|
PR COLECTOMY PRTL W/COLOPROCTOSTOMY
|
Professional
|
Both
|
$2,772.00
|
|
|
Service Code
|
HCPCS 44145
|
| Min. Negotiated Rate |
$1,068.08 |
| Max. Negotiated Rate |
$2,356.20 |
| Rate for Payer: AlohaCare Medicaid |
$1,620.80
|
| Rate for Payer: AlohaCare Medicare |
$1,480.48
|
| Rate for Payer: Cash Price |
$1,663.20
|
| Rate for Payer: Cash Price |
$1,663.20
|
| Rate for Payer: Devoted Health Medicare |
$1,628.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,480.48
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,068.08
|
| Rate for Payer: Health Management Network Commercial |
$2,356.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,776.58
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,776.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,776.58
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,620.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,480.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,620.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,480.48
|
|
|
PR COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY
|
Professional
|
Both
|
$3,530.00
|
|
|
Service Code
|
HCPCS 44146
|
| Min. Negotiated Rate |
$1,163.50 |
| Max. Negotiated Rate |
$3,000.50 |
| Rate for Payer: AlohaCare Medicaid |
$2,066.36
|
| Rate for Payer: AlohaCare Medicare |
$1,903.23
|
| Rate for Payer: Cash Price |
$2,118.00
|
| Rate for Payer: Cash Price |
$2,118.00
|
| Rate for Payer: Devoted Health Medicare |
$2,093.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,903.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,163.50
|
| Rate for Payer: Health Management Network Commercial |
$3,000.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,283.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,283.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,283.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,066.36
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,903.23
|
| Rate for Payer: UnitedHealthcare Medicaid |
$2,066.36
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,903.23
|
|
|
PR COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA
|
Professional
|
Both
|
$2,958.00
|
|
|
Service Code
|
HCPCS 44144
|
| Min. Negotiated Rate |
$1,209.52 |
| Max. Negotiated Rate |
$2,514.30 |
| Rate for Payer: AlohaCare Medicaid |
$1,729.92
|
| Rate for Payer: AlohaCare Medicare |
$1,594.32
|
| Rate for Payer: Cash Price |
$1,774.80
|
| Rate for Payer: Cash Price |
$1,774.80
|
| Rate for Payer: Devoted Health Medicare |
$1,753.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,594.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,209.52
|
| Rate for Payer: Health Management Network Commercial |
$2,514.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,913.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,913.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,913.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,729.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,594.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,729.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,594.32
|
|
|
PR COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT
|
Professional
|
Both
|
$2,769.00
|
|
|
Service Code
|
HCPCS 44143
|
| Min. Negotiated Rate |
$1,274.26 |
| Max. Negotiated Rate |
$2,353.65 |
| Rate for Payer: AlohaCare Medicaid |
$1,621.09
|
| Rate for Payer: AlohaCare Medicare |
$1,493.46
|
| Rate for Payer: Cash Price |
$1,661.40
|
| Rate for Payer: Cash Price |
$1,661.40
|
| Rate for Payer: Devoted Health Medicare |
$1,642.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,493.46
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,274.26
|
| Rate for Payer: Health Management Network Commercial |
$2,353.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,792.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,792.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,792.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,621.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,493.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,621.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,493.46
|
|
|
PR COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS
|
Professional
|
Both
|
$2,095.00
|
|
|
Service Code
|
HCPCS 44160
|
| Min. Negotiated Rate |
$831.22 |
| Max. Negotiated Rate |
$1,780.75 |
| Rate for Payer: AlohaCare Medicaid |
$1,223.11
|
| Rate for Payer: AlohaCare Medicare |
$1,131.36
|
| Rate for Payer: Cash Price |
$1,257.00
|
| Rate for Payer: Cash Price |
$1,257.00
|
| Rate for Payer: Devoted Health Medicare |
$1,244.50
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,131.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$831.22
|
| Rate for Payer: Health Management Network Commercial |
$1,780.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,357.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,357.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,357.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,223.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,131.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,223.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,131.36
|
|
|
PR COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY
|
Professional
|
Both
|
$3,047.00
|
|
|
Service Code
|
HCPCS 44141
|
| Min. Negotiated Rate |
$939.38 |
| Max. Negotiated Rate |
$2,589.95 |
| Rate for Payer: AlohaCare Medicaid |
$1,784.74
|
| Rate for Payer: AlohaCare Medicare |
$1,655.89
|
| Rate for Payer: Cash Price |
$1,828.20
|
| Rate for Payer: Cash Price |
$1,828.20
|
| Rate for Payer: Devoted Health Medicare |
$1,821.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,655.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$939.38
|
| Rate for Payer: Health Management Network Commercial |
$2,589.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,987.07
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,987.07
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,987.07
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,784.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,655.89
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,784.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,655.89
|
|
|
PR COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE
|
Professional
|
Both
|
$60.81
|
|
|
Service Code
|
HCPCS 36591
|
| Min. Negotiated Rate |
$31.55 |
| Max. Negotiated Rate |
$51.69 |
| Rate for Payer: AlohaCare Medicaid |
$31.55
|
| Rate for Payer: AlohaCare Medicare |
$34.37
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Devoted Health Medicare |
$37.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$34.37
|
| Rate for Payer: Health Management Network Commercial |
$51.69
|
| Rate for Payer: Kaiser Permanente Commercial |
$41.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$41.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$41.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$31.55
|
| Rate for Payer: Ohana Health Plan Medicare |
$34.37
|
| Rate for Payer: UnitedHealthcare Medicaid |
$31.55
|
| Rate for Payer: UnitedHealthcare Medicare |
$34.37
|
|
|
PR COLLECTION VENOUS BLOOD VENIPUNCTURE
|
Professional
|
Both
|
$16.00
|
|
|
Service Code
|
HCPCS 36415
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: AlohaCare Medicaid |
$3.00
|
| Rate for Payer: AlohaCare Medicare |
$9.34
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Devoted Health Medicare |
$10.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3.12
|
| Rate for Payer: Health Management Network Commercial |
$13.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$11.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$11.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.34
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Professional
|
Both
|
$713.82
|
|
|
Service Code
|
HCPCS G0121
|
| Min. Negotiated Rate |
$125.26 |
| Max. Negotiated Rate |
$606.75 |
| Rate for Payer: AlohaCare Medicaid |
$184.24
|
| Rate for Payer: AlohaCare Medicare |
$165.23
|
| Rate for Payer: Cash Price |
$428.29
|
| Rate for Payer: Cash Price |
$428.29
|
| Rate for Payer: Devoted Health Medicare |
$181.75
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$184.24
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$348.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$165.23
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$184.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$319.54
|
| Rate for Payer: Health Management Network Commercial |
$606.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$198.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$198.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$198.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$184.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$165.23
|
| Rate for Payer: UnitedHealthcare Medicaid |
$184.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$165.23
|
| Rate for Payer: University Health Alliance Commercial |
$125.26
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Professional
|
Both
|
$423.00
|
|
|
Service Code
|
HCPCS 45393
|
| Min. Negotiated Rate |
$217.07 |
| Max. Negotiated Rate |
$359.55 |
| Rate for Payer: AlohaCare Medicare |
$217.07
|
| Rate for Payer: Cash Price |
$253.80
|
| Rate for Payer: Cash Price |
$253.80
|
| Rate for Payer: Devoted Health Medicare |
$238.78
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$217.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$274.82
|
| Rate for Payer: Health Management Network Commercial |
$359.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$260.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$260.48
|
| Rate for Payer: Kaiser Permanente Medicare |
$260.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$217.07
|
| Rate for Payer: UnitedHealthcare Medicare |
$217.07
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Professional
|
Both
|
$5,237.80
|
|
|
Service Code
|
HCPCS 45388
|
| Min. Negotiated Rate |
$238.19 |
| Max. Negotiated Rate |
$4,452.13 |
| Rate for Payer: AlohaCare Medicare |
$238.19
|
| Rate for Payer: Cash Price |
$3,142.68
|
| Rate for Payer: Cash Price |
$3,142.68
|
| Rate for Payer: Devoted Health Medicare |
$262.01
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$268.30
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$537.74
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$238.19
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$268.30
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$609.44
|
| Rate for Payer: Health Management Network Commercial |
$4,452.13
|
| Rate for Payer: Kaiser Permanente Commercial |
$285.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$285.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$285.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$238.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$238.19
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Professional
|
Both
|
$713.48
|
|
|
Service Code
|
HCPCS 45378
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$606.46 |
| Rate for Payer: AlohaCare Medicaid |
$184.06
|
| Rate for Payer: AlohaCare Medicare |
$165.03
|
| Rate for Payer: Cash Price |
$428.09
|
| Rate for Payer: Cash Price |
$428.09
|
| Rate for Payer: Devoted Health Medicare |
$181.53
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$184.06
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$348.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$165.03
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$184.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$319.54
|
| Rate for Payer: Health Management Network Commercial |
$606.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$198.04
|
| Rate for Payer: Kaiser Permanente Medicaid |
$198.04
|
| Rate for Payer: Kaiser Permanente Medicare |
$198.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$184.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$165.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$184.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$165.03
|
| Rate for Payer: University Health Alliance Commercial |
$124.82
|
|
|
PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 45390
|
| Min. Negotiated Rate |
$290.95 |
| Max. Negotiated Rate |
$478.55 |
| Rate for Payer: AlohaCare Medicare |
$290.95
|
| Rate for Payer: Cash Price |
$337.80
|
| Rate for Payer: Cash Price |
$337.80
|
| Rate for Payer: Devoted Health Medicare |
$320.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$290.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$359.84
|
| Rate for Payer: Health Management Network Commercial |
$478.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$349.14
|
| Rate for Payer: Kaiser Permanente Medicaid |
$349.14
|
| Rate for Payer: Kaiser Permanente Medicare |
$349.14
|
| Rate for Payer: Ohana Health Plan Medicare |
$290.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$290.95
|
|
|
PR COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 45389
|
| Min. Negotiated Rate |
$253.67 |
| Max. Negotiated Rate |
$416.50 |
| Rate for Payer: AlohaCare Medicare |
$253.67
|
| Rate for Payer: Cash Price |
$294.00
|
| Rate for Payer: Cash Price |
$294.00
|
| Rate for Payer: Devoted Health Medicare |
$279.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$253.67
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$352.04
|
| Rate for Payer: Health Management Network Commercial |
$416.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$304.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$304.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$304.40
|
| Rate for Payer: Ohana Health Plan Medicare |
$253.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$253.67
|
|
|
PR COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)
|
Professional
|
Both
|
$904.00
|
|
|
Service Code
|
HCPCS 45379
|
| Min. Negotiated Rate |
$210.66 |
| Max. Negotiated Rate |
$768.40 |
| Rate for Payer: AlohaCare Medicaid |
$237.47
|
| Rate for Payer: AlohaCare Medicare |
$210.66
|
| Rate for Payer: Cash Price |
$542.40
|
| Rate for Payer: Cash Price |
$542.40
|
| Rate for Payer: Devoted Health Medicare |
$231.73
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$237.47
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$434.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$210.66
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$237.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$303.42
|
| Rate for Payer: Health Management Network Commercial |
$768.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$252.79
|
| Rate for Payer: Kaiser Permanente Medicaid |
$252.79
|
| Rate for Payer: Kaiser Permanente Medicare |
$252.79
|
| Rate for Payer: Ohana Health Plan Medicaid |
$237.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$210.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$237.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$210.66
|
| Rate for Payer: University Health Alliance Commercial |
$323.56
|
|
|
PR COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX
|
Professional
|
Both
|
$669.22
|
|
|
Service Code
|
HCPCS 44388
|
| Min. Negotiated Rate |
$105.24 |
| Max. Negotiated Rate |
$568.84 |
| Rate for Payer: AlohaCare Medicaid |
$155.19
|
| Rate for Payer: AlohaCare Medicare |
$140.49
|
| Rate for Payer: Cash Price |
$401.53
|
| Rate for Payer: Cash Price |
$401.53
|
| Rate for Payer: Devoted Health Medicare |
$154.54
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$155.19
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$243.24
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$140.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$155.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$203.58
|
| Rate for Payer: Health Management Network Commercial |
$568.84
|
| Rate for Payer: Kaiser Permanente Commercial |
$168.59
|
| Rate for Payer: Kaiser Permanente Medicaid |
$168.59
|
| Rate for Payer: Kaiser Permanente Medicare |
$168.59
|
| Rate for Payer: Ohana Health Plan Medicaid |
$155.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$140.49
|
| Rate for Payer: UnitedHealthcare Medicaid |
$155.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$140.49
|
| Rate for Payer: University Health Alliance Commercial |
$105.24
|
|
|
PR COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$873.90
|
|
|
Service Code
|
HCPCS 44389
|
| Min. Negotiated Rate |
$153.79 |
| Max. Negotiated Rate |
$742.82 |
| Rate for Payer: AlohaCare Medicaid |
$171.11
|
| Rate for Payer: AlohaCare Medicare |
$153.79
|
| Rate for Payer: Cash Price |
$524.34
|
| Rate for Payer: Cash Price |
$524.34
|
| Rate for Payer: Devoted Health Medicare |
$169.17
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$171.11
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$268.11
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$153.79
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$171.11
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$223.60
|
| Rate for Payer: Health Management Network Commercial |
$742.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$184.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$184.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$184.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$171.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$153.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$171.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$153.79
|
| Rate for Payer: University Health Alliance Commercial |
$227.00
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$914.20
|
|
|
Service Code
|
HCPCS 45380
|
| Min. Negotiated Rate |
$178.33 |
| Max. Negotiated Rate |
$777.07 |
| Rate for Payer: AlohaCare Medicaid |
$200.16
|
| Rate for Payer: AlohaCare Medicare |
$178.33
|
| Rate for Payer: Cash Price |
$548.52
|
| Rate for Payer: Cash Price |
$548.52
|
| Rate for Payer: Devoted Health Medicare |
$196.16
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$200.16
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$412.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$178.33
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$200.16
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$351.52
|
| Rate for Payer: Health Management Network Commercial |
$777.07
|
| Rate for Payer: Kaiser Permanente Commercial |
$214.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$214.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$214.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$200.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$178.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$200.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$178.33
|
| Rate for Payer: University Health Alliance Commercial |
$400.00
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Professional
|
Both
|
$713.48
|
|
|
Service Code
|
HCPCS G0105
|
| Min. Negotiated Rate |
$125.26 |
| Max. Negotiated Rate |
$713.46 |
| Rate for Payer: AlohaCare Medicaid |
$184.06
|
| Rate for Payer: AlohaCare Medicare |
$165.03
|
| Rate for Payer: Cash Price |
$428.09
|
| Rate for Payer: Cash Price |
$428.09
|
| Rate for Payer: Devoted Health Medicare |
$181.53
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$184.06
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$348.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$165.03
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$184.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$713.46
|
| Rate for Payer: Health Management Network Commercial |
$606.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$198.04
|
| Rate for Payer: Kaiser Permanente Medicaid |
$198.04
|
| Rate for Payer: Kaiser Permanente Medicare |
$198.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$184.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$165.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$184.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$165.03
|
| Rate for Payer: University Health Alliance Commercial |
$125.26
|
|
|
PR COLOSTOMY/SKIN LEVEL CECOSTOMY
|
Professional
|
Both
|
$2,036.00
|
|
|
Service Code
|
HCPCS 44320
|
| Min. Negotiated Rate |
$623.48 |
| Max. Negotiated Rate |
$1,730.60 |
| Rate for Payer: AlohaCare Medicaid |
$1,188.55
|
| Rate for Payer: AlohaCare Medicare |
$1,102.95
|
| Rate for Payer: Cash Price |
$1,221.60
|
| Rate for Payer: Cash Price |
$1,221.60
|
| Rate for Payer: Devoted Health Medicare |
$1,213.24
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,102.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$623.48
|
| Rate for Payer: Health Management Network Commercial |
$1,730.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,323.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,323.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,323.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,188.55
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,102.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,188.55
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,102.95
|
|
|
PR COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$1,661.00
|
|
|
Service Code
|
HCPCS 44025
|
| Min. Negotiated Rate |
$584.22 |
| Max. Negotiated Rate |
$1,411.85 |
| Rate for Payer: AlohaCare Medicaid |
$967.19
|
| Rate for Payer: AlohaCare Medicare |
$898.58
|
| Rate for Payer: Cash Price |
$996.60
|
| Rate for Payer: Cash Price |
$996.60
|
| Rate for Payer: Devoted Health Medicare |
$988.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$898.58
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$584.22
|
| Rate for Payer: Health Management Network Commercial |
$1,411.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,078.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,078.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,078.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$967.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$898.58
|
| Rate for Payer: UnitedHealthcare Medicaid |
$967.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$898.58
|
|
|
PR COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH
|
Professional
|
Both
|
$1,208.00
|
|
|
Service Code
|
HCPCS 57283
|
| Min. Negotiated Rate |
$615.34 |
| Max. Negotiated Rate |
$1,026.80 |
| Rate for Payer: AlohaCare Medicaid |
$710.85
|
| Rate for Payer: AlohaCare Medicare |
$615.34
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Devoted Health Medicare |
$676.87
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$615.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$623.22
|
| Rate for Payer: Health Management Network Commercial |
$1,026.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$738.41
|
| Rate for Payer: Kaiser Permanente Medicaid |
$738.41
|
| Rate for Payer: Kaiser Permanente Medicare |
$738.41
|
| Rate for Payer: Ohana Health Plan Medicaid |
$710.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$615.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$710.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$615.34
|
|
|
PR COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE
|
Professional
|
Both
|
$299.74
|
|
|
Service Code
|
HCPCS 57454
|
| Min. Negotiated Rate |
$104.78 |
| Max. Negotiated Rate |
$254.78 |
| Rate for Payer: AlohaCare Medicaid |
$134.18
|
| Rate for Payer: AlohaCare Medicare |
$117.36
|
| Rate for Payer: Cash Price |
$179.84
|
| Rate for Payer: Cash Price |
$179.84
|
| Rate for Payer: Devoted Health Medicare |
$129.10
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$134.18
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$208.80
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$117.36
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$134.18
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$104.78
|
| Rate for Payer: Health Management Network Commercial |
$254.78
|
| Rate for Payer: Kaiser Permanente Commercial |
$140.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$140.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$140.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$134.18
|
| Rate for Payer: Ohana Health Plan Medicare |
$117.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$134.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$117.36
|
| Rate for Payer: University Health Alliance Commercial |
$166.07
|
|
|
PR COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
HCPCS 57456
|
| Min. Negotiated Rate |
$87.01 |
| Max. Negotiated Rate |
$233.75 |
| Rate for Payer: AlohaCare Medicaid |
$100.65
|
| Rate for Payer: AlohaCare Medicare |
$87.01
|
| Rate for Payer: Cash Price |
$165.00
|
| Rate for Payer: Cash Price |
$165.00
|
| Rate for Payer: Devoted Health Medicare |
$95.71
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$100.65
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$156.99
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$87.01
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$100.65
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$129.74
|
| Rate for Payer: Health Management Network Commercial |
$233.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$104.41
|
| Rate for Payer: Kaiser Permanente Medicaid |
$104.41
|
| Rate for Payer: Kaiser Permanente Medicare |
$104.41
|
| Rate for Payer: Ohana Health Plan Medicaid |
$100.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$87.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$100.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$87.01
|
| Rate for Payer: University Health Alliance Commercial |
$123.75
|
|
|
PR COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA
|
Professional
|
Both
|
$229.72
|
|
|
Service Code
|
HCPCS 57452
|
| Min. Negotiated Rate |
$73.58 |
| Max. Negotiated Rate |
$195.26 |
| Rate for Payer: AlohaCare Medicaid |
$92.28
|
| Rate for Payer: AlohaCare Medicare |
$82.28
|
| Rate for Payer: Cash Price |
$137.83
|
| Rate for Payer: Cash Price |
$137.83
|
| Rate for Payer: Devoted Health Medicare |
$90.51
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$92.28
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$142.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$82.28
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$92.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$73.58
|
| Rate for Payer: Health Management Network Commercial |
$195.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$98.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$98.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$98.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$92.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$82.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$92.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$82.28
|
| Rate for Payer: University Health Alliance Commercial |
$114.35
|
|
