|
CHG FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 77001 26
|
| Min. Negotiated Rate |
$17.69 |
| Max. Negotiated Rate |
$89.19 |
| Rate for Payer: AlohaCare Medicaid |
$66.21
|
| Rate for Payer: AlohaCare Medicare |
$17.69
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Devoted Health Medicare |
$19.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$17.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$89.19
|
| Rate for Payer: Health Management Network Commercial |
$26.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$21.23
|
| Rate for Payer: Kaiser Permanente Medicaid |
$21.23
|
| Rate for Payer: Kaiser Permanente Medicare |
$21.23
|
| Rate for Payer: Ohana Health Plan Medicaid |
$66.21
|
| Rate for Payer: Ohana Health Plan Medicare |
$17.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$66.21
|
| Rate for Payer: UnitedHealthcare Medicare |
$17.69
|
|
|
CHG FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 77002 26
|
| Min. Negotiated Rate |
$27.78 |
| Max. Negotiated Rate |
$80.40 |
| Rate for Payer: AlohaCare Medicaid |
$77.78
|
| Rate for Payer: AlohaCare Medicare |
$27.78
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Devoted Health Medicare |
$30.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$27.78
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network Commercial |
$41.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$33.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$33.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$33.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$77.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$27.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$77.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$27.78
|
|
|
CHG FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON
|
Professional
|
Both
|
$374.00
|
|
|
Service Code
|
HCPCS 77002
|
| Min. Negotiated Rate |
$77.78 |
| Max. Negotiated Rate |
$317.90 |
| Rate for Payer: AlohaCare Medicaid |
$77.78
|
| Rate for Payer: AlohaCare Medicare |
$134.69
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Devoted Health Medicare |
$148.16
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$134.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network Commercial |
$317.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$161.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$161.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$161.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$77.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$134.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$77.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$134.69
|
|
|
CHG FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 77002 TC
|
| Min. Negotiated Rate |
$77.78 |
| Max. Negotiated Rate |
$276.25 |
| Rate for Payer: AlohaCare Medicaid |
$77.78
|
| Rate for Payer: AlohaCare Medicare |
$106.91
|
| Rate for Payer: Cash Price |
$195.00
|
| Rate for Payer: Cash Price |
$195.00
|
| Rate for Payer: Devoted Health Medicare |
$117.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$106.91
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network Commercial |
$276.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$128.29
|
| Rate for Payer: Kaiser Permanente Medicaid |
$128.29
|
| Rate for Payer: Kaiser Permanente Medicare |
$128.29
|
| Rate for Payer: Ohana Health Plan Medicaid |
$77.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$106.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$77.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$106.91
|
|
|
CHG FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 76000 26
|
| Min. Negotiated Rate |
$15.54 |
| Max. Negotiated Rate |
$41.25 |
| Rate for Payer: AlohaCare Medicaid |
$28.01
|
| Rate for Payer: AlohaCare Medicare |
$15.54
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Devoted Health Medicare |
$17.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$15.54
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$41.25
|
| Rate for Payer: Health Management Network Commercial |
$22.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$18.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$18.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$18.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$28.01
|
| Rate for Payer: Ohana Health Plan Medicare |
$15.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$28.01
|
| Rate for Payer: UnitedHealthcare Medicare |
$15.54
|
|
|
CHG FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME
|
Professional
|
Both
|
$104.00
|
|
|
Service Code
|
HCPCS 76000 TC
|
| Min. Negotiated Rate |
$28.01 |
| Max. Negotiated Rate |
$88.40 |
| Rate for Payer: AlohaCare Medicaid |
$28.01
|
| Rate for Payer: AlohaCare Medicare |
$32.47
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Devoted Health Medicare |
$35.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$32.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$41.25
|
| Rate for Payer: Health Management Network Commercial |
$88.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$38.96
|
| Rate for Payer: Kaiser Permanente Medicaid |
$38.96
|
| Rate for Payer: Kaiser Permanente Medicare |
$38.96
|
| Rate for Payer: Ohana Health Plan Medicaid |
$28.01
|
| Rate for Payer: Ohana Health Plan Medicare |
$32.47
|
| Rate for Payer: UnitedHealthcare Medicaid |
$28.01
|
| Rate for Payer: UnitedHealthcare Medicare |
$32.47
|
|
|
CHG FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 76000
|
| Min. Negotiated Rate |
$28.01 |
| Max. Negotiated Rate |
$111.35 |
| Rate for Payer: AlohaCare Medicaid |
$28.01
|
| Rate for Payer: AlohaCare Medicare |
$48.01
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Devoted Health Medicare |
$52.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$48.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$41.25
|
| Rate for Payer: Health Management Network Commercial |
$111.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$57.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$57.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$57.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$28.01
|
| Rate for Payer: Ohana Health Plan Medicare |
$48.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$28.01
|
| Rate for Payer: UnitedHealthcare Medicare |
$48.01
|
|
|
CHG GENERAL HEALTH PANEL
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 80050
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$90.10 |
| Rate for Payer: AlohaCare Medicaid |
$41.19
|
| Rate for Payer: Cash Price |
$63.60
|
| Rate for Payer: Cash Price |
$63.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$40.00
|
| Rate for Payer: Health Management Network Commercial |
$90.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$41.19
|
| Rate for Payer: UnitedHealthcare Medicaid |
$41.19
|
|
|
CHG GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS 82962
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$5.10 |
| Rate for Payer: AlohaCare Medicaid |
$2.50
|
| Rate for Payer: AlohaCare Medicare |
$3.28
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Devoted Health Medicare |
$3.61
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4.38
|
| Rate for Payer: Health Management Network Commercial |
$5.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$3.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$3.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$3.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$3.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$2.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$3.28
|
|
|
CHG GLUCOSE BLOOD REAGENT STRIP
|
Professional
|
Both
|
$9.00
|
|
|
Service Code
|
HCPCS 82948
|
| Min. Negotiated Rate |
$4.37 |
| Max. Negotiated Rate |
$7.65 |
| Rate for Payer: AlohaCare Medicaid |
$4.37
|
| Rate for Payer: AlohaCare Medicare |
$5.04
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Devoted Health Medicare |
$5.54
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$5.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4.38
|
| Rate for Payer: Health Management Network Commercial |
$7.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$6.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$6.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$6.05
|
| Rate for Payer: Ohana Health Plan Medicaid |
$4.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$5.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$5.04
|
|
|
CHG GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 82947
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$5.95 |
| Rate for Payer: AlohaCare Medicaid |
$5.42
|
| Rate for Payer: AlohaCare Medicare |
$3.93
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Devoted Health Medicare |
$4.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$5.43
|
| Rate for Payer: Health Management Network Commercial |
$5.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$4.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$4.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$4.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$5.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$3.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$5.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$3.93
|
|
|
CHG HEMOGLOBIN GLYCOSYLATED A1C
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS 83036
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$14.45 |
| Rate for Payer: AlohaCare Medicaid |
$13.42
|
| Rate for Payer: AlohaCare Medicare |
$9.71
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Devoted Health Medicare |
$10.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.71
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$13.43
|
| Rate for Payer: Health Management Network Commercial |
$14.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$11.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$11.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$13.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.71
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.71
|
|
|
CHG HGB GLYCOSYLATED A1C DEVICE CLEARED FDA HOME USE
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS 83037
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$21.05 |
| Rate for Payer: AlohaCare Medicare |
$9.71
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Devoted Health Medicare |
$10.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.71
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$21.05
|
| Rate for Payer: Health Management Network Commercial |
$14.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$11.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$11.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.71
|
|
|
CHG HYSTEROSALPINGOGRAPHY RS&I
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 74740 26
|
| Min. Negotiated Rate |
$18.06 |
| Max. Negotiated Rate |
$77.76 |
| Rate for Payer: AlohaCare Medicaid |
$63.00
|
| Rate for Payer: AlohaCare Medicare |
$18.06
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Devoted Health Medicare |
$19.87
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$18.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$77.76
|
| Rate for Payer: Health Management Network Commercial |
$26.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$21.67
|
| Rate for Payer: Kaiser Permanente Medicaid |
$21.67
|
| Rate for Payer: Kaiser Permanente Medicare |
$21.67
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$18.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$63.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$18.06
|
|
|
CHG HYSTEROSALPINGOGRAPHY RS&I
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 74740
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$149.60 |
| Rate for Payer: AlohaCare Medicaid |
$63.00
|
| Rate for Payer: AlohaCare Medicare |
$100.29
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Devoted Health Medicare |
$110.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$100.29
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$77.76
|
| Rate for Payer: Health Management Network Commercial |
$149.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$120.35
|
| Rate for Payer: Kaiser Permanente Medicaid |
$120.35
|
| Rate for Payer: Kaiser Permanente Medicare |
$120.35
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$100.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$63.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$100.29
|
|
|
CHG HYSTEROSALPINGOGRAPHY RS&I
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 74740 TC
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$123.25 |
| Rate for Payer: AlohaCare Medicaid |
$63.00
|
| Rate for Payer: AlohaCare Medicare |
$82.22
|
| Rate for Payer: Cash Price |
$87.00
|
| Rate for Payer: Cash Price |
$87.00
|
| Rate for Payer: Devoted Health Medicare |
$90.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$82.22
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$77.76
|
| Rate for Payer: Health Management Network Commercial |
$123.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$98.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$98.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$98.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$82.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$63.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$82.22
|
|
|
CHG IAADIADOO HIV1 ANTIGEN W/HIV1 & HIV2 ANTIBODIES
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 87806
|
| Min. Negotiated Rate |
$32.77 |
| Max. Negotiated Rate |
$48.45 |
| Rate for Payer: AlohaCare Medicare |
$32.77
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Devoted Health Medicare |
$36.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$32.77
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$33.03
|
| Rate for Payer: Health Management Network Commercial |
$48.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$39.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$39.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$39.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$32.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$32.77
|
|
|
CHG IAADIADOO INFLUENZA
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 87804
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$24.65 |
| Rate for Payer: AlohaCare Medicaid |
$16.58
|
| Rate for Payer: AlohaCare Medicare |
$16.55
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Devoted Health Medicare |
$18.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$16.55
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$16.58
|
| Rate for Payer: Health Management Network Commercial |
$24.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$19.86
|
| Rate for Payer: Kaiser Permanente Medicaid |
$19.86
|
| Rate for Payer: Kaiser Permanente Medicare |
$19.86
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$16.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$16.55
|
|
|
CHG IAADIADOO SEVERE AQT RESPIR SYND CORONAVIRUS
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 87811
|
| Min. Negotiated Rate |
$41.38 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: AlohaCare Medicaid |
$41.38
|
| Rate for Payer: AlohaCare Medicare |
$41.38
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Devoted Health Medicare |
$45.52
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$41.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$41.38
|
| Rate for Payer: Health Management Network Commercial |
$61.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$49.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$49.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$49.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$41.38
|
| Rate for Payer: Ohana Health Plan Medicare |
$41.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$41.38
|
| Rate for Payer: UnitedHealthcare Medicare |
$41.38
|
|
|
CHG IAADIADOO STREPTOCOCCUS GROUP A
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 87880
|
| Min. Negotiated Rate |
$16.53 |
| Max. Negotiated Rate |
$24.65 |
| Rate for Payer: AlohaCare Medicaid |
$16.58
|
| Rate for Payer: AlohaCare Medicare |
$16.53
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Devoted Health Medicare |
$18.18
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$16.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$19.08
|
| Rate for Payer: Health Management Network Commercial |
$24.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$19.84
|
| Rate for Payer: Kaiser Permanente Medicaid |
$19.84
|
| Rate for Payer: Kaiser Permanente Medicare |
$19.84
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$16.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$16.53
|
|
|
CHG IADNA DNA/RNA RSV AMPLIFIED PROBE TECHNIQUE
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 87634
|
| Min. Negotiated Rate |
$52.00 |
| Max. Negotiated Rate |
$104.55 |
| Rate for Payer: AlohaCare Medicaid |
$52.00
|
| Rate for Payer: AlohaCare Medicare |
$70.20
|
| Rate for Payer: Cash Price |
$73.80
|
| Rate for Payer: Cash Price |
$73.80
|
| Rate for Payer: Devoted Health Medicare |
$77.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$70.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$86.65
|
| Rate for Payer: Health Management Network Commercial |
$104.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$84.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$84.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$84.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$52.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$70.20
|
| Rate for Payer: UnitedHealthcare Medicaid |
$52.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$70.20
|
|
|
CHG IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ
|
Professional
|
Both
|
$430.00
|
|
|
Service Code
|
HCPCS 87635
|
| Min. Negotiated Rate |
$51.31 |
| Max. Negotiated Rate |
$365.50 |
| Rate for Payer: AlohaCare Medicaid |
$51.31
|
| Rate for Payer: AlohaCare Medicare |
$51.31
|
| Rate for Payer: Cash Price |
$258.00
|
| Rate for Payer: Cash Price |
$258.00
|
| Rate for Payer: Devoted Health Medicare |
$56.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$51.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$51.33
|
| Rate for Payer: Health Management Network Commercial |
$365.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$61.57
|
| Rate for Payer: Kaiser Permanente Medicaid |
$61.57
|
| Rate for Payer: Kaiser Permanente Medicare |
$61.57
|
| Rate for Payer: Ohana Health Plan Medicaid |
$51.31
|
| Rate for Payer: Ohana Health Plan Medicare |
$51.31
|
| Rate for Payer: UnitedHealthcare Medicaid |
$51.31
|
| Rate for Payer: UnitedHealthcare Medicare |
$51.31
|
|
|
CHG IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TQ
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 87651
|
| Min. Negotiated Rate |
$29.42 |
| Max. Negotiated Rate |
$51.85 |
| Rate for Payer: AlohaCare Medicaid |
$29.42
|
| Rate for Payer: AlohaCare Medicare |
$35.09
|
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Devoted Health Medicare |
$38.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$35.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$49.05
|
| Rate for Payer: Health Management Network Commercial |
$51.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$42.11
|
| Rate for Payer: Kaiser Permanente Medicaid |
$42.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$42.11
|
| Rate for Payer: Ohana Health Plan Medicaid |
$29.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$35.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$29.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$35.09
|
|
|
CHG IMHCHEM/IMCYTCHM 1ST SINGLE ANTB STAIN PROCEDURE
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 88342 26
|
| Min. Negotiated Rate |
$33.92 |
| Max. Negotiated Rate |
$70.66 |
| Rate for Payer: AlohaCare Medicaid |
$70.66
|
| Rate for Payer: AlohaCare Medicare |
$33.92
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Devoted Health Medicare |
$37.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$33.92
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$59.45
|
| Rate for Payer: Health Management Network Commercial |
$50.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$40.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$40.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$40.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$70.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$33.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$70.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$33.92
|
|
|
CHG IMHCHEM/IMCYTCHM 1ST SINGLE ANTB STAIN PROCEDURE
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 88342
|
| Min. Negotiated Rate |
$59.45 |
| Max. Negotiated Rate |
$300.90 |
| Rate for Payer: AlohaCare Medicaid |
$70.66
|
| Rate for Payer: AlohaCare Medicare |
$121.84
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Devoted Health Medicare |
$134.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$121.84
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$59.45
|
| Rate for Payer: Health Management Network Commercial |
$300.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$146.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$146.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$146.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$70.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$121.84
|
| Rate for Payer: UnitedHealthcare Medicaid |
$70.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$121.84
|
|
