|
PR EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH
|
Professional
|
Both
|
$1,854.00
|
|
|
Service Code
|
HCPCS 45130
|
| Min. Negotiated Rate |
$669.76 |
| Max. Negotiated Rate |
$1,575.90 |
| Rate for Payer: AlohaCare Medicaid |
$1,083.88
|
| Rate for Payer: AlohaCare Medicare |
$999.41
|
| Rate for Payer: Cash Price |
$1,112.40
|
| Rate for Payer: Cash Price |
$1,112.40
|
| Rate for Payer: Devoted Health Medicare |
$1,099.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$999.41
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$669.76
|
| Rate for Payer: Health Management Network Commercial |
$1,575.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,199.29
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,199.29
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,199.29
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,083.88
|
| Rate for Payer: Ohana Health Plan Medicare |
$999.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,083.88
|
| Rate for Payer: UnitedHealthcare Medicare |
$999.41
|
|
|
PR EXC RCT TUM INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,444.00
|
|
|
Service Code
|
HCPCS 45172
|
| Min. Negotiated Rate |
$809.46 |
| Max. Negotiated Rate |
$1,227.40 |
| Rate for Payer: AlohaCare Medicaid |
$844.38
|
| Rate for Payer: AlohaCare Medicare |
$809.46
|
| Rate for Payer: Cash Price |
$866.40
|
| Rate for Payer: Cash Price |
$866.40
|
| Rate for Payer: Devoted Health Medicare |
$890.41
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$809.46
|
| Rate for Payer: Health Management Network Commercial |
$1,227.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$971.35
|
| Rate for Payer: Kaiser Permanente Medicaid |
$971.35
|
| Rate for Payer: Kaiser Permanente Medicare |
$971.35
|
| Rate for Payer: Ohana Health Plan Medicaid |
$844.38
|
| Rate for Payer: Ohana Health Plan Medicare |
$809.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$844.38
|
| Rate for Payer: UnitedHealthcare Medicare |
$809.46
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,103.48
|
|
|
Service Code
|
HCPCS 45171
|
| Min. Negotiated Rate |
$577.46 |
| Max. Negotiated Rate |
$937.96 |
| Rate for Payer: AlohaCare Medicaid |
$640.36
|
| Rate for Payer: AlohaCare Medicare |
$630.37
|
| Rate for Payer: Cash Price |
$662.09
|
| Rate for Payer: Cash Price |
$662.09
|
| Rate for Payer: Devoted Health Medicare |
$693.41
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$630.37
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$577.46
|
| Rate for Payer: Health Management Network Commercial |
$937.96
|
| Rate for Payer: Kaiser Permanente Commercial |
$756.44
|
| Rate for Payer: Kaiser Permanente Medicaid |
$756.44
|
| Rate for Payer: Kaiser Permanente Medicare |
$756.44
|
| Rate for Payer: Ohana Health Plan Medicaid |
$640.36
|
| Rate for Payer: Ohana Health Plan Medicare |
$630.37
|
| Rate for Payer: UnitedHealthcare Medicaid |
$640.36
|
| Rate for Payer: UnitedHealthcare Medicare |
$630.37
|
|
|
PR EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY
|
Professional
|
Both
|
$1,535.00
|
|
|
Service Code
|
HCPCS 15933
|
| Min. Negotiated Rate |
$533.26 |
| Max. Negotiated Rate |
$1,304.75 |
| Rate for Payer: AlohaCare Medicaid |
$896.43
|
| Rate for Payer: AlohaCare Medicare |
$833.83
|
| Rate for Payer: Cash Price |
$921.00
|
| Rate for Payer: Cash Price |
$921.00
|
| Rate for Payer: Devoted Health Medicare |
$917.21
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$833.83
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$533.26
|
| Rate for Payer: Health Management Network Commercial |
$1,304.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,000.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,000.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,000.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$896.43
|
| Rate for Payer: Ohana Health Plan Medicare |
$833.83
|
| Rate for Payer: UnitedHealthcare Medicaid |
$896.43
|
| Rate for Payer: UnitedHealthcare Medicare |
$833.83
|
|
|
PR EXC SUBLINGUAL SALIVARY CYST RANULA
|
Professional
|
Both
|
$1,076.92
|
|
|
Service Code
|
HCPCS 42408
|
| Min. Negotiated Rate |
$100.36 |
| Max. Negotiated Rate |
$915.38 |
| Rate for Payer: AlohaCare Medicaid |
$368.90
|
| Rate for Payer: AlohaCare Medicare |
$335.87
|
| Rate for Payer: Cash Price |
$646.15
|
| Rate for Payer: Cash Price |
$646.15
|
| Rate for Payer: Devoted Health Medicare |
$369.46
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$368.90
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$561.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$335.87
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$368.90
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$100.36
|
| Rate for Payer: Health Management Network Commercial |
$915.38
|
| Rate for Payer: Kaiser Permanente Commercial |
$403.04
|
| Rate for Payer: Kaiser Permanente Medicaid |
$403.04
|
| Rate for Payer: Kaiser Permanente Medicare |
$403.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$368.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$335.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$368.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$335.87
|
| Rate for Payer: University Health Alliance Commercial |
$479.32
|
|
|
PR EXC THROMBOSED HEMORRHOID XTRNL
|
Professional
|
Both
|
$441.28
|
|
|
Service Code
|
HCPCS 46320
|
| Min. Negotiated Rate |
$108.94 |
| Max. Negotiated Rate |
$375.09 |
| Rate for Payer: AlohaCare Medicaid |
$117.38
|
| Rate for Payer: AlohaCare Medicare |
$110.50
|
| Rate for Payer: Cash Price |
$264.77
|
| Rate for Payer: Cash Price |
$264.77
|
| Rate for Payer: Devoted Health Medicare |
$121.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$117.38
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$181.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$110.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$117.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$108.94
|
| Rate for Payer: Health Management Network Commercial |
$375.09
|
| Rate for Payer: Kaiser Permanente Commercial |
$132.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$132.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$132.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$117.38
|
| Rate for Payer: Ohana Health Plan Medicare |
$110.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$117.38
|
| Rate for Payer: UnitedHealthcare Medicare |
$110.50
|
| Rate for Payer: University Health Alliance Commercial |
$152.04
|
|
|
PR EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR
|
Professional
|
Both
|
$1,143.00
|
|
|
Service Code
|
HCPCS 15950
|
| Min. Negotiated Rate |
$312.78 |
| Max. Negotiated Rate |
$971.55 |
| Rate for Payer: AlohaCare Medicaid |
$665.74
|
| Rate for Payer: AlohaCare Medicare |
$606.30
|
| Rate for Payer: Cash Price |
$685.80
|
| Rate for Payer: Cash Price |
$685.80
|
| Rate for Payer: Devoted Health Medicare |
$666.93
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$606.30
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$312.78
|
| Rate for Payer: Health Management Network Commercial |
$971.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$727.56
|
| Rate for Payer: Kaiser Permanente Medicaid |
$727.56
|
| Rate for Payer: Kaiser Permanente Medicare |
$727.56
|
| Rate for Payer: Ohana Health Plan Medicaid |
$665.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$606.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$665.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$606.30
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$965.00
|
|
|
Service Code
|
HCPCS 25073
|
| Min. Negotiated Rate |
$518.43 |
| Max. Negotiated Rate |
$820.25 |
| Rate for Payer: AlohaCare Medicaid |
$560.44
|
| Rate for Payer: AlohaCare Medicare |
$518.43
|
| Rate for Payer: Cash Price |
$579.00
|
| Rate for Payer: Cash Price |
$579.00
|
| Rate for Payer: Devoted Health Medicare |
$570.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$518.43
|
| Rate for Payer: Health Management Network Commercial |
$820.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$622.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$622.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$622.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$560.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$518.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$560.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$518.43
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$784.00
|
|
|
Service Code
|
HCPCS 21552
|
| Min. Negotiated Rate |
$431.08 |
| Max. Negotiated Rate |
$666.40 |
| Rate for Payer: AlohaCare Medicaid |
$456.89
|
| Rate for Payer: AlohaCare Medicare |
$431.08
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Devoted Health Medicare |
$474.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$431.08
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$432.12
|
| Rate for Payer: Health Management Network Commercial |
$666.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$517.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$517.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$517.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$456.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$431.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$431.08
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,279.00
|
|
|
Service Code
|
HCPCS 21933
|
| Min. Negotiated Rate |
$546.52 |
| Max. Negotiated Rate |
$1,087.15 |
| Rate for Payer: AlohaCare Medicaid |
$746.05
|
| Rate for Payer: AlohaCare Medicare |
$697.14
|
| Rate for Payer: Cash Price |
$767.40
|
| Rate for Payer: Cash Price |
$767.40
|
| Rate for Payer: Devoted Health Medicare |
$766.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$697.14
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$546.52
|
| Rate for Payer: Health Management Network Commercial |
$1,087.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$836.57
|
| Rate for Payer: Kaiser Permanente Medicaid |
$836.57
|
| Rate for Payer: Kaiser Permanente Medicare |
$836.57
|
| Rate for Payer: Ohana Health Plan Medicaid |
$746.05
|
| Rate for Payer: Ohana Health Plan Medicare |
$697.14
|
| Rate for Payer: UnitedHealthcare Medicaid |
$746.05
|
| Rate for Payer: UnitedHealthcare Medicare |
$697.14
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,161.00
|
|
|
Service Code
|
HCPCS 21932
|
| Min. Negotiated Rate |
$627.48 |
| Max. Negotiated Rate |
$986.85 |
| Rate for Payer: AlohaCare Medicaid |
$674.32
|
| Rate for Payer: AlohaCare Medicare |
$627.48
|
| Rate for Payer: Cash Price |
$696.60
|
| Rate for Payer: Cash Price |
$696.60
|
| Rate for Payer: Devoted Health Medicare |
$690.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$627.48
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$646.88
|
| Rate for Payer: Health Management Network Commercial |
$986.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$752.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$752.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$752.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$674.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$627.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$674.32
|
| Rate for Payer: UnitedHealthcare Medicare |
$627.48
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$929.00
|
|
|
Service Code
|
HCPCS 21014
|
| Min. Negotiated Rate |
$489.70 |
| Max. Negotiated Rate |
$789.65 |
| Rate for Payer: AlohaCare Medicaid |
$541.76
|
| Rate for Payer: AlohaCare Medicare |
$489.70
|
| Rate for Payer: Cash Price |
$557.40
|
| Rate for Payer: Cash Price |
$557.40
|
| Rate for Payer: Devoted Health Medicare |
$538.67
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$489.70
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$571.74
|
| Rate for Payer: Health Management Network Commercial |
$789.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$587.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$587.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$587.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$541.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$489.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$541.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$489.70
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM
|
Professional
|
Both
|
$1,050.91
|
|
|
Service Code
|
HCPCS 21013
|
| Min. Negotiated Rate |
$380.26 |
| Max. Negotiated Rate |
$893.27 |
| Rate for Payer: AlohaCare Medicaid |
$419.80
|
| Rate for Payer: AlohaCare Medicare |
$380.26
|
| Rate for Payer: Cash Price |
$630.55
|
| Rate for Payer: Cash Price |
$630.55
|
| Rate for Payer: Devoted Health Medicare |
$418.29
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$419.80
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$644.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$380.26
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$419.80
|
| Rate for Payer: Health Management Network Commercial |
$893.27
|
| Rate for Payer: Kaiser Permanente Commercial |
$456.31
|
| Rate for Payer: Kaiser Permanente Medicaid |
$456.31
|
| Rate for Payer: Kaiser Permanente Medicare |
$456.31
|
| Rate for Payer: Ohana Health Plan Medicaid |
$419.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$380.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$419.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$380.26
|
|
|
PR EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Professional
|
Both
|
$755.00
|
|
|
Service Code
|
HCPCS 25071
|
| Min. Negotiated Rate |
$409.69 |
| Max. Negotiated Rate |
$641.75 |
| Rate for Payer: AlohaCare Medicaid |
$439.60
|
| Rate for Payer: AlohaCare Medicare |
$409.69
|
| Rate for Payer: Cash Price |
$453.00
|
| Rate for Payer: Cash Price |
$453.00
|
| Rate for Payer: Devoted Health Medicare |
$450.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$409.69
|
| Rate for Payer: Health Management Network Commercial |
$641.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$491.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$491.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$491.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$439.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$409.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$439.60
|
| Rate for Payer: UnitedHealthcare Medicare |
$409.69
|
|
|
PR EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 25076
|
| Min. Negotiated Rate |
$307.84 |
| Max. Negotiated Rate |
$799.85 |
| Rate for Payer: AlohaCare Medicaid |
$546.77
|
| Rate for Payer: AlohaCare Medicare |
$503.97
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Devoted Health Medicare |
$554.37
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$503.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$307.84
|
| Rate for Payer: Health Management Network Commercial |
$799.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$604.76
|
| Rate for Payer: Kaiser Permanente Medicaid |
$604.76
|
| Rate for Payer: Kaiser Permanente Medicare |
$604.76
|
| Rate for Payer: Ohana Health Plan Medicaid |
$546.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$503.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$546.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$503.97
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$936.00
|
|
|
Service Code
|
HCPCS 21556
|
| Min. Negotiated Rate |
$359.32 |
| Max. Negotiated Rate |
$795.60 |
| Rate for Payer: AlohaCare Medicaid |
$546.14
|
| Rate for Payer: AlohaCare Medicare |
$496.87
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Devoted Health Medicare |
$546.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$496.87
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$359.32
|
| Rate for Payer: Health Management Network Commercial |
$795.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$596.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$596.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$596.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$546.14
|
| Rate for Payer: Ohana Health Plan Medicare |
$496.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$546.14
|
| Rate for Payer: UnitedHealthcare Medicare |
$496.87
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$971.00
|
|
|
Service Code
|
HCPCS 23076
|
| Min. Negotiated Rate |
$345.80 |
| Max. Negotiated Rate |
$825.35 |
| Rate for Payer: AlohaCare Medicaid |
$562.61
|
| Rate for Payer: AlohaCare Medicare |
$531.68
|
| Rate for Payer: Cash Price |
$582.60
|
| Rate for Payer: Cash Price |
$582.60
|
| Rate for Payer: Devoted Health Medicare |
$584.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$531.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$345.80
|
| Rate for Payer: Health Management Network Commercial |
$825.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$638.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$638.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$638.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$562.61
|
| Rate for Payer: Ohana Health Plan Medicare |
$531.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$562.61
|
| Rate for Payer: UnitedHealthcare Medicare |
$531.68
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$991.00
|
|
|
Service Code
|
HCPCS 22900
|
| Min. Negotiated Rate |
$351.52 |
| Max. Negotiated Rate |
$842.35 |
| Rate for Payer: AlohaCare Medicaid |
$576.51
|
| Rate for Payer: AlohaCare Medicare |
$548.43
|
| Rate for Payer: Cash Price |
$594.60
|
| Rate for Payer: Cash Price |
$594.60
|
| Rate for Payer: Devoted Health Medicare |
$603.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$548.43
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$351.52
|
| Rate for Payer: Health Management Network Commercial |
$842.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$658.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$658.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$658.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$576.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$548.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$576.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$548.43
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Professional
|
Both
|
$1,156.00
|
|
|
Service Code
|
HCPCS 22901
|
| Min. Negotiated Rate |
$638.38 |
| Max. Negotiated Rate |
$982.60 |
| Rate for Payer: AlohaCare Medicaid |
$673.37
|
| Rate for Payer: AlohaCare Medicare |
$638.38
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Devoted Health Medicare |
$702.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$638.38
|
| Rate for Payer: Health Management Network Commercial |
$982.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$766.06
|
| Rate for Payer: Kaiser Permanente Medicaid |
$766.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$766.06
|
| Rate for Payer: Ohana Health Plan Medicaid |
$673.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$638.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$673.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$638.38
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$770.00
|
|
|
Service Code
|
HCPCS 22903
|
| Min. Negotiated Rate |
$423.02 |
| Max. Negotiated Rate |
$654.50 |
| Rate for Payer: AlohaCare Medicaid |
$448.37
|
| Rate for Payer: AlohaCare Medicare |
$430.04
|
| Rate for Payer: Cash Price |
$462.00
|
| Rate for Payer: Cash Price |
$462.00
|
| Rate for Payer: Devoted Health Medicare |
$473.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$430.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$423.02
|
| Rate for Payer: Health Management Network Commercial |
$654.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$516.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$516.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$516.05
|
| Rate for Payer: Ohana Health Plan Medicaid |
$448.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$448.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$430.04
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM
|
Professional
|
Both
|
$959.70
|
|
|
Service Code
|
HCPCS 22902
|
| Min. Negotiated Rate |
$337.07 |
| Max. Negotiated Rate |
$815.75 |
| Rate for Payer: AlohaCare Medicaid |
$345.92
|
| Rate for Payer: AlohaCare Medicare |
$337.07
|
| Rate for Payer: Cash Price |
$575.82
|
| Rate for Payer: Cash Price |
$575.82
|
| Rate for Payer: Devoted Health Medicare |
$370.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$345.92
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$534.57
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$337.07
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$345.92
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$408.20
|
| Rate for Payer: Health Management Network Commercial |
$815.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$404.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$404.48
|
| Rate for Payer: Kaiser Permanente Medicare |
$404.48
|
| Rate for Payer: Ohana Health Plan Medicaid |
$345.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$337.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$345.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$337.07
|
| Rate for Payer: University Health Alliance Commercial |
$452.60
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$1,041.92
|
|
|
Service Code
|
HCPCS 25075
|
| Min. Negotiated Rate |
$95.16 |
| Max. Negotiated Rate |
$885.63 |
| Rate for Payer: AlohaCare Medicaid |
$333.98
|
| Rate for Payer: AlohaCare Medicare |
$315.87
|
| Rate for Payer: Cash Price |
$625.15
|
| Rate for Payer: Cash Price |
$625.15
|
| Rate for Payer: Devoted Health Medicare |
$347.46
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$333.98
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$511.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$315.87
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$333.98
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.16
|
| Rate for Payer: Health Management Network Commercial |
$885.63
|
| Rate for Payer: Kaiser Permanente Commercial |
$379.04
|
| Rate for Payer: Kaiser Permanente Medicaid |
$379.04
|
| Rate for Payer: Kaiser Permanente Medicare |
$379.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$333.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$315.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$333.98
|
| Rate for Payer: UnitedHealthcare Medicare |
$315.87
|
| Rate for Payer: University Health Alliance Commercial |
$433.02
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM
|
Professional
|
Both
|
$830.00
|
|
|
Service Code
|
HCPCS 27619
|
| Min. Negotiated Rate |
$404.04 |
| Max. Negotiated Rate |
$705.50 |
| Rate for Payer: AlohaCare Medicaid |
$488.99
|
| Rate for Payer: AlohaCare Medicare |
$444.07
|
| Rate for Payer: Cash Price |
$498.00
|
| Rate for Payer: Cash Price |
$498.00
|
| Rate for Payer: Devoted Health Medicare |
$488.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$444.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$404.04
|
| Rate for Payer: Health Management Network Commercial |
$705.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$532.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$532.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$532.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$488.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$444.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$488.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$444.07
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$975.10
|
|
|
Service Code
|
HCPCS 27618
|
| Min. Negotiated Rate |
$205.92 |
| Max. Negotiated Rate |
$828.84 |
| Rate for Payer: AlohaCare Medicaid |
$321.95
|
| Rate for Payer: AlohaCare Medicare |
$306.93
|
| Rate for Payer: Cash Price |
$585.06
|
| Rate for Payer: Cash Price |
$585.06
|
| Rate for Payer: Devoted Health Medicare |
$337.62
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$321.95
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$496.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$306.93
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$321.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$205.92
|
| Rate for Payer: Health Management Network Commercial |
$828.84
|
| Rate for Payer: Kaiser Permanente Commercial |
$368.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$368.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$368.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$321.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$306.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$321.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$306.93
|
| Rate for Payer: University Health Alliance Commercial |
$418.15
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$863.00
|
|
|
Service Code
|
HCPCS 21555
|
| Min. Negotiated Rate |
$238.42 |
| Max. Negotiated Rate |
$733.55 |
| Rate for Payer: AlohaCare Medicaid |
$321.74
|
| Rate for Payer: AlohaCare Medicare |
$305.43
|
| Rate for Payer: Cash Price |
$517.80
|
| Rate for Payer: Cash Price |
$517.80
|
| Rate for Payer: Devoted Health Medicare |
$335.97
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$321.74
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$494.58
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$305.43
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$321.74
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$238.42
|
| Rate for Payer: Health Management Network Commercial |
$733.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$366.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$366.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$366.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$321.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$305.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$321.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$305.43
|
| Rate for Payer: University Health Alliance Commercial |
$418.74
|
|
