|
PR EXCISION LINGUAL FRENUM FRENECTOMY
|
Professional
|
Both
|
$486.92
|
|
|
Service Code
|
HCPCS 41115
|
| Min. Negotiated Rate |
$108.94 |
| Max. Negotiated Rate |
$413.88 |
| Rate for Payer: AlohaCare Medicaid |
$155.28
|
| Rate for Payer: AlohaCare Medicare |
$138.86
|
| Rate for Payer: Cash Price |
$292.15
|
| Rate for Payer: Cash Price |
$292.15
|
| Rate for Payer: Devoted Health Medicare |
$152.75
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$155.28
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$238.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$138.86
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$155.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$108.94
|
| Rate for Payer: Health Management Network Commercial |
$413.88
|
| Rate for Payer: Kaiser Permanente Commercial |
$166.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$166.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$166.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$155.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$138.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$155.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$138.86
|
| Rate for Payer: University Health Alliance Commercial |
$201.92
|
|
|
PR EXCISION LOCAL LESION EPIDIDYMIS
|
Professional
|
Both
|
$660.00
|
|
|
Service Code
|
HCPCS 54830
|
| Min. Negotiated Rate |
$259.22 |
| Max. Negotiated Rate |
$561.00 |
| Rate for Payer: AlohaCare Medicaid |
$385.22
|
| Rate for Payer: AlohaCare Medicare |
$353.99
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Devoted Health Medicare |
$389.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$353.99
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$259.22
|
| Rate for Payer: Health Management Network Commercial |
$561.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$424.79
|
| Rate for Payer: Kaiser Permanente Medicaid |
$424.79
|
| Rate for Payer: Kaiser Permanente Medicare |
$424.79
|
| Rate for Payer: Ohana Health Plan Medicaid |
$385.22
|
| Rate for Payer: Ohana Health Plan Medicare |
$353.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$385.22
|
| Rate for Payer: UnitedHealthcare Medicare |
$353.99
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Professional
|
Both
|
$383.16
|
|
|
Service Code
|
HCPCS 11640
|
| Min. Negotiated Rate |
$114.90 |
| Max. Negotiated Rate |
$325.69 |
| Rate for Payer: AlohaCare Medicaid |
$133.33
|
| Rate for Payer: AlohaCare Medicare |
$114.90
|
| Rate for Payer: Cash Price |
$229.90
|
| Rate for Payer: Cash Price |
$229.90
|
| Rate for Payer: Devoted Health Medicare |
$126.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$133.33
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$202.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$114.90
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$133.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$131.30
|
| Rate for Payer: Health Management Network Commercial |
$325.69
|
| Rate for Payer: Kaiser Permanente Commercial |
$137.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$137.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$137.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$133.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$114.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$133.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$114.90
|
| Rate for Payer: University Health Alliance Commercial |
$150.15
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Professional
|
Both
|
$446.41
|
|
|
Service Code
|
HCPCS 11641
|
| Min. Negotiated Rate |
$138.50 |
| Max. Negotiated Rate |
$379.45 |
| Rate for Payer: AlohaCare Medicaid |
$162.19
|
| Rate for Payer: AlohaCare Medicare |
$138.50
|
| Rate for Payer: Cash Price |
$267.85
|
| Rate for Payer: Cash Price |
$267.85
|
| Rate for Payer: Devoted Health Medicare |
$152.35
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$162.19
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$247.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$138.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$162.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$180.44
|
| Rate for Payer: Health Management Network Commercial |
$379.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$166.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$166.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$166.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$162.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$138.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$162.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$138.50
|
| Rate for Payer: University Health Alliance Commercial |
$183.32
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Professional
|
Both
|
$500.80
|
|
|
Service Code
|
HCPCS 11642
|
| Min. Negotiated Rate |
$158.57 |
| Max. Negotiated Rate |
$425.68 |
| Rate for Payer: AlohaCare Medicaid |
$188.80
|
| Rate for Payer: AlohaCare Medicare |
$158.57
|
| Rate for Payer: Cash Price |
$300.48
|
| Rate for Payer: Cash Price |
$300.48
|
| Rate for Payer: Devoted Health Medicare |
$174.43
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$188.80
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$289.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$158.57
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$188.80
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$213.46
|
| Rate for Payer: Health Management Network Commercial |
$425.68
|
| Rate for Payer: Kaiser Permanente Commercial |
$190.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$190.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$190.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$188.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$158.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$188.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$158.57
|
| Rate for Payer: University Health Alliance Commercial |
$214.00
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Professional
|
Both
|
$588.02
|
|
|
Service Code
|
HCPCS 11643
|
| Min. Negotiated Rate |
$196.63 |
| Max. Negotiated Rate |
$499.82 |
| Rate for Payer: AlohaCare Medicaid |
$233.73
|
| Rate for Payer: AlohaCare Medicare |
$196.63
|
| Rate for Payer: Cash Price |
$352.81
|
| Rate for Payer: Cash Price |
$352.81
|
| Rate for Payer: Devoted Health Medicare |
$216.29
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$233.73
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$359.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$196.63
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$233.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$251.68
|
| Rate for Payer: Health Management Network Commercial |
$499.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$235.96
|
| Rate for Payer: Kaiser Permanente Medicaid |
$235.96
|
| Rate for Payer: Kaiser Permanente Medicare |
$235.96
|
| Rate for Payer: Ohana Health Plan Medicaid |
$233.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$196.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$233.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$196.63
|
| Rate for Payer: University Health Alliance Commercial |
$266.33
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Professional
|
Both
|
$727.79
|
|
|
Service Code
|
HCPCS 11644
|
| Min. Negotiated Rate |
$236.60 |
| Max. Negotiated Rate |
$618.62 |
| Rate for Payer: AlohaCare Medicaid |
$288.00
|
| Rate for Payer: AlohaCare Medicare |
$242.32
|
| Rate for Payer: Cash Price |
$436.67
|
| Rate for Payer: Cash Price |
$436.67
|
| Rate for Payer: Devoted Health Medicare |
$266.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$288.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$445.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$242.32
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$288.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$236.60
|
| Rate for Payer: Health Management Network Commercial |
$618.62
|
| Rate for Payer: Kaiser Permanente Commercial |
$290.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$290.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$290.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$288.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$242.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$288.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$242.32
|
| Rate for Payer: University Health Alliance Commercial |
$329.70
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Professional
|
Both
|
$945.30
|
|
|
Service Code
|
HCPCS 11646
|
| Min. Negotiated Rate |
$306.80 |
| Max. Negotiated Rate |
$803.50 |
| Rate for Payer: AlohaCare Medicaid |
$393.63
|
| Rate for Payer: AlohaCare Medicare |
$333.01
|
| Rate for Payer: Cash Price |
$567.18
|
| Rate for Payer: Cash Price |
$567.18
|
| Rate for Payer: Devoted Health Medicare |
$366.31
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$393.63
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$613.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$333.01
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$393.63
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$306.80
|
| Rate for Payer: Health Management Network Commercial |
$803.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$399.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$399.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$399.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$393.63
|
| Rate for Payer: Ohana Health Plan Medicare |
$333.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$393.63
|
| Rate for Payer: UnitedHealthcare Medicare |
$333.01
|
| Rate for Payer: University Health Alliance Commercial |
$454.10
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<
|
Professional
|
Both
|
$375.78
|
|
|
Service Code
|
HCPCS 11620
|
| Min. Negotiated Rate |
$96.46 |
| Max. Negotiated Rate |
$319.41 |
| Rate for Payer: AlohaCare Medicaid |
$129.26
|
| Rate for Payer: AlohaCare Medicare |
$112.95
|
| Rate for Payer: Cash Price |
$225.47
|
| Rate for Payer: Cash Price |
$225.47
|
| Rate for Payer: Devoted Health Medicare |
$124.25
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$129.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$197.18
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$112.95
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$129.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$96.46
|
| Rate for Payer: Health Management Network Commercial |
$319.41
|
| Rate for Payer: Kaiser Permanente Commercial |
$135.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$135.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$135.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$129.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$112.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$129.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$112.95
|
| Rate for Payer: University Health Alliance Commercial |
$140.05
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM
|
Professional
|
Both
|
$430.50
|
|
|
Service Code
|
HCPCS 11621
|
| Min. Negotiated Rate |
$133.21 |
| Max. Negotiated Rate |
$365.93 |
| Rate for Payer: AlohaCare Medicaid |
$155.56
|
| Rate for Payer: AlohaCare Medicare |
$133.21
|
| Rate for Payer: Cash Price |
$258.30
|
| Rate for Payer: Cash Price |
$258.30
|
| Rate for Payer: Devoted Health Medicare |
$146.53
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$155.56
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$238.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$133.21
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$155.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$150.28
|
| Rate for Payer: Health Management Network Commercial |
$365.93
|
| Rate for Payer: Kaiser Permanente Commercial |
$159.85
|
| Rate for Payer: Kaiser Permanente Medicaid |
$159.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$159.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$155.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$133.21
|
| Rate for Payer: UnitedHealthcare Medicaid |
$155.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$133.21
|
| Rate for Payer: University Health Alliance Commercial |
$169.64
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Professional
|
Both
|
$469.82
|
|
|
Service Code
|
HCPCS 11622
|
| Min. Negotiated Rate |
$148.08 |
| Max. Negotiated Rate |
$399.35 |
| Rate for Payer: AlohaCare Medicaid |
$176.28
|
| Rate for Payer: AlohaCare Medicare |
$148.08
|
| Rate for Payer: Cash Price |
$281.89
|
| Rate for Payer: Cash Price |
$281.89
|
| Rate for Payer: Devoted Health Medicare |
$162.89
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$176.28
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$269.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$148.08
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$176.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$179.92
|
| Rate for Payer: Health Management Network Commercial |
$399.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$177.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$177.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$177.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$176.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$148.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$176.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$148.08
|
| Rate for Payer: University Health Alliance Commercial |
$199.29
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Professional
|
Both
|
$550.85
|
|
|
Service Code
|
HCPCS 11623
|
| Min. Negotiated Rate |
$162.76 |
| Max. Negotiated Rate |
$468.22 |
| Rate for Payer: AlohaCare Medicaid |
$215.79
|
| Rate for Payer: AlohaCare Medicare |
$181.09
|
| Rate for Payer: Cash Price |
$330.51
|
| Rate for Payer: Cash Price |
$330.51
|
| Rate for Payer: Devoted Health Medicare |
$199.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$215.79
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$331.58
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.09
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$215.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$162.76
|
| Rate for Payer: Health Management Network Commercial |
$468.22
|
| Rate for Payer: Kaiser Permanente Commercial |
$217.31
|
| Rate for Payer: Kaiser Permanente Medicaid |
$217.31
|
| Rate for Payer: Kaiser Permanente Medicare |
$217.31
|
| Rate for Payer: Ohana Health Plan Medicaid |
$215.79
|
| Rate for Payer: Ohana Health Plan Medicare |
$181.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$215.79
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.09
|
| Rate for Payer: University Health Alliance Commercial |
$245.37
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Professional
|
Both
|
$631.31
|
|
|
Service Code
|
HCPCS 11624
|
| Min. Negotiated Rate |
$205.80 |
| Max. Negotiated Rate |
$536.61 |
| Rate for Payer: AlohaCare Medicaid |
$243.81
|
| Rate for Payer: AlohaCare Medicare |
$205.80
|
| Rate for Payer: Cash Price |
$378.79
|
| Rate for Payer: Cash Price |
$378.79
|
| Rate for Payer: Devoted Health Medicare |
$226.38
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$243.81
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$375.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$205.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$243.81
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$255.58
|
| Rate for Payer: Health Management Network Commercial |
$536.61
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.96
|
| Rate for Payer: Kaiser Permanente Medicaid |
$246.96
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.96
|
| Rate for Payer: Ohana Health Plan Medicaid |
$243.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$205.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$243.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$205.80
|
| Rate for Payer: University Health Alliance Commercial |
$278.10
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Professional
|
Both
|
$773.32
|
|
|
Service Code
|
HCPCS 11626
|
| Min. Negotiated Rate |
$232.18 |
| Max. Negotiated Rate |
$657.32 |
| Rate for Payer: AlohaCare Medicaid |
$294.43
|
| Rate for Payer: AlohaCare Medicare |
$254.29
|
| Rate for Payer: Cash Price |
$463.99
|
| Rate for Payer: Cash Price |
$463.99
|
| Rate for Payer: Devoted Health Medicare |
$279.72
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$294.43
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$459.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$254.29
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$294.43
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$232.18
|
| Rate for Payer: Health Management Network Commercial |
$657.32
|
| Rate for Payer: Kaiser Permanente Commercial |
$305.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$305.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$305.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$294.43
|
| Rate for Payer: Ohana Health Plan Medicare |
$254.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$294.43
|
| Rate for Payer: UnitedHealthcare Medicare |
$254.29
|
| Rate for Payer: University Health Alliance Commercial |
$346.49
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Professional
|
Both
|
$855.24
|
|
|
Service Code
|
HCPCS 11606
|
| Min. Negotiated Rate |
$198.38 |
| Max. Negotiated Rate |
$726.95 |
| Rate for Payer: AlohaCare Medicaid |
$319.89
|
| Rate for Payer: AlohaCare Medicare |
$274.90
|
| Rate for Payer: Cash Price |
$513.14
|
| Rate for Payer: Cash Price |
$513.14
|
| Rate for Payer: Devoted Health Medicare |
$302.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$319.89
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$497.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$274.90
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$319.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$198.38
|
| Rate for Payer: Health Management Network Commercial |
$726.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$329.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$329.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$329.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$319.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$274.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$319.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$274.90
|
| Rate for Payer: University Health Alliance Commercial |
$347.12
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<
|
Professional
|
Both
|
$375.18
|
|
|
Service Code
|
HCPCS 11600
|
| Min. Negotiated Rate |
$108.94 |
| Max. Negotiated Rate |
$318.90 |
| Rate for Payer: AlohaCare Medicaid |
$128.36
|
| Rate for Payer: AlohaCare Medicare |
$112.24
|
| Rate for Payer: Cash Price |
$225.11
|
| Rate for Payer: Cash Price |
$225.11
|
| Rate for Payer: Devoted Health Medicare |
$123.46
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$128.36
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$196.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$112.24
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$128.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$108.94
|
| Rate for Payer: Health Management Network Commercial |
$318.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$134.69
|
| Rate for Payer: Kaiser Permanente Medicaid |
$134.69
|
| Rate for Payer: Kaiser Permanente Medicare |
$134.69
|
| Rate for Payer: Ohana Health Plan Medicaid |
$128.36
|
| Rate for Payer: Ohana Health Plan Medicare |
$112.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$128.36
|
| Rate for Payer: UnitedHealthcare Medicare |
$112.24
|
| Rate for Payer: University Health Alliance Commercial |
$145.08
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM
|
Professional
|
Both
|
$427.93
|
|
|
Service Code
|
HCPCS 11601
|
| Min. Negotiated Rate |
$132.11 |
| Max. Negotiated Rate |
$363.74 |
| Rate for Payer: AlohaCare Medicaid |
$155.04
|
| Rate for Payer: AlohaCare Medicare |
$132.11
|
| Rate for Payer: Cash Price |
$256.76
|
| Rate for Payer: Cash Price |
$256.76
|
| Rate for Payer: Devoted Health Medicare |
$145.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$155.04
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$237.14
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$132.11
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$155.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$134.68
|
| Rate for Payer: Health Management Network Commercial |
$363.74
|
| Rate for Payer: Kaiser Permanente Commercial |
$158.53
|
| Rate for Payer: Kaiser Permanente Medicaid |
$158.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$158.53
|
| Rate for Payer: Ohana Health Plan Medicaid |
$155.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$132.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$155.04
|
| Rate for Payer: UnitedHealthcare Medicare |
$132.11
|
| Rate for Payer: University Health Alliance Commercial |
$175.48
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Professional
|
Both
|
$452.64
|
|
|
Service Code
|
HCPCS 11602
|
| Min. Negotiated Rate |
$140.93 |
| Max. Negotiated Rate |
$384.74 |
| Rate for Payer: AlohaCare Medicaid |
$168.58
|
| Rate for Payer: AlohaCare Medicare |
$140.93
|
| Rate for Payer: Cash Price |
$271.58
|
| Rate for Payer: Cash Price |
$271.58
|
| Rate for Payer: Devoted Health Medicare |
$155.02
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$168.58
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$257.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$140.93
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$168.58
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$157.04
|
| Rate for Payer: Health Management Network Commercial |
$384.74
|
| Rate for Payer: Kaiser Permanente Commercial |
$169.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$169.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$169.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$168.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$140.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$168.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$140.93
|
| Rate for Payer: University Health Alliance Commercial |
$190.71
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Professional
|
Both
|
$516.83
|
|
|
Service Code
|
HCPCS 11603
|
| Min. Negotiated Rate |
$166.97 |
| Max. Negotiated Rate |
$439.31 |
| Rate for Payer: AlohaCare Medicaid |
$200.05
|
| Rate for Payer: AlohaCare Medicare |
$166.97
|
| Rate for Payer: Cash Price |
$310.10
|
| Rate for Payer: Cash Price |
$310.10
|
| Rate for Payer: Devoted Health Medicare |
$183.67
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$200.05
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$306.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$166.97
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$200.05
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$178.88
|
| Rate for Payer: Health Management Network Commercial |
$439.31
|
| Rate for Payer: Kaiser Permanente Commercial |
$200.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$200.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$200.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$200.05
|
| Rate for Payer: Ohana Health Plan Medicare |
$166.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$200.05
|
| Rate for Payer: UnitedHealthcare Medicare |
$166.97
|
| Rate for Payer: University Health Alliance Commercial |
$226.85
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Professional
|
Both
|
$580.95
|
|
|
Service Code
|
HCPCS 11604
|
| Min. Negotiated Rate |
$148.46 |
| Max. Negotiated Rate |
$493.81 |
| Rate for Payer: AlohaCare Medicaid |
$218.93
|
| Rate for Payer: AlohaCare Medicare |
$184.24
|
| Rate for Payer: Cash Price |
$348.57
|
| Rate for Payer: Cash Price |
$348.57
|
| Rate for Payer: Devoted Health Medicare |
$202.66
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$218.93
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$336.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$184.24
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$218.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$148.46
|
| Rate for Payer: Health Management Network Commercial |
$493.81
|
| Rate for Payer: Kaiser Permanente Commercial |
$221.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$221.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$221.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$218.93
|
| Rate for Payer: Ohana Health Plan Medicare |
$184.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$218.93
|
| Rate for Payer: UnitedHealthcare Medicare |
$184.24
|
| Rate for Payer: University Health Alliance Commercial |
$249.27
|
|
|
PR EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS
|
Professional
|
Both
|
$645.14
|
|
|
Service Code
|
HCPCS 46230
|
| Min. Negotiated Rate |
$119.08 |
| Max. Negotiated Rate |
$548.37 |
| Rate for Payer: AlohaCare Medicaid |
$178.22
|
| Rate for Payer: AlohaCare Medicare |
$168.51
|
| Rate for Payer: Cash Price |
$387.08
|
| Rate for Payer: Cash Price |
$387.08
|
| Rate for Payer: Devoted Health Medicare |
$185.36
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$178.22
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$274.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$168.51
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$178.22
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$119.08
|
| Rate for Payer: Health Management Network Commercial |
$548.37
|
| Rate for Payer: Kaiser Permanente Commercial |
$202.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$202.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$202.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$178.22
|
| Rate for Payer: Ohana Health Plan Medicare |
$168.51
|
| Rate for Payer: UnitedHealthcare Medicaid |
$178.22
|
| Rate for Payer: UnitedHealthcare Medicare |
$168.51
|
| Rate for Payer: University Health Alliance Commercial |
$235.05
|
|
|
PR EXCISION NAIL MATRIX PERMANENT REMOVAL
|
Professional
|
Both
|
$296.78
|
|
|
Service Code
|
HCPCS 11750
|
| Min. Negotiated Rate |
$97.44 |
| Max. Negotiated Rate |
$252.26 |
| Rate for Payer: AlohaCare Medicaid |
$106.66
|
| Rate for Payer: AlohaCare Medicare |
$97.44
|
| Rate for Payer: Cash Price |
$178.07
|
| Rate for Payer: Cash Price |
$178.07
|
| Rate for Payer: Devoted Health Medicare |
$107.18
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$106.66
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$236.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$97.44
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$106.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$150.02
|
| Rate for Payer: Health Management Network Commercial |
$252.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$116.93
|
| Rate for Payer: Kaiser Permanente Medicaid |
$116.93
|
| Rate for Payer: Kaiser Permanente Medicare |
$116.93
|
| Rate for Payer: Ohana Health Plan Medicaid |
$106.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$97.44
|
| Rate for Payer: UnitedHealthcare Medicaid |
$106.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$97.44
|
| Rate for Payer: University Health Alliance Commercial |
$115.45
|
|
|
PR EXCISION NASAL POLYP SIMPLE
|
Professional
|
Both
|
$470.50
|
|
|
Service Code
|
HCPCS 30110
|
| Min. Negotiated Rate |
$119.08 |
| Max. Negotiated Rate |
$399.93 |
| Rate for Payer: AlohaCare Medicaid |
$141.11
|
| Rate for Payer: AlohaCare Medicare |
$124.55
|
| Rate for Payer: Cash Price |
$282.30
|
| Rate for Payer: Cash Price |
$282.30
|
| Rate for Payer: Devoted Health Medicare |
$137.00
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$141.11
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$213.96
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$124.55
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$141.11
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$119.08
|
| Rate for Payer: Health Management Network Commercial |
$399.93
|
| Rate for Payer: Kaiser Permanente Commercial |
$149.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$149.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$149.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$141.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$124.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$141.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$124.55
|
| Rate for Payer: University Health Alliance Commercial |
$181.15
|
|
|
PR EXCISION OLECRANON BURSA
|
Professional
|
Both
|
$674.00
|
|
|
Service Code
|
HCPCS 24105
|
| Min. Negotiated Rate |
$301.86 |
| Max. Negotiated Rate |
$572.90 |
| Rate for Payer: AlohaCare Medicaid |
$391.88
|
| Rate for Payer: AlohaCare Medicare |
$376.25
|
| Rate for Payer: Cash Price |
$404.40
|
| Rate for Payer: Cash Price |
$404.40
|
| Rate for Payer: Devoted Health Medicare |
$413.88
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$376.25
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$301.86
|
| Rate for Payer: Health Management Network Commercial |
$572.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$451.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$451.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$451.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$391.88
|
| Rate for Payer: Ohana Health Plan Medicare |
$376.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$391.88
|
| Rate for Payer: UnitedHealthcare Medicare |
$376.25
|
|
|
PR EXCISION PAROTID TUMOR/GLAND TOTAL EN BLOC RMVL
|
Professional
|
Both
|
$1,474.00
|
|
|
Service Code
|
HCPCS 42425
|
| Min. Negotiated Rate |
$721.76 |
| Max. Negotiated Rate |
$1,252.90 |
| Rate for Payer: AlohaCare Medicaid |
$861.75
|
| Rate for Payer: AlohaCare Medicare |
$734.54
|
| Rate for Payer: Cash Price |
$884.40
|
| Rate for Payer: Cash Price |
$884.40
|
| Rate for Payer: Devoted Health Medicare |
$807.99
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$734.54
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$721.76
|
| Rate for Payer: Health Management Network Commercial |
$1,252.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$881.45
|
| Rate for Payer: Kaiser Permanente Medicaid |
$881.45
|
| Rate for Payer: Kaiser Permanente Medicare |
$881.45
|
| Rate for Payer: Ohana Health Plan Medicaid |
$861.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$734.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$861.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$734.54
|
|
