|
IS-1 RECEPTACLE PLUG AC-IP-2
|
Facility
|
IP
|
$175.00
|
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$98.00 |
| Max. Negotiated Rate |
$169.75 |
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$122.50
|
| Rate for Payer: Health Management Network Commercial |
$148.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$157.50
|
| Rate for Payer: MDX Hawaii PPO |
$169.75
|
| Rate for Payer: University Health Alliance Commercial |
$98.00
|
|
|
IS-1 RECEPTACLE PLUG AC-IP-2
|
Facility
|
OP
|
$175.00
|
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$87.50 |
| Max. Negotiated Rate |
$169.75 |
| Rate for Payer: AlohaCare Medicaid |
$87.50
|
| Rate for Payer: AlohaCare Medicare |
$133.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Devoted Health Medicare |
$147.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$133.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$122.50
|
| Rate for Payer: Health Management Network Commercial |
$148.75
|
| Rate for Payer: Humana Medicare |
$133.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$157.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$89.25
|
| Rate for Payer: Kaiser Permanente Medicare |
$133.00
|
| Rate for Payer: MDX Hawaii PPO |
$169.75
|
| Rate for Payer: Ohana Health Plan Medicaid |
$133.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$133.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$133.00
|
| Rate for Payer: University Health Alliance Commercial |
$98.00
|
|
|
ISATUXIMAB-IRFC 20 MG/ML INTRAVENOUS SOLUTION [172102]
|
Facility
|
IP
|
$1,566.00
|
|
|
Service Code
|
HCPCS J9227
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1,331.10 |
| Max. Negotiated Rate |
$1,519.02 |
| Rate for Payer: Cash Price |
$939.60
|
| Rate for Payer: Cash Price |
$4,698.00
|
| Rate for Payer: Health Management Network Commercial |
$1,331.10
|
| Rate for Payer: Health Management Network Commercial |
$6,655.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,409.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$7,047.00
|
| Rate for Payer: MDX Hawaii PPO |
$7,595.10
|
| Rate for Payer: MDX Hawaii PPO |
$1,519.02
|
|
|
ISATUXIMAB-IRFC 20 MG/ML INTRAVENOUS SOLUTION [172102]
|
Facility
|
OP
|
$1,566.00
|
|
|
Service Code
|
HCPCS J9227
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$82.86 |
| Max. Negotiated Rate |
$1,519.02 |
| Rate for Payer: UnitedHealthcare Medicaid |
$939.60
|
| Rate for Payer: AlohaCare Medicaid |
$783.00
|
| Rate for Payer: AlohaCare Medicaid |
$3,915.00
|
| Rate for Payer: AlohaCare Medicare |
$5,950.80
|
| Rate for Payer: AlohaCare Medicare |
$1,190.16
|
| Rate for Payer: Cash Price |
$4,698.00
|
| Rate for Payer: Cash Price |
$939.60
|
| Rate for Payer: Cash Price |
$4,698.00
|
| Rate for Payer: Cash Price |
$939.60
|
| Rate for Payer: Devoted Health Medicare |
$1,315.44
|
| Rate for Payer: Devoted Health Medicare |
$6,577.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$82.86
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$82.86
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$104.47
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$104.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$5,950.80
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,190.16
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$82.86
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$82.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,487.70
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$7,438.50
|
| Rate for Payer: Health Management Network Commercial |
$6,655.50
|
| Rate for Payer: Health Management Network Commercial |
$1,331.10
|
| Rate for Payer: Humana Medicare |
$1,190.16
|
| Rate for Payer: Humana Medicare |
$5,950.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,409.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$7,047.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$3,993.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$798.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,190.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$5,950.80
|
| Rate for Payer: MDX Hawaii PPO |
$1,519.02
|
| Rate for Payer: MDX Hawaii PPO |
$7,595.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$5,950.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,190.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,190.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$5,950.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4,698.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,190.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$5,950.80
|
| Rate for Payer: University Health Alliance Commercial |
$1,141.46
|
| Rate for Payer: University Health Alliance Commercial |
$5,707.29
|
|
|
ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC
|
Facility
|
IP
|
$50,817.09
|
|
|
Service Code
|
MSDRG 062
|
| Min. Negotiated Rate |
$50,817.09 |
| Max. Negotiated Rate |
$50,817.09 |
| Rate for Payer: Hawaii Medical Service Association Commercial |
$50,817.09
|
|
|
ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC
|
Facility
|
IP
|
$50,817.09
|
|
|
Service Code
|
MSDRG 061
|
| Min. Negotiated Rate |
$50,817.09 |
| Max. Negotiated Rate |
$50,817.09 |
| Rate for Payer: Hawaii Medical Service Association Commercial |
$50,817.09
|
|
|
ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC
|
Facility
|
IP
|
$50,817.09
|
|
|
Service Code
|
MSDRG 063
|
| Min. Negotiated Rate |
$50,817.09 |
| Max. Negotiated Rate |
$50,817.09 |
| Rate for Payer: Hawaii Medical Service Association Commercial |
$50,817.09
|
|
|
ISOFLEX PACING LEAD 1948-58CM
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS C1898
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$840.00 |
| Max. Negotiated Rate |
$1,455.00 |
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,050.00
|
| Rate for Payer: Health Management Network Commercial |
$1,275.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,350.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,455.00
|
| Rate for Payer: University Health Alliance Commercial |
$840.00
|
|
|
ISOFLEX PACING LEAD 1948-58CM
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS C1898
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$1,455.00 |
| Rate for Payer: AlohaCare Medicaid |
$750.00
|
| Rate for Payer: AlohaCare Medicare |
$1,140.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Devoted Health Medicare |
$1,260.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,140.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,050.00
|
| Rate for Payer: Health Management Network Commercial |
$1,275.00
|
| Rate for Payer: Humana Medicare |
$1,140.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,350.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$765.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,140.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,455.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,140.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,140.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,140.00
|
| Rate for Payer: University Health Alliance Commercial |
$840.00
|
|
|
ISONIAZID 300 MG TABLET [4027]
|
Facility
|
OP
|
$2.00
|
|
|
Service Code
|
NDC 00555007102
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: AlohaCare Medicaid |
$1.00
|
| Rate for Payer: AlohaCare Medicare |
$1.52
|
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Devoted Health Medicare |
$1.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.52
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1.90
|
| Rate for Payer: Health Management Network Commercial |
$1.70
|
| Rate for Payer: Humana Medicare |
$1.52
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.52
|
| Rate for Payer: MDX Hawaii PPO |
$1.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.52
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.52
|
| Rate for Payer: University Health Alliance Commercial |
$1.46
|
|
|
ISONIAZID 300 MG TABLET [4027]
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
NDC 64950021710
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.05 |
| Max. Negotiated Rate |
$12.61 |
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Health Management Network Commercial |
$11.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.70
|
| Rate for Payer: MDX Hawaii PPO |
$12.61
|
|
|
ISONIAZID 300 MG TABLET [4027]
|
Facility
|
IP
|
$2.00
|
|
|
Service Code
|
NDC 00555007101
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Health Management Network Commercial |
$1.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.80
|
| Rate for Payer: MDX Hawaii PPO |
$1.94
|
|
|
ISONIAZID 300 MG TABLET [4027]
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
NDC 64950021710
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$12.61 |
| Rate for Payer: AlohaCare Medicaid |
$6.50
|
| Rate for Payer: AlohaCare Medicare |
$9.88
|
| Rate for Payer: Cash Price |
$7.80
|
| Rate for Payer: Devoted Health Medicare |
$10.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.88
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$12.35
|
| Rate for Payer: Health Management Network Commercial |
$11.05
|
| Rate for Payer: Humana Medicare |
$9.88
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$6.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$9.88
|
| Rate for Payer: MDX Hawaii PPO |
$12.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$9.88
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.88
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.88
|
| Rate for Payer: University Health Alliance Commercial |
$9.48
|
|
|
ISONIAZID 300 MG TABLET [4027]
|
Facility
|
IP
|
$2.00
|
|
|
Service Code
|
NDC 00555007102
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Health Management Network Commercial |
$1.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.80
|
| Rate for Payer: MDX Hawaii PPO |
$1.94
|
|
|
ISONIAZID 300 MG TABLET [4027]
|
Facility
|
OP
|
$2.00
|
|
|
Service Code
|
NDC 00555007101
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: AlohaCare Medicaid |
$1.00
|
| Rate for Payer: AlohaCare Medicare |
$1.52
|
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Devoted Health Medicare |
$1.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.52
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1.90
|
| Rate for Payer: Health Management Network Commercial |
$1.70
|
| Rate for Payer: Humana Medicare |
$1.52
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.52
|
| Rate for Payer: MDX Hawaii PPO |
$1.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.52
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.52
|
| Rate for Payer: University Health Alliance Commercial |
$1.46
|
|
|
ISONIAZID 50 MG/5 ML ORAL SOLUTION [4025]
|
Facility
|
IP
|
$695.00
|
|
|
Service Code
|
NDC 46287000901
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$590.75 |
| Max. Negotiated Rate |
$674.15 |
| Rate for Payer: Cash Price |
$417.00
|
| Rate for Payer: Health Management Network Commercial |
$590.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$625.50
|
| Rate for Payer: MDX Hawaii PPO |
$674.15
|
|
|
ISONIAZID 50 MG/5 ML ORAL SOLUTION [4025]
|
Facility
|
OP
|
$695.00
|
|
|
Service Code
|
NDC 46287000901
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$347.50 |
| Max. Negotiated Rate |
$674.15 |
| Rate for Payer: AlohaCare Medicaid |
$347.50
|
| Rate for Payer: AlohaCare Medicare |
$528.20
|
| Rate for Payer: Cash Price |
$417.00
|
| Rate for Payer: Devoted Health Medicare |
$583.80
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$528.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$660.25
|
| Rate for Payer: Health Management Network Commercial |
$590.75
|
| Rate for Payer: Humana Medicare |
$528.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$625.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$354.45
|
| Rate for Payer: Kaiser Permanente Medicare |
$528.20
|
| Rate for Payer: MDX Hawaii PPO |
$674.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$528.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$528.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$528.20
|
| Rate for Payer: University Health Alliance Commercial |
$506.59
|
|
|
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION [4034]
|
Facility
|
IP
|
$420.00
|
|
|
Service Code
|
NDC 69918073510
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$357.00 |
| Max. Negotiated Rate |
$407.40 |
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Health Management Network Commercial |
$357.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$378.00
|
| Rate for Payer: MDX Hawaii PPO |
$407.40
|
|
|
ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION [4034]
|
Facility
|
IP
|
$420.00
|
|
|
Service Code
|
NDC 69918073501
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$357.00 |
| Max. Negotiated Rate |
$407.40 |
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Health Management Network Commercial |
$357.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$378.00
|
| Rate for Payer: MDX Hawaii PPO |
$407.40
|
|
|
ISOSORBIDE DINITRATE 10 MG TABLET [4064]
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
NDC 68084008201
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$4.85 |
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Health Management Network Commercial |
$4.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$4.50
|
| Rate for Payer: MDX Hawaii PPO |
$4.85
|
|
|
ISOSORBIDE DINITRATE 10 MG TABLET [4064]
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
NDC 68084008211
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$4.85 |
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Health Management Network Commercial |
$4.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$4.50
|
| Rate for Payer: MDX Hawaii PPO |
$4.85
|
|
|
ISOSORBIDE DINITRATE 10 MG TABLET [4064]
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
NDC 68084008201
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$4.85 |
| Rate for Payer: AlohaCare Medicaid |
$2.50
|
| Rate for Payer: AlohaCare Medicare |
$3.80
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Devoted Health Medicare |
$4.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3.80
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4.75
|
| Rate for Payer: Health Management Network Commercial |
$4.25
|
| Rate for Payer: Humana Medicare |
$3.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$4.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$3.80
|
| Rate for Payer: MDX Hawaii PPO |
$4.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$3.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$3.80
|
| Rate for Payer: University Health Alliance Commercial |
$3.64
|
|
|
ISOSORBIDE DINITRATE 10 MG TABLET [4064]
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
NDC 68084008211
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$4.85 |
| Rate for Payer: AlohaCare Medicaid |
$2.50
|
| Rate for Payer: AlohaCare Medicare |
$3.80
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Devoted Health Medicare |
$4.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3.80
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4.75
|
| Rate for Payer: Health Management Network Commercial |
$4.25
|
| Rate for Payer: Humana Medicare |
$3.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$4.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$3.80
|
| Rate for Payer: MDX Hawaii PPO |
$4.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$3.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$3.80
|
| Rate for Payer: University Health Alliance Commercial |
$3.64
|
|
|
ISOSORBIDE DINITRATE 20 MG TABLET [4065]
|
Facility
|
IP
|
$3.00
|
|
|
Service Code
|
NDC 00904662061
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$2.91 |
| Rate for Payer: Cash Price |
$1.80
|
| Rate for Payer: Health Management Network Commercial |
$2.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.70
|
| Rate for Payer: MDX Hawaii PPO |
$2.91
|
|
|
ISOSORBIDE DINITRATE 20 MG TABLET [4065]
|
Facility
|
OP
|
$3.00
|
|
|
Service Code
|
NDC 00904662061
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$2.91 |
| Rate for Payer: AlohaCare Medicaid |
$1.50
|
| Rate for Payer: AlohaCare Medicare |
$2.28
|
| Rate for Payer: Cash Price |
$1.80
|
| Rate for Payer: Devoted Health Medicare |
$2.52
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2.85
|
| Rate for Payer: Health Management Network Commercial |
$2.55
|
| Rate for Payer: Humana Medicare |
$2.28
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$2.28
|
| Rate for Payer: MDX Hawaii PPO |
$2.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$2.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$2.28
|
| Rate for Payer: University Health Alliance Commercial |
$2.19
|
|
