|
PR BIOPSY OF LIP
|
Professional
|
Both
|
$225.80
|
|
|
Service Code
|
HCPCS 40490
|
| Min. Negotiated Rate |
$56.12 |
| Max. Negotiated Rate |
$191.93 |
| Rate for Payer: AlohaCare Medicaid |
$70.19
|
| Rate for Payer: AlohaCare Medicare |
$56.12
|
| Rate for Payer: Cash Price |
$135.48
|
| Rate for Payer: Cash Price |
$135.48
|
| Rate for Payer: Devoted Health Medicare |
$61.73
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$70.19
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$108.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$56.12
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$70.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.08
|
| Rate for Payer: Health Management Network Commercial |
$191.93
|
| Rate for Payer: Kaiser Permanente Commercial |
$67.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$67.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$67.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$70.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$56.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$70.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$56.12
|
| Rate for Payer: University Health Alliance Commercial |
$91.58
|
|
|
PR BIOPSY OROPHARYNX
|
Professional
|
Both
|
$300.28
|
|
|
Service Code
|
HCPCS 42800
|
| Min. Negotiated Rate |
$73.06 |
| Max. Negotiated Rate |
$255.24 |
| Rate for Payer: AlohaCare Medicaid |
$124.53
|
| Rate for Payer: AlohaCare Medicare |
$110.45
|
| Rate for Payer: Cash Price |
$180.17
|
| Rate for Payer: Cash Price |
$180.17
|
| Rate for Payer: Devoted Health Medicare |
$121.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$124.53
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$188.12
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$110.45
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$124.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$73.06
|
| Rate for Payer: Health Management Network Commercial |
$255.24
|
| Rate for Payer: Kaiser Permanente Commercial |
$132.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$132.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$132.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$124.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$110.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$124.53
|
| Rate for Payer: UnitedHealthcare Medicare |
$110.45
|
| Rate for Payer: University Health Alliance Commercial |
$159.27
|
|
|
PR BIOPSY PALATE UVULA
|
Professional
|
Both
|
$281.89
|
|
|
Service Code
|
HCPCS 42100
|
| Min. Negotiated Rate |
$91.26 |
| Max. Negotiated Rate |
$239.61 |
| Rate for Payer: AlohaCare Medicaid |
$117.10
|
| Rate for Payer: AlohaCare Medicare |
$106.01
|
| Rate for Payer: Cash Price |
$169.13
|
| Rate for Payer: Cash Price |
$169.13
|
| Rate for Payer: Devoted Health Medicare |
$116.61
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$117.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$177.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$106.01
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$117.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$91.26
|
| Rate for Payer: Health Management Network Commercial |
$239.61
|
| Rate for Payer: Kaiser Permanente Commercial |
$127.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$127.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$127.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$117.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$106.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$117.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$106.01
|
| Rate for Payer: University Health Alliance Commercial |
$150.61
|
|
|
PR BIOPSY PANCREA PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$927.62
|
|
|
Service Code
|
HCPCS 48102
|
| Min. Negotiated Rate |
$201.57 |
| Max. Negotiated Rate |
$788.48 |
| Rate for Payer: AlohaCare Medicaid |
$231.78
|
| Rate for Payer: AlohaCare Medicare |
$201.57
|
| Rate for Payer: Cash Price |
$556.57
|
| Rate for Payer: Cash Price |
$556.57
|
| Rate for Payer: Devoted Health Medicare |
$221.73
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$231.78
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$364.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$201.57
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$231.78
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$228.80
|
| Rate for Payer: Health Management Network Commercial |
$788.48
|
| Rate for Payer: Kaiser Permanente Commercial |
$241.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$241.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$241.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$231.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$201.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$231.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$201.57
|
| Rate for Payer: University Health Alliance Commercial |
$308.20
|
|
|
PR BIOPSY PENIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$382.74
|
|
|
Service Code
|
HCPCS 54100
|
| Min. Negotiated Rate |
$71.50 |
| Max. Negotiated Rate |
$325.33 |
| Rate for Payer: AlohaCare Medicaid |
$125.30
|
| Rate for Payer: AlohaCare Medicare |
$105.91
|
| Rate for Payer: Cash Price |
$229.64
|
| Rate for Payer: Cash Price |
$229.64
|
| Rate for Payer: Devoted Health Medicare |
$116.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$125.30
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$190.28
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$105.91
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$125.30
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.50
|
| Rate for Payer: Health Management Network Commercial |
$325.33
|
| Rate for Payer: Kaiser Permanente Commercial |
$127.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$127.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$127.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$125.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$105.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$125.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$105.91
|
| Rate for Payer: University Health Alliance Commercial |
$161.10
|
|
|
PR BIOPSY PLEURA PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$311.32
|
|
|
Service Code
|
HCPCS 32400
|
| Min. Negotiated Rate |
$71.18 |
| Max. Negotiated Rate |
$264.62 |
| Rate for Payer: AlohaCare Medicaid |
$81.84
|
| Rate for Payer: AlohaCare Medicare |
$71.18
|
| Rate for Payer: Cash Price |
$186.79
|
| Rate for Payer: Cash Price |
$186.79
|
| Rate for Payer: Devoted Health Medicare |
$78.30
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$81.84
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$130.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$71.18
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$81.84
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.16
|
| Rate for Payer: Health Management Network Commercial |
$264.62
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.42
|
| Rate for Payer: Kaiser Permanente Medicaid |
$85.42
|
| Rate for Payer: Kaiser Permanente Medicare |
$85.42
|
| Rate for Payer: Ohana Health Plan Medicaid |
$81.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$71.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$81.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$71.18
|
| Rate for Payer: University Health Alliance Commercial |
$110.79
|
|
|
PR BIOPSY PROSTATE INCISIONAL ANY APPROACH
|
Professional
|
Both
|
$442.00
|
|
|
Service Code
|
HCPCS 55705
|
| Min. Negotiated Rate |
$100.66 |
| Max. Negotiated Rate |
$375.70 |
| Rate for Payer: AlohaCare Medicaid |
$269.09
|
| Rate for Payer: AlohaCare Medicare |
$100.66
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Devoted Health Medicare |
$110.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$100.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$233.48
|
| Rate for Payer: Health Management Network Commercial |
$375.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$120.79
|
| Rate for Payer: Kaiser Permanente Medicaid |
$120.79
|
| Rate for Payer: Kaiser Permanente Medicare |
$120.79
|
| Rate for Payer: Ohana Health Plan Medicaid |
$269.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$100.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$269.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$100.66
|
|
|
PR BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED
|
Professional
|
Both
|
$649.00
|
|
|
Service Code
|
HCPCS 55707
|
| Min. Negotiated Rate |
$136.39 |
| Max. Negotiated Rate |
$551.65 |
| Rate for Payer: AlohaCare Medicare |
$136.39
|
| Rate for Payer: Cash Price |
$389.40
|
| Rate for Payer: Cash Price |
$389.40
|
| Rate for Payer: Devoted Health Medicare |
$150.03
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$136.39
|
| Rate for Payer: Health Management Network Commercial |
$551.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$163.67
|
| Rate for Payer: Kaiser Permanente Medicaid |
$163.67
|
| Rate for Payer: Kaiser Permanente Medicare |
$163.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$136.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$136.39
|
|
|
PR BIOPSY SALIVARY GLAND NEEDLE
|
Professional
|
Both
|
$180.06
|
|
|
Service Code
|
HCPCS 42400
|
| Min. Negotiated Rate |
$49.34 |
| Max. Negotiated Rate |
$153.05 |
| Rate for Payer: AlohaCare Medicaid |
$55.00
|
| Rate for Payer: AlohaCare Medicare |
$49.34
|
| Rate for Payer: Cash Price |
$108.04
|
| Rate for Payer: Cash Price |
$108.04
|
| Rate for Payer: Devoted Health Medicare |
$54.27
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$55.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$84.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$49.34
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$55.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$76.96
|
| Rate for Payer: Health Management Network Commercial |
$153.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$59.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$59.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$59.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$55.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$49.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$55.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$49.34
|
| Rate for Payer: University Health Alliance Commercial |
$68.58
|
|
|
PR BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL
|
Professional
|
Both
|
$498.75
|
|
|
Service Code
|
HCPCS 21920
|
| Min. Negotiated Rate |
$89.70 |
| Max. Negotiated Rate |
$423.94 |
| Rate for Payer: AlohaCare Medicaid |
$161.69
|
| Rate for Payer: AlohaCare Medicare |
$146.76
|
| Rate for Payer: Cash Price |
$299.25
|
| Rate for Payer: Cash Price |
$299.25
|
| Rate for Payer: Devoted Health Medicare |
$161.44
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$161.69
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$250.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$146.76
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$161.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$89.70
|
| Rate for Payer: Health Management Network Commercial |
$423.94
|
| Rate for Payer: Kaiser Permanente Commercial |
$176.11
|
| Rate for Payer: Kaiser Permanente Medicaid |
$176.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$176.11
|
| Rate for Payer: Ohana Health Plan Medicaid |
$161.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$146.76
|
| Rate for Payer: UnitedHealthcare Medicaid |
$161.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$146.76
|
| Rate for Payer: University Health Alliance Commercial |
$212.28
|
|
|
PR BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP
|
Professional
|
Both
|
$686.00
|
|
|
Service Code
|
HCPCS 25066
|
| Min. Negotiated Rate |
$190.84 |
| Max. Negotiated Rate |
$583.10 |
| Rate for Payer: AlohaCare Medicaid |
$394.20
|
| Rate for Payer: AlohaCare Medicare |
$373.17
|
| Rate for Payer: Cash Price |
$411.60
|
| Rate for Payer: Cash Price |
$411.60
|
| Rate for Payer: Devoted Health Medicare |
$410.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$373.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$190.84
|
| Rate for Payer: Health Management Network Commercial |
$583.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$447.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$447.80
|
| Rate for Payer: Kaiser Permanente Medicare |
$447.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$394.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$373.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$394.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$373.17
|
|
|
PR BIOPSY SOFT TISSUE NECK/THORAX
|
Professional
|
Both
|
$515.00
|
|
|
Service Code
|
HCPCS 21550
|
| Min. Negotiated Rate |
$90.74 |
| Max. Negotiated Rate |
$437.75 |
| Rate for Payer: AlohaCare Medicaid |
$163.23
|
| Rate for Payer: AlohaCare Medicare |
$148.28
|
| Rate for Payer: Cash Price |
$309.00
|
| Rate for Payer: Cash Price |
$309.00
|
| Rate for Payer: Devoted Health Medicare |
$163.11
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$163.23
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$251.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$148.28
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$163.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$90.74
|
| Rate for Payer: Health Management Network Commercial |
$437.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$177.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$177.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$177.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$163.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$148.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$163.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$148.28
|
| Rate for Payer: University Health Alliance Commercial |
$212.78
|
|
|
PR BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP
|
Professional
|
Both
|
$744.00
|
|
|
Service Code
|
HCPCS 27324
|
| Min. Negotiated Rate |
$190.84 |
| Max. Negotiated Rate |
$632.40 |
| Rate for Payer: AlohaCare Medicaid |
$432.30
|
| Rate for Payer: AlohaCare Medicare |
$414.09
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Devoted Health Medicare |
$455.50
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$414.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$190.84
|
| Rate for Payer: Health Management Network Commercial |
$632.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$496.91
|
| Rate for Payer: Kaiser Permanente Medicaid |
$496.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$496.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$432.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$414.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$432.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$414.09
|
|
|
PR BIOPSY THYROID PERCUTANEOUS CORE NEEDLE
|
Professional
|
Both
|
$198.28
|
|
|
Service Code
|
HCPCS 60100
|
| Min. Negotiated Rate |
$64.31 |
| Max. Negotiated Rate |
$168.54 |
| Rate for Payer: AlohaCare Medicaid |
$75.37
|
| Rate for Payer: AlohaCare Medicare |
$64.31
|
| Rate for Payer: Cash Price |
$118.97
|
| Rate for Payer: Cash Price |
$118.97
|
| Rate for Payer: Devoted Health Medicare |
$70.74
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$75.37
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$118.74
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$64.31
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$75.37
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$92.82
|
| Rate for Payer: Health Management Network Commercial |
$168.54
|
| Rate for Payer: Kaiser Permanente Commercial |
$77.17
|
| Rate for Payer: Kaiser Permanente Medicaid |
$77.17
|
| Rate for Payer: Kaiser Permanente Medicare |
$77.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$75.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$64.31
|
| Rate for Payer: UnitedHealthcare Medicaid |
$75.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$64.31
|
| Rate for Payer: University Health Alliance Commercial |
$93.26
|
|
|
PR BIOPSY TONGUE ANTERIOR TWO-THIRDS
|
Professional
|
Both
|
$356.91
|
|
|
Service Code
|
HCPCS 41100
|
| Min. Negotiated Rate |
$72.80 |
| Max. Negotiated Rate |
$303.37 |
| Rate for Payer: AlohaCare Medicaid |
$113.16
|
| Rate for Payer: AlohaCare Medicare |
$101.04
|
| Rate for Payer: Cash Price |
$214.15
|
| Rate for Payer: Cash Price |
$214.15
|
| Rate for Payer: Devoted Health Medicare |
$111.14
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$113.16
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$173.67
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$101.04
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$113.16
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$72.80
|
| Rate for Payer: Health Management Network Commercial |
$303.37
|
| Rate for Payer: Kaiser Permanente Commercial |
$121.25
|
| Rate for Payer: Kaiser Permanente Medicaid |
$121.25
|
| Rate for Payer: Kaiser Permanente Medicare |
$121.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$113.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$101.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$113.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$101.04
|
| Rate for Payer: University Health Alliance Commercial |
$145.25
|
|
|
PR BIOPSY TONGUE POSTERIOR ONE-THIRD
|
Professional
|
Both
|
$359.52
|
|
|
Service Code
|
HCPCS 41105
|
| Min. Negotiated Rate |
$104.04 |
| Max. Negotiated Rate |
$305.59 |
| Rate for Payer: AlohaCare Medicaid |
$116.35
|
| Rate for Payer: AlohaCare Medicare |
$104.04
|
| Rate for Payer: Cash Price |
$215.71
|
| Rate for Payer: Cash Price |
$215.71
|
| Rate for Payer: Devoted Health Medicare |
$114.44
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$116.35
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$177.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$104.04
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$116.35
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$104.26
|
| Rate for Payer: Health Management Network Commercial |
$305.59
|
| Rate for Payer: Kaiser Permanente Commercial |
$124.85
|
| Rate for Payer: Kaiser Permanente Medicaid |
$124.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$124.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$116.35
|
| Rate for Payer: Ohana Health Plan Medicare |
$104.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$116.35
|
| Rate for Payer: UnitedHealthcare Medicare |
$104.04
|
| Rate for Payer: University Health Alliance Commercial |
$150.25
|
|
|
PR BIOPSY URETHRA
|
Professional
|
Both
|
$297.66
|
|
|
Service Code
|
HCPCS 53200
|
| Min. Negotiated Rate |
$126.79 |
| Max. Negotiated Rate |
$253.01 |
| Rate for Payer: AlohaCare Medicaid |
$142.09
|
| Rate for Payer: AlohaCare Medicare |
$126.79
|
| Rate for Payer: Cash Price |
$178.60
|
| Rate for Payer: Cash Price |
$178.60
|
| Rate for Payer: Devoted Health Medicare |
$139.47
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$142.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$126.79
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$142.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$130.78
|
| Rate for Payer: Health Management Network Commercial |
$253.01
|
| Rate for Payer: Kaiser Permanente Commercial |
$152.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$152.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$152.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$142.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$126.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$142.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$126.79
|
| Rate for Payer: University Health Alliance Commercial |
$185.55
|
|
|
PR BIOPSY VAGINAL MUCOSA SIMPLE
|
Professional
|
Both
|
$192.80
|
|
|
Service Code
|
HCPCS 57100
|
| Min. Negotiated Rate |
$57.01 |
| Max. Negotiated Rate |
$163.88 |
| Rate for Payer: AlohaCare Medicaid |
$65.10
|
| Rate for Payer: AlohaCare Medicare |
$57.01
|
| Rate for Payer: Cash Price |
$115.68
|
| Rate for Payer: Cash Price |
$115.68
|
| Rate for Payer: Devoted Health Medicare |
$62.71
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$65.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$101.96
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$57.01
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$65.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$69.16
|
| Rate for Payer: Health Management Network Commercial |
$163.88
|
| Rate for Payer: Kaiser Permanente Commercial |
$68.41
|
| Rate for Payer: Kaiser Permanente Medicaid |
$68.41
|
| Rate for Payer: Kaiser Permanente Medicare |
$68.41
|
| Rate for Payer: Ohana Health Plan Medicaid |
$65.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$57.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$65.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$57.01
|
| Rate for Payer: University Health Alliance Commercial |
$86.32
|
|
|
PR BIOPSY VESTIBULE MOUTH
|
Professional
|
Both
|
$321.56
|
|
|
Service Code
|
HCPCS 40808
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$273.33 |
| Rate for Payer: AlohaCare Medicaid |
$95.13
|
| Rate for Payer: AlohaCare Medicare |
$86.53
|
| Rate for Payer: Cash Price |
$192.94
|
| Rate for Payer: Cash Price |
$192.94
|
| Rate for Payer: Devoted Health Medicare |
$95.18
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$95.13
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$152.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$86.53
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$95.13
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$57.20
|
| Rate for Payer: Health Management Network Commercial |
$273.33
|
| Rate for Payer: Kaiser Permanente Commercial |
$103.84
|
| Rate for Payer: Kaiser Permanente Medicaid |
$103.84
|
| Rate for Payer: Kaiser Permanente Medicare |
$103.84
|
| Rate for Payer: Ohana Health Plan Medicaid |
$95.13
|
| Rate for Payer: Ohana Health Plan Medicare |
$86.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$95.13
|
| Rate for Payer: UnitedHealthcare Medicare |
$86.53
|
| Rate for Payer: University Health Alliance Commercial |
$150.00
|
|
|
PR BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Professional
|
Both
|
$171.99
|
|
|
Service Code
|
HCPCS 56605
|
| Min. Negotiated Rate |
$50.43 |
| Max. Negotiated Rate |
$146.19 |
| Rate for Payer: AlohaCare Medicaid |
$58.72
|
| Rate for Payer: AlohaCare Medicare |
$50.43
|
| Rate for Payer: Cash Price |
$103.19
|
| Rate for Payer: Cash Price |
$103.19
|
| Rate for Payer: Devoted Health Medicare |
$55.47
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$58.72
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$91.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$50.43
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$58.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.50
|
| Rate for Payer: Health Management Network Commercial |
$146.19
|
| Rate for Payer: Kaiser Permanente Commercial |
$60.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$60.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$60.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$58.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$50.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$58.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$50.43
|
| Rate for Payer: University Health Alliance Commercial |
$125.00
|
|
|
PR BIOPSY VULVA/PERINEUM EACH ADDL LESION
|
Professional
|
Both
|
$70.49
|
|
|
Service Code
|
HCPCS 56606
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$59.92 |
| Rate for Payer: AlohaCare Medicaid |
$28.79
|
| Rate for Payer: AlohaCare Medicare |
$24.71
|
| Rate for Payer: Cash Price |
$42.29
|
| Rate for Payer: Cash Price |
$42.29
|
| Rate for Payer: Devoted Health Medicare |
$27.18
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$28.79
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$45.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$24.71
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$28.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$39.26
|
| Rate for Payer: Health Management Network Commercial |
$59.92
|
| Rate for Payer: Kaiser Permanente Commercial |
$29.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$29.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$29.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$28.79
|
| Rate for Payer: Ohana Health Plan Medicare |
$24.71
|
| Rate for Payer: UnitedHealthcare Medicaid |
$28.79
|
| Rate for Payer: UnitedHealthcare Medicare |
$24.71
|
| Rate for Payer: University Health Alliance Commercial |
$38.14
|
|
|
PR BLADDER INSTILLATION ANTICARCINOGENIC AGENT
|
Professional
|
Both
|
$172.38
|
|
|
Service Code
|
HCPCS 51720
|
| Min. Negotiated Rate |
$37.35 |
| Max. Negotiated Rate |
$146.52 |
| Rate for Payer: AlohaCare Medicaid |
$42.87
|
| Rate for Payer: AlohaCare Medicare |
$37.35
|
| Rate for Payer: Cash Price |
$103.43
|
| Rate for Payer: Cash Price |
$103.43
|
| Rate for Payer: Devoted Health Medicare |
$41.09
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$42.87
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$121.87
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$37.35
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$42.87
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$117.00
|
| Rate for Payer: Health Management Network Commercial |
$146.52
|
| Rate for Payer: Kaiser Permanente Commercial |
$44.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$44.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$44.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$42.87
|
| Rate for Payer: Ohana Health Plan Medicare |
$37.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$42.87
|
| Rate for Payer: UnitedHealthcare Medicare |
$37.35
|
| Rate for Payer: University Health Alliance Commercial |
$56.65
|
|
|
PR BLADDER PRESSURE MEASUREMENT DURING FILLING
|
Professional
|
Both
|
$722.00
|
|
|
Service Code
|
HCPCS 51726 TC
|
| Min. Negotiated Rate |
$114.14 |
| Max. Negotiated Rate |
$613.70 |
| Rate for Payer: AlohaCare Medicaid |
$332.80
|
| Rate for Payer: AlohaCare Medicare |
$211.92
|
| Rate for Payer: Cash Price |
$433.20
|
| Rate for Payer: Cash Price |
$433.20
|
| Rate for Payer: Devoted Health Medicare |
$233.11
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$211.92
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$114.14
|
| Rate for Payer: Health Management Network Commercial |
$613.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$254.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$254.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$254.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$332.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$211.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$332.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$211.92
|
|
|
PR BLADDER PRESSURE MEASUREMENT DURING FILLING
|
Professional
|
Both
|
$871.00
|
|
|
Service Code
|
HCPCS 51726
|
| Min. Negotiated Rate |
$114.14 |
| Max. Negotiated Rate |
$740.35 |
| Rate for Payer: AlohaCare Medicaid |
$332.80
|
| Rate for Payer: AlohaCare Medicare |
$297.18
|
| Rate for Payer: Cash Price |
$522.60
|
| Rate for Payer: Cash Price |
$522.60
|
| Rate for Payer: Devoted Health Medicare |
$326.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$297.18
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$114.14
|
| Rate for Payer: Health Management Network Commercial |
$740.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$356.62
|
| Rate for Payer: Kaiser Permanente Medicaid |
$356.62
|
| Rate for Payer: Kaiser Permanente Medicare |
$356.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$332.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$297.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$332.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$297.18
|
|
|
PR BLADDER PRESSURE MEASUREMENT DURING FILLING
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 51726 26
|
| Min. Negotiated Rate |
$85.26 |
| Max. Negotiated Rate |
$332.80 |
| Rate for Payer: AlohaCare Medicaid |
$332.80
|
| Rate for Payer: AlohaCare Medicare |
$85.26
|
| Rate for Payer: Cash Price |
$89.40
|
| Rate for Payer: Cash Price |
$89.40
|
| Rate for Payer: Devoted Health Medicare |
$93.79
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$85.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$114.14
|
| Rate for Payer: Health Management Network Commercial |
$126.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$102.31
|
| Rate for Payer: Kaiser Permanente Medicaid |
$102.31
|
| Rate for Payer: Kaiser Permanente Medicare |
$102.31
|
| Rate for Payer: Ohana Health Plan Medicaid |
$332.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$85.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$332.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$85.26
|
|
