|
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 LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 95870 26
|
| Min. Negotiated Rate |
$20.39 |
| Max. Negotiated Rate |
$92.81 |
| Rate for Payer: AlohaCare Medicaid |
$92.81
|
| Rate for Payer: AlohaCare Medicare |
$20.39
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Devoted Health Medicare |
$22.43
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$20.39
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.17
|
| Rate for Payer: Health Management Network Commercial |
$30.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$24.47
|
| Rate for Payer: Kaiser Permanente Medicaid |
$24.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$24.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$92.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$20.39
|
| Rate for Payer: UnitedHealthcare Medicaid |
$92.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$20.39
|
|
|
PR NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 95870
|
| Min. Negotiated Rate |
$34.17 |
| Max. Negotiated Rate |
$221.85 |
| Rate for Payer: AlohaCare Medicaid |
$92.81
|
| Rate for Payer: AlohaCare Medicare |
$96.15
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Devoted Health Medicare |
$105.77
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$96.15
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.17
|
| Rate for Payer: Health Management Network Commercial |
$221.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$115.38
|
| Rate for Payer: Kaiser Permanente Medicaid |
$115.38
|
| Rate for Payer: Kaiser Permanente Medicare |
$115.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$92.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$96.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$92.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$96.15
|
|
|
PR NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 95870 TC
|
| Min. Negotiated Rate |
$34.17 |
| Max. Negotiated Rate |
$191.25 |
| Rate for Payer: AlohaCare Medicaid |
$92.81
|
| Rate for Payer: AlohaCare Medicare |
$75.77
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Devoted Health Medicare |
$83.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$75.77
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.17
|
| Rate for Payer: Health Management Network Commercial |
$191.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$90.92
|
| Rate for Payer: Kaiser Permanente Medicaid |
$90.92
|
| Rate for Payer: Kaiser Permanente Medicare |
$90.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$92.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$75.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$92.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$75.77
|
|
|
PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION
|
Professional
|
Both
|
$233.00
|
|
|
Service Code
|
HCPCS 95887
|
| Min. Negotiated Rate |
$79.69 |
| Max. Negotiated Rate |
$198.05 |
| Rate for Payer: AlohaCare Medicaid |
$90.74
|
| Rate for Payer: AlohaCare Medicare |
$96.54
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Devoted Health Medicare |
$106.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$96.54
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$79.69
|
| Rate for Payer: Health Management Network Commercial |
$198.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$115.85
|
| Rate for Payer: Kaiser Permanente Medicaid |
$115.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$115.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$90.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$96.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$90.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$96.54
|
|
|
PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 95887 TC
|
| Min. Negotiated Rate |
$58.10 |
| Max. Negotiated Rate |
$141.10 |
| Rate for Payer: AlohaCare Medicaid |
$90.74
|
| Rate for Payer: AlohaCare Medicare |
$58.10
|
| Rate for Payer: Cash Price |
$99.60
|
| Rate for Payer: Cash Price |
$99.60
|
| Rate for Payer: Devoted Health Medicare |
$63.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$58.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$79.69
|
| Rate for Payer: Health Management Network Commercial |
$141.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$69.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$69.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$69.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$90.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$58.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$90.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$58.10
|
|
|
PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 95887 26
|
| Min. Negotiated Rate |
$38.44 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: AlohaCare Medicaid |
$90.74
|
| Rate for Payer: AlohaCare Medicare |
$38.44
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Devoted Health Medicare |
$42.28
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.44
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$79.69
|
| Rate for Payer: Health Management Network Commercial |
$56.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$46.13
|
| Rate for Payer: Kaiser Permanente Medicaid |
$46.13
|
| Rate for Payer: Kaiser Permanente Medicare |
$46.13
|
| Rate for Payer: Ohana Health Plan Medicaid |
$90.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.44
|
| Rate for Payer: UnitedHealthcare Medicaid |
$90.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.44
|
|
|
PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12
|
Professional
|
Both
|
$186.00
|
|
|
Service Code
|
HCPCS 95869
|
| Min. Negotiated Rate |
$34.26 |
| Max. Negotiated Rate |
$158.10 |
| Rate for Payer: AlohaCare Medicaid |
$106.58
|
| Rate for Payer: AlohaCare Medicare |
$106.03
|
| Rate for Payer: Cash Price |
$111.60
|
| Rate for Payer: Cash Price |
$111.60
|
| Rate for Payer: Devoted Health Medicare |
$116.63
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$106.03
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.26
|
| Rate for Payer: Health Management Network Commercial |
$158.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$127.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$127.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$127.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$106.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$106.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$106.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$106.03
|
|
|
PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 95869 TC
|
| Min. Negotiated Rate |
$34.26 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: AlohaCare Medicaid |
$106.58
|
| Rate for Payer: AlohaCare Medicare |
$85.64
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Devoted Health Medicare |
$94.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$85.64
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.26
|
| Rate for Payer: Health Management Network Commercial |
$127.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$102.77
|
| Rate for Payer: Kaiser Permanente Medicaid |
$102.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$102.77
|
| Rate for Payer: Ohana Health Plan Medicaid |
$106.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$85.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$106.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$85.64
|
|
|
PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 95869 26
|
| Min. Negotiated Rate |
$20.39 |
| Max. Negotiated Rate |
$106.58 |
| Rate for Payer: AlohaCare Medicaid |
$106.58
|
| Rate for Payer: AlohaCare Medicare |
$20.39
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Devoted Health Medicare |
$22.43
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$20.39
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$34.26
|
| Rate for Payer: Health Management Network Commercial |
$30.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$24.47
|
| Rate for Payer: Kaiser Permanente Medicaid |
$24.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$24.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$106.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$20.39
|
| Rate for Payer: UnitedHealthcare Medicaid |
$106.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$20.39
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME <= 50 SQ CM
|
Professional
|
Both
|
$79.08
|
|
|
Service Code
|
HCPCS 97605
|
| Min. Negotiated Rate |
$21.27 |
| Max. Negotiated Rate |
$67.22 |
| Rate for Payer: AlohaCare Medicaid |
$24.61
|
| Rate for Payer: AlohaCare Medicare |
$21.27
|
| Rate for Payer: Cash Price |
$47.45
|
| Rate for Payer: Cash Price |
$47.45
|
| Rate for Payer: Devoted Health Medicare |
$23.40
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$24.61
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$34.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$21.27
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$24.61
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$32.67
|
| Rate for Payer: Health Management Network Commercial |
$67.22
|
| Rate for Payer: Kaiser Permanente Commercial |
$25.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$25.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$25.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$24.61
|
| Rate for Payer: Ohana Health Plan Medicare |
$21.27
|
| Rate for Payer: UnitedHealthcare Medicaid |
$24.61
|
| Rate for Payer: UnitedHealthcare Medicare |
$21.27
|
| Rate for Payer: University Health Alliance Commercial |
$30.44
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM
|
Professional
|
Both
|
$95.30
|
|
|
Service Code
|
HCPCS 97606
|
| Min. Negotiated Rate |
$23.32 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: AlohaCare Medicaid |
$27.04
|
| Rate for Payer: AlohaCare Medicare |
$23.32
|
| Rate for Payer: Cash Price |
$57.18
|
| Rate for Payer: Cash Price |
$57.18
|
| Rate for Payer: Devoted Health Medicare |
$25.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$27.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$23.32
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$27.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$35.63
|
| Rate for Payer: Health Management Network Commercial |
$81.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$27.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$27.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$27.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$27.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$23.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$27.04
|
| Rate for Payer: UnitedHealthcare Medicare |
$23.32
|
| Rate for Payer: University Health Alliance Commercial |
$33.42
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME <= 50 SQ CM
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
HCPCS 97607
|
| Min. Negotiated Rate |
$18.32 |
| Max. Negotiated Rate |
$617.10 |
| Rate for Payer: AlohaCare Medicaid |
$20.89
|
| Rate for Payer: AlohaCare Medicare |
$18.32
|
| Rate for Payer: Cash Price |
$435.60
|
| Rate for Payer: Cash Price |
$435.60
|
| Rate for Payer: Devoted Health Medicare |
$20.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$20.89
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$33.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$18.32
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$20.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$45.19
|
| Rate for Payer: Health Management Network Commercial |
$617.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$21.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$21.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$21.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$20.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$18.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$20.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$18.32
|
| Rate for Payer: University Health Alliance Commercial |
$23.97
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
HCPCS 97608
|
| Min. Negotiated Rate |
$21.13 |
| Max. Negotiated Rate |
$665.55 |
| Rate for Payer: AlohaCare Medicaid |
$24.26
|
| Rate for Payer: AlohaCare Medicare |
$21.13
|
| Rate for Payer: Cash Price |
$469.80
|
| Rate for Payer: Cash Price |
$469.80
|
| Rate for Payer: Devoted Health Medicare |
$23.24
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$24.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$37.88
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$21.13
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$24.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$47.78
|
| Rate for Payer: Health Management Network Commercial |
$665.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$25.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$25.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$25.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$24.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$21.13
|
| Rate for Payer: UnitedHealthcare Medicaid |
$24.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$21.13
|
| Rate for Payer: University Health Alliance Commercial |
$30.07
|
|
|
PR NEPHRECTOMY PARTIAL
|
Professional
|
Both
|
$2,280.00
|
|
|
Service Code
|
HCPCS 50240
|
| Min. Negotiated Rate |
$1,086.54 |
| Max. Negotiated Rate |
$1,938.00 |
| Rate for Payer: AlohaCare Medicaid |
$1,331.16
|
| Rate for Payer: AlohaCare Medicare |
$1,186.61
|
| Rate for Payer: Cash Price |
$1,368.00
|
| Rate for Payer: Cash Price |
$1,368.00
|
| Rate for Payer: Devoted Health Medicare |
$1,305.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,186.61
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,086.54
|
| Rate for Payer: Health Management Network Commercial |
$1,938.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,423.93
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,423.93
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,423.93
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,331.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,186.61
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,331.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,186.61
|
|
|
PR NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ
|
Professional
|
Both
|
$1,809.00
|
|
|
Service Code
|
HCPCS 50220
|
| Min. Negotiated Rate |
$863.46 |
| Max. Negotiated Rate |
$1,537.65 |
| Rate for Payer: AlohaCare Medicaid |
$1,051.94
|
| Rate for Payer: AlohaCare Medicare |
$955.27
|
| Rate for Payer: Cash Price |
$1,085.40
|
| Rate for Payer: Cash Price |
$1,085.40
|
| Rate for Payer: Devoted Health Medicare |
$1,050.80
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$955.27
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$863.46
|
| Rate for Payer: Health Management Network Commercial |
$1,537.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,146.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,146.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,146.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,051.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$955.27
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,051.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$955.27
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD
|
Professional
|
Both
|
$2,181.00
|
|
|
Service Code
|
HCPCS 50230
|
| Min. Negotiated Rate |
$1,132.03 |
| Max. Negotiated Rate |
$1,853.85 |
| Rate for Payer: AlohaCare Medicaid |
$1,273.44
|
| Rate for Payer: AlohaCare Medicare |
$1,132.03
|
| Rate for Payer: Cash Price |
$1,308.60
|
| Rate for Payer: Cash Price |
$1,308.60
|
| Rate for Payer: Devoted Health Medicare |
$1,245.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,132.03
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,136.98
|
| Rate for Payer: Health Management Network Commercial |
$1,853.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,358.44
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,358.44
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,358.44
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,273.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,132.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,273.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,132.03
|
|
|
PR NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC
|
Professional
|
Both
|
$2,225.00
|
|
|
Service Code
|
HCPCS 50234
|
| Min. Negotiated Rate |
$1,099.28 |
| Max. Negotiated Rate |
$1,891.25 |
| Rate for Payer: AlohaCare Medicaid |
$1,298.89
|
| Rate for Payer: AlohaCare Medicare |
$1,153.49
|
| Rate for Payer: Cash Price |
$1,335.00
|
| Rate for Payer: Cash Price |
$1,335.00
|
| Rate for Payer: Devoted Health Medicare |
$1,268.84
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,153.49
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,099.28
|
| Rate for Payer: Health Management Network Commercial |
$1,891.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,384.19
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,384.19
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,384.19
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,298.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,153.49
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,298.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,153.49
|
|
|
PR NEPHROLITHOTOMY REMOVAL CALCULUS
|
Professional
|
Both
|
$1,956.00
|
|
|
Service Code
|
HCPCS 50060
|
| Min. Negotiated Rate |
$892.84 |
| Max. Negotiated Rate |
$1,662.60 |
| Rate for Payer: AlohaCare Medicaid |
$1,141.80
|
| Rate for Payer: AlohaCare Medicare |
$1,016.36
|
| Rate for Payer: Cash Price |
$1,173.60
|
| Rate for Payer: Cash Price |
$1,173.60
|
| Rate for Payer: Devoted Health Medicare |
$1,118.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,016.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$892.84
|
| Rate for Payer: Health Management Network Commercial |
$1,662.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,219.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,219.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,219.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,141.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,016.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,141.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,016.36
|
|
|
PR NEPHROLITHOTOMY SECONDARY SURG OPERJ CALCULUS
|
Professional
|
Both
|
$2,071.00
|
|
|
Service Code
|
HCPCS 50065
|
| Min. Negotiated Rate |
$983.06 |
| Max. Negotiated Rate |
$1,760.35 |
| Rate for Payer: AlohaCare Medicaid |
$1,208.75
|
| Rate for Payer: AlohaCare Medicare |
$1,074.32
|
| Rate for Payer: Cash Price |
$1,242.60
|
| Rate for Payer: Cash Price |
$1,242.60
|
| Rate for Payer: Devoted Health Medicare |
$1,181.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,074.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$983.06
|
| Rate for Payer: Health Management Network Commercial |
$1,760.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,289.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,289.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,289.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,208.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,074.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,208.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,074.32
|
|
|
PR NEPHROSTOMY NEPHROTOMY W/DRAINAGE
|
Professional
|
Both
|
$1,599.00
|
|
|
Service Code
|
HCPCS 50040
|
| Min. Negotiated Rate |
$648.96 |
| Max. Negotiated Rate |
$1,359.15 |
| Rate for Payer: AlohaCare Medicaid |
$932.78
|
| Rate for Payer: AlohaCare Medicare |
$833.78
|
| Rate for Payer: Cash Price |
$959.40
|
| Rate for Payer: Cash Price |
$959.40
|
| Rate for Payer: Devoted Health Medicare |
$917.16
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$833.78
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$648.96
|
| Rate for Payer: Health Management Network Commercial |
$1,359.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,000.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,000.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,000.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$932.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$833.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$932.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$833.78
|
|
|
PR NERVE CONDUCTION STUDIES 11-12 STUDIES
|
Professional
|
Both
|
$312.00
|
|
|
Service Code
|
HCPCS 95912 TC
|
| Min. Negotiated Rate |
$109.38 |
| Max. Negotiated Rate |
$282.63 |
| Rate for Payer: AlohaCare Medicaid |
$265.41
|
| Rate for Payer: AlohaCare Medicare |
$109.38
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Devoted Health Medicare |
$120.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$109.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$282.63
|
| Rate for Payer: Health Management Network Commercial |
$265.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$131.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$131.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$131.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$265.41
|
| Rate for Payer: Ohana Health Plan Medicare |
$109.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$265.41
|
| Rate for Payer: UnitedHealthcare Medicare |
$109.38
|
|
|
PR NERVE CONDUCTION STUDIES 11-12 STUDIES
|
Professional
|
Both
|
$600.00
|
|
|
Service Code
|
HCPCS 95912
|
| Min. Negotiated Rate |
$265.41 |
| Max. Negotiated Rate |
$510.00 |
| Rate for Payer: AlohaCare Medicaid |
$265.41
|
| Rate for Payer: AlohaCare Medicare |
$273.75
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Devoted Health Medicare |
$301.12
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$273.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$282.63
|
| Rate for Payer: Health Management Network Commercial |
$510.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$328.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$328.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$328.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$265.41
|
| Rate for Payer: Ohana Health Plan Medicare |
$273.75
|
| Rate for Payer: UnitedHealthcare Medicaid |
$265.41
|
| Rate for Payer: UnitedHealthcare Medicare |
$273.75
|
|
|
PR NERVE CONDUCTION STUDIES 11-12 STUDIES
|
Professional
|
Both
|
$288.00
|
|
|
Service Code
|
HCPCS 95912 26
|
| Min. Negotiated Rate |
$164.37 |
| Max. Negotiated Rate |
$282.63 |
| Rate for Payer: AlohaCare Medicaid |
$265.41
|
| Rate for Payer: AlohaCare Medicare |
$164.37
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Devoted Health Medicare |
$180.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$164.37
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$282.63
|
| Rate for Payer: Health Management Network Commercial |
$244.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$197.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$197.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$197.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$265.41
|
| Rate for Payer: Ohana Health Plan Medicare |
$164.37
|
| Rate for Payer: UnitedHealthcare Medicaid |
$265.41
|
| Rate for Payer: UnitedHealthcare Medicare |
$164.37
|
|
|
PR NERVE CONDUCTION STUDIES 1-2 STUDIES
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 95907 TC
|
| Min. Negotiated Rate |
$46.15 |
| Max. Negotiated Rate |
$111.35 |
| Rate for Payer: AlohaCare Medicaid |
$97.33
|
| Rate for Payer: AlohaCare Medicare |
$46.15
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Devoted Health Medicare |
$50.77
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$46.15
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$102.98
|
| Rate for Payer: Health Management Network Commercial |
$111.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$55.38
|
| Rate for Payer: Kaiser Permanente Medicaid |
$55.38
|
| Rate for Payer: Kaiser Permanente Medicare |
$55.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$97.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$46.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$97.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$46.15
|
|
