| Rate for Payer: Devoted Health Medicare |
$98.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$89.69
|
| Rate for Payer: Health Management Network Commercial |
$202.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$107.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$107.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$107.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$85.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$89.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$85.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$89.69
|
|
|
PR NEEDLE EMG GUID W/CHEMODENERVATION
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 95874 TC
|
| Min. Negotiated Rate |
$69.12 |
| Max. Negotiated Rate |
$171.70 |
| Rate for Payer: AlohaCare Medicaid |
$85.17
|
| Rate for Payer: AlohaCare Medicare |
$69.12
|
| Rate for Payer: Cash Price |
$121.20
|
| Rate for Payer: Cash Price |
$121.20
|
| Rate for Payer: Devoted Health Medicare |
$76.03
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.12
|
| Rate for Payer: Health Management Network Commercial |
$171.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$82.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$82.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$82.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$85.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$85.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.12
|
|
|
PR NEEDLE EMG GUID W/CHEMODENERVATION
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 95874 26
|
| Min. Negotiated Rate |
$20.57 |
| Max. Negotiated Rate |
$85.17 |
| Rate for Payer: AlohaCare Medicaid |
$85.17
|
| Rate for Payer: AlohaCare Medicare |
$20.57
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Devoted Health Medicare |
$22.63
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$20.57
|
| Rate for Payer: Health Management Network Commercial |
$30.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$24.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$24.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$24.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$85.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$20.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$85.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$20.57
|
|
|
PR NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 95870
|
| Min. Negotiated Rate |
$34.17 |
| Max. Negotiated Rate |
$221.85 |
| Rate for Payer: AlohaCare Medicaid |
$92.81
|
| Rate for Payer: AlohaCare Medicare |
$96.15
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Devoted Health Medicare |
$105.77
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$96.15
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.17
|
| Rate for Payer: Health Management Network Commercial |
$221.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$115.38
|
| Rate for Payer: Kaiser Permanente Medicaid |
$115.38
|
| Rate for Payer: Kaiser Permanente Medicare |
$115.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$92.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$96.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$92.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$96.15
|
|
|
PR NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 95870 TC
|
| Min. Negotiated Rate |
$34.17 |
| Max. Negotiated Rate |
$191.25 |
| Rate for Payer: AlohaCare Medicaid |
$92.81
|
| Rate for Payer: AlohaCare Medicare |
$75.77
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Devoted Health Medicare |
$83.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$75.77
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.17
|
| Rate for Payer: Health Management Network Commercial |
$191.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$90.92
|
| Rate for Payer: Kaiser Permanente Medicaid |
$90.92
|
| Rate for Payer: Kaiser Permanente Medicare |
$90.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$92.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$75.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$92.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$75.77
|
|
|
PR NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 95870 26
|
| Min. Negotiated Rate |
$20.39 |
| Max. Negotiated Rate |
$92.81 |
| Rate for Payer: AlohaCare Medicaid |
$92.81
|
| Rate for Payer: AlohaCare Medicare |
$20.39
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Devoted Health Medicare |
$22.43
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$20.39
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.17
|
| Rate for Payer: Health Management Network Commercial |
$30.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$24.47
|
| Rate for Payer: Kaiser Permanente Medicaid |
$24.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$24.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$92.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$20.39
|
| Rate for Payer: UnitedHealthcare Medicaid |
$92.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$20.39
|
|
|
PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 95887 26
|
| Min. Negotiated Rate |
$38.44 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: AlohaCare Medicaid |
$90.74
|
| Rate for Payer: AlohaCare Medicare |
$38.44
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Devoted Health Medicare |
$42.28
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.44
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$79.69
|
| Rate for Payer: Health Management Network Commercial |
$56.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$46.13
|
| Rate for Payer: Kaiser Permanente Medicaid |
$46.13
|
| Rate for Payer: Kaiser Permanente Medicare |
$46.13
|
| Rate for Payer: Ohana Health Plan Medicaid |
$90.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.44
|
| Rate for Payer: UnitedHealthcare Medicaid |
$90.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.44
|
|
|
PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 95887 TC
|
| Min. Negotiated Rate |
$58.10 |
| Max. Negotiated Rate |
$141.10 |
| Rate for Payer: AlohaCare Medicaid |
$90.74
|
| Rate for Payer: AlohaCare Medicare |
$58.10
|
| Rate for Payer: Cash Price |
$99.60
|
| Rate for Payer: Cash Price |
$99.60
|
| Rate for Payer: Devoted Health Medicare |
$63.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$58.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$79.69
|
| Rate for Payer: Health Management Network Commercial |
$141.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$69.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$69.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$69.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$90.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$58.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$90.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$58.10
|
|
|
PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION
|
Professional
|
Both
|
$233.00
|
|
|
Service Code
|
HCPCS 95887
|
| Min. Negotiated Rate |
$79.69 |
| Max. Negotiated Rate |
$198.05 |
| Rate for Payer: AlohaCare Medicaid |
$90.74
|
| Rate for Payer: AlohaCare Medicare |
$96.54
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Devoted Health Medicare |
$106.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$96.54
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$79.69
|
| Rate for Payer: Health Management Network Commercial |
$198.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$115.85
|
| Rate for Payer: Kaiser Permanente Medicaid |
$115.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$115.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$90.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$96.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$90.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$96.54
|
|
|
PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12
|
Professional
|
Both
|
$186.00
|
|
|
Service Code
|
HCPCS 95869
|
| Min. Negotiated Rate |
$34.26 |
| Max. Negotiated Rate |
$158.10 |
| Rate for Payer: AlohaCare Medicaid |
$106.58
|
| Rate for Payer: AlohaCare Medicare |
$106.03
|
| Rate for Payer: Cash Price |
$111.60
|
| Rate for Payer: Cash Price |
$111.60
|
| Rate for Payer: Devoted Health Medicare |
$116.63
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$106.03
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.26
|
| Rate for Payer: Health Management Network Commercial |
$158.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$127.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$127.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$127.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$106.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$106.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$106.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$106.03
|
|
|
PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 95869 26
|
| Min. Negotiated Rate |
$20.39 |
| Max. Negotiated Rate |
$106.58 |
| Rate for Payer: AlohaCare Medicaid |
$106.58
|
| Rate for Payer: AlohaCare Medicare |
$20.39
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Devoted Health Medicare |
$22.43
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$20.39
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.26
|
| Rate for Payer: Health Management Network Commercial |
$30.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$24.47
|
| Rate for Payer: Kaiser Permanente Medicaid |
$24.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$24.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$106.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$20.39
|
| Rate for Payer: UnitedHealthcare Medicaid |
$106.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$20.39
|
|
|
PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 95869 TC
|
| Min. Negotiated Rate |
$34.26 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: AlohaCare Medicaid |
$106.58
|
| Rate for Payer: AlohaCare Medicare |
$85.64
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Devoted Health Medicare |
$94.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$85.64
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.26
|
| Rate for Payer: Health Management Network Commercial |
$127.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$102.77
|
| Rate for Payer: Kaiser Permanente Medicaid |
$102.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$102.77
|
| Rate for Payer: Ohana Health Plan Medicaid |
$106.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$85.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$106.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$85.64
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME <= 50 SQ CM
|
Professional
|
Both
|
$79.08
|
|
|
Service Code
|
HCPCS 97605
|
| Min. Negotiated Rate |
$21.27 |
| Max. Negotiated Rate |
$67.22 |
| Rate for Payer: AlohaCare Medicaid |
$24.61
|
| Rate for Payer: AlohaCare Medicare |
$21.27
|
| Rate for Payer: Cash Price |
$47.45
|
| Rate for Payer: Cash Price |
$47.45
|
| Rate for Payer: Devoted Health Medicare |
$23.40
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$24.61
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$35.77
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$21.27
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$24.61
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$32.67
|
| Rate for Payer: Health Management Network Commercial |
$67.22
|
| Rate for Payer: Kaiser Permanente Commercial |
$25.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$25.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$25.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$24.61
|
| Rate for Payer: Ohana Health Plan Medicare |
$21.27
|
| Rate for Payer: UnitedHealthcare Medicaid |
$24.61
|
| Rate for Payer: UnitedHealthcare Medicare |
$21.27
|
| Rate for Payer: University Health Alliance Commercial |
$30.44
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM
|
Professional
|
Both
|
$95.30
|
|
|
Service Code
|
HCPCS 97606
|
| Min. Negotiated Rate |
$23.32 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: AlohaCare Medicaid |
$27.04
|
| Rate for Payer: AlohaCare Medicare |
$23.32
|
| Rate for Payer: Cash Price |
$57.18
|
| Rate for Payer: Cash Price |
$57.18
|
| Rate for Payer: Devoted Health Medicare |
$25.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$27.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$23.32
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$27.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$35.63
|
| Rate for Payer: Health Management Network Commercial |
$81.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$27.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$27.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$27.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$27.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$23.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$27.04
|
| Rate for Payer: UnitedHealthcare Medicare |
$23.32
|
| Rate for Payer: University Health Alliance Commercial |
$33.42
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME <= 50 SQ CM
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
HCPCS 97607
|
| Min. Negotiated Rate |
$18.32 |
| Max. Negotiated Rate |
$617.10 |
| Rate for Payer: AlohaCare Medicaid |
$20.89
|
| Rate for Payer: AlohaCare Medicare |
$18.32
|
| Rate for Payer: Cash Price |
$435.60
|
| Rate for Payer: Cash Price |
$435.60
|
| Rate for Payer: Devoted Health Medicare |
$20.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$20.89
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$35.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$18.32
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$20.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$45.19
|
| Rate for Payer: Health Management Network Commercial |
$617.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$21.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$21.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$21.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$20.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$18.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$20.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$18.32
|
| Rate for Payer: University Health Alliance Commercial |
$23.97
|
|
