|
PR COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX
|
Professional
|
Both
|
$293.06
|
|
|
Service Code
|
HCPCS 57455
|
| Min. Negotiated Rate |
$94.17 |
| Max. Negotiated Rate |
$249.10 |
| Rate for Payer: AlohaCare Medicaid |
$107.97
|
| Rate for Payer: AlohaCare Medicare |
$94.17
|
| Rate for Payer: Cash Price |
$175.84
|
| Rate for Payer: Cash Price |
$175.84
|
| Rate for Payer: Devoted Health Medicare |
$103.59
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$107.97
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$168.95
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$94.17
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$107.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$137.02
|
| Rate for Payer: Health Management Network Commercial |
$249.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$113.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$113.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$113.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$107.97
|
| Rate for Payer: Ohana Health Plan Medicare |
$94.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$107.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$94.17
|
| Rate for Payer: University Health Alliance Commercial |
$133.96
|
|
|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Professional
|
Both
|
$577.66
|
|
|
Service Code
|
HCPCS 57460
|
| Min. Negotiated Rate |
$139.45 |
| Max. Negotiated Rate |
$491.01 |
| Rate for Payer: AlohaCare Medicaid |
$159.59
|
| Rate for Payer: AlohaCare Medicare |
$139.45
|
| Rate for Payer: Cash Price |
$346.60
|
| Rate for Payer: Cash Price |
$346.60
|
| Rate for Payer: Devoted Health Medicare |
$153.40
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$159.59
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$247.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$139.45
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$159.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$191.88
|
| Rate for Payer: Health Management Network Commercial |
$491.01
|
| Rate for Payer: Kaiser Permanente Commercial |
$167.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$167.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$167.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$159.59
|
| Rate for Payer: Ohana Health Plan Medicare |
$139.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$159.59
|
| Rate for Payer: UnitedHealthcare Medicare |
$139.45
|
| Rate for Payer: University Health Alliance Commercial |
$197.88
|
|
|
PR COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX
|
Professional
|
Both
|
$331.29
|
|
|
Service Code
|
HCPCS 57421
|
| Min. Negotiated Rate |
$106.52 |
| Max. Negotiated Rate |
$281.60 |
| Rate for Payer: AlohaCare Medicaid |
$121.25
|
| Rate for Payer: AlohaCare Medicare |
$106.52
|
| Rate for Payer: Cash Price |
$198.77
|
| Rate for Payer: Cash Price |
$198.77
|
| Rate for Payer: Devoted Health Medicare |
$117.17
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$121.25
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$188.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$106.52
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$121.25
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$158.34
|
| Rate for Payer: Health Management Network Commercial |
$281.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$127.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$127.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$127.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$121.25
|
| Rate for Payer: Ohana Health Plan Medicare |
$106.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$121.25
|
| Rate for Payer: UnitedHealthcare Medicare |
$106.52
|
| Rate for Payer: University Health Alliance Commercial |
$159.78
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,400.80
|
|
|
Service Code
|
HCPCS 45382
|
| Min. Negotiated Rate |
$227.77 |
| Max. Negotiated Rate |
$1,190.68 |
| Rate for Payer: AlohaCare Medicaid |
$257.57
|
| Rate for Payer: AlohaCare Medicare |
$227.77
|
| Rate for Payer: Cash Price |
$840.48
|
| Rate for Payer: Cash Price |
$840.48
|
| Rate for Payer: Devoted Health Medicare |
$250.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$257.57
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$506.13
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$227.77
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$257.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$453.18
|
| Rate for Payer: Health Management Network Commercial |
$1,190.68
|
| Rate for Payer: Kaiser Permanente Commercial |
$273.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$273.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$273.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$257.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$227.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$257.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$227.77
|
| Rate for Payer: University Health Alliance Commercial |
$342.94
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Professional
|
Both
|
$934.13
|
|
|
Service Code
|
HCPCS 45381
|
| Min. Negotiated Rate |
$178.33 |
| Max. Negotiated Rate |
$794.01 |
| Rate for Payer: AlohaCare Medicaid |
$199.77
|
| Rate for Payer: AlohaCare Medicare |
$178.33
|
| Rate for Payer: Cash Price |
$560.48
|
| Rate for Payer: Cash Price |
$560.48
|
| Rate for Payer: Devoted Health Medicare |
$196.16
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$199.77
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$377.77
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$178.33
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$199.77
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$436.28
|
| Rate for Payer: Health Management Network Commercial |
$794.01
|
| 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 |
$199.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$178.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$199.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$178.33
|
| Rate for Payer: University Health Alliance Commercial |
$271.68
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Professional
|
Both
|
$1,021.63
|
|
|
Service Code
|
HCPCS 45384
|
| Min. Negotiated Rate |
$201.74 |
| Max. Negotiated Rate |
$868.39 |
| Rate for Payer: AlohaCare Medicaid |
$225.47
|
| Rate for Payer: AlohaCare Medicare |
$201.74
|
| Rate for Payer: Cash Price |
$612.98
|
| Rate for Payer: Cash Price |
$612.98
|
| Rate for Payer: Devoted Health Medicare |
$221.91
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$225.47
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$435.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$201.74
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$225.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$395.20
|
| Rate for Payer: Health Management Network Commercial |
$868.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$242.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$242.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$242.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$225.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$201.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$225.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$201.74
|
| Rate for Payer: University Health Alliance Commercial |
$495.00
|
|
|
PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ
|
Professional
|
Both
|
$943.22
|
|
|
Service Code
|
HCPCS 45385
|
| Min. Negotiated Rate |
$224.15 |
| Max. Negotiated Rate |
$801.74 |
| Rate for Payer: AlohaCare Medicaid |
$252.85
|
| Rate for Payer: AlohaCare Medicare |
$224.15
|
| Rate for Payer: Cash Price |
$565.93
|
| Rate for Payer: Cash Price |
$565.93
|
| Rate for Payer: Devoted Health Medicare |
$246.56
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$252.85
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$489.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$224.15
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$252.85
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$466.18
|
| Rate for Payer: Health Management Network Commercial |
$801.74
|
| Rate for Payer: Kaiser Permanente Commercial |
$268.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$268.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$268.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$252.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$224.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$252.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$224.15
|
| Rate for Payer: University Health Alliance Commercial |
$420.00
|
|
|
PR COMMUNITY SPORTS PHYSICAL
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 98388
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Health Management Network Commercial |
$51.00
|
|
|
PR COMP ASSES CARE PLAN CCM SVC
|
Professional
|
Both
|
$123.32
|
|
|
Service Code
|
HCPCS G0506
|
| Min. Negotiated Rate |
$38.57 |
| Max. Negotiated Rate |
$104.82 |
| Rate for Payer: AlohaCare Medicare |
$38.57
|
| Rate for Payer: Cash Price |
$73.99
|
| Rate for Payer: Cash Price |
$73.99
|
| Rate for Payer: Devoted Health Medicare |
$42.43
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$44.61
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$52.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.57
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$44.61
|
| Rate for Payer: Health Management Network Commercial |
$104.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$46.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$46.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$46.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.57
|
| Rate for Payer: University Health Alliance Commercial |
$42.80
|
|
|
PR COMPLETE REPLACEMENT PICC RS&I
|
Professional
|
Both
|
$599.15
|
|
|
Service Code
|
HCPCS 36584
|
| Min. Negotiated Rate |
$49.95 |
| Max. Negotiated Rate |
$509.28 |
| Rate for Payer: AlohaCare Medicaid |
$57.10
|
| Rate for Payer: AlohaCare Medicare |
$49.95
|
| Rate for Payer: Cash Price |
$359.49
|
| Rate for Payer: Cash Price |
$359.49
|
| Rate for Payer: Devoted Health Medicare |
$54.95
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$57.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$97.59
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$49.95
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$57.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$262.34
|
| Rate for Payer: Health Management Network Commercial |
$509.28
|
| Rate for Payer: Kaiser Permanente Commercial |
$59.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$59.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$59.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$57.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$49.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$57.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$49.95
|
| Rate for Payer: University Health Alliance Commercial |
$76.62
|
|
|
PR COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
HCPCS 93303 26
|
| Min. Negotiated Rate |
$61.80 |
| Max. Negotiated Rate |
$243.85 |
| Rate for Payer: AlohaCare Medicaid |
$243.85
|
| Rate for Payer: AlohaCare Medicare |
$61.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Devoted Health Medicare |
$67.98
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$61.80
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$204.57
|
| Rate for Payer: Health Management Network Commercial |
$91.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$74.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$74.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$74.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$243.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$61.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$243.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$61.80
|
|
|
PR COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY
|
Professional
|
Both
|
$577.00
|
|
|
Service Code
|
HCPCS 93303 TC
|
| Min. Negotiated Rate |
$181.73 |
| Max. Negotiated Rate |
$490.45 |
| Rate for Payer: AlohaCare Medicaid |
$243.85
|
| Rate for Payer: AlohaCare Medicare |
$181.73
|
| Rate for Payer: Cash Price |
$346.20
|
| Rate for Payer: Cash Price |
$346.20
|
| Rate for Payer: Devoted Health Medicare |
$199.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$204.57
|
| Rate for Payer: Health Management Network Commercial |
$490.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$218.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$218.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$218.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$243.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$181.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$243.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.73
|
|
|
PR COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY
|
Professional
|
Both
|
$685.00
|
|
|
Service Code
|
HCPCS 93303
|
| Min. Negotiated Rate |
$204.57 |
| Max. Negotiated Rate |
$582.25 |
| Rate for Payer: AlohaCare Medicaid |
$243.85
|
| Rate for Payer: AlohaCare Medicare |
$243.53
|
| Rate for Payer: Cash Price |
$411.00
|
| Rate for Payer: Cash Price |
$411.00
|
| Rate for Payer: Devoted Health Medicare |
$267.88
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$243.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$204.57
|
| Rate for Payer: Health Management Network Commercial |
$582.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$292.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$292.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$292.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$243.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$243.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$243.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$243.53
|
|
|
PR COMPLEX CHRONIC CARE MGMT SVC 1ST 60 MIN CAL MO
|
Professional
|
Both
|
$268.36
|
|
|
Service Code
|
HCPCS 99487
|
| Min. Negotiated Rate |
$79.30 |
| Max. Negotiated Rate |
$228.11 |
| Rate for Payer: AlohaCare Medicare |
$79.30
|
| Rate for Payer: Cash Price |
$161.02
|
| Rate for Payer: Cash Price |
$161.02
|
| Rate for Payer: Devoted Health Medicare |
$87.23
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$91.18
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$79.30
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$91.18
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$100.18
|
| Rate for Payer: Health Management Network Commercial |
$228.11
|
| Rate for Payer: Kaiser Permanente Commercial |
$95.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$95.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$95.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$79.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$79.30
|
|
|
PR COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 51728 26
|
| Min. Negotiated Rate |
$105.33 |
| Max. Negotiated Rate |
$402.70 |
| Rate for Payer: AlohaCare Medicaid |
$402.70
|
| Rate for Payer: AlohaCare Medicare |
$105.33
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Devoted Health Medicare |
$115.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$105.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$236.08
|
| Rate for Payer: Health Management Network Commercial |
$156.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$126.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$126.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$126.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$402.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$105.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$402.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$105.33
|
|
|
PR COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES
|
Professional
|
Both
|
$879.00
|
|
|
Service Code
|
HCPCS 51728 TC
|
| Min. Negotiated Rate |
$236.08 |
| Max. Negotiated Rate |
$747.15 |
| Rate for Payer: AlohaCare Medicaid |
$402.70
|
| Rate for Payer: AlohaCare Medicare |
$263.95
|
| Rate for Payer: Cash Price |
$527.40
|
| Rate for Payer: Cash Price |
$527.40
|
| Rate for Payer: Devoted Health Medicare |
$290.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$263.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$236.08
|
| Rate for Payer: Health Management Network Commercial |
$747.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$316.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$316.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$316.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$402.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$263.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$402.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$263.95
|
|
|
PR COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES
|
Professional
|
Both
|
$1,063.00
|
|
|
Service Code
|
HCPCS 51728
|
| Min. Negotiated Rate |
$236.08 |
| Max. Negotiated Rate |
$903.55 |
| Rate for Payer: AlohaCare Medicaid |
$402.70
|
| Rate for Payer: AlohaCare Medicare |
$369.28
|
| Rate for Payer: Cash Price |
$637.80
|
| Rate for Payer: Cash Price |
$637.80
|
| Rate for Payer: Devoted Health Medicare |
$406.21
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$369.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$236.08
|
| Rate for Payer: Health Management Network Commercial |
$903.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$443.14
|
| Rate for Payer: Kaiser Permanente Medicaid |
$443.14
|
| Rate for Payer: Kaiser Permanente Medicare |
$443.14
|
| Rate for Payer: Ohana Health Plan Medicaid |
$402.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$369.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$402.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$369.28
|
|
|
PR COMPLEX E/M VISIT ADD ON
|
Professional
|
Both
|
$31.27
|
|
|
Service Code
|
HCPCS G2211
|
| Min. Negotiated Rate |
$14.45 |
| Max. Negotiated Rate |
$26.58 |
| Rate for Payer: AlohaCare Medicaid |
$16.71
|
| Rate for Payer: AlohaCare Medicare |
$14.45
|
| Rate for Payer: Cash Price |
$18.76
|
| Rate for Payer: Cash Price |
$18.76
|
| Rate for Payer: Devoted Health Medicare |
$15.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$14.45
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$15.61
|
| Rate for Payer: Health Management Network Commercial |
$26.58
|
| Rate for Payer: Kaiser Permanente Commercial |
$17.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$17.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$17.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$14.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$14.45
|
|
|
PR COMPLEX UROFLOMETRY
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 51741
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: AlohaCare Medicaid |
$15.02
|
| Rate for Payer: AlohaCare Medicare |
$16.13
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Devoted Health Medicare |
$17.74
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$16.13
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$59.80
|
| Rate for Payer: Health Management Network Commercial |
$30.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$19.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$19.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$19.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$15.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$16.13
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.02
|
| Rate for Payer: UnitedHealthcare Medicare |
$16.13
|
|
|
PR COMPLEX UROFLOMETRY
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS 51741 TC
|
| Min. Negotiated Rate |
$7.41 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: AlohaCare Medicaid |
$15.02
|
| Rate for Payer: AlohaCare Medicare |
$7.41
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Devoted Health Medicare |
$8.15
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$7.41
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$59.80
|
| Rate for Payer: Health Management Network Commercial |
$17.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$8.89
|
| Rate for Payer: Kaiser Permanente Medicaid |
$8.89
|
| Rate for Payer: Kaiser Permanente Medicare |
$8.89
|
| Rate for Payer: Ohana Health Plan Medicaid |
$15.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$7.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.02
|
| Rate for Payer: UnitedHealthcare Medicare |
$7.41
|
|
|
PR COMPLEX UROFLOMETRY
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 51741 26
|
| Min. Negotiated Rate |
$8.72 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: AlohaCare Medicaid |
$15.02
|
| Rate for Payer: AlohaCare Medicare |
$8.72
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Devoted Health Medicare |
$9.59
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$8.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$59.80
|
| Rate for Payer: Health Management Network Commercial |
$12.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$10.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$10.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$10.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$15.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$8.72
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.02
|
| Rate for Payer: UnitedHealthcare Medicare |
$8.72
|
|
|
PR COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 51729 26
|
| Min. Negotiated Rate |
$126.74 |
| Max. Negotiated Rate |
$422.10 |
| Rate for Payer: AlohaCare Medicaid |
$422.10
|
| Rate for Payer: AlohaCare Medicare |
$126.74
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Devoted Health Medicare |
$139.41
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$126.74
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$252.98
|
| Rate for Payer: Health Management Network Commercial |
$188.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$152.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$152.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$152.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$422.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$126.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$422.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$126.74
|
|
|
PR COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL
|
Professional
|
Both
|
$1,091.00
|
|
|
Service Code
|
HCPCS 51729
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$927.35 |
| Rate for Payer: AlohaCare Medicaid |
$422.10
|
| Rate for Payer: AlohaCare Medicare |
$385.57
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Devoted Health Medicare |
$424.13
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$385.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$252.98
|
| Rate for Payer: Health Management Network Commercial |
$927.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$462.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$462.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$462.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$422.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$385.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$422.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$385.57
|
|
|
PR COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 51729 TC
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$738.65 |
| Rate for Payer: AlohaCare Medicaid |
$422.10
|
| Rate for Payer: AlohaCare Medicare |
$258.82
|
| Rate for Payer: Cash Price |
$521.40
|
| Rate for Payer: Cash Price |
$521.40
|
| Rate for Payer: Devoted Health Medicare |
$284.70
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$258.82
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$252.98
|
| Rate for Payer: Health Management Network Commercial |
$738.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$310.58
|
| Rate for Payer: Kaiser Permanente Medicaid |
$310.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$310.58
|
| Rate for Payer: Ohana Health Plan Medicaid |
$422.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$258.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$422.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$258.82
|
|
|
PR COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ
|
Professional
|
Both
|
$65.97
|
|
|
Service Code
|
HCPCS 92557
|
| Min. Negotiated Rate |
$26.31 |
| Max. Negotiated Rate |
$56.07 |
| Rate for Payer: AlohaCare Medicaid |
$32.59
|
| Rate for Payer: AlohaCare Medicare |
$26.31
|
| Rate for Payer: Cash Price |
$39.58
|
| Rate for Payer: Cash Price |
$39.58
|
| Rate for Payer: Devoted Health Medicare |
$28.94
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$32.59
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$26.31
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$32.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$51.51
|
| Rate for Payer: Health Management Network Commercial |
$56.07
|
| Rate for Payer: Kaiser Permanente Commercial |
$31.57
|
| Rate for Payer: Kaiser Permanente Medicaid |
$31.57
|
| Rate for Payer: Kaiser Permanente Medicare |
$31.57
|
| Rate for Payer: Ohana Health Plan Medicaid |
$32.59
|
| Rate for Payer: Ohana Health Plan Medicare |
$26.31
|
| Rate for Payer: UnitedHealthcare Medicaid |
$32.59
|
| Rate for Payer: UnitedHealthcare Medicare |
$26.31
|
|
