|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK
|
Professional
|
Both
|
$1,651.00
|
|
|
Service Code
|
HCPCS 15835
|
| Min. Negotiated Rate |
$546.78 |
| Max. Negotiated Rate |
$1,403.35 |
| Rate for Payer: AlohaCare Medicaid |
$959.34
|
| Rate for Payer: AlohaCare Medicare |
$858.66
|
| Rate for Payer: Cash Price |
$990.60
|
| Rate for Payer: Cash Price |
$990.60
|
| Rate for Payer: Devoted Health Medicare |
$944.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$858.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$546.78
|
| Rate for Payer: Health Management Network Commercial |
$1,403.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,030.39
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,030.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,030.39
|
| Rate for Payer: Ohana Health Plan Medicaid |
$959.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$858.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$959.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$858.66
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 15834
|
| Min. Negotiated Rate |
$532.22 |
| Max. Negotiated Rate |
$1,350.65 |
| Rate for Payer: AlohaCare Medicaid |
$923.12
|
| Rate for Payer: AlohaCare Medicare |
$827.70
|
| Rate for Payer: Cash Price |
$953.40
|
| Rate for Payer: Cash Price |
$953.40
|
| Rate for Payer: Devoted Health Medicare |
$910.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$827.70
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$532.22
|
| Rate for Payer: Health Management Network Commercial |
$1,350.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$993.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$993.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$993.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$923.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$827.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$923.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$827.70
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE LEG
|
Professional
|
Both
|
$1,561.00
|
|
|
Service Code
|
HCPCS 15833
|
| Min. Negotiated Rate |
$494.52 |
| Max. Negotiated Rate |
$1,326.85 |
| Rate for Payer: AlohaCare Medicaid |
$907.26
|
| Rate for Payer: AlohaCare Medicare |
$814.11
|
| Rate for Payer: Cash Price |
$936.60
|
| Rate for Payer: Cash Price |
$936.60
|
| Rate for Payer: Devoted Health Medicare |
$895.52
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$814.11
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$494.52
|
| Rate for Payer: Health Management Network Commercial |
$1,326.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$976.93
|
| Rate for Payer: Kaiser Permanente Medicaid |
$976.93
|
| Rate for Payer: Kaiser Permanente Medicare |
$976.93
|
| Rate for Payer: Ohana Health Plan Medicaid |
$907.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$814.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$907.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$814.11
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA
|
Professional
|
Both
|
$1,763.77
|
|
|
Service Code
|
HCPCS 15839
|
| Min. Negotiated Rate |
$474.76 |
| Max. Negotiated Rate |
$1,499.20 |
| Rate for Payer: AlohaCare Medicaid |
$761.53
|
| Rate for Payer: AlohaCare Medicare |
$692.66
|
| Rate for Payer: Cash Price |
$1,058.26
|
| Rate for Payer: Cash Price |
$1,058.26
|
| Rate for Payer: Devoted Health Medicare |
$761.93
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$761.53
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,177.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$692.66
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$761.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$474.76
|
| Rate for Payer: Health Management Network Commercial |
$1,499.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$831.19
|
| Rate for Payer: Kaiser Permanente Medicaid |
$831.19
|
| Rate for Payer: Kaiser Permanente Medicare |
$831.19
|
| Rate for Payer: Ohana Health Plan Medicaid |
$761.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$692.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$761.53
|
| Rate for Payer: UnitedHealthcare Medicare |
$692.66
|
| Rate for Payer: University Health Alliance Commercial |
$871.44
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH
|
Professional
|
Both
|
$1,644.00
|
|
|
Service Code
|
HCPCS 15832
|
| Min. Negotiated Rate |
$580.32 |
| Max. Negotiated Rate |
$1,397.40 |
| Rate for Payer: AlohaCare Medicaid |
$949.11
|
| Rate for Payer: AlohaCare Medicare |
$856.45
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Devoted Health Medicare |
$942.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$856.45
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$580.32
|
| Rate for Payer: Health Management Network Commercial |
$1,397.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,027.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,027.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,027.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$949.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$856.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$949.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$856.45
|
|
|
PR EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$1,652.00
|
|
|
Service Code
|
HCPCS 69140
|
| Min. Negotiated Rate |
$638.56 |
| Max. Negotiated Rate |
$1,404.20 |
| Rate for Payer: AlohaCare Medicaid |
$976.65
|
| Rate for Payer: AlohaCare Medicare |
$900.20
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Devoted Health Medicare |
$990.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$900.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$638.56
|
| Rate for Payer: Health Management Network Commercial |
$1,404.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,080.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,080.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,080.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$976.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$900.20
|
| Rate for Payer: UnitedHealthcare Medicaid |
$976.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$900.20
|
|
|
PR EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Professional
|
Both
|
$889.89
|
|
|
Service Code
|
HCPCS 69110
|
| Min. Negotiated Rate |
$182.52 |
| Max. Negotiated Rate |
$756.41 |
| Rate for Payer: AlohaCare Medicaid |
$351.34
|
| Rate for Payer: AlohaCare Medicare |
$316.73
|
| Rate for Payer: Cash Price |
$533.93
|
| Rate for Payer: Cash Price |
$533.93
|
| Rate for Payer: Devoted Health Medicare |
$348.40
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$351.34
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$543.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$316.73
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$351.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$182.52
|
| Rate for Payer: Health Management Network Commercial |
$756.41
|
| Rate for Payer: Kaiser Permanente Commercial |
$380.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$380.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$380.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$351.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$316.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$351.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$316.73
|
| Rate for Payer: University Health Alliance Commercial |
$460.17
|
|
|
PR EXCISION FACIAL BONE
|
Professional
|
Both
|
$1,078.10
|
|
|
Service Code
|
HCPCS 21026
|
| Min. Negotiated Rate |
$247.78 |
| Max. Negotiated Rate |
$916.38 |
| Rate for Payer: AlohaCare Medicaid |
$453.95
|
| Rate for Payer: AlohaCare Medicare |
$430.73
|
| Rate for Payer: Cash Price |
$646.86
|
| Rate for Payer: Cash Price |
$646.86
|
| Rate for Payer: Devoted Health Medicare |
$473.80
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$453.95
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$694.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$430.73
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$453.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$247.78
|
| Rate for Payer: Health Management Network Commercial |
$916.38
|
| Rate for Payer: Kaiser Permanente Commercial |
$516.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$516.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$516.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$453.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$453.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$430.73
|
| Rate for Payer: University Health Alliance Commercial |
$632.17
|
|
|
PR EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY
|
Professional
|
Both
|
$609.00
|
|
|
Service Code
|
HCPCS 25111
|
| Min. Negotiated Rate |
$285.48 |
| Max. Negotiated Rate |
$517.65 |
| Rate for Payer: AlohaCare Medicaid |
$353.19
|
| Rate for Payer: AlohaCare Medicare |
$336.92
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Devoted Health Medicare |
$370.61
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$336.92
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$285.48
|
| Rate for Payer: Health Management Network Commercial |
$517.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$404.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$404.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$404.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$353.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$336.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$353.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$336.92
|
|
|
PR EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT
|
Professional
|
Both
|
$723.00
|
|
|
Service Code
|
HCPCS 25112
|
| Min. Negotiated Rate |
$267.80 |
| Max. Negotiated Rate |
$614.55 |
| Rate for Payer: AlohaCare Medicaid |
$419.72
|
| Rate for Payer: AlohaCare Medicare |
$391.54
|
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Devoted Health Medicare |
$430.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$391.54
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$267.80
|
| Rate for Payer: Health Management Network Commercial |
$614.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$469.85
|
| Rate for Payer: Kaiser Permanente Medicaid |
$469.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$469.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$419.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$391.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$419.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$391.54
|
|
|
PR EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR
|
Professional
|
Both
|
$869.84
|
|
|
Service Code
|
HCPCS 11450
|
| Min. Negotiated Rate |
$133.64 |
| Max. Negotiated Rate |
$739.36 |
| Rate for Payer: AlohaCare Medicaid |
$273.23
|
| Rate for Payer: AlohaCare Medicare |
$261.98
|
| Rate for Payer: Cash Price |
$521.90
|
| Rate for Payer: Cash Price |
$521.90
|
| Rate for Payer: Devoted Health Medicare |
$288.18
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$273.23
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$410.29
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$261.98
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$273.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$133.64
|
| Rate for Payer: Health Management Network Commercial |
$739.36
|
| Rate for Payer: Kaiser Permanente Commercial |
$314.38
|
| Rate for Payer: Kaiser Permanente Medicaid |
$314.38
|
| Rate for Payer: Kaiser Permanente Medicare |
$314.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$273.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$261.98
|
| Rate for Payer: UnitedHealthcare Medicaid |
$273.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$261.98
|
| Rate for Payer: University Health Alliance Commercial |
$311.65
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Professional
|
Both
|
$850.20
|
|
|
Service Code
|
HCPCS 11462
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$722.67 |
| Rate for Payer: AlohaCare Medicaid |
$260.96
|
| Rate for Payer: AlohaCare Medicare |
$250.76
|
| Rate for Payer: Cash Price |
$510.12
|
| Rate for Payer: Cash Price |
$510.12
|
| Rate for Payer: Devoted Health Medicare |
$275.84
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$260.96
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$399.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$250.76
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$260.96
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$57.20
|
| Rate for Payer: Health Management Network Commercial |
$722.67
|
| Rate for Payer: Kaiser Permanente Commercial |
$300.91
|
| Rate for Payer: Kaiser Permanente Medicaid |
$300.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$300.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$260.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$250.76
|
| Rate for Payer: UnitedHealthcare Medicaid |
$260.96
|
| Rate for Payer: UnitedHealthcare Medicare |
$250.76
|
| Rate for Payer: University Health Alliance Commercial |
$297.27
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Professional
|
Both
|
$1,096.83
|
|
|
Service Code
|
HCPCS 11471
|
| Min. Negotiated Rate |
$220.48 |
| Max. Negotiated Rate |
$932.31 |
| Rate for Payer: AlohaCare Medicaid |
$364.12
|
| Rate for Payer: AlohaCare Medicare |
$338.14
|
| Rate for Payer: Cash Price |
$658.10
|
| Rate for Payer: Cash Price |
$658.10
|
| Rate for Payer: Devoted Health Medicare |
$371.95
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$364.12
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$560.78
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$338.14
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$364.12
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$220.48
|
| Rate for Payer: Health Management Network Commercial |
$932.31
|
| Rate for Payer: Kaiser Permanente Commercial |
$405.77
|
| Rate for Payer: Kaiser Permanente Medicaid |
$405.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$405.77
|
| Rate for Payer: Ohana Health Plan Medicaid |
$364.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$338.14
|
| Rate for Payer: UnitedHealthcare Medicaid |
$364.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$338.14
|
| Rate for Payer: University Health Alliance Commercial |
$414.97
|
|
|
PR EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR
|
Professional
|
Both
|
$942.57
|
|
|
Service Code
|
HCPCS 11470
|
| Min. Negotiated Rate |
$95.16 |
| Max. Negotiated Rate |
$801.18 |
| Rate for Payer: AlohaCare Medicaid |
$298.17
|
| Rate for Payer: AlohaCare Medicare |
$287.96
|
| Rate for Payer: Cash Price |
$565.54
|
| Rate for Payer: Cash Price |
$565.54
|
| Rate for Payer: Devoted Health Medicare |
$316.76
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$298.17
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$458.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$287.96
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$298.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.16
|
| Rate for Payer: Health Management Network Commercial |
$801.18
|
| Rate for Payer: Kaiser Permanente Commercial |
$345.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$345.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$345.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$298.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$287.96
|
| Rate for Payer: UnitedHealthcare Medicaid |
$298.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$287.96
|
| Rate for Payer: University Health Alliance Commercial |
$339.29
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$899.00
|
|
|
Service Code
|
HCPCS 55041
|
| Min. Negotiated Rate |
$433.16 |
| Max. Negotiated Rate |
$764.15 |
| Rate for Payer: AlohaCare Medicaid |
$525.13
|
| Rate for Payer: AlohaCare Medicare |
$476.85
|
| Rate for Payer: Cash Price |
$539.40
|
| Rate for Payer: Cash Price |
$539.40
|
| Rate for Payer: Devoted Health Medicare |
$524.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$476.85
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$433.16
|
| Rate for Payer: Health Management Network Commercial |
$764.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$572.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$572.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$572.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$525.13
|
| Rate for Payer: Ohana Health Plan Medicare |
$476.85
|
| Rate for Payer: UnitedHealthcare Medicaid |
$525.13
|
| Rate for Payer: UnitedHealthcare Medicare |
$476.85
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$599.00
|
|
|
Service Code
|
HCPCS 55040
|
| Min. Negotiated Rate |
$320.59 |
| Max. Negotiated Rate |
$509.15 |
| Rate for Payer: AlohaCare Medicaid |
$349.77
|
| Rate for Payer: AlohaCare Medicare |
$320.59
|
| Rate for Payer: Cash Price |
$359.40
|
| Rate for Payer: Cash Price |
$359.40
|
| Rate for Payer: Devoted Health Medicare |
$352.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$320.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$386.62
|
| Rate for Payer: Health Management Network Commercial |
$509.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$384.71
|
| Rate for Payer: Kaiser Permanente Medicaid |
$384.71
|
| Rate for Payer: Kaiser Permanente Medicare |
$384.71
|
| Rate for Payer: Ohana Health Plan Medicaid |
$349.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$320.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$349.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$320.59
|
| Rate for Payer: University Health Alliance Commercial |
$453.99
|
|
|
PR EXCISION INFECTED GRAFT ABDOMEN
|
Professional
|
Both
|
$3,025.00
|
|
|
Service Code
|
HCPCS 35907
|
| Min. Negotiated Rate |
$795.86 |
| Max. Negotiated Rate |
$2,571.25 |
| Rate for Payer: AlohaCare Medicaid |
$1,770.57
|
| Rate for Payer: AlohaCare Medicare |
$1,620.72
|
| Rate for Payer: Cash Price |
$1,815.00
|
| Rate for Payer: Cash Price |
$1,815.00
|
| Rate for Payer: Devoted Health Medicare |
$1,782.79
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,620.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$795.86
|
| Rate for Payer: Health Management Network Commercial |
$2,571.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,944.86
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,944.86
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,944.86
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,770.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,620.72
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,770.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,620.72
|
|
|
PR EXCISION INFECTED GRAFT EXTREMITY
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 35903
|
| Min. Negotiated Rate |
$502.34 |
| Max. Negotiated Rate |
$783.70 |
| Rate for Payer: AlohaCare Medicaid |
$542.98
|
| Rate for Payer: AlohaCare Medicare |
$502.34
|
| Rate for Payer: Cash Price |
$553.20
|
| Rate for Payer: Cash Price |
$553.20
|
| Rate for Payer: Devoted Health Medicare |
$552.57
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$502.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$507.52
|
| Rate for Payer: Health Management Network Commercial |
$783.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$602.81
|
| Rate for Payer: Kaiser Permanente Medicaid |
$602.81
|
| Rate for Payer: Kaiser Permanente Medicare |
$602.81
|
| Rate for Payer: Ohana Health Plan Medicaid |
$542.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$502.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$542.98
|
| Rate for Payer: UnitedHealthcare Medicare |
$502.34
|
|
|
PR EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE
|
Professional
|
Both
|
$768.00
|
|
|
Service Code
|
HCPCS 30130
|
| Min. Negotiated Rate |
$215.54 |
| Max. Negotiated Rate |
$652.80 |
| Rate for Payer: AlohaCare Medicaid |
$455.12
|
| Rate for Payer: AlohaCare Medicare |
$422.57
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Devoted Health Medicare |
$464.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$422.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$215.54
|
| Rate for Payer: Health Management Network Commercial |
$652.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$507.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$507.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$507.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$455.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$422.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$455.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$422.57
|
|
|
PR EXCISION LACTIFEROUS DUCT FISTULA
|
Professional
|
Both
|
$944.21
|
|
|
Service Code
|
HCPCS 19112
|
| Min. Negotiated Rate |
$278.46 |
| Max. Negotiated Rate |
$802.58 |
| Rate for Payer: AlohaCare Medicaid |
$337.51
|
| Rate for Payer: AlohaCare Medicare |
$340.55
|
| Rate for Payer: Cash Price |
$566.53
|
| Rate for Payer: Cash Price |
$566.53
|
| Rate for Payer: Devoted Health Medicare |
$374.61
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$337.51
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$511.52
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$340.55
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$337.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$278.46
|
| Rate for Payer: Health Management Network Commercial |
$802.58
|
| Rate for Payer: Kaiser Permanente Commercial |
$408.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$408.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$408.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$337.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$340.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$337.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$340.55
|
| Rate for Payer: University Health Alliance Commercial |
$386.27
|
|
|
PR EXCISION LESION FLOOR MOUTH
|
Professional
|
Both
|
$636.48
|
|
|
Service Code
|
HCPCS 41116
|
| Min. Negotiated Rate |
$150.54 |
| Max. Negotiated Rate |
$541.01 |
| Rate for Payer: AlohaCare Medicaid |
$230.98
|
| Rate for Payer: AlohaCare Medicare |
$211.03
|
| Rate for Payer: Cash Price |
$381.89
|
| Rate for Payer: Cash Price |
$381.89
|
| Rate for Payer: Devoted Health Medicare |
$232.13
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$230.98
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$352.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$211.03
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$230.98
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$150.54
|
| Rate for Payer: Health Management Network Commercial |
$541.01
|
| Rate for Payer: Kaiser Permanente Commercial |
$253.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$253.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$253.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$230.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$211.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$230.98
|
| Rate for Payer: UnitedHealthcare Medicare |
$211.03
|
| Rate for Payer: University Health Alliance Commercial |
$298.18
|
|
|
PR EXCISION LESION MENISCUS/CAPSULE KNEE
|
Professional
|
Both
|
$958.00
|
|
|
Service Code
|
HCPCS 27347
|
| Min. Negotiated Rate |
$437.32 |
| Max. Negotiated Rate |
$814.30 |
| Rate for Payer: AlohaCare Medicaid |
$557.70
|
| Rate for Payer: AlohaCare Medicare |
$522.63
|
| Rate for Payer: Cash Price |
$574.80
|
| Rate for Payer: Cash Price |
$574.80
|
| Rate for Payer: Devoted Health Medicare |
$574.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$522.63
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$437.32
|
| Rate for Payer: Health Management Network Commercial |
$814.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$627.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$627.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$627.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$557.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$522.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$557.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$522.63
|
|
|
PR EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK
|
Professional
|
Both
|
$1,067.06
|
|
|
Service Code
|
HCPCS 27630
|
| Min. Negotiated Rate |
$268.58 |
| Max. Negotiated Rate |
$907.00 |
| Rate for Payer: AlohaCare Medicaid |
$377.73
|
| Rate for Payer: AlohaCare Medicare |
$358.72
|
| Rate for Payer: Cash Price |
$640.24
|
| Rate for Payer: Cash Price |
$640.24
|
| Rate for Payer: Devoted Health Medicare |
$394.59
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$377.73
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$579.45
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$358.72
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$377.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$268.58
|
| Rate for Payer: Health Management Network Commercial |
$907.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$430.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$430.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$430.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$377.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$358.72
|
| Rate for Payer: UnitedHealthcare Medicaid |
$377.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$358.72
|
| Rate for Payer: University Health Alliance Commercial |
$473.24
|
|
|
PR EXCISION LESION TENDON SHEATH FOREARM&/WRIST
|
Professional
|
Both
|
$641.00
|
|
|
Service Code
|
HCPCS 25110
|
| Min. Negotiated Rate |
$238.42 |
| Max. Negotiated Rate |
$544.85 |
| Rate for Payer: AlohaCare Medicaid |
$372.61
|
| Rate for Payer: AlohaCare Medicare |
$351.38
|
| Rate for Payer: Cash Price |
$384.60
|
| Rate for Payer: Cash Price |
$384.60
|
| Rate for Payer: Devoted Health Medicare |
$386.52
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$351.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$238.42
|
| Rate for Payer: Health Management Network Commercial |
$544.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$421.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$421.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$421.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$372.61
|
| Rate for Payer: Ohana Health Plan Medicare |
$351.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$372.61
|
| Rate for Payer: UnitedHealthcare Medicare |
$351.38
|
|
|
PR EXCISION LESION TONGUE W/O CLOSURE
|
Professional
|
Both
|
$432.23
|
|
|
Service Code
|
HCPCS 41110
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$367.40 |
| Rate for Payer: AlohaCare Medicaid |
$138.27
|
| Rate for Payer: AlohaCare Medicare |
$124.33
|
| Rate for Payer: Cash Price |
$259.34
|
| Rate for Payer: Cash Price |
$259.34
|
| Rate for Payer: Devoted Health Medicare |
$136.76
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$138.27
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$211.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$124.33
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$138.27
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$121.68
|
| Rate for Payer: Health Management Network Commercial |
$367.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$149.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$149.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$149.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$138.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$124.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$138.27
|
| Rate for Payer: UnitedHealthcare Medicare |
$124.33
|
| Rate for Payer: University Health Alliance Commercial |
$180.90
|
|
