|
PR ECHO R-T 2D W/PROBE PLACEMENT ONLY
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 93313
|
| Min. Negotiated Rate |
$10.26 |
| Max. Negotiated Rate |
$110.78 |
| Rate for Payer: AlohaCare Medicaid |
$10.94
|
| Rate for Payer: AlohaCare Medicare |
$10.26
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Devoted Health Medicare |
$11.29
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$10.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$110.78
|
| Rate for Payer: Health Management Network Commercial |
$16.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$12.31
|
| Rate for Payer: Kaiser Permanente Medicaid |
$12.31
|
| Rate for Payer: Kaiser Permanente Medicare |
$12.31
|
| Rate for Payer: Ohana Health Plan Medicaid |
$10.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$10.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$10.26
|
|
|
PR ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN
|
Professional
|
Both
|
$379.00
|
|
|
Service Code
|
HCPCS 93355
|
| Min. Negotiated Rate |
$191.26 |
| Max. Negotiated Rate |
$322.15 |
| Rate for Payer: AlohaCare Medicaid |
$222.10
|
| Rate for Payer: AlohaCare Medicare |
$191.26
|
| Rate for Payer: Cash Price |
$227.40
|
| Rate for Payer: Cash Price |
$227.40
|
| Rate for Payer: Devoted Health Medicare |
$210.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$191.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$236.36
|
| Rate for Payer: Health Management Network Commercial |
$322.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$229.51
|
| Rate for Payer: Kaiser Permanente Medicaid |
$229.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$229.51
|
| Rate for Payer: Ohana Health Plan Medicaid |
$222.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$191.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$222.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$191.26
|
|
|
PR ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R
|
Professional
|
Both
|
$222.30
|
|
|
Service Code
|
HCPCS 93315
|
| Min. Negotiated Rate |
$32.78 |
| Max. Negotiated Rate |
$242.18 |
| Rate for Payer: AlohaCare Medicaid |
$242.18
|
| Rate for Payer: Cash Price |
$133.38
|
| Rate for Payer: Cash Price |
$133.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$32.78
|
| Rate for Payer: Health Management Network Commercial |
$188.96
|
| Rate for Payer: Ohana Health Plan Medicaid |
$242.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$242.18
|
|
|
PR ECHO TRANSESOPHAG CONGEN PROBE PLCMT ONLY
|
Professional
|
Both
|
$42.16
|
|
|
Service Code
|
HCPCS 93316
|
| Min. Negotiated Rate |
$24.09 |
| Max. Negotiated Rate |
$48.62 |
| Rate for Payer: AlohaCare Medicaid |
$25.11
|
| Rate for Payer: AlohaCare Medicare |
$24.09
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Devoted Health Medicare |
$26.50
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$24.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$48.62
|
| Rate for Payer: Health Management Network Commercial |
$35.84
|
| Rate for Payer: Kaiser Permanente Commercial |
$28.91
|
| Rate for Payer: Kaiser Permanente Medicaid |
$28.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$28.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$25.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$24.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$25.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$24.09
|
|
|
PR ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT
|
Professional
|
Both
|
$153.86
|
|
|
Service Code
|
HCPCS 93317
|
| Min. Negotiated Rate |
$130.78 |
| Max. Negotiated Rate |
$199.34 |
| Rate for Payer: AlohaCare Medicaid |
$199.34
|
| Rate for Payer: Cash Price |
$92.32
|
| Rate for Payer: Cash Price |
$92.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$163.65
|
| Rate for Payer: Health Management Network Commercial |
$130.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$199.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$199.34
|
|
|
PR ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ
|
Professional
|
Both
|
$181.32
|
|
|
Service Code
|
HCPCS 93318
|
| Min. Negotiated Rate |
$154.12 |
| Max. Negotiated Rate |
$154.12 |
| Rate for Payer: Cash Price |
$108.79
|
| Rate for Payer: Health Management Network Commercial |
$154.12
|
|
|
PR ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY
|
Professional
|
Both
|
$157.00
|
|
|
Service Code
|
HCPCS 93314 26
|
| Min. Negotiated Rate |
$89.61 |
| Max. Negotiated Rate |
$246.04 |
| Rate for Payer: AlohaCare Medicaid |
$246.04
|
| Rate for Payer: AlohaCare Medicare |
$89.61
|
| Rate for Payer: Cash Price |
$94.20
|
| Rate for Payer: Cash Price |
$94.20
|
| Rate for Payer: Devoted Health Medicare |
$98.57
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$89.61
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$131.15
|
| Rate for Payer: Health Management Network Commercial |
$133.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$107.53
|
| Rate for Payer: Kaiser Permanente Medicaid |
$107.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$107.53
|
| Rate for Payer: Ohana Health Plan Medicaid |
$246.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$89.61
|
| Rate for Payer: UnitedHealthcare Medicaid |
$246.04
|
| Rate for Payer: UnitedHealthcare Medicare |
$89.61
|
|
|
PR ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY
|
Professional
|
Both
|
$497.00
|
|
|
Service Code
|
HCPCS 93314 TC
|
| Min. Negotiated Rate |
$131.15 |
| Max. Negotiated Rate |
$422.45 |
| Rate for Payer: AlohaCare Medicaid |
$246.04
|
| Rate for Payer: AlohaCare Medicare |
$161.98
|
| Rate for Payer: Cash Price |
$298.20
|
| Rate for Payer: Cash Price |
$298.20
|
| Rate for Payer: Devoted Health Medicare |
$178.18
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$161.98
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$131.15
|
| Rate for Payer: Health Management Network Commercial |
$422.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$194.38
|
| Rate for Payer: Kaiser Permanente Medicaid |
$194.38
|
| Rate for Payer: Kaiser Permanente Medicare |
$194.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$246.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$161.98
|
| Rate for Payer: UnitedHealthcare Medicaid |
$246.04
|
| Rate for Payer: UnitedHealthcare Medicare |
$161.98
|
|
|
PR ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY
|
Professional
|
Both
|
$654.00
|
|
|
Service Code
|
HCPCS 93314
|
| Min. Negotiated Rate |
$131.15 |
| Max. Negotiated Rate |
$555.90 |
| Rate for Payer: AlohaCare Medicaid |
$246.04
|
| Rate for Payer: AlohaCare Medicare |
$251.59
|
| Rate for Payer: Cash Price |
$392.40
|
| Rate for Payer: Cash Price |
$392.40
|
| Rate for Payer: Devoted Health Medicare |
$276.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$251.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$131.15
|
| Rate for Payer: Health Management Network Commercial |
$555.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$301.91
|
| Rate for Payer: Kaiser Permanente Medicaid |
$301.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$301.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$246.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$251.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$246.04
|
| Rate for Payer: UnitedHealthcare Medicare |
$251.59
|
|
|
PR ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R
|
Professional
|
Both
|
$189.00
|
|
|
Service Code
|
HCPCS 93312 26
|
| Min. Negotiated Rate |
$108.07 |
| Max. Negotiated Rate |
$288.56 |
| Rate for Payer: AlohaCare Medicaid |
$256.47
|
| Rate for Payer: AlohaCare Medicare |
$108.07
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Devoted Health Medicare |
$118.88
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$108.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$288.56
|
| Rate for Payer: Health Management Network Commercial |
$160.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$129.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$129.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$129.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$256.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$108.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$256.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$108.07
|
|
|
PR ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R
|
Professional
|
Both
|
$472.00
|
|
|
Service Code
|
HCPCS 93312 TC
|
| Min. Negotiated Rate |
$152.11 |
| Max. Negotiated Rate |
$401.20 |
| Rate for Payer: AlohaCare Medicaid |
$256.47
|
| Rate for Payer: AlohaCare Medicare |
$152.11
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Devoted Health Medicare |
$167.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$152.11
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$288.56
|
| Rate for Payer: Health Management Network Commercial |
$401.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$182.53
|
| Rate for Payer: Kaiser Permanente Medicaid |
$182.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$182.53
|
| Rate for Payer: Ohana Health Plan Medicaid |
$256.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$152.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$256.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$152.11
|
|
|
PR ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R
|
Professional
|
Both
|
$661.00
|
|
|
Service Code
|
HCPCS 93312
|
| Min. Negotiated Rate |
$256.47 |
| Max. Negotiated Rate |
$561.85 |
| Rate for Payer: AlohaCare Medicaid |
$256.47
|
| Rate for Payer: AlohaCare Medicare |
$260.18
|
| Rate for Payer: Cash Price |
$396.60
|
| Rate for Payer: Cash Price |
$396.60
|
| Rate for Payer: Devoted Health Medicare |
$286.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$260.18
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$288.56
|
| Rate for Payer: Health Management Network Commercial |
$561.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$312.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$312.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$312.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$256.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$260.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$256.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$260.18
|
|
|
PR ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP
|
Professional
|
Both
|
$421.00
|
|
|
Service Code
|
HCPCS 93307
|
| Min. Negotiated Rate |
$150.89 |
| Max. Negotiated Rate |
$357.85 |
| Rate for Payer: AlohaCare Medicaid |
$150.89
|
| Rate for Payer: AlohaCare Medicare |
$151.79
|
| Rate for Payer: Cash Price |
$252.60
|
| Rate for Payer: Cash Price |
$252.60
|
| Rate for Payer: Devoted Health Medicare |
$166.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$151.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$212.77
|
| Rate for Payer: Health Management Network Commercial |
$357.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$182.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$182.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$182.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$150.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$151.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$150.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$151.79
|
|
|
PR ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 93307 TC
|
| Min. Negotiated Rate |
$107.48 |
| Max. Negotiated Rate |
$291.55 |
| Rate for Payer: AlohaCare Medicaid |
$150.89
|
| Rate for Payer: AlohaCare Medicare |
$107.48
|
| Rate for Payer: Cash Price |
$205.80
|
| Rate for Payer: Cash Price |
$205.80
|
| Rate for Payer: Devoted Health Medicare |
$118.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$107.48
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$212.77
|
| Rate for Payer: Health Management Network Commercial |
$291.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$128.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$128.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$128.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$150.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$107.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$150.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$107.48
|
|
|
PR ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
HCPCS 93307 26
|
| Min. Negotiated Rate |
$44.31 |
| Max. Negotiated Rate |
$212.77 |
| Rate for Payer: AlohaCare Medicaid |
$150.89
|
| Rate for Payer: AlohaCare Medicare |
$44.31
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Devoted Health Medicare |
$48.74
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$44.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$212.77
|
| Rate for Payer: Health Management Network Commercial |
$66.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$53.17
|
| Rate for Payer: Kaiser Permanente Medicaid |
$53.17
|
| Rate for Payer: Kaiser Permanente Medicare |
$53.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$150.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$44.31
|
| Rate for Payer: UnitedHealthcare Medicaid |
$150.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$44.31
|
|
|
PR ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 93308
|
| Min. Negotiated Rate |
$80.16 |
| Max. Negotiated Rate |
$267.75 |
| Rate for Payer: AlohaCare Medicaid |
$109.80
|
| Rate for Payer: AlohaCare Medicare |
$111.94
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Devoted Health Medicare |
$123.13
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$111.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.16
|
| Rate for Payer: Health Management Network Commercial |
$267.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$134.33
|
| Rate for Payer: Kaiser Permanente Medicaid |
$134.33
|
| Rate for Payer: Kaiser Permanente Medicare |
$134.33
|
| Rate for Payer: Ohana Health Plan Medicaid |
$109.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$111.94
|
| Rate for Payer: UnitedHealthcare Medicaid |
$109.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$111.94
|
|
|
PR ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD
|
Professional
|
Both
|
$271.00
|
|
|
Service Code
|
HCPCS 93308 TC
|
| Min. Negotiated Rate |
$80.16 |
| Max. Negotiated Rate |
$230.35 |
| Rate for Payer: AlohaCare Medicaid |
$109.80
|
| Rate for Payer: AlohaCare Medicare |
$86.59
|
| Rate for Payer: Cash Price |
$162.60
|
| Rate for Payer: Cash Price |
$162.60
|
| Rate for Payer: Devoted Health Medicare |
$95.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$86.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.16
|
| Rate for Payer: Health Management Network Commercial |
$230.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$103.91
|
| Rate for Payer: Kaiser Permanente Medicaid |
$103.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$103.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$109.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$86.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$109.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$86.59
|
|
|
PR ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 93308 26
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$109.80 |
| Rate for Payer: AlohaCare Medicaid |
$109.80
|
| Rate for Payer: AlohaCare Medicare |
$25.35
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Devoted Health Medicare |
$27.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$25.35
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.16
|
| Rate for Payer: Health Management Network Commercial |
$37.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$30.42
|
| Rate for Payer: Kaiser Permanente Medicaid |
$30.42
|
| Rate for Payer: Kaiser Permanente Medicare |
$30.42
|
| Rate for Payer: Ohana Health Plan Medicaid |
$109.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$25.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$109.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$25.35
|
|
|
PR ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST
|
Professional
|
Both
|
$428.00
|
|
|
Service Code
|
HCPCS 93350 TC
|
| Min. Negotiated Rate |
$133.69 |
| Max. Negotiated Rate |
$363.80 |
| Rate for Payer: AlohaCare Medicaid |
$204.04
|
| Rate for Payer: AlohaCare Medicare |
$133.69
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Devoted Health Medicare |
$147.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$133.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$133.95
|
| Rate for Payer: Health Management Network Commercial |
$363.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$160.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$160.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$160.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$204.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$133.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$204.04
|
| Rate for Payer: UnitedHealthcare Medicare |
$133.69
|
|
|
PR ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST
|
Professional
|
Both
|
$549.00
|
|
|
Service Code
|
HCPCS 93350
|
| Min. Negotiated Rate |
$133.95 |
| Max. Negotiated Rate |
$466.65 |
| Rate for Payer: AlohaCare Medicaid |
$204.04
|
| Rate for Payer: AlohaCare Medicare |
$202.97
|
| Rate for Payer: Cash Price |
$329.40
|
| Rate for Payer: Cash Price |
$329.40
|
| Rate for Payer: Devoted Health Medicare |
$223.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$202.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$133.95
|
| Rate for Payer: Health Management Network Commercial |
$466.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$243.56
|
| Rate for Payer: Kaiser Permanente Medicaid |
$243.56
|
| Rate for Payer: Kaiser Permanente Medicare |
$243.56
|
| Rate for Payer: Ohana Health Plan Medicaid |
$204.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$202.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$204.04
|
| Rate for Payer: UnitedHealthcare Medicare |
$202.97
|
|
|
PR ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 93350 26
|
| Min. Negotiated Rate |
$69.28 |
| Max. Negotiated Rate |
$204.04 |
| Rate for Payer: AlohaCare Medicaid |
$204.04
|
| Rate for Payer: AlohaCare Medicare |
$69.28
|
| Rate for Payer: Cash Price |
$72.60
|
| Rate for Payer: Cash Price |
$72.60
|
| Rate for Payer: Devoted Health Medicare |
$76.21
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$133.95
|
| Rate for Payer: Health Management Network Commercial |
$102.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$83.14
|
| Rate for Payer: Kaiser Permanente Medicaid |
$83.14
|
| Rate for Payer: Kaiser Permanente Medicare |
$83.14
|
| Rate for Payer: Ohana Health Plan Medicaid |
$204.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$204.04
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.28
|
|
|
PR ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D
|
Professional
|
Both
|
$470.00
|
|
|
Service Code
|
HCPCS 93306 TC
|
| Min. Negotiated Rate |
$146.41 |
| Max. Negotiated Rate |
$399.50 |
| Rate for Payer: AlohaCare Medicaid |
$216.47
|
| Rate for Payer: AlohaCare Medicare |
$146.41
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Devoted Health Medicare |
$161.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$146.41
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$270.09
|
| Rate for Payer: Health Management Network Commercial |
$399.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$175.69
|
| Rate for Payer: Kaiser Permanente Medicaid |
$175.69
|
| Rate for Payer: Kaiser Permanente Medicare |
$175.69
|
| Rate for Payer: Ohana Health Plan Medicaid |
$216.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$146.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$216.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$146.41
|
|
|
PR ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 93306
|
| Min. Negotiated Rate |
$215.69 |
| Max. Negotiated Rate |
$502.35 |
| Rate for Payer: AlohaCare Medicaid |
$216.47
|
| Rate for Payer: AlohaCare Medicare |
$215.69
|
| Rate for Payer: Cash Price |
$354.60
|
| Rate for Payer: Cash Price |
$354.60
|
| Rate for Payer: Devoted Health Medicare |
$237.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$215.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$270.09
|
| Rate for Payer: Health Management Network Commercial |
$502.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$258.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$258.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$258.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$216.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$215.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$216.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$215.69
|
|
|
PR ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 93306 26
|
| Min. Negotiated Rate |
$69.28 |
| Max. Negotiated Rate |
$270.09 |
| Rate for Payer: AlohaCare Medicaid |
$216.47
|
| Rate for Payer: AlohaCare Medicare |
$69.28
|
| Rate for Payer: Cash Price |
$72.60
|
| Rate for Payer: Cash Price |
$72.60
|
| Rate for Payer: Devoted Health Medicare |
$76.21
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$270.09
|
| Rate for Payer: Health Management Network Commercial |
$102.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$83.14
|
| Rate for Payer: Kaiser Permanente Medicaid |
$83.14
|
| Rate for Payer: Kaiser Permanente Medicare |
$83.14
|
| Rate for Payer: Ohana Health Plan Medicaid |
$216.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$216.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.28
|
|
|
PR ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 93351 26
|
| Min. Negotiated Rate |
$83.34 |
| Max. Negotiated Rate |
$278.29 |
| Rate for Payer: AlohaCare Medicaid |
$255.56
|
| Rate for Payer: AlohaCare Medicare |
$83.34
|
| Rate for Payer: Cash Price |
$87.60
|
| Rate for Payer: Cash Price |
$87.60
|
| Rate for Payer: Devoted Health Medicare |
$91.67
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$83.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$278.29
|
| Rate for Payer: Health Management Network Commercial |
$124.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$100.01
|
| Rate for Payer: Kaiser Permanente Medicaid |
$100.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$100.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$255.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$83.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$255.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$83.34
|
|
