|
PR BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT
|
Professional
|
Both
|
$154.65
|
|
|
Service Code
|
HCPCS 90912
|
| Min. Negotiated Rate |
$37.48 |
| Max. Negotiated Rate |
$131.45 |
| Rate for Payer: AlohaCare Medicaid |
$42.75
|
| Rate for Payer: AlohaCare Medicare |
$37.48
|
| Rate for Payer: Cash Price |
$92.79
|
| Rate for Payer: Cash Price |
$92.79
|
| Rate for Payer: Devoted Health Medicare |
$41.23
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$42.75
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$55.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$37.48
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$42.75
|
| Rate for Payer: Health Management Network Commercial |
$131.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$44.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$44.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$44.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$42.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$37.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$42.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$37.48
|
| Rate for Payer: University Health Alliance Commercial |
$52.07
|
|
|
PR BFB TRAING W/EMG&/MANOMETRY EA ADDL 15 MIN CNTCT
|
Professional
|
Both
|
$60.81
|
|
|
Service Code
|
HCPCS 90913
|
| Min. Negotiated Rate |
$21.08 |
| Max. Negotiated Rate |
$51.69 |
| Rate for Payer: AlohaCare Medicaid |
$24.09
|
| Rate for Payer: AlohaCare Medicare |
$21.08
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Devoted Health Medicare |
$23.19
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$24.09
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$31.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$21.08
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$24.09
|
| Rate for Payer: Health Management Network Commercial |
$51.69
|
| Rate for Payer: Kaiser Permanente Commercial |
$25.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$25.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$25.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$24.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$21.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$24.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$21.08
|
| Rate for Payer: University Health Alliance Commercial |
$29.15
|
|
|
PR BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH
|
Professional
|
Both
|
$461.00
|
|
|
Service Code
|
HCPCS 47552
|
| Min. Negotiated Rate |
$210.34 |
| Max. Negotiated Rate |
$391.85 |
| Rate for Payer: AlohaCare Medicaid |
$266.94
|
| Rate for Payer: AlohaCare Medicare |
$248.32
|
| Rate for Payer: Cash Price |
$276.60
|
| Rate for Payer: Cash Price |
$276.60
|
| Rate for Payer: Devoted Health Medicare |
$273.15
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$248.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$210.34
|
| Rate for Payer: Health Management Network Commercial |
$391.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$297.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$297.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$297.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$266.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$248.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$266.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$248.32
|
|
|
PR BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS
|
Professional
|
Both
|
$744.00
|
|
|
Service Code
|
HCPCS 47554
|
| Min. Negotiated Rate |
$368.68 |
| Max. Negotiated Rate |
$632.40 |
| Rate for Payer: AlohaCare Medicaid |
$432.83
|
| Rate for Payer: AlohaCare Medicare |
$387.13
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Devoted Health Medicare |
$425.84
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$387.13
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$368.68
|
| Rate for Payer: Health Management Network Commercial |
$632.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$464.56
|
| Rate for Payer: Kaiser Permanente Medicaid |
$464.56
|
| Rate for Payer: Kaiser Permanente Medicare |
$464.56
|
| Rate for Payer: Ohana Health Plan Medicaid |
$432.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$387.13
|
| Rate for Payer: UnitedHealthcare Medicaid |
$432.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$387.13
|
|
|
PR BILIARY NDSC INTRAOPERATIVE
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 47550
|
| Min. Negotiated Rate |
$132.60 |
| Max. Negotiated Rate |
$226.10 |
| Rate for Payer: AlohaCare Medicaid |
$156.43
|
| Rate for Payer: AlohaCare Medicare |
$138.13
|
| Rate for Payer: Cash Price |
$159.60
|
| Rate for Payer: Cash Price |
$159.60
|
| Rate for Payer: Devoted Health Medicare |
$151.94
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$138.13
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$132.60
|
| Rate for Payer: Health Management Network Commercial |
$226.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$165.76
|
| Rate for Payer: Kaiser Permanente Medicaid |
$165.76
|
| Rate for Payer: Kaiser Permanente Medicare |
$165.76
|
| Rate for Payer: Ohana Health Plan Medicaid |
$156.43
|
| Rate for Payer: Ohana Health Plan Medicare |
$138.13
|
| Rate for Payer: UnitedHealthcare Medicaid |
$156.43
|
| Rate for Payer: UnitedHealthcare Medicare |
$138.13
|
|
|
PR BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT
|
Professional
|
Both
|
$615.00
|
|
|
Service Code
|
HCPCS 47556
|
| Min. Negotiated Rate |
$310.96 |
| Max. Negotiated Rate |
$522.75 |
| Rate for Payer: AlohaCare Medicaid |
$357.37
|
| Rate for Payer: AlohaCare Medicare |
$328.89
|
| Rate for Payer: Cash Price |
$369.00
|
| Rate for Payer: Cash Price |
$369.00
|
| Rate for Payer: Devoted Health Medicare |
$361.78
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$328.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$310.96
|
| Rate for Payer: Health Management Network Commercial |
$522.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$394.67
|
| Rate for Payer: Kaiser Permanente Medicaid |
$394.67
|
| Rate for Payer: Kaiser Permanente Medicare |
$394.67
|
| Rate for Payer: Ohana Health Plan Medicaid |
$357.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$328.89
|
| Rate for Payer: UnitedHealthcare Medicaid |
$357.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$328.89
|
|
|
PR BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$457.00
|
|
|
Service Code
|
HCPCS 47553
|
| Min. Negotiated Rate |
$243.73 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: AlohaCare Medicaid |
$265.00
|
| Rate for Payer: AlohaCare Medicare |
$243.73
|
| Rate for Payer: Cash Price |
$274.20
|
| Rate for Payer: Cash Price |
$274.20
|
| Rate for Payer: Devoted Health Medicare |
$268.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$243.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$285.22
|
| Rate for Payer: Health Management Network Commercial |
$388.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$292.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$292.48
|
| Rate for Payer: Kaiser Permanente Medicare |
$292.48
|
| Rate for Payer: Ohana Health Plan Medicaid |
$265.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$243.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$265.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$243.73
|
|
|
PR BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT
|
Professional
|
Both
|
$543.00
|
|
|
Service Code
|
HCPCS 47555
|
| Min. Negotiated Rate |
$283.14 |
| Max. Negotiated Rate |
$461.55 |
| Rate for Payer: AlohaCare Medicaid |
$315.54
|
| Rate for Payer: AlohaCare Medicare |
$290.22
|
| Rate for Payer: Cash Price |
$325.80
|
| Rate for Payer: Cash Price |
$325.80
|
| Rate for Payer: Devoted Health Medicare |
$319.24
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$290.22
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$283.14
|
| Rate for Payer: Health Management Network Commercial |
$461.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$348.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$348.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$348.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$315.54
|
| Rate for Payer: Ohana Health Plan Medicare |
$290.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$315.54
|
| Rate for Payer: UnitedHealthcare Medicare |
$290.22
|
|
|
PR BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Professional
|
Both
|
$55.39
|
|
|
Service Code
|
HCPCS 92504
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$47.08 |
| Rate for Payer: AlohaCare Medicaid |
$9.24
|
| Rate for Payer: AlohaCare Medicare |
$7.72
|
| Rate for Payer: Cash Price |
$33.23
|
| Rate for Payer: Cash Price |
$33.23
|
| Rate for Payer: Devoted Health Medicare |
$8.49
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$9.24
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$7.72
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$9.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$16.85
|
| Rate for Payer: Health Management Network Commercial |
$47.08
|
| Rate for Payer: Kaiser Permanente Commercial |
$9.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$9.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$9.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$9.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$7.72
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$7.72
|
| Rate for Payer: University Health Alliance Commercial |
$11.24
|
|
|
PR BIOFEEDBACK TRAINING ANY MODALITY
|
Professional
|
Both
|
$78.14
|
|
|
Service Code
|
HCPCS 90901
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$66.42 |
| Rate for Payer: AlohaCare Medicare |
$16.55
|
| Rate for Payer: Cash Price |
$46.88
|
| Rate for Payer: Cash Price |
$46.88
|
| Rate for Payer: Devoted Health Medicare |
$18.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$19.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$16.55
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$19.38
|
| Rate for Payer: Health Management Network Commercial |
$66.42
|
| 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 Medicare |
$16.55
|
| Rate for Payer: UnitedHealthcare Medicare |
$16.55
|
| Rate for Payer: University Health Alliance Commercial |
$23.13
|
|
|
PR BIOPSY BONE OPEN DEEP
|
Professional
|
Both
|
$585.00
|
|
|
Service Code
|
HCPCS 20245
|
| Min. Negotiated Rate |
$229.58 |
| Max. Negotiated Rate |
$497.25 |
| Rate for Payer: AlohaCare Medicaid |
$341.72
|
| Rate for Payer: AlohaCare Medicare |
$298.49
|
| Rate for Payer: Cash Price |
$351.00
|
| Rate for Payer: Cash Price |
$351.00
|
| Rate for Payer: Devoted Health Medicare |
$328.34
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$298.49
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$229.58
|
| Rate for Payer: Health Management Network Commercial |
$497.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$358.19
|
| Rate for Payer: Kaiser Permanente Medicaid |
$358.19
|
| Rate for Payer: Kaiser Permanente Medicare |
$358.19
|
| Rate for Payer: Ohana Health Plan Medicaid |
$341.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$298.49
|
| Rate for Payer: UnitedHealthcare Medicaid |
$341.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$298.49
|
|
|
PR BIOPSY BONE OPEN SUPERFICIAL
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 20240
|
| Min. Negotiated Rate |
$126.72 |
| Max. Negotiated Rate |
$205.70 |
| Rate for Payer: AlohaCare Medicaid |
$141.06
|
| Rate for Payer: AlohaCare Medicare |
$126.72
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Cash Price |
$145.20
|
| Rate for Payer: Devoted Health Medicare |
$139.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$126.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$157.04
|
| Rate for Payer: Health Management Network Commercial |
$205.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$152.06
|
| Rate for Payer: Kaiser Permanente Medicaid |
$152.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$152.06
|
| Rate for Payer: Ohana Health Plan Medicaid |
$141.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$126.72
|
| Rate for Payer: UnitedHealthcare Medicaid |
$141.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$126.72
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE DEEP
|
Professional
|
Both
|
$698.78
|
|
|
Service Code
|
HCPCS 20225
|
| Min. Negotiated Rate |
$112.96 |
| Max. Negotiated Rate |
$593.96 |
| Rate for Payer: AlohaCare Medicaid |
$128.68
|
| Rate for Payer: AlohaCare Medicare |
$112.96
|
| Rate for Payer: Cash Price |
$419.27
|
| Rate for Payer: Cash Price |
$419.27
|
| Rate for Payer: Devoted Health Medicare |
$124.26
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$128.68
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$201.42
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$112.96
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$128.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$154.44
|
| Rate for Payer: Health Management Network Commercial |
$593.96
|
| Rate for Payer: Kaiser Permanente Commercial |
$135.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$135.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$135.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$128.68
|
| Rate for Payer: Ohana Health Plan Medicare |
$112.96
|
| Rate for Payer: UnitedHealthcare Medicaid |
$128.68
|
| Rate for Payer: UnitedHealthcare Medicare |
$112.96
|
| Rate for Payer: University Health Alliance Commercial |
$185.00
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$425.51
|
|
|
Service Code
|
HCPCS 20220
|
| Min. Negotiated Rate |
$76.43 |
| Max. Negotiated Rate |
$361.68 |
| Rate for Payer: AlohaCare Medicaid |
$86.98
|
| Rate for Payer: AlohaCare Medicare |
$76.43
|
| Rate for Payer: Cash Price |
$255.31
|
| Rate for Payer: Cash Price |
$255.31
|
| Rate for Payer: Devoted Health Medicare |
$84.07
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$86.98
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.37
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$76.43
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$86.98
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$89.18
|
| Rate for Payer: Health Management Network Commercial |
$361.68
|
| Rate for Payer: Kaiser Permanente Commercial |
$91.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$91.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$91.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$86.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$76.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$86.98
|
| Rate for Payer: UnitedHealthcare Medicare |
$76.43
|
| Rate for Payer: University Health Alliance Commercial |
$115.07
|
|
|
PR BIOPSY BREAST OPEN INCISIONAL
|
Professional
|
Both
|
$646.17
|
|
|
Service Code
|
HCPCS 19101
|
| Min. Negotiated Rate |
$216.95 |
| Max. Negotiated Rate |
$549.24 |
| Rate for Payer: AlohaCare Medicaid |
$226.30
|
| Rate for Payer: AlohaCare Medicare |
$216.95
|
| Rate for Payer: Cash Price |
$387.70
|
| Rate for Payer: Cash Price |
$387.70
|
| Rate for Payer: Devoted Health Medicare |
$238.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$226.30
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$355.34
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$216.95
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$226.30
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$268.58
|
| Rate for Payer: Health Management Network Commercial |
$549.24
|
| Rate for Payer: Kaiser Permanente Commercial |
$260.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$260.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$260.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$226.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$216.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$226.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$216.95
|
| Rate for Payer: University Health Alliance Commercial |
$262.95
|
|
|
PR BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX
|
Professional
|
Both
|
$285.51
|
|
|
Service Code
|
HCPCS 57500
|
| Min. Negotiated Rate |
$67.34 |
| Max. Negotiated Rate |
$242.68 |
| Rate for Payer: AlohaCare Medicaid |
$76.57
|
| Rate for Payer: AlohaCare Medicare |
$68.58
|
| Rate for Payer: Cash Price |
$171.31
|
| Rate for Payer: Cash Price |
$171.31
|
| Rate for Payer: Devoted Health Medicare |
$75.44
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$76.57
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$117.98
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$68.58
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$76.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$67.34
|
| Rate for Payer: Health Management Network Commercial |
$242.68
|
| Rate for Payer: Kaiser Permanente Commercial |
$82.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$82.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$82.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$76.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$68.58
|
| Rate for Payer: UnitedHealthcare Medicaid |
$76.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$68.58
|
| Rate for Payer: University Health Alliance Commercial |
$94.97
|
|
|
PR BIOPSY EXTERNAL EAR
|
Professional
|
Both
|
$175.49
|
|
|
Service Code
|
HCPCS 69100
|
| Min. Negotiated Rate |
$37.61 |
| Max. Negotiated Rate |
$149.17 |
| Rate for Payer: AlohaCare Medicaid |
$47.00
|
| Rate for Payer: AlohaCare Medicare |
$37.61
|
| Rate for Payer: Cash Price |
$105.29
|
| Rate for Payer: Cash Price |
$105.29
|
| Rate for Payer: Devoted Health Medicare |
$41.37
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$47.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$72.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$37.61
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$47.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$62.66
|
| Rate for Payer: Health Management Network Commercial |
$149.17
|
| Rate for Payer: Kaiser Permanente Commercial |
$45.13
|
| Rate for Payer: Kaiser Permanente Medicaid |
$45.13
|
| Rate for Payer: Kaiser Permanente Medicare |
$45.13
|
| Rate for Payer: Ohana Health Plan Medicaid |
$47.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$37.61
|
| Rate for Payer: UnitedHealthcare Medicaid |
$47.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$37.61
|
| Rate for Payer: University Health Alliance Commercial |
$64.64
|
|
|
PR BIOPSY FLOOR MOUTH
|
Professional
|
Both
|
$324.82
|
|
|
Service Code
|
HCPCS 41108
|
| Min. Negotiated Rate |
$63.70 |
| Max. Negotiated Rate |
$276.10 |
| Rate for Payer: AlohaCare Medicaid |
$97.17
|
| Rate for Payer: AlohaCare Medicare |
$88.01
|
| Rate for Payer: Cash Price |
$194.89
|
| Rate for Payer: Cash Price |
$194.89
|
| Rate for Payer: Devoted Health Medicare |
$96.81
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$97.17
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$146.84
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$88.01
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$97.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$63.70
|
| Rate for Payer: Health Management Network Commercial |
$276.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$105.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$105.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$105.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$97.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$88.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$97.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$88.01
|
| Rate for Payer: University Health Alliance Commercial |
$124.32
|
|
|
PR BIOPSY INTRANASAL
|
Professional
|
Both
|
$269.52
|
|
|
Service Code
|
HCPCS 30100
|
| Min. Negotiated Rate |
$50.96 |
| Max. Negotiated Rate |
$229.09 |
| Rate for Payer: AlohaCare Medicaid |
$71.58
|
| Rate for Payer: AlohaCare Medicare |
$62.86
|
| Rate for Payer: Cash Price |
$161.71
|
| Rate for Payer: Cash Price |
$161.71
|
| Rate for Payer: Devoted Health Medicare |
$69.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$71.58
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$108.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$62.86
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$71.58
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$50.96
|
| Rate for Payer: Health Management Network Commercial |
$229.09
|
| Rate for Payer: Kaiser Permanente Commercial |
$75.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$75.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$75.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$71.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$62.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$71.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$62.86
|
| Rate for Payer: University Health Alliance Commercial |
$89.28
|
|
|
PR BIOPSY LIVER NEEDLE PERCUTANEOUS
|
Professional
|
Both
|
$554.43
|
|
|
Service Code
|
HCPCS 47000
|
| Min. Negotiated Rate |
$76.43 |
| Max. Negotiated Rate |
$471.27 |
| Rate for Payer: AlohaCare Medicaid |
$87.17
|
| Rate for Payer: AlohaCare Medicare |
$76.43
|
| Rate for Payer: Cash Price |
$332.66
|
| Rate for Payer: Cash Price |
$332.66
|
| Rate for Payer: Devoted Health Medicare |
$84.07
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$87.17
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$136.50
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$76.43
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$87.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$184.86
|
| Rate for Payer: Health Management Network Commercial |
$471.27
|
| Rate for Payer: Kaiser Permanente Commercial |
$91.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$91.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$91.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$87.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$76.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$87.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$76.43
|
| Rate for Payer: University Health Alliance Commercial |
$115.57
|
|
|
PR BIOPSY LIVER WEDGE
|
Professional
|
Both
|
$1,457.00
|
|
|
Service Code
|
HCPCS 47100
|
| Min. Negotiated Rate |
$324.74 |
| Max. Negotiated Rate |
$1,238.45 |
| Rate for Payer: AlohaCare Medicaid |
$852.08
|
| Rate for Payer: AlohaCare Medicare |
$809.38
|
| Rate for Payer: Cash Price |
$874.20
|
| Rate for Payer: Cash Price |
$874.20
|
| Rate for Payer: Devoted Health Medicare |
$890.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$809.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$324.74
|
| Rate for Payer: Health Management Network Commercial |
$1,238.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$971.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$971.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$971.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$852.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$809.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$852.08
|
| Rate for Payer: UnitedHealthcare Medicare |
$809.38
|
|
|
PR BIOPSY MUSCLE DEEP
|
Professional
|
Both
|
$634.36
|
|
|
Service Code
|
HCPCS 20205
|
| Min. Negotiated Rate |
$141.18 |
| Max. Negotiated Rate |
$539.21 |
| Rate for Payer: AlohaCare Medicaid |
$153.66
|
| Rate for Payer: AlohaCare Medicare |
$144.50
|
| Rate for Payer: Cash Price |
$380.62
|
| Rate for Payer: Cash Price |
$380.62
|
| Rate for Payer: Devoted Health Medicare |
$158.95
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$153.66
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$238.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$144.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$153.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$141.18
|
| Rate for Payer: Health Management Network Commercial |
$539.21
|
| Rate for Payer: Kaiser Permanente Commercial |
$173.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$173.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$173.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$153.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$144.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$153.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$144.50
|
| Rate for Payer: University Health Alliance Commercial |
$202.08
|
|
|
PR BIOPSY MUSCLE PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$406.02
|
|
|
Service Code
|
HCPCS 20206
|
| Min. Negotiated Rate |
$51.62 |
| Max. Negotiated Rate |
$345.12 |
| Rate for Payer: AlohaCare Medicaid |
$57.77
|
| Rate for Payer: AlohaCare Medicare |
$51.62
|
| Rate for Payer: Cash Price |
$243.61
|
| Rate for Payer: Cash Price |
$243.61
|
| Rate for Payer: Devoted Health Medicare |
$56.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$57.77
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$90.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$51.62
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$57.77
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.68
|
| Rate for Payer: Health Management Network Commercial |
$345.12
|
| Rate for Payer: Kaiser Permanente Commercial |
$61.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$61.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$61.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$57.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$51.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$57.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$51.62
|
| Rate for Payer: University Health Alliance Commercial |
$76.25
|
|
|
PR BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE
|
Professional
|
Both
|
$412.70
|
|
|
Service Code
|
HCPCS 42804
|
| Min. Negotiated Rate |
$102.96 |
| Max. Negotiated Rate |
$350.80 |
| Rate for Payer: AlohaCare Medicaid |
$132.93
|
| Rate for Payer: AlohaCare Medicare |
$119.24
|
| Rate for Payer: Cash Price |
$247.62
|
| Rate for Payer: Cash Price |
$247.62
|
| Rate for Payer: Devoted Health Medicare |
$131.16
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$132.93
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$194.36
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$119.24
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$132.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$102.96
|
| Rate for Payer: Health Management Network Commercial |
$350.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$143.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$143.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$143.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$132.93
|
| Rate for Payer: Ohana Health Plan Medicare |
$119.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$132.93
|
| Rate for Payer: UnitedHealthcare Medicare |
$119.24
|
| Rate for Payer: University Health Alliance Commercial |
$170.70
|
|
|
PR BIOPSY NERVE
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 64795
|
| Min. Negotiated Rate |
$157.56 |
| Max. Negotiated Rate |
$284.75 |
| Rate for Payer: AlohaCare Medicaid |
$192.17
|
| Rate for Payer: AlohaCare Medicare |
$182.10
|
| Rate for Payer: Cash Price |
$201.00
|
| Rate for Payer: Cash Price |
$201.00
|
| Rate for Payer: Devoted Health Medicare |
$200.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$182.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$157.56
|
| Rate for Payer: Health Management Network Commercial |
$284.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$218.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$218.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$218.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$192.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$182.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$192.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$182.10
|
|
