|
PR CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA
|
Professional
|
Both
|
$413.14
|
|
|
Service Code
|
HCPCS 26750
|
| Min. Negotiated Rate |
$86.06 |
| Max. Negotiated Rate |
$351.17 |
| Rate for Payer: AlohaCare Medicaid |
$213.71
|
| Rate for Payer: AlohaCare Medicare |
$222.03
|
| Rate for Payer: Cash Price |
$247.88
|
| Rate for Payer: Cash Price |
$247.88
|
| Rate for Payer: Devoted Health Medicare |
$244.23
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$213.71
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$222.03
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$213.71
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$86.06
|
| Rate for Payer: Health Management Network Commercial |
$351.17
|
| Rate for Payer: Kaiser Permanente Commercial |
$266.44
|
| Rate for Payer: Kaiser Permanente Medicaid |
$266.44
|
| Rate for Payer: Kaiser Permanente Medicare |
$266.44
|
| Rate for Payer: Ohana Health Plan Medicaid |
$213.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$222.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$213.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$222.03
|
| Rate for Payer: University Health Alliance Commercial |
$268.21
|
|
|
PR CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ
|
Professional
|
Both
|
$727.30
|
|
|
Service Code
|
HCPCS 25600
|
| Min. Negotiated Rate |
$249.86 |
| Max. Negotiated Rate |
$618.21 |
| Rate for Payer: AlohaCare Medicaid |
$365.00
|
| Rate for Payer: AlohaCare Medicare |
$366.23
|
| Rate for Payer: Cash Price |
$436.38
|
| Rate for Payer: Cash Price |
$436.38
|
| Rate for Payer: Devoted Health Medicare |
$402.85
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$365.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$366.23
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$365.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$249.86
|
| Rate for Payer: Health Management Network Commercial |
$618.21
|
| Rate for Payer: Kaiser Permanente Commercial |
$439.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$439.48
|
| Rate for Payer: Kaiser Permanente Medicare |
$439.48
|
| Rate for Payer: Ohana Health Plan Medicaid |
$365.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$366.23
|
| Rate for Payer: UnitedHealthcare Medicaid |
$365.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$366.23
|
| Rate for Payer: University Health Alliance Commercial |
$470.00
|
|
|
PR CLTX DSTL RDL FX/EPIPHYSL SEP W/MNPJ
|
Professional
|
Both
|
$1,169.94
|
|
|
Service Code
|
HCPCS 25605
|
| Min. Negotiated Rate |
$357.50 |
| Max. Negotiated Rate |
$994.45 |
| Rate for Payer: Ohana Health Plan Medicaid |
$549.02
|
| Rate for Payer: AlohaCare Medicaid |
$549.02
|
| Rate for Payer: AlohaCare Medicare |
$571.32
|
| Rate for Payer: Cash Price |
$701.96
|
| Rate for Payer: Cash Price |
$701.96
|
| Rate for Payer: Devoted Health Medicare |
$628.45
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$549.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$571.32
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$549.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$357.50
|
| Rate for Payer: Health Management Network Commercial |
$994.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$685.58
|
| Rate for Payer: Kaiser Permanente Medicaid |
$685.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$685.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$571.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$549.02
|
| Rate for Payer: UnitedHealthcare Medicare |
$571.32
|
| Rate for Payer: University Health Alliance Commercial |
$715.00
|
|
|
PR CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING
|
Professional
|
Both
|
$1,022.02
|
|
|
Service Code
|
HCPCS 26432
|
| Min. Negotiated Rate |
$268.06 |
| Max. Negotiated Rate |
$868.72 |
| Rate for Payer: AlohaCare Medicaid |
$597.86
|
| Rate for Payer: AlohaCare Medicare |
$583.82
|
| Rate for Payer: Cash Price |
$613.21
|
| Rate for Payer: Cash Price |
$613.21
|
| Rate for Payer: Devoted Health Medicare |
$642.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$583.82
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$268.06
|
| Rate for Payer: Health Management Network Commercial |
$868.72
|
| Rate for Payer: Kaiser Permanente Commercial |
$700.58
|
| Rate for Payer: Kaiser Permanente Medicaid |
$700.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$700.58
|
| Rate for Payer: Ohana Health Plan Medicaid |
$597.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$583.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$597.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$583.82
|
|
|
PR CLTX FX GRT TOE PHLX/PHLG W/O MANJ
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 28490
|
| Min. Negotiated Rate |
$66.82 |
| Max. Negotiated Rate |
$255.85 |
| Rate for Payer: AlohaCare Medicaid |
$139.08
|
| Rate for Payer: AlohaCare Medicare |
$142.00
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Devoted Health Medicare |
$156.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$139.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$142.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$139.08
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$66.82
|
| Rate for Payer: Health Management Network Commercial |
$255.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$170.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$170.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$170.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$139.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$142.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$139.08
|
| Rate for Payer: UnitedHealthcare Medicare |
$142.00
|
| Rate for Payer: University Health Alliance Commercial |
$205.00
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ
|
Professional
|
Both
|
$328.88
|
|
|
Service Code
|
HCPCS 28515
|
| Min. Negotiated Rate |
$82.16 |
| Max. Negotiated Rate |
$279.55 |
| Rate for Payer: AlohaCare Medicaid |
$159.14
|
| Rate for Payer: AlohaCare Medicare |
$154.51
|
| Rate for Payer: Cash Price |
$197.33
|
| Rate for Payer: Cash Price |
$197.33
|
| Rate for Payer: Devoted Health Medicare |
$169.96
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$159.14
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$235.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$154.51
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$159.14
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$82.16
|
| Rate for Payer: Health Management Network Commercial |
$279.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$185.41
|
| Rate for Payer: Kaiser Permanente Medicaid |
$185.41
|
| Rate for Payer: Kaiser Permanente Medicare |
$185.41
|
| Rate for Payer: Ohana Health Plan Medicaid |
$159.14
|
| Rate for Payer: Ohana Health Plan Medicare |
$154.51
|
| Rate for Payer: UnitedHealthcare Medicaid |
$159.14
|
| Rate for Payer: UnitedHealthcare Medicare |
$154.51
|
| Rate for Payer: University Health Alliance Commercial |
$198.04
|
|
|
PR CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ
|
Professional
|
Both
|
$246.50
|
|
|
Service Code
|
HCPCS 28510
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$209.53 |
| Rate for Payer: AlohaCare Medicaid |
$134.88
|
| Rate for Payer: AlohaCare Medicare |
$134.02
|
| Rate for Payer: Cash Price |
$147.90
|
| Rate for Payer: Cash Price |
$147.90
|
| Rate for Payer: Devoted Health Medicare |
$147.42
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$134.88
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$134.02
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$134.88
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$57.20
|
| Rate for Payer: Health Management Network Commercial |
$209.53
|
| Rate for Payer: Kaiser Permanente Commercial |
$160.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$160.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$160.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$134.88
|
| Rate for Payer: Ohana Health Plan Medicare |
$134.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$134.88
|
| Rate for Payer: UnitedHealthcare Medicare |
$134.02
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ
|
Professional
|
Both
|
$663.39
|
|
|
Service Code
|
HCPCS 27824
|
| Min. Negotiated Rate |
$224.90 |
| Max. Negotiated Rate |
$563.88 |
| Rate for Payer: AlohaCare Medicaid |
$335.38
|
| Rate for Payer: AlohaCare Medicare |
$334.26
|
| Rate for Payer: Cash Price |
$398.03
|
| Rate for Payer: Cash Price |
$398.03
|
| Rate for Payer: Devoted Health Medicare |
$367.69
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$335.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$334.26
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$335.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$224.90
|
| Rate for Payer: Health Management Network Commercial |
$563.88
|
| Rate for Payer: Kaiser Permanente Commercial |
$401.11
|
| Rate for Payer: Kaiser Permanente Medicaid |
$401.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$401.11
|
| Rate for Payer: Ohana Health Plan Medicaid |
$335.38
|
| Rate for Payer: Ohana Health Plan Medicare |
$334.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$335.38
|
| Rate for Payer: UnitedHealthcare Medicare |
$334.26
|
| Rate for Payer: University Health Alliance Commercial |
$427.75
|
|
|
PR CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ
|
Professional
|
Both
|
$1,106.00
|
|
|
Service Code
|
HCPCS 27825
|
| Min. Negotiated Rate |
$411.58 |
| Max. Negotiated Rate |
$940.10 |
| Rate for Payer: AlohaCare Medicaid |
$519.66
|
| Rate for Payer: AlohaCare Medicare |
$489.59
|
| Rate for Payer: Cash Price |
$663.60
|
| Rate for Payer: Cash Price |
$663.60
|
| Rate for Payer: Devoted Health Medicare |
$538.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$519.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$489.59
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$519.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$411.58
|
| Rate for Payer: Health Management Network Commercial |
$940.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$587.51
|
| Rate for Payer: Kaiser Permanente Medicaid |
$587.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$587.51
|
| Rate for Payer: Ohana Health Plan Medicaid |
$519.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$489.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$519.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$489.59
|
| Rate for Payer: University Health Alliance Commercial |
$675.77
|
|
|
PR CLTX GREATER HUMERAL TUBEROSITY FX W/O MNPJ
|
Professional
|
Both
|
$579.83
|
|
|
Service Code
|
HCPCS 23620
|
| Min. Negotiated Rate |
$26.78 |
| Max. Negotiated Rate |
$492.86 |
| Rate for Payer: AlohaCare Medicaid |
$289.28
|
| Rate for Payer: AlohaCare Medicare |
$288.04
|
| Rate for Payer: Cash Price |
$347.90
|
| Rate for Payer: Cash Price |
$347.90
|
| Rate for Payer: Devoted Health Medicare |
$316.84
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$289.28
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$288.04
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$289.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$26.78
|
| Rate for Payer: Health Management Network Commercial |
$492.86
|
| Rate for Payer: Kaiser Permanente Commercial |
$345.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$345.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$345.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$289.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$288.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$289.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$288.04
|
| Rate for Payer: University Health Alliance Commercial |
$395.00
|
|
|
PR CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA
|
Professional
|
Both
|
$1,314.00
|
|
|
Service Code
|
HCPCS 27252
|
| Min. Negotiated Rate |
$381.42 |
| Max. Negotiated Rate |
$1,116.90 |
| Rate for Payer: AlohaCare Medicaid |
$769.27
|
| Rate for Payer: AlohaCare Medicare |
$723.71
|
| Rate for Payer: Cash Price |
$788.40
|
| Rate for Payer: Cash Price |
$788.40
|
| Rate for Payer: Devoted Health Medicare |
$796.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$723.71
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$381.42
|
| Rate for Payer: Health Management Network Commercial |
$1,116.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$868.45
|
| Rate for Payer: Kaiser Permanente Medicaid |
$868.45
|
| Rate for Payer: Kaiser Permanente Medicare |
$868.45
|
| Rate for Payer: Ohana Health Plan Medicaid |
$769.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$723.71
|
| Rate for Payer: UnitedHealthcare Medicaid |
$769.27
|
| Rate for Payer: UnitedHealthcare Medicare |
$723.71
|
|
|
PR CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ
|
Professional
|
Both
|
$771.38
|
|
|
Service Code
|
HCPCS 24576
|
| Min. Negotiated Rate |
$178.88 |
| Max. Negotiated Rate |
$655.67 |
| Rate for Payer: AlohaCare Medicaid |
$349.62
|
| Rate for Payer: AlohaCare Medicare |
$358.38
|
| Rate for Payer: Cash Price |
$462.83
|
| Rate for Payer: Cash Price |
$462.83
|
| Rate for Payer: Devoted Health Medicare |
$394.22
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$349.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$358.38
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$349.62
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$178.88
|
| Rate for Payer: Health Management Network Commercial |
$655.67
|
| Rate for Payer: Kaiser Permanente Commercial |
$430.06
|
| Rate for Payer: Kaiser Permanente Medicaid |
$430.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$430.06
|
| Rate for Payer: Ohana Health Plan Medicaid |
$349.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$358.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$349.62
|
| Rate for Payer: UnitedHealthcare Medicare |
$358.38
|
| Rate for Payer: University Health Alliance Commercial |
$465.00
|
|
|
PR CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ
|
Professional
|
Both
|
$734.72
|
|
|
Service Code
|
HCPCS 24560
|
| Min. Negotiated Rate |
$176.54 |
| Max. Negotiated Rate |
$624.51 |
| Rate for Payer: AlohaCare Medicaid |
$327.08
|
| Rate for Payer: AlohaCare Medicare |
$338.95
|
| Rate for Payer: Cash Price |
$440.83
|
| Rate for Payer: Cash Price |
$440.83
|
| Rate for Payer: Devoted Health Medicare |
$372.85
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$327.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$338.95
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$327.08
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$176.54
|
| Rate for Payer: Health Management Network Commercial |
$624.51
|
| Rate for Payer: Kaiser Permanente Commercial |
$406.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$406.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$406.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$327.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$338.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$327.08
|
| Rate for Payer: UnitedHealthcare Medicare |
$338.95
|
| Rate for Payer: University Health Alliance Commercial |
$428.00
|
|
|
PR CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ
|
Professional
|
Both
|
$1,078.12
|
|
|
Service Code
|
HCPCS 24505
|
| Min. Negotiated Rate |
$286.00 |
| Max. Negotiated Rate |
$916.40 |
| Rate for Payer: AlohaCare Medicaid |
$487.76
|
| Rate for Payer: AlohaCare Medicare |
$492.26
|
| Rate for Payer: Cash Price |
$646.87
|
| Rate for Payer: Cash Price |
$646.87
|
| Rate for Payer: Devoted Health Medicare |
$541.49
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$487.76
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$492.26
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$487.76
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$286.00
|
| Rate for Payer: Health Management Network Commercial |
$916.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$590.71
|
| Rate for Payer: Kaiser Permanente Medicaid |
$590.71
|
| Rate for Payer: Kaiser Permanente Medicare |
$590.71
|
| Rate for Payer: Ohana Health Plan Medicaid |
$487.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$492.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$487.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$492.26
|
| Rate for Payer: University Health Alliance Commercial |
$628.56
|
|
|
PR CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ
|
Professional
|
Both
|
$857.00
|
|
|
Service Code
|
HCPCS 27238
|
| Min. Negotiated Rate |
$318.76 |
| Max. Negotiated Rate |
$728.45 |
| Rate for Payer: AlohaCare Medicaid |
$498.57
|
| Rate for Payer: AlohaCare Medicare |
$472.06
|
| Rate for Payer: Cash Price |
$514.20
|
| Rate for Payer: Cash Price |
$514.20
|
| Rate for Payer: Devoted Health Medicare |
$519.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$472.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$318.76
|
| Rate for Payer: Health Management Network Commercial |
$728.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$566.47
|
| Rate for Payer: Kaiser Permanente Medicaid |
$566.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$566.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$498.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$472.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$498.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$472.06
|
|
|
PR CLTX IPHAL JT DISLC W/MANJ W/O ANES
|
Professional
|
Both
|
$672.66
|
|
|
Service Code
|
HCPCS 26770
|
| Min. Negotiated Rate |
$142.74 |
| Max. Negotiated Rate |
$571.76 |
| Rate for Payer: AlohaCare Medicaid |
$287.78
|
| Rate for Payer: AlohaCare Medicare |
$322.86
|
| Rate for Payer: Cash Price |
$403.60
|
| Rate for Payer: Cash Price |
$403.60
|
| Rate for Payer: Devoted Health Medicare |
$355.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$287.78
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$322.86
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$287.78
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$142.74
|
| Rate for Payer: Health Management Network Commercial |
$571.76
|
| Rate for Payer: Kaiser Permanente Commercial |
$387.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$387.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$387.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$287.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$322.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$287.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$322.86
|
| Rate for Payer: University Health Alliance Commercial |
$361.87
|
|
|
PR CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION
|
Professional
|
Both
|
$705.36
|
|
|
Service Code
|
HCPCS 27760
|
| Min. Negotiated Rate |
$259.22 |
| Max. Negotiated Rate |
$599.56 |
| Rate for Payer: AlohaCare Medicaid |
$340.86
|
| Rate for Payer: AlohaCare Medicare |
$338.12
|
| Rate for Payer: Cash Price |
$423.22
|
| Rate for Payer: Cash Price |
$423.22
|
| Rate for Payer: Devoted Health Medicare |
$371.93
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$340.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$338.12
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$340.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$259.22
|
| Rate for Payer: Health Management Network Commercial |
$599.56
|
| Rate for Payer: Kaiser Permanente Commercial |
$405.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$405.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$405.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$340.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$338.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$338.12
|
| Rate for Payer: University Health Alliance Commercial |
$433.68
|
|
|
PR CLTX METACARPAL FX W/MANIPULATION EACH BONE
|
Professional
|
Both
|
$706.14
|
|
|
Service Code
|
HCPCS 26605
|
| Min. Negotiated Rate |
$238.42 |
| Max. Negotiated Rate |
$600.22 |
| Rate for Payer: AlohaCare Medicaid |
$329.51
|
| Rate for Payer: AlohaCare Medicare |
$329.84
|
| Rate for Payer: Cash Price |
$423.68
|
| Rate for Payer: Cash Price |
$423.68
|
| Rate for Payer: Devoted Health Medicare |
$362.82
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$329.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$329.84
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$329.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$238.42
|
| Rate for Payer: Health Management Network Commercial |
$600.22
|
| Rate for Payer: Kaiser Permanente Commercial |
$395.81
|
| Rate for Payer: Kaiser Permanente Medicaid |
$395.81
|
| Rate for Payer: Kaiser Permanente Medicare |
$395.81
|
| Rate for Payer: Ohana Health Plan Medicaid |
$329.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$329.84
|
| Rate for Payer: UnitedHealthcare Medicaid |
$329.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$329.84
|
| Rate for Payer: University Health Alliance Commercial |
$421.06
|
|
|
PR CLTX METACARPAL FX W/O MANIPULATION EACH BONE
|
Professional
|
Both
|
$644.23
|
|
|
Service Code
|
HCPCS 26600
|
| Min. Negotiated Rate |
$166.92 |
| Max. Negotiated Rate |
$547.60 |
| Rate for Payer: AlohaCare Medicaid |
$322.31
|
| Rate for Payer: AlohaCare Medicare |
$321.04
|
| Rate for Payer: Cash Price |
$386.54
|
| Rate for Payer: Cash Price |
$386.54
|
| Rate for Payer: Devoted Health Medicare |
$353.14
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$322.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$321.04
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$322.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$166.92
|
| Rate for Payer: Health Management Network Commercial |
$547.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$385.25
|
| Rate for Payer: Kaiser Permanente Medicaid |
$385.25
|
| Rate for Payer: Kaiser Permanente Medicare |
$385.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$322.31
|
| Rate for Payer: Ohana Health Plan Medicare |
$321.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$322.31
|
| Rate for Payer: UnitedHealthcare Medicare |
$321.04
|
| Rate for Payer: University Health Alliance Commercial |
$407.54
|
|
|
PR CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES
|
Professional
|
Both
|
$908.42
|
|
|
Service Code
|
HCPCS 26705
|
| Min. Negotiated Rate |
$209.04 |
| Max. Negotiated Rate |
$772.16 |
| Rate for Payer: AlohaCare Medicaid |
$432.82
|
| Rate for Payer: AlohaCare Medicare |
$414.29
|
| Rate for Payer: Cash Price |
$545.05
|
| Rate for Payer: Cash Price |
$545.05
|
| Rate for Payer: Devoted Health Medicare |
$455.72
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$432.82
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$414.29
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$432.82
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$209.04
|
| Rate for Payer: Health Management Network Commercial |
$772.16
|
| Rate for Payer: Kaiser Permanente Commercial |
$497.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$497.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$497.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$432.82
|
| Rate for Payer: Ohana Health Plan Medicare |
$414.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$432.82
|
| Rate for Payer: UnitedHealthcare Medicare |
$414.29
|
| Rate for Payer: University Health Alliance Commercial |
$538.86
|
|
|
PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA
|
Professional
|
Both
|
$736.91
|
|
|
Service Code
|
HCPCS 26725
|
| Min. Negotiated Rate |
$170.82 |
| Max. Negotiated Rate |
$626.37 |
| Rate for Payer: AlohaCare Medicaid |
$333.73
|
| Rate for Payer: AlohaCare Medicare |
$337.17
|
| Rate for Payer: Cash Price |
$442.15
|
| Rate for Payer: Cash Price |
$442.15
|
| Rate for Payer: Devoted Health Medicare |
$370.89
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$333.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$337.17
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$333.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$170.82
|
| Rate for Payer: Health Management Network Commercial |
$626.37
|
| Rate for Payer: Kaiser Permanente Commercial |
$404.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$404.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$404.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$333.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$337.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$333.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$337.17
|
| Rate for Payer: University Health Alliance Commercial |
$426.02
|
|
|
PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA
|
Professional
|
Both
|
$443.03
|
|
|
Service Code
|
HCPCS 26720
|
| Min. Negotiated Rate |
$118.30 |
| Max. Negotiated Rate |
$376.58 |
| Rate for Payer: AlohaCare Medicaid |
$212.76
|
| Rate for Payer: AlohaCare Medicare |
$218.60
|
| Rate for Payer: Cash Price |
$265.82
|
| Rate for Payer: Cash Price |
$265.82
|
| Rate for Payer: Devoted Health Medicare |
$240.46
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$212.76
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$218.60
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$212.76
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$118.30
|
| Rate for Payer: Health Management Network Commercial |
$376.58
|
| Rate for Payer: Kaiser Permanente Commercial |
$262.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$262.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$262.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$212.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$218.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$212.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$218.60
|
| Rate for Payer: University Health Alliance Commercial |
$275.00
|
|
|
PR CLTX POST HIP ARTHRP DISLC REQ ANES
|
Professional
|
Both
|
$1,044.00
|
|
|
Service Code
|
HCPCS 27266
|
| Min. Negotiated Rate |
$366.86 |
| Max. Negotiated Rate |
$887.40 |
| Rate for Payer: AlohaCare Medicaid |
$610.71
|
| Rate for Payer: AlohaCare Medicare |
$569.29
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Devoted Health Medicare |
$626.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$569.29
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$366.86
|
| Rate for Payer: Health Management Network Commercial |
$887.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$683.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$683.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$683.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$610.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$569.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$610.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$569.29
|
|
|
PR CLTX POST HIP ARTHRP DISLC W/O ANES
|
Professional
|
Both
|
$901.23
|
|
|
Service Code
|
HCPCS 27265
|
| Min. Negotiated Rate |
$263.64 |
| Max. Negotiated Rate |
$766.05 |
| Rate for Payer: AlohaCare Medicaid |
$445.68
|
| Rate for Payer: AlohaCare Medicare |
$514.61
|
| Rate for Payer: Cash Price |
$540.74
|
| Rate for Payer: Cash Price |
$540.74
|
| Rate for Payer: Devoted Health Medicare |
$566.07
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$514.61
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$263.64
|
| Rate for Payer: Health Management Network Commercial |
$766.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$617.53
|
| Rate for Payer: Kaiser Permanente Medicaid |
$617.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$617.53
|
| Rate for Payer: Ohana Health Plan Medicaid |
$445.68
|
| Rate for Payer: Ohana Health Plan Medicare |
$514.61
|
| Rate for Payer: UnitedHealthcare Medicaid |
$445.68
|
| Rate for Payer: UnitedHealthcare Medicare |
$514.61
|
|
|
PR CLTX PROX FIBULA/SHFT FX W/O MANJ
|
Professional
|
Both
|
$663.44
|
|
|
Service Code
|
HCPCS 27780
|
| Min. Negotiated Rate |
$154.18 |
| Max. Negotiated Rate |
$563.92 |
| Rate for Payer: AlohaCare Medicaid |
$316.56
|
| Rate for Payer: AlohaCare Medicare |
$315.69
|
| Rate for Payer: Cash Price |
$398.06
|
| Rate for Payer: Cash Price |
$398.06
|
| Rate for Payer: Devoted Health Medicare |
$347.26
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$316.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$315.69
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$316.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$154.18
|
| Rate for Payer: Health Management Network Commercial |
$563.92
|
| Rate for Payer: Kaiser Permanente Commercial |
$378.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$378.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$378.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$316.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$315.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$316.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$315.69
|
| Rate for Payer: University Health Alliance Commercial |
$403.45
|
|
