|
PR EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT
|
Professional
|
Both
|
$1,341.00
|
|
|
Service Code
|
HCPCS 27637
|
| Min. Negotiated Rate |
$570.70 |
| Max. Negotiated Rate |
$1,139.85 |
| Rate for Payer: AlohaCare Medicaid |
$778.15
|
| Rate for Payer: AlohaCare Medicare |
$721.47
|
| Rate for Payer: Cash Price |
$804.60
|
| Rate for Payer: Cash Price |
$804.60
|
| Rate for Payer: Devoted Health Medicare |
$793.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$721.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$570.70
|
| Rate for Payer: Health Management Network Commercial |
$1,139.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$865.76
|
| Rate for Payer: Kaiser Permanente Medicaid |
$865.76
|
| Rate for Payer: Kaiser Permanente Medicare |
$865.76
|
| Rate for Payer: Ohana Health Plan Medicaid |
$778.15
|
| Rate for Payer: Ohana Health Plan Medicare |
$721.47
|
| Rate for Payer: UnitedHealthcare Medicaid |
$778.15
|
| Rate for Payer: UnitedHealthcare Medicare |
$721.47
|
|
|
PR EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL
|
Professional
|
Both
|
$1,014.02
|
|
|
Service Code
|
HCPCS 28104
|
| Min. Negotiated Rate |
$294.32 |
| Max. Negotiated Rate |
$861.92 |
| Rate for Payer: AlohaCare Medicaid |
$372.93
|
| Rate for Payer: AlohaCare Medicare |
$350.44
|
| Rate for Payer: Cash Price |
$608.41
|
| Rate for Payer: Cash Price |
$608.41
|
| Rate for Payer: Devoted Health Medicare |
$385.48
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$372.93
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$564.98
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$350.44
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$372.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$294.32
|
| Rate for Payer: Health Management Network Commercial |
$861.92
|
| Rate for Payer: Kaiser Permanente Commercial |
$420.53
|
| Rate for Payer: Kaiser Permanente Medicaid |
$420.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$420.53
|
| Rate for Payer: Ohana Health Plan Medicaid |
$372.93
|
| Rate for Payer: Ohana Health Plan Medicare |
$350.44
|
| Rate for Payer: UnitedHealthcare Medicaid |
$372.93
|
| Rate for Payer: UnitedHealthcare Medicare |
$350.44
|
| Rate for Payer: University Health Alliance Commercial |
$478.35
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA
|
Professional
|
Both
|
$1,006.00
|
|
|
Service Code
|
HCPCS 23140
|
| Min. Negotiated Rate |
$342.94 |
| Max. Negotiated Rate |
$855.10 |
| Rate for Payer: AlohaCare Medicaid |
$585.92
|
| Rate for Payer: AlohaCare Medicare |
$545.06
|
| Rate for Payer: Cash Price |
$603.60
|
| Rate for Payer: Cash Price |
$603.60
|
| Rate for Payer: Devoted Health Medicare |
$599.57
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$545.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$342.94
|
| Rate for Payer: Health Management Network Commercial |
$855.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$654.07
|
| Rate for Payer: Kaiser Permanente Medicaid |
$654.07
|
| Rate for Payer: Kaiser Permanente Medicare |
$654.07
|
| Rate for Payer: Ohana Health Plan Medicaid |
$585.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$545.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$585.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$545.06
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,046.94
|
|
|
Service Code
|
HCPCS 19120
|
| Min. Negotiated Rate |
$332.54 |
| Max. Negotiated Rate |
$889.90 |
| Rate for Payer: AlohaCare Medicaid |
$426.08
|
| Rate for Payer: AlohaCare Medicare |
$410.27
|
| Rate for Payer: Cash Price |
$628.16
|
| Rate for Payer: Cash Price |
$628.16
|
| Rate for Payer: Devoted Health Medicare |
$451.30
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$426.08
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$661.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$410.27
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$426.08
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$332.54
|
| Rate for Payer: Health Management Network Commercial |
$889.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$492.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$492.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$492.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$426.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$410.27
|
| Rate for Payer: UnitedHealthcare Medicaid |
$426.08
|
| Rate for Payer: UnitedHealthcare Medicare |
$410.27
|
| Rate for Payer: University Health Alliance Commercial |
$463.91
|
|
|
PR EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS
|
Professional
|
Both
|
$1,167.00
|
|
|
Service Code
|
HCPCS 60200
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$991.95 |
| Rate for Payer: AlohaCare Medicaid |
$682.96
|
| Rate for Payer: AlohaCare Medicare |
$624.02
|
| Rate for Payer: Cash Price |
$700.20
|
| Rate for Payer: Cash Price |
$700.20
|
| Rate for Payer: Devoted Health Medicare |
$686.42
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$624.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$465.40
|
| Rate for Payer: Health Management Network Commercial |
$991.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$748.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$748.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$748.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$682.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$624.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$682.96
|
| Rate for Payer: UnitedHealthcare Medicare |
$624.02
|
|
|
PR EXC EXCSV SKN ABD INFRAUMBILICAL PANNICULECTOMY
|
Professional
|
Both
|
$2,059.00
|
|
|
Service Code
|
HCPCS 15830
|
| Min. Negotiated Rate |
$826.28 |
| Max. Negotiated Rate |
$1,750.15 |
| Rate for Payer: AlohaCare Medicaid |
$1,194.90
|
| Rate for Payer: AlohaCare Medicare |
$1,074.60
|
| Rate for Payer: Cash Price |
$1,235.40
|
| Rate for Payer: Cash Price |
$1,235.40
|
| Rate for Payer: Devoted Health Medicare |
$1,182.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,074.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$826.28
|
| Rate for Payer: Health Management Network Commercial |
$1,750.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,289.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,289.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,289.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,194.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,074.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,194.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,074.60
|
|
|
PR EXC FRENUM LABIAL/BUCCAL
|
Professional
|
Both
|
$522.52
|
|
|
Service Code
|
HCPCS 40819
|
| Min. Negotiated Rate |
$117.00 |
| Max. Negotiated Rate |
$444.14 |
| Rate for Payer: AlohaCare Medicaid |
$212.72
|
| Rate for Payer: AlohaCare Medicare |
$198.33
|
| Rate for Payer: Cash Price |
$313.51
|
| Rate for Payer: Cash Price |
$313.51
|
| Rate for Payer: Devoted Health Medicare |
$218.16
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$212.72
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$327.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$198.33
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$212.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$117.00
|
| Rate for Payer: Health Management Network Commercial |
$444.14
|
| Rate for Payer: Kaiser Permanente Commercial |
$238.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$238.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$238.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$212.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$198.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$212.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$198.33
|
| Rate for Payer: University Health Alliance Commercial |
$274.17
|
|
|
PR EXC/FULGURATION URETHRAL CARUNCLE
|
Professional
|
Both
|
$421.49
|
|
|
Service Code
|
HCPCS 53265
|
| Min. Negotiated Rate |
$166.92 |
| Max. Negotiated Rate |
$358.27 |
| Rate for Payer: AlohaCare Medicaid |
$192.33
|
| Rate for Payer: AlohaCare Medicare |
$170.97
|
| Rate for Payer: Cash Price |
$252.89
|
| Rate for Payer: Cash Price |
$252.89
|
| Rate for Payer: Devoted Health Medicare |
$188.07
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$192.33
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$296.03
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$170.97
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$192.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$166.92
|
| Rate for Payer: Health Management Network Commercial |
$358.27
|
| Rate for Payer: Kaiser Permanente Commercial |
$205.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$205.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$205.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$192.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$170.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$192.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$170.97
|
| Rate for Payer: University Health Alliance Commercial |
$250.63
|
|
|
PR EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I
|
Professional
|
Both
|
$1,174.11
|
|
|
Service Code
|
HCPCS 47536
|
| Min. Negotiated Rate |
$113.42 |
| Max. Negotiated Rate |
$997.99 |
| Rate for Payer: AlohaCare Medicaid |
$128.26
|
| Rate for Payer: AlohaCare Medicare |
$113.42
|
| Rate for Payer: Cash Price |
$704.47
|
| Rate for Payer: Cash Price |
$704.47
|
| Rate for Payer: Devoted Health Medicare |
$124.76
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$128.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$217.84
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$113.42
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$128.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$943.80
|
| Rate for Payer: Health Management Network Commercial |
$997.99
|
| Rate for Payer: Kaiser Permanente Commercial |
$136.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$136.10
|
| Rate for Payer: Kaiser Permanente Medicare |
$136.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$128.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$113.42
|
| Rate for Payer: UnitedHealthcare Medicaid |
$128.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$113.42
|
|
|
PR EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I
|
Professional
|
Both
|
$1,101.14
|
|
|
Service Code
|
HCPCS 50435
|
| Min. Negotiated Rate |
$88.05 |
| Max. Negotiated Rate |
$935.97 |
| Rate for Payer: AlohaCare Medicaid |
$98.94
|
| Rate for Payer: AlohaCare Medicare |
$88.05
|
| Rate for Payer: Cash Price |
$660.68
|
| Rate for Payer: Cash Price |
$660.68
|
| Rate for Payer: Devoted Health Medicare |
$96.86
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$98.94
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$154.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$88.05
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$98.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$545.22
|
| Rate for Payer: Health Management Network Commercial |
$935.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$105.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$105.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$105.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$98.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$88.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$98.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$88.05
|
|
|
PR EXCHNG ABSC/CST DRG CATH RAD GID SPX
|
Professional
|
Both
|
$1,077.34
|
|
|
Service Code
|
HCPCS 49423
|
| Min. Negotiated Rate |
$59.64 |
| Max. Negotiated Rate |
$915.74 |
| Rate for Payer: AlohaCare Medicaid |
$68.42
|
| Rate for Payer: AlohaCare Medicare |
$59.64
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Devoted Health Medicare |
$65.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$68.42
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$107.45
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$59.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$68.42
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$91.78
|
| Rate for Payer: Health Management Network Commercial |
$915.74
|
| Rate for Payer: Kaiser Permanente Commercial |
$71.57
|
| Rate for Payer: Kaiser Permanente Medicaid |
$71.57
|
| Rate for Payer: Kaiser Permanente Medicare |
$71.57
|
| Rate for Payer: Ohana Health Plan Medicaid |
$68.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$59.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$68.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$59.64
|
| Rate for Payer: University Health Alliance Commercial |
$110.00
|
|
|
PR EXC HYDROCELE SPRMATIC CORD UNI SPX
|
Professional
|
Both
|
$690.00
|
|
|
Service Code
|
HCPCS 55500
|
| Min. Negotiated Rate |
$373.06 |
| Max. Negotiated Rate |
$586.50 |
| Rate for Payer: AlohaCare Medicaid |
$402.84
|
| Rate for Payer: AlohaCare Medicare |
$373.06
|
| Rate for Payer: Cash Price |
$414.00
|
| Rate for Payer: Cash Price |
$414.00
|
| Rate for Payer: Devoted Health Medicare |
$410.37
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$373.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$376.22
|
| Rate for Payer: Health Management Network Commercial |
$586.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$447.67
|
| Rate for Payer: Kaiser Permanente Medicaid |
$447.67
|
| Rate for Payer: Kaiser Permanente Medicare |
$447.67
|
| Rate for Payer: Ohana Health Plan Medicaid |
$402.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$373.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$402.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$373.06
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,244.00
|
|
|
Service Code
|
HCPCS 15940
|
| Min. Negotiated Rate |
$384.02 |
| Max. Negotiated Rate |
$1,057.40 |
| Rate for Payer: AlohaCare Medicaid |
$723.69
|
| Rate for Payer: AlohaCare Medicare |
$667.52
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Devoted Health Medicare |
$734.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$667.52
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$384.02
|
| Rate for Payer: Health Management Network Commercial |
$1,057.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$801.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$801.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$801.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$723.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$667.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$723.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$667.52
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 15944
|
| Min. Negotiated Rate |
$618.02 |
| Max. Negotiated Rate |
$1,414.40 |
| Rate for Payer: AlohaCare Medicaid |
$968.99
|
| Rate for Payer: AlohaCare Medicare |
$870.21
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Devoted Health Medicare |
$957.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$870.21
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$618.02
|
| Rate for Payer: Health Management Network Commercial |
$1,414.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,044.25
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,044.25
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,044.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$968.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$870.21
|
| Rate for Payer: UnitedHealthcare Medicaid |
$968.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$870.21
|
|
|
PR EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT
|
Professional
|
Both
|
$1,690.00
|
|
|
Service Code
|
HCPCS 15941
|
| Min. Negotiated Rate |
$560.82 |
| Max. Negotiated Rate |
$1,436.50 |
| Rate for Payer: AlohaCare Medicaid |
$959.91
|
| Rate for Payer: AlohaCare Medicare |
$887.44
|
| Rate for Payer: Cash Price |
$1,014.00
|
| Rate for Payer: Cash Price |
$1,014.00
|
| Rate for Payer: Devoted Health Medicare |
$976.18
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$887.44
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$560.82
|
| Rate for Payer: Health Management Network Commercial |
$1,436.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,064.93
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,064.93
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,064.93
|
| Rate for Payer: Ohana Health Plan Medicaid |
$959.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$887.44
|
| Rate for Payer: UnitedHealthcare Medicaid |
$959.91
|
| Rate for Payer: UnitedHealthcare Medicare |
$887.44
|
|
|
PR EXCISION BARTHOLINS GLAND OR CYST
|
Professional
|
Both
|
$547.00
|
|
|
Service Code
|
HCPCS 56740
|
| Min. Negotiated Rate |
$264.94 |
| Max. Negotiated Rate |
$464.95 |
| Rate for Payer: AlohaCare Medicaid |
$323.67
|
| Rate for Payer: AlohaCare Medicare |
$283.67
|
| Rate for Payer: Cash Price |
$328.20
|
| Rate for Payer: Cash Price |
$328.20
|
| Rate for Payer: Devoted Health Medicare |
$312.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$283.67
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$264.94
|
| Rate for Payer: Health Management Network Commercial |
$464.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$340.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$340.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$340.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$323.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$283.67
|
| Rate for Payer: UnitedHealthcare Medicaid |
$323.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$283.67
|
|
|
PR EXCISION BONE MANDIBLE
|
Professional
|
Both
|
$1,550.41
|
|
|
Service Code
|
HCPCS 21025
|
| Min. Negotiated Rate |
$423.80 |
| Max. Negotiated Rate |
$1,317.85 |
| Rate for Payer: AlohaCare Medicaid |
$689.66
|
| Rate for Payer: AlohaCare Medicare |
$628.47
|
| Rate for Payer: Cash Price |
$930.25
|
| Rate for Payer: Cash Price |
$930.25
|
| Rate for Payer: Devoted Health Medicare |
$691.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$689.66
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,121.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$628.47
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$689.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$423.80
|
| Rate for Payer: Health Management Network Commercial |
$1,317.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$754.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$754.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$754.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$689.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$628.47
|
| Rate for Payer: UnitedHealthcare Medicaid |
$689.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$628.47
|
| Rate for Payer: University Health Alliance Commercial |
$896.57
|
|
|
PR EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA
|
Professional
|
Both
|
$1,036.00
|
|
|
Service Code
|
HCPCS 27635
|
| Min. Negotiated Rate |
$492.18 |
| Max. Negotiated Rate |
$880.60 |
| Rate for Payer: AlohaCare Medicaid |
$605.91
|
| Rate for Payer: AlohaCare Medicare |
$558.81
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Devoted Health Medicare |
$614.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$558.81
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$492.18
|
| Rate for Payer: Health Management Network Commercial |
$880.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$670.57
|
| Rate for Payer: Kaiser Permanente Medicaid |
$670.57
|
| Rate for Payer: Kaiser Permanente Medicare |
$670.57
|
| Rate for Payer: Ohana Health Plan Medicaid |
$605.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$558.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$605.91
|
| Rate for Payer: UnitedHealthcare Medicare |
$558.81
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT
|
Professional
|
Both
|
$1,456.00
|
|
|
Service Code
|
HCPCS 27357
|
| Min. Negotiated Rate |
$593.58 |
| Max. Negotiated Rate |
$1,237.60 |
| Rate for Payer: AlohaCare Medicaid |
$850.65
|
| Rate for Payer: AlohaCare Medicare |
$778.73
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Devoted Health Medicare |
$856.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$778.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$593.58
|
| Rate for Payer: Health Management Network Commercial |
$1,237.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$934.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$934.48
|
| Rate for Payer: Kaiser Permanente Medicare |
$934.48
|
| Rate for Payer: Ohana Health Plan Medicaid |
$850.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$778.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$850.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$778.73
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER
|
Professional
|
Both
|
$828.00
|
|
|
Service Code
|
HCPCS 26210
|
| Min. Negotiated Rate |
$323.44 |
| Max. Negotiated Rate |
$703.80 |
| Rate for Payer: AlohaCare Medicaid |
$480.89
|
| Rate for Payer: AlohaCare Medicare |
$444.86
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Devoted Health Medicare |
$489.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$444.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$323.44
|
| Rate for Payer: Health Management Network Commercial |
$703.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$533.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$533.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$533.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$480.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$444.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$480.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$444.86
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA
|
Professional
|
Both
|
$918.00
|
|
|
Service Code
|
HCPCS 25120
|
| Min. Negotiated Rate |
$429.52 |
| Max. Negotiated Rate |
$780.30 |
| Rate for Payer: AlohaCare Medicaid |
$533.84
|
| Rate for Payer: AlohaCare Medicare |
$490.09
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Devoted Health Medicare |
$539.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$490.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$429.52
|
| Rate for Payer: Health Management Network Commercial |
$780.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$588.11
|
| Rate for Payer: Kaiser Permanente Medicaid |
$588.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$588.11
|
| Rate for Payer: Ohana Health Plan Medicaid |
$533.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$490.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$533.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$490.09
|
|
|
PR EXCISION/DESTRUCTION INTRANASAL LESION INT APPR
|
Professional
|
Both
|
$1,845.64
|
|
|
Service Code
|
HCPCS 30117
|
| Min. Negotiated Rate |
$185.90 |
| Max. Negotiated Rate |
$1,568.79 |
| Rate for Payer: AlohaCare Medicaid |
$447.74
|
| Rate for Payer: AlohaCare Medicare |
$398.04
|
| Rate for Payer: Cash Price |
$1,107.38
|
| Rate for Payer: Cash Price |
$1,107.38
|
| Rate for Payer: Devoted Health Medicare |
$437.84
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$447.74
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$553.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$398.04
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$447.74
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$185.90
|
| Rate for Payer: Health Management Network Commercial |
$1,568.79
|
| Rate for Payer: Kaiser Permanente Commercial |
$477.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$477.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$477.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$447.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$398.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$447.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$398.04
|
| Rate for Payer: University Health Alliance Commercial |
$545.95
|
|
|
PR EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD
|
Professional
|
Both
|
$436.80
|
|
|
Service Code
|
HCPCS 42808
|
| Min. Negotiated Rate |
$151.62 |
| Max. Negotiated Rate |
$371.28 |
| Rate for Payer: AlohaCare Medicaid |
$174.07
|
| Rate for Payer: AlohaCare Medicare |
$151.62
|
| Rate for Payer: Cash Price |
$262.08
|
| Rate for Payer: Cash Price |
$262.08
|
| Rate for Payer: Devoted Health Medicare |
$166.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$174.07
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$265.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$151.62
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$174.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$154.44
|
| Rate for Payer: Health Management Network Commercial |
$371.28
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$181.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$174.07
|
| Rate for Payer: Ohana Health Plan Medicare |
$151.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$174.07
|
| Rate for Payer: UnitedHealthcare Medicare |
$151.62
|
| Rate for Payer: University Health Alliance Commercial |
$225.12
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE ABDOMEN
|
Professional
|
Both
|
$1,670.00
|
|
|
Service Code
|
HCPCS 15847
|
| Min. Negotiated Rate |
$1,419.50 |
| Max. Negotiated Rate |
$1,419.50 |
| Rate for Payer: Cash Price |
$1,002.00
|
| Rate for Payer: Health Management Network Commercial |
$1,419.50
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM
|
Professional
|
Both
|
$1,422.00
|
|
|
Service Code
|
HCPCS 15836
|
| Min. Negotiated Rate |
$446.68 |
| Max. Negotiated Rate |
$1,208.70 |
| Rate for Payer: AlohaCare Medicaid |
$826.95
|
| Rate for Payer: AlohaCare Medicare |
$745.55
|
| Rate for Payer: Cash Price |
$853.20
|
| Rate for Payer: Cash Price |
$853.20
|
| Rate for Payer: Devoted Health Medicare |
$820.11
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$745.55
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$446.68
|
| Rate for Payer: Health Management Network Commercial |
$1,208.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$894.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$894.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$894.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$826.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$745.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$826.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$745.55
|
|
