|
PR NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS
|
Professional
|
Both
|
$356.00
|
|
|
Service Code
|
HCPCS 95864 TC
|
| Min. Negotiated Rate |
$154.00 |
| Max. Negotiated Rate |
$302.60 |
| Rate for Payer: AlohaCare Medicaid |
$253.41
|
| Rate for Payer: AlohaCare Medicare |
$154.00
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Devoted Health Medicare |
$169.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$154.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$209.17
|
| Rate for Payer: Health Management Network Commercial |
$302.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$184.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$184.80
|
| Rate for Payer: Kaiser Permanente Medicare |
$184.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$253.41
|
| Rate for Payer: Ohana Health Plan Medicare |
$154.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$253.41
|
| Rate for Payer: UnitedHealthcare Medicare |
$154.00
|
|
|
PR NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ
|
Professional
|
Both
|
$1,124.00
|
|
|
Service Code
|
HCPCS 51785 TC
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$955.40 |
| Rate for Payer: AlohaCare Medicaid |
$484.23
|
| Rate for Payer: AlohaCare Medicare |
$339.33
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Devoted Health Medicare |
$373.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.42
|
| Rate for Payer: Health Management Network Commercial |
$955.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$407.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$407.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$407.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$484.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$339.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$484.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.33
|
|
|
PR NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ
|
Professional
|
Both
|
$159.00
|
|
|
Service Code
|
HCPCS 51785 26
|
| Min. Negotiated Rate |
$90.57 |
| Max. Negotiated Rate |
$484.23 |
| Rate for Payer: AlohaCare Medicaid |
$484.23
|
| Rate for Payer: AlohaCare Medicare |
$90.57
|
| Rate for Payer: Cash Price |
$95.40
|
| Rate for Payer: Cash Price |
$95.40
|
| Rate for Payer: Devoted Health Medicare |
$99.63
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$90.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.42
|
| Rate for Payer: Health Management Network Commercial |
$135.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$108.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$108.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$108.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$484.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$90.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$484.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$90.57
|
|
|
PR NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ
|
Professional
|
Both
|
$1,283.00
|
|
|
Service Code
|
HCPCS 51785
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$1,090.55 |
| Rate for Payer: AlohaCare Medicaid |
$484.23
|
| Rate for Payer: AlohaCare Medicare |
$429.90
|
| Rate for Payer: Cash Price |
$769.80
|
| Rate for Payer: Cash Price |
$769.80
|
| Rate for Payer: Devoted Health Medicare |
$472.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$429.90
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.42
|
| Rate for Payer: Health Management Network Commercial |
$1,090.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$515.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$515.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$515.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$484.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$429.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$484.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$429.90
|
|
|
PR NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX
|
Professional
|
Both
|
$473.57
|
|
|
Service Code
|
HCPCS 44385
|
| Min. Negotiated Rate |
$68.19 |
| Max. Negotiated Rate |
$402.53 |
| Rate for Payer: AlohaCare Medicaid |
$73.72
|
| Rate for Payer: AlohaCare Medicare |
$68.19
|
| Rate for Payer: Cash Price |
$284.14
|
| Rate for Payer: Cash Price |
$284.14
|
| Rate for Payer: Devoted Health Medicare |
$75.01
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$73.72
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$145.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$68.19
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$73.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$135.20
|
| Rate for Payer: Health Management Network Commercial |
$402.53
|
| Rate for Payer: Kaiser Permanente Commercial |
$81.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$81.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$81.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$73.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$68.19
|
| Rate for Payer: UnitedHealthcare Medicaid |
$73.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$68.19
|
| Rate for Payer: University Health Alliance Commercial |
$96.49
|
|
|
PR NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$674.94
|
|
|
Service Code
|
HCPCS 44386
|
| Min. Negotiated Rate |
$82.25 |
| Max. Negotiated Rate |
$573.70 |
| Rate for Payer: AlohaCare Medicaid |
$90.20
|
| Rate for Payer: AlohaCare Medicare |
$82.25
|
| Rate for Payer: Cash Price |
$404.96
|
| Rate for Payer: Cash Price |
$404.96
|
| Rate for Payer: Devoted Health Medicare |
$90.47
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$90.20
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$171.58
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$82.25
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$90.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$129.74
|
| Rate for Payer: Health Management Network Commercial |
$573.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$98.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$98.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$98.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$90.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$82.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$90.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$82.25
|
| Rate for Payer: University Health Alliance Commercial |
$118.73
|
|
|
PR NDSC NJX IMPLT MATRL URT&/BLDR NCK
|
Professional
|
Both
|
$643.00
|
|
|
Service Code
|
HCPCS 51715
|
| Min. Negotiated Rate |
$173.98 |
| Max. Negotiated Rate |
$546.55 |
| Rate for Payer: AlohaCare Medicaid |
$197.94
|
| Rate for Payer: AlohaCare Medicare |
$173.98
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Devoted Health Medicare |
$191.38
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$197.94
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$307.41
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$173.98
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$197.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$255.84
|
| Rate for Payer: Health Management Network Commercial |
$546.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$208.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$208.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$208.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$197.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$173.98
|
| Rate for Payer: UnitedHealthcare Medicaid |
$197.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$173.98
|
| Rate for Payer: University Health Alliance Commercial |
$260.27
|
|
|
PR NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM
|
Professional
|
Both
|
$937.00
|
|
|
Service Code
|
HCPCS 29848
|
| Min. Negotiated Rate |
$395.98 |
| Max. Negotiated Rate |
$796.45 |
| Rate for Payer: AlohaCare Medicaid |
$543.95
|
| Rate for Payer: AlohaCare Medicare |
$501.12
|
| Rate for Payer: Cash Price |
$562.20
|
| Rate for Payer: Cash Price |
$562.20
|
| Rate for Payer: Devoted Health Medicare |
$551.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$501.12
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$395.98
|
| Rate for Payer: Health Management Network Commercial |
$796.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$601.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$601.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$601.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$543.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$501.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$543.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$501.12
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 95868 26
|
| Min. Negotiated Rate |
$64.06 |
| Max. Negotiated Rate |
$151.70 |
| Rate for Payer: AlohaCare Medicaid |
$151.70
|
| Rate for Payer: AlohaCare Medicare |
$64.06
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Devoted Health Medicare |
$70.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$64.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$88.45
|
| Rate for Payer: Health Management Network Commercial |
$95.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$76.87
|
| Rate for Payer: Kaiser Permanente Medicaid |
$76.87
|
| Rate for Payer: Kaiser Permanente Medicare |
$76.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$151.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$64.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$151.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$64.06
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 95868
|
| Min. Negotiated Rate |
$88.45 |
| Max. Negotiated Rate |
$209.10 |
| Rate for Payer: AlohaCare Medicaid |
$151.70
|
| Rate for Payer: AlohaCare Medicare |
$140.59
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Devoted Health Medicare |
$154.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$140.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$88.45
|
| Rate for Payer: Health Management Network Commercial |
$209.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$168.71
|
| Rate for Payer: Kaiser Permanente Medicaid |
$168.71
|
| Rate for Payer: Kaiser Permanente Medicare |
$168.71
|
| Rate for Payer: Ohana Health Plan Medicaid |
$151.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$140.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$151.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$140.59
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI
|
Professional
|
Both
|
$134.00
|
|
|
Service Code
|
HCPCS 95868 TC
|
| Min. Negotiated Rate |
$76.53 |
| Max. Negotiated Rate |
$151.70 |
| Rate for Payer: AlohaCare Medicaid |
$151.70
|
| Rate for Payer: AlohaCare Medicare |
$76.53
|
| Rate for Payer: Cash Price |
$80.40
|
| Rate for Payer: Cash Price |
$80.40
|
| Rate for Payer: Devoted Health Medicare |
$84.18
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$76.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$88.45
|
| Rate for Payer: Health Management Network Commercial |
$113.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$91.84
|
| Rate for Payer: Kaiser Permanente Medicaid |
$91.84
|
| Rate for Payer: Kaiser Permanente Medicare |
$91.84
|
| Rate for Payer: Ohana Health Plan Medicaid |
$151.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$76.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$151.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$76.53
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI
|
Professional
|
Both
|
$206.00
|
|
|
Service Code
|
HCPCS 95867
|
| Min. Negotiated Rate |
$73.88 |
| Max. Negotiated Rate |
$175.10 |
| Rate for Payer: AlohaCare Medicaid |
$117.11
|
| Rate for Payer: AlohaCare Medicare |
$117.64
|
| Rate for Payer: Cash Price |
$123.60
|
| Rate for Payer: Cash Price |
$123.60
|
| Rate for Payer: Devoted Health Medicare |
$129.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$117.64
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$73.88
|
| Rate for Payer: Health Management Network Commercial |
$175.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$141.17
|
| Rate for Payer: Kaiser Permanente Medicaid |
$141.17
|
| Rate for Payer: Kaiser Permanente Medicare |
$141.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$117.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$117.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$117.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$117.64
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 95867 TC
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$117.11 |
| Rate for Payer: AlohaCare Medicaid |
$117.11
|
| Rate for Payer: AlohaCare Medicare |
$75.01
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Devoted Health Medicare |
$82.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$75.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$73.88
|
| Rate for Payer: Health Management Network Commercial |
$63.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$90.01
|
| Rate for Payer: Kaiser Permanente Medicaid |
$90.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$90.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$117.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$75.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$117.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$75.01
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 95867 26
|
| Min. Negotiated Rate |
$42.63 |
| Max. Negotiated Rate |
$117.11 |
| Rate for Payer: AlohaCare Medicaid |
$117.11
|
| Rate for Payer: AlohaCare Medicare |
$42.63
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Devoted Health Medicare |
$46.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$42.63
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$73.88
|
| Rate for Payer: Health Management Network Commercial |
$111.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$51.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$51.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$51.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$117.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$42.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$117.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$42.63
|
|
|
PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 95866 TC
|
| Min. Negotiated Rate |
$79.19 |
| Max. Negotiated Rate |
$132.99 |
| Rate for Payer: AlohaCare Medicaid |
$132.99
|
| Rate for Payer: AlohaCare Medicare |
$79.19
|
| Rate for Payer: Cash Price |
$83.40
|
| Rate for Payer: Cash Price |
$83.40
|
| Rate for Payer: Devoted Health Medicare |
$87.11
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$79.19
|
| Rate for Payer: Health Management Network Commercial |
$118.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$95.03
|
| Rate for Payer: Kaiser Permanente Medicaid |
$95.03
|
| Rate for Payer: Kaiser Permanente Medicare |
$95.03
|
| Rate for Payer: Ohana Health Plan Medicaid |
$132.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$79.19
|
| Rate for Payer: UnitedHealthcare Medicaid |
$132.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$79.19
|
|
|
PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 95866 26
|
| Min. Negotiated Rate |
$69.25 |
| Max. Negotiated Rate |
$132.99 |
| Rate for Payer: AlohaCare Medicaid |
$132.99
|
| Rate for Payer: AlohaCare Medicare |
$69.25
|
| Rate for Payer: Cash Price |
$72.60
|
| Rate for Payer: Cash Price |
$72.60
|
| Rate for Payer: Devoted Health Medicare |
$76.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.25
|
| Rate for Payer: Health Management Network Commercial |
$102.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$83.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$83.10
|
| Rate for Payer: Kaiser Permanente Medicare |
$83.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$132.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$132.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.25
|
|
|
PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 95866
|
| Min. Negotiated Rate |
$132.99 |
| Max. Negotiated Rate |
$221.00 |
| Rate for Payer: AlohaCare Medicaid |
$132.99
|
| Rate for Payer: AlohaCare Medicare |
$148.43
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Devoted Health Medicare |
$163.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$148.43
|
| Rate for Payer: Health Management Network Commercial |
$221.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$178.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$178.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$178.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$132.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$148.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$132.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$148.43
|
|
|
PR NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED
|
Professional
|
Both
|
$189.00
|
|
|
Service Code
|
HCPCS 95885
|
| Min. Negotiated Rate |
$68.53 |
| Max. Negotiated Rate |
$160.65 |
| Rate for Payer: AlohaCare Medicaid |
$68.83
|
| Rate for Payer: AlohaCare Medicare |
$71.55
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Devoted Health Medicare |
$78.70
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$71.55
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$68.53
|
| Rate for Payer: Health Management Network Commercial |
$160.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.86
|
| Rate for Payer: Kaiser Permanente Medicaid |
$85.86
|
| Rate for Payer: Kaiser Permanente Medicare |
$85.86
|
| Rate for Payer: Ohana Health Plan Medicaid |
$68.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$71.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$68.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$71.55
|
|
|
PR NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 95885 TC
|
| Min. Negotiated Rate |
$52.41 |
| Max. Negotiated Rate |
$131.75 |
| Rate for Payer: AlohaCare Medicaid |
$68.83
|
| Rate for Payer: AlohaCare Medicare |
$52.41
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Devoted Health Medicare |
$57.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$52.41
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$68.53
|
| Rate for Payer: Health Management Network Commercial |
$131.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$62.89
|
| Rate for Payer: Kaiser Permanente Medicaid |
$62.89
|
| Rate for Payer: Kaiser Permanente Medicare |
$62.89
|
| Rate for Payer: Ohana Health Plan Medicaid |
$68.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$52.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$68.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$52.41
|
|
|
PR NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 95885 26
|
| Min. Negotiated Rate |
$19.15 |
| Max. Negotiated Rate |
$68.83 |
| Rate for Payer: AlohaCare Medicaid |
$68.83
|
| Rate for Payer: AlohaCare Medicare |
$19.15
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Devoted Health Medicare |
$21.07
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$19.15
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$68.53
|
| Rate for Payer: Health Management Network Commercial |
$28.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$22.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$22.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$22.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$68.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$19.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$68.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$19.15
|
|
|
PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE
|
Professional
|
Both
|
$262.00
|
|
|
Service Code
|
HCPCS 95886
|
| Min. Negotiated Rate |
$93.62 |
| Max. Negotiated Rate |
$222.70 |
| Rate for Payer: AlohaCare Medicaid |
$105.30
|
| Rate for Payer: AlohaCare Medicare |
$109.15
|
| Rate for Payer: Cash Price |
$157.20
|
| Rate for Payer: Cash Price |
$157.20
|
| Rate for Payer: Devoted Health Medicare |
$120.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$109.15
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$93.62
|
| Rate for Payer: Health Management Network Commercial |
$222.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$130.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$130.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$130.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$105.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$109.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$105.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$109.15
|
|
|
PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
HCPCS 95886 26
|
| Min. Negotiated Rate |
$47.25 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: AlohaCare Medicaid |
$105.30
|
| Rate for Payer: AlohaCare Medicare |
$47.25
|
| Rate for Payer: Cash Price |
$49.80
|
| Rate for Payer: Cash Price |
$49.80
|
| Rate for Payer: Devoted Health Medicare |
$51.98
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$47.25
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$93.62
|
| Rate for Payer: Health Management Network Commercial |
$70.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$56.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$56.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$56.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$105.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$47.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$105.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$47.25
|
|
|
PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 95886 TC
|
| Min. Negotiated Rate |
$61.90 |
| Max. Negotiated Rate |
$152.15 |
| Rate for Payer: AlohaCare Medicaid |
$105.30
|
| Rate for Payer: AlohaCare Medicare |
$61.90
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Devoted Health Medicare |
$68.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$61.90
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$93.62
|
| Rate for Payer: Health Management Network Commercial |
$152.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$74.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$74.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$74.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$105.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$61.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$105.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$61.90
|
|
|
PR NEEDLE EMG GUID W/CHEMODENERVATION
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 95874
|
| Min. Negotiated Rate |
$85.17 |
| Max. Negotiated Rate |
$202.30 |
| Rate for Payer: AlohaCare Medicaid |
$85.17
|
| Rate for Payer: AlohaCare Medicare |
$89.69
|
| Rate for Payer: Cash Price |
$142.80
|
| Rate for Payer: Cash Price |
$142.80
|
| Rate for Payer: Devoted Health Medicare |
$98.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$89.69
|
| Rate for Payer: Health Management Network Commercial |
$202.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$107.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$107.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$107.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$85.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$89.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$85.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$89.69
|
|
|
PR NEEDLE EMG GUID W/CHEMODENERVATION
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 95874 TC
|
| Min. Negotiated Rate |
$69.12 |
| Max. Negotiated Rate |
$171.70 |
| Rate for Payer: AlohaCare Medicaid |
$85.17
|
| Rate for Payer: AlohaCare Medicare |
$69.12
|
| Rate for Payer: Cash Price |
$121.20
|
| Rate for Payer: Cash Price |
$121.20
|
| Rate for Payer: Devoted Health Medicare |
$76.03
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.12
|
| Rate for Payer: Health Management Network Commercial |
$171.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$82.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$82.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$82.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$85.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$85.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.12
|
|
