|
PR CLTX PROX HUMRL FX W/MNPJ W/WO SKELETAL TRACJ
|
Professional
|
Both
|
$989.31
|
|
|
Service Code
|
HCPCS 23605
|
| Min. Negotiated Rate |
$309.66 |
| Max. Negotiated Rate |
$840.91 |
| Rate for Payer: AlohaCare Medicaid |
$461.51
|
| Rate for Payer: AlohaCare Medicare |
$458.61
|
| Rate for Payer: Cash Price |
$593.59
|
| Rate for Payer: Cash Price |
$593.59
|
| Rate for Payer: Devoted Health Medicare |
$504.47
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$461.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$458.61
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$461.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$309.66
|
| Rate for Payer: Health Management Network Commercial |
$840.91
|
| Rate for Payer: Kaiser Permanente Commercial |
$550.33
|
| Rate for Payer: Kaiser Permanente Medicaid |
$550.33
|
| Rate for Payer: Kaiser Permanente Medicare |
$550.33
|
| Rate for Payer: Ohana Health Plan Medicaid |
$461.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$458.61
|
| Rate for Payer: UnitedHealthcare Medicaid |
$461.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$458.61
|
| Rate for Payer: University Health Alliance Commercial |
$593.45
|
|
|
PR CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$714.94
|
|
|
Service Code
|
HCPCS 23600
|
| Min. Negotiated Rate |
$173.16 |
| Max. Negotiated Rate |
$607.70 |
| Rate for Payer: AlohaCare Medicaid |
$352.60
|
| Rate for Payer: AlohaCare Medicare |
$352.71
|
| Rate for Payer: Cash Price |
$428.96
|
| Rate for Payer: Cash Price |
$428.96
|
| Rate for Payer: Devoted Health Medicare |
$387.98
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$352.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$352.71
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$352.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$173.16
|
| Rate for Payer: Health Management Network Commercial |
$607.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$423.25
|
| Rate for Payer: Kaiser Permanente Medicaid |
$423.25
|
| Rate for Payer: Kaiser Permanente Medicare |
$423.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$352.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$352.71
|
| Rate for Payer: UnitedHealthcare Medicaid |
$352.60
|
| Rate for Payer: UnitedHealthcare Medicare |
$352.71
|
| Rate for Payer: University Health Alliance Commercial |
$447.85
|
|
|
PR CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ
|
Professional
|
Both
|
$195.96
|
|
|
Service Code
|
HCPCS 24640
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$202.00 |
| Rate for Payer: AlohaCare Medicaid |
$84.60
|
| Rate for Payer: AlohaCare Medicare |
$74.38
|
| Rate for Payer: Cash Price |
$117.58
|
| Rate for Payer: Cash Price |
$117.58
|
| Rate for Payer: Devoted Health Medicare |
$81.82
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$84.60
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$130.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$74.38
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$84.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$93.60
|
| Rate for Payer: Health Management Network Commercial |
$166.57
|
| Rate for Payer: Kaiser Permanente Commercial |
$89.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$89.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$89.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$84.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$74.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$84.60
|
| Rate for Payer: UnitedHealthcare Medicare |
$74.38
|
| Rate for Payer: University Health Alliance Commercial |
$202.00
|
|
|
PR CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT
|
Professional
|
Both
|
$1,172.24
|
|
|
Service Code
|
HCPCS 25520
|
| Min. Negotiated Rate |
$381.42 |
| Max. Negotiated Rate |
$996.40 |
| Rate for Payer: AlohaCare Medicaid |
$585.62
|
| Rate for Payer: AlohaCare Medicare |
$550.98
|
| Rate for Payer: Cash Price |
$703.34
|
| Rate for Payer: Cash Price |
$703.34
|
| Rate for Payer: Devoted Health Medicare |
$606.08
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$585.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$550.98
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$585.62
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$381.42
|
| Rate for Payer: Health Management Network Commercial |
$996.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$661.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$661.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$661.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$585.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$550.98
|
| Rate for Payer: UnitedHealthcare Medicaid |
$585.62
|
| Rate for Payer: UnitedHealthcare Medicare |
$550.98
|
| Rate for Payer: University Health Alliance Commercial |
$754.98
|
|
|
PR CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MNPJ
|
Professional
|
Both
|
$923.26
|
|
|
Service Code
|
HCPCS 23665
|
| Min. Negotiated Rate |
$228.80 |
| Max. Negotiated Rate |
$784.77 |
| Rate for Payer: AlohaCare Medicaid |
$434.46
|
| Rate for Payer: AlohaCare Medicare |
$434.16
|
| Rate for Payer: Cash Price |
$553.96
|
| Rate for Payer: Cash Price |
$553.96
|
| Rate for Payer: Devoted Health Medicare |
$477.58
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$434.16
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.46
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$228.80
|
| Rate for Payer: Health Management Network Commercial |
$784.77
|
| Rate for Payer: Kaiser Permanente Commercial |
$520.99
|
| Rate for Payer: Kaiser Permanente Medicaid |
$520.99
|
| Rate for Payer: Kaiser Permanente Medicare |
$520.99
|
| Rate for Payer: Ohana Health Plan Medicaid |
$434.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$434.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$434.16
|
| Rate for Payer: University Health Alliance Commercial |
$556.54
|
|
|
PR CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ
|
Professional
|
Both
|
$1,269.61
|
|
|
Service Code
|
HCPCS 24535
|
| Min. Negotiated Rate |
$384.80 |
| Max. Negotiated Rate |
$1,079.17 |
| Rate for Payer: AlohaCare Medicaid |
$612.37
|
| Rate for Payer: AlohaCare Medicare |
$583.08
|
| Rate for Payer: Cash Price |
$761.77
|
| Rate for Payer: Cash Price |
$761.77
|
| Rate for Payer: Devoted Health Medicare |
$641.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$612.37
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$583.08
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$612.37
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$384.80
|
| Rate for Payer: Health Management Network Commercial |
$1,079.17
|
| Rate for Payer: Kaiser Permanente Commercial |
$699.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$699.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$699.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$612.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$583.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$612.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$583.08
|
| Rate for Payer: University Health Alliance Commercial |
$784.53
|
|
|
PR CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ
|
Professional
|
Both
|
$810.69
|
|
|
Service Code
|
HCPCS 24530
|
| Min. Negotiated Rate |
$220.48 |
| Max. Negotiated Rate |
$689.09 |
| Rate for Payer: AlohaCare Medicaid |
$387.55
|
| Rate for Payer: AlohaCare Medicare |
$378.18
|
| Rate for Payer: Cash Price |
$486.41
|
| Rate for Payer: Cash Price |
$486.41
|
| Rate for Payer: Devoted Health Medicare |
$416.00
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$387.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$378.18
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$387.55
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$220.48
|
| Rate for Payer: Health Management Network Commercial |
$689.09
|
| Rate for Payer: Kaiser Permanente Commercial |
$453.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$453.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$453.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$387.55
|
| Rate for Payer: Ohana Health Plan Medicare |
$378.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$387.55
|
| Rate for Payer: UnitedHealthcare Medicare |
$378.18
|
| Rate for Payer: University Health Alliance Commercial |
$493.89
|
|
|
PR CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ
|
Professional
|
Both
|
$1,423.00
|
|
|
Service Code
|
HCPCS 27503
|
| Min. Negotiated Rate |
$559.52 |
| Max. Negotiated Rate |
$1,209.55 |
| Rate for Payer: AlohaCare Medicaid |
$827.54
|
| Rate for Payer: AlohaCare Medicare |
$759.06
|
| Rate for Payer: Cash Price |
$853.80
|
| Rate for Payer: Cash Price |
$853.80
|
| Rate for Payer: Devoted Health Medicare |
$834.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$759.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$559.52
|
| Rate for Payer: Health Management Network Commercial |
$1,209.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$910.87
|
| Rate for Payer: Kaiser Permanente Medicaid |
$910.87
|
| Rate for Payer: Kaiser Permanente Medicare |
$910.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$827.54
|
| Rate for Payer: Ohana Health Plan Medicare |
$759.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$827.54
|
| Rate for Payer: UnitedHealthcare Medicare |
$759.06
|
|
|
PR CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES
|
Professional
|
Both
|
$373.08
|
|
|
Service Code
|
HCPCS 28540
|
| Min. Negotiated Rate |
$60.84 |
| Max. Negotiated Rate |
$317.12 |
| Rate for Payer: AlohaCare Medicaid |
$193.49
|
| Rate for Payer: AlohaCare Medicare |
$181.29
|
| Rate for Payer: Cash Price |
$223.85
|
| Rate for Payer: Cash Price |
$223.85
|
| Rate for Payer: Devoted Health Medicare |
$199.42
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$193.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.29
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$193.49
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$60.84
|
| Rate for Payer: Health Management Network Commercial |
$317.12
|
| Rate for Payer: Kaiser Permanente Commercial |
$217.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$217.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$217.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$193.49
|
| Rate for Payer: Ohana Health Plan Medicare |
$181.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$193.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.29
|
| Rate for Payer: University Health Alliance Commercial |
$243.51
|
|
|
PR CLTX TIBIAL FX PROXIMAL W/O MANIPULATION
|
Professional
|
Both
|
$656.55
|
|
|
Service Code
|
HCPCS 27530
|
| Min. Negotiated Rate |
$245.70 |
| Max. Negotiated Rate |
$558.07 |
| Rate for Payer: AlohaCare Medicaid |
$323.20
|
| Rate for Payer: AlohaCare Medicare |
$320.49
|
| Rate for Payer: Cash Price |
$393.93
|
| Rate for Payer: Cash Price |
$393.93
|
| Rate for Payer: Devoted Health Medicare |
$352.54
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$323.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$320.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$323.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$245.70
|
| Rate for Payer: Health Management Network Commercial |
$558.07
|
| Rate for Payer: Kaiser Permanente Commercial |
$384.59
|
| Rate for Payer: Kaiser Permanente Medicaid |
$384.59
|
| Rate for Payer: Kaiser Permanente Medicare |
$384.59
|
| Rate for Payer: Ohana Health Plan Medicaid |
$323.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$320.49
|
| Rate for Payer: UnitedHealthcare Medicaid |
$323.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$320.49
|
| Rate for Payer: University Health Alliance Commercial |
$411.45
|
|
|
PR CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ
|
Professional
|
Both
|
$1,241.96
|
|
|
Service Code
|
HCPCS 27532
|
| Min. Negotiated Rate |
$395.20 |
| Max. Negotiated Rate |
$1,055.67 |
| Rate for Payer: AlohaCare Medicaid |
$612.25
|
| Rate for Payer: AlohaCare Medicare |
$569.55
|
| Rate for Payer: Cash Price |
$745.18
|
| Rate for Payer: Cash Price |
$745.18
|
| Rate for Payer: Devoted Health Medicare |
$626.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$612.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$569.55
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$612.25
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$395.20
|
| Rate for Payer: Health Management Network Commercial |
$1,055.67
|
| Rate for Payer: Kaiser Permanente Commercial |
$683.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$683.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$683.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$612.25
|
| Rate for Payer: Ohana Health Plan Medicare |
$569.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$612.25
|
| Rate for Payer: UnitedHealthcare Medicare |
$569.55
|
| Rate for Payer: University Health Alliance Commercial |
$793.75
|
|
|
PR CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$1,118.25
|
|
|
Service Code
|
HCPCS 27752
|
| Min. Negotiated Rate |
$472.68 |
| Max. Negotiated Rate |
$950.51 |
| Rate for Payer: AlohaCare Medicaid |
$521.19
|
| Rate for Payer: AlohaCare Medicare |
$516.34
|
| Rate for Payer: Cash Price |
$670.95
|
| Rate for Payer: Cash Price |
$670.95
|
| Rate for Payer: Devoted Health Medicare |
$567.97
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$521.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$516.34
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$521.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$472.68
|
| Rate for Payer: Health Management Network Commercial |
$950.51
|
| Rate for Payer: Kaiser Permanente Commercial |
$619.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$619.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$619.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$521.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$516.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$521.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$516.34
|
| Rate for Payer: University Health Alliance Commercial |
$675.47
|
|
|
PR CLTX TIBIAL SHAFT FX W/O MANIPULATION
|
Professional
|
Both
|
$738.36
|
|
|
Service Code
|
HCPCS 27750
|
| Min. Negotiated Rate |
$299.78 |
| Max. Negotiated Rate |
$627.61 |
| Rate for Payer: AlohaCare Medicaid |
$356.47
|
| Rate for Payer: AlohaCare Medicare |
$351.66
|
| Rate for Payer: Cash Price |
$443.02
|
| Rate for Payer: Cash Price |
$443.02
|
| Rate for Payer: Devoted Health Medicare |
$386.83
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$356.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$351.66
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$356.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$299.78
|
| Rate for Payer: Health Management Network Commercial |
$627.61
|
| Rate for Payer: Kaiser Permanente Commercial |
$421.99
|
| Rate for Payer: Kaiser Permanente Medicaid |
$421.99
|
| Rate for Payer: Kaiser Permanente Medicare |
$421.99
|
| Rate for Payer: Ohana Health Plan Medicaid |
$356.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$351.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$356.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$351.66
|
| Rate for Payer: University Health Alliance Commercial |
$475.00
|
|
|
PR CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MNPJ
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 25680
|
| Min. Negotiated Rate |
$261.82 |
| Max. Negotiated Rate |
$833.85 |
| Rate for Payer: AlohaCare Medicaid |
$570.16
|
| Rate for Payer: AlohaCare Medicare |
$538.15
|
| Rate for Payer: Cash Price |
$588.60
|
| Rate for Payer: Cash Price |
$588.60
|
| Rate for Payer: Devoted Health Medicare |
$591.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$538.15
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$261.82
|
| Rate for Payer: Health Management Network Commercial |
$833.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$645.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$645.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$645.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$570.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$538.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$570.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$538.15
|
|
|
PR CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION
|
Professional
|
Both
|
$1,078.49
|
|
|
Service Code
|
HCPCS 27818
|
| Min. Negotiated Rate |
$378.30 |
| Max. Negotiated Rate |
$916.72 |
| Rate for Payer: AlohaCare Medicaid |
$470.19
|
| Rate for Payer: AlohaCare Medicare |
$492.86
|
| Rate for Payer: Cash Price |
$647.09
|
| Rate for Payer: Cash Price |
$647.09
|
| Rate for Payer: Devoted Health Medicare |
$542.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$470.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$492.86
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$470.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$378.30
|
| Rate for Payer: Health Management Network Commercial |
$916.72
|
| Rate for Payer: Kaiser Permanente Commercial |
$591.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$591.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$591.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$470.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$492.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$470.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$492.86
|
| Rate for Payer: University Health Alliance Commercial |
$602.28
|
|
|
PR CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION
|
Professional
|
Both
|
$716.80
|
|
|
Service Code
|
HCPCS 27816
|
| Min. Negotiated Rate |
$223.86 |
| Max. Negotiated Rate |
$609.28 |
| Rate for Payer: AlohaCare Medicaid |
$325.48
|
| Rate for Payer: AlohaCare Medicare |
$331.36
|
| Rate for Payer: Cash Price |
$430.08
|
| Rate for Payer: Cash Price |
$430.08
|
| Rate for Payer: Devoted Health Medicare |
$364.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$325.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$331.36
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$325.48
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$223.86
|
| Rate for Payer: Health Management Network Commercial |
$609.28
|
| Rate for Payer: Kaiser Permanente Commercial |
$397.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$397.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$397.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$325.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$331.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$325.48
|
| Rate for Payer: UnitedHealthcare Medicare |
$331.36
|
| Rate for Payer: University Health Alliance Commercial |
$414.29
|
|
|
PR CNSLT BEFORE SCREEN COLONOSC
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS S0285
|
| Min. Negotiated Rate |
$74.80 |
| Max. Negotiated Rate |
$74.80 |
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Health Management Network Commercial |
$74.80
|
|
|
PR CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX
|
Professional
|
Both
|
$332.73
|
|
|
Service Code
|
HCPCS 49424
|
| Min. Negotiated Rate |
$31.77 |
| Max. Negotiated Rate |
$282.82 |
| Rate for Payer: AlohaCare Medicaid |
$36.35
|
| Rate for Payer: AlohaCare Medicare |
$31.77
|
| Rate for Payer: Cash Price |
$199.64
|
| Rate for Payer: Cash Price |
$199.64
|
| Rate for Payer: Devoted Health Medicare |
$34.95
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$36.35
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$58.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$31.77
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$36.35
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$47.84
|
| Rate for Payer: Health Management Network Commercial |
$282.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$38.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$38.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$38.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$36.35
|
| Rate for Payer: Ohana Health Plan Medicare |
$31.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$36.35
|
| Rate for Payer: UnitedHealthcare Medicare |
$31.77
|
| Rate for Payer: University Health Alliance Commercial |
$59.00
|
|
|
PR CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT
|
Professional
|
Both
|
$223.23
|
|
|
Service Code
|
HCPCS 36598
|
| Min. Negotiated Rate |
$29.96 |
| Max. Negotiated Rate |
$189.75 |
| Rate for Payer: AlohaCare Medicaid |
$34.74
|
| Rate for Payer: AlohaCare Medicare |
$29.96
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Devoted Health Medicare |
$32.96
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$34.74
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$55.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$29.96
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$34.74
|
| Rate for Payer: Health Management Network Commercial |
$189.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$35.95
|
| Rate for Payer: Kaiser Permanente Medicaid |
$35.95
|
| Rate for Payer: Kaiser Permanente Medicare |
$35.95
|
| Rate for Payer: Ohana Health Plan Medicaid |
$34.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$29.96
|
| Rate for Payer: UnitedHealthcare Medicaid |
$34.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$29.96
|
| Rate for Payer: University Health Alliance Commercial |
$43.12
|
|
|
PR CO DIFFUSING CAPACITY
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 94729 TC
|
| Min. Negotiated Rate |
$60.47 |
| Max. Negotiated Rate |
$148.75 |
| Rate for Payer: AlohaCare Medicaid |
$63.69
|
| Rate for Payer: AlohaCare Medicare |
$61.34
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Devoted Health Medicare |
$67.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$61.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$60.47
|
| Rate for Payer: Health Management Network Commercial |
$148.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$73.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$73.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$73.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$61.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$63.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$61.34
|
|
|
PR CO DIFFUSING CAPACITY
|
Professional
|
Both
|
$192.00
|
|
|
Service Code
|
HCPCS 94729
|
| Min. Negotiated Rate |
$60.47 |
| Max. Negotiated Rate |
$163.20 |
| Rate for Payer: AlohaCare Medicaid |
$63.69
|
| Rate for Payer: AlohaCare Medicare |
$70.91
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Devoted Health Medicare |
$78.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$70.91
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$60.47
|
| Rate for Payer: Health Management Network Commercial |
$163.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$85.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$85.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$70.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$63.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$70.91
|
|
|
PR CO DIFFUSING CAPACITY
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS 94729 26
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$63.69 |
| Rate for Payer: AlohaCare Medicaid |
$63.69
|
| Rate for Payer: AlohaCare Medicare |
$9.58
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Devoted Health Medicare |
$10.54
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.58
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$60.47
|
| Rate for Payer: Health Management Network Commercial |
$14.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$11.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$11.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.58
|
| Rate for Payer: UnitedHealthcare Medicaid |
$63.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.58
|
|
|
PR COGNITIVE&BEHAVIORAL IMPAIRMENT SCRNG PERFORMED
|
Professional
|
Both
|
$643.00
|
|
|
Service Code
|
HCPCS 3755F
|
| Min. Negotiated Rate |
$546.55 |
| Max. Negotiated Rate |
$546.55 |
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Health Management Network Commercial |
$546.55
|
|
|
PR COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS
|
Professional
|
Both
|
$3,134.00
|
|
|
Service Code
|
HCPCS 44150
|
| Min. Negotiated Rate |
$1,069.90 |
| Max. Negotiated Rate |
$2,663.90 |
| Rate for Payer: AlohaCare Medicaid |
$1,832.90
|
| Rate for Payer: AlohaCare Medicare |
$1,706.36
|
| Rate for Payer: Cash Price |
$1,880.40
|
| Rate for Payer: Cash Price |
$1,880.40
|
| Rate for Payer: Devoted Health Medicare |
$1,877.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,706.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,069.90
|
| Rate for Payer: Health Management Network Commercial |
$2,663.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,047.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,047.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,047.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,832.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,706.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,832.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,706.36
|
|
|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$2,260.00
|
|
|
Service Code
|
HCPCS 44140
|
| Min. Negotiated Rate |
$1,142.18 |
| Max. Negotiated Rate |
$1,921.00 |
| Rate for Payer: AlohaCare Medicaid |
$1,320.02
|
| Rate for Payer: AlohaCare Medicare |
$1,220.02
|
| Rate for Payer: Cash Price |
$1,356.00
|
| Rate for Payer: Cash Price |
$1,356.00
|
| Rate for Payer: Devoted Health Medicare |
$1,342.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,220.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,142.18
|
| Rate for Payer: Health Management Network Commercial |
$1,921.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,464.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,464.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,464.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,320.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,220.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,320.02
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,220.02
|
|
