|
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
|
|
|
PR NERVE CONDUCTION STUDIES 1-2 STUDIES
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 95907 26
|
| Min. Negotiated Rate |
$55.53 |
| Max. Negotiated Rate |
$102.98 |
| Rate for Payer: AlohaCare Medicaid |
$97.33
|
| Rate for Payer: AlohaCare Medicare |
$55.53
|
| Rate for Payer: Cash Price |
$58.20
|
| Rate for Payer: Cash Price |
$58.20
|
| Rate for Payer: Devoted Health Medicare |
$61.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$55.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$102.98
|
| Rate for Payer: Health Management Network Commercial |
$82.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$66.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$66.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$66.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$97.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$55.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$97.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$55.53
|
|
|
PR NERVE CONDUCTION STUDIES 13/> STUDIES
|
Professional
|
Both
|
$341.00
|
|
|
Service Code
|
HCPCS 95913 26
|
| Min. Negotiated Rate |
$194.94 |
| Max. Negotiated Rate |
$327.14 |
| Rate for Payer: AlohaCare Medicaid |
$305.84
|
| Rate for Payer: AlohaCare Medicare |
$194.94
|
| Rate for Payer: Cash Price |
$204.60
|
| Rate for Payer: Cash Price |
$204.60
|
| Rate for Payer: Devoted Health Medicare |
$214.43
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$194.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$327.14
|
| Rate for Payer: Health Management Network Commercial |
$289.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$233.93
|
| Rate for Payer: Kaiser Permanente Medicaid |
$233.93
|
| Rate for Payer: Kaiser Permanente Medicare |
$233.93
|
| Rate for Payer: Ohana Health Plan Medicaid |
$305.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$194.94
|
| Rate for Payer: UnitedHealthcare Medicaid |
$305.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$194.94
|
|
|
PR NERVE CONDUCTION STUDIES 13/> STUDIES
|
Professional
|
Both
|
$698.00
|
|
|
Service Code
|
HCPCS 95913
|
| Min. Negotiated Rate |
$305.84 |
| Max. Negotiated Rate |
$593.30 |
| Rate for Payer: AlohaCare Medicaid |
$305.84
|
| Rate for Payer: AlohaCare Medicare |
$322.17
|
| Rate for Payer: Cash Price |
$418.80
|
| Rate for Payer: Cash Price |
$418.80
|
| Rate for Payer: Devoted Health Medicare |
$354.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$322.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$327.14
|
| Rate for Payer: Health Management Network Commercial |
$593.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$386.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$386.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$386.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$305.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$322.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$305.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$322.17
|
|
|
PR NERVE CONDUCTION STUDIES 13/> STUDIES
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 95913 TC
|
| Min. Negotiated Rate |
$127.23 |
| Max. Negotiated Rate |
$327.14 |
| Rate for Payer: AlohaCare Medicaid |
$305.84
|
| Rate for Payer: AlohaCare Medicare |
$127.23
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Cash Price |
$214.20
|
| Rate for Payer: Devoted Health Medicare |
$139.95
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$127.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$327.14
|
| Rate for Payer: Health Management Network Commercial |
$303.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$152.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$152.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$152.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$305.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$127.23
|
| Rate for Payer: UnitedHealthcare Medicaid |
$305.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$127.23
|
|
|
PR NERVE CONDUCTION STUDIES 3-4 STUDIES
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
HCPCS 95908 TC
|
| Min. Negotiated Rate |
$57.92 |
| Max. Negotiated Rate |
$138.55 |
| Rate for Payer: AlohaCare Medicaid |
$120.75
|
| Rate for Payer: AlohaCare Medicare |
$57.92
|
| Rate for Payer: Cash Price |
$97.80
|
| Rate for Payer: Cash Price |
$97.80
|
| Rate for Payer: Devoted Health Medicare |
$63.71
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$57.92
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$127.04
|
| Rate for Payer: Health Management Network Commercial |
$138.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$69.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$69.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$69.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$120.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$57.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$120.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$57.92
|
|
|
PR NERVE CONDUCTION STUDIES 3-4 STUDIES
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
HCPCS 95908
|
| Min. Negotiated Rate |
$120.75 |
| Max. Negotiated Rate |
$242.25 |
| Rate for Payer: AlohaCare Medicaid |
$120.75
|
| Rate for Payer: AlohaCare Medicare |
$127.74
|
| Rate for Payer: Cash Price |
$171.00
|
| Rate for Payer: Cash Price |
$171.00
|
| Rate for Payer: Devoted Health Medicare |
$140.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$127.74
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$127.04
|
| Rate for Payer: Health Management Network Commercial |
$242.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$153.29
|
| Rate for Payer: Kaiser Permanente Medicaid |
$153.29
|
| Rate for Payer: Kaiser Permanente Medicare |
$153.29
|
| Rate for Payer: Ohana Health Plan Medicaid |
$120.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$127.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$120.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$127.74
|
|
|
PR NERVE CONDUCTION STUDIES 3-4 STUDIES
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 95908 26
|
| Min. Negotiated Rate |
$69.82 |
| Max. Negotiated Rate |
$127.04 |
| Rate for Payer: AlohaCare Medicaid |
$120.75
|
| Rate for Payer: AlohaCare Medicare |
$69.82
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Devoted Health Medicare |
$76.80
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.82
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$127.04
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$83.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$83.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$83.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$120.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$120.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.82
|
|
|
PR NERVE CONDUCTION STUDIES 5-6 STUDIES
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 95909
|
| Min. Negotiated Rate |
$144.94 |
| Max. Negotiated Rate |
$291.55 |
| Rate for Payer: AlohaCare Medicaid |
$144.94
|
| Rate for Payer: AlohaCare Medicare |
$153.42
|
| Rate for Payer: Cash Price |
$205.80
|
| Rate for Payer: Cash Price |
$205.80
|
| Rate for Payer: Devoted Health Medicare |
$168.76
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$153.42
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$152.12
|
| Rate for Payer: Health Management Network Commercial |
$291.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$184.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$184.10
|
| Rate for Payer: Kaiser Permanente Medicare |
$184.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$144.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$153.42
|
| Rate for Payer: UnitedHealthcare Medicaid |
$144.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$153.42
|
|
|
PR NERVE CONDUCTION STUDIES 5-6 STUDIES
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 95909 26
|
| Min. Negotiated Rate |
$83.35 |
| Max. Negotiated Rate |
$152.12 |
| Rate for Payer: AlohaCare Medicaid |
$144.94
|
| Rate for Payer: AlohaCare Medicare |
$83.35
|
| Rate for Payer: Cash Price |
$87.60
|
| Rate for Payer: Cash Price |
$87.60
|
| Rate for Payer: Devoted Health Medicare |
$91.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$83.35
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$152.12
|
| Rate for Payer: Health Management Network Commercial |
$124.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$100.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$100.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$100.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$144.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$83.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$144.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$83.35
|
|
|
PR NERVE CONDUCTION STUDIES 5-6 STUDIES
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 95909 TC
|
| Min. Negotiated Rate |
$70.07 |
| Max. Negotiated Rate |
$167.45 |
| Rate for Payer: AlohaCare Medicaid |
$144.94
|
| Rate for Payer: AlohaCare Medicare |
$70.07
|
| Rate for Payer: Cash Price |
$118.20
|
| Rate for Payer: Cash Price |
$118.20
|
| Rate for Payer: Devoted Health Medicare |
$77.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$70.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$152.12
|
| Rate for Payer: Health Management Network Commercial |
$167.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$84.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$84.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$84.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$144.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$70.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$144.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$70.07
|
|
|
PR NERVE CONDUCTION STUDIES 7-8 STUDIES
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 95910
|
| Min. Negotiated Rate |
$189.12 |
| Max. Negotiated Rate |
$377.40 |
| Rate for Payer: AlohaCare Medicaid |
$189.12
|
| Rate for Payer: AlohaCare Medicare |
$199.60
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Devoted Health Medicare |
$219.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$199.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$200.08
|
| Rate for Payer: Health Management Network Commercial |
$377.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$239.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$239.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$239.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$189.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$199.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$189.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$199.60
|
|
|
PR NERVE CONDUCTION STUDIES 7-8 STUDIES
|
Professional
|
Both
|
$193.00
|
|
|
Service Code
|
HCPCS 95910 26
|
| Min. Negotiated Rate |
$110.54 |
| Max. Negotiated Rate |
$200.08 |
| Rate for Payer: AlohaCare Medicaid |
$189.12
|
| Rate for Payer: AlohaCare Medicare |
$110.54
|
| Rate for Payer: Cash Price |
$115.80
|
| Rate for Payer: Cash Price |
$115.80
|
| Rate for Payer: Devoted Health Medicare |
$121.59
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$110.54
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$200.08
|
| Rate for Payer: Health Management Network Commercial |
$164.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$132.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$132.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$132.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$189.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$110.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$189.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$110.54
|
|
|
PR NERVE CONDUCTION STUDIES 7-8 STUDIES
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 95910 TC
|
| Min. Negotiated Rate |
$89.06 |
| Max. Negotiated Rate |
$213.35 |
| Rate for Payer: AlohaCare Medicaid |
$189.12
|
| Rate for Payer: AlohaCare Medicare |
$89.06
|
| Rate for Payer: Cash Price |
$150.60
|
| Rate for Payer: Cash Price |
$150.60
|
| Rate for Payer: Devoted Health Medicare |
$97.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$89.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$200.08
|
| Rate for Payer: Health Management Network Commercial |
$213.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$106.87
|
| Rate for Payer: Kaiser Permanente Medicaid |
$106.87
|
| Rate for Payer: Kaiser Permanente Medicare |
$106.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$189.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$89.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$189.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$89.06
|
|
|
PR NERVE CONDUCTION STUDIES 9-10 STUDIES
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 95911 26
|
| Min. Negotiated Rate |
$137.93 |
| Max. Negotiated Rate |
$241.74 |
| Rate for Payer: AlohaCare Medicaid |
$227.55
|
| Rate for Payer: AlohaCare Medicare |
$137.93
|
| Rate for Payer: Cash Price |
$144.60
|
| Rate for Payer: Cash Price |
$144.60
|
| Rate for Payer: Devoted Health Medicare |
$151.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$137.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$241.74
|
| Rate for Payer: Health Management Network Commercial |
$204.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$165.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$165.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$165.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$227.55
|
| Rate for Payer: Ohana Health Plan Medicare |
$137.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$227.55
|
| Rate for Payer: UnitedHealthcare Medicare |
$137.93
|
|
|
PR NERVE CONDUCTION STUDIES 9-10 STUDIES
|
Professional
|
Both
|
$282.00
|
|
|
Service Code
|
HCPCS 95911 TC
|
| Min. Negotiated Rate |
$99.31 |
| Max. Negotiated Rate |
$241.74 |
| Rate for Payer: AlohaCare Medicaid |
$227.55
|
| Rate for Payer: AlohaCare Medicare |
$99.31
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Devoted Health Medicare |
$109.24
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$99.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$241.74
|
| Rate for Payer: Health Management Network Commercial |
$239.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$119.17
|
| Rate for Payer: Kaiser Permanente Medicaid |
$119.17
|
| Rate for Payer: Kaiser Permanente Medicare |
$119.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$227.55
|
| Rate for Payer: Ohana Health Plan Medicare |
$99.31
|
| Rate for Payer: UnitedHealthcare Medicaid |
$227.55
|
| Rate for Payer: UnitedHealthcare Medicare |
$99.31
|
|
|
PR NERVE CONDUCTION STUDIES 9-10 STUDIES
|
Professional
|
Both
|
$523.00
|
|
|
Service Code
|
HCPCS 95911
|
| Min. Negotiated Rate |
$227.55 |
| Max. Negotiated Rate |
$444.55 |
| Rate for Payer: AlohaCare Medicaid |
$227.55
|
| Rate for Payer: AlohaCare Medicare |
$237.24
|
| Rate for Payer: Cash Price |
$313.80
|
| Rate for Payer: Cash Price |
$313.80
|
| Rate for Payer: Devoted Health Medicare |
$260.96
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$241.74
|
| Rate for Payer: Health Management Network Commercial |
$444.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$284.69
|
| Rate for Payer: Kaiser Permanente Medicaid |
$284.69
|
| Rate for Payer: Kaiser Permanente Medicare |
$284.69
|
| Rate for Payer: Ohana Health Plan Medicaid |
$227.55
|
| Rate for Payer: Ohana Health Plan Medicare |
$237.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$227.55
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.24
|
|
|
PR NERVE GRAFT HEAD/NECK < 4 CM
|
Professional
|
Both
|
$1,870.00
|
|
|
Service Code
|
HCPCS 64885
|
| Min. Negotiated Rate |
$886.60 |
| Max. Negotiated Rate |
$1,589.50 |
| Rate for Payer: AlohaCare Medicaid |
$1,095.88
|
| Rate for Payer: AlohaCare Medicare |
$931.02
|
| Rate for Payer: Cash Price |
$1,122.00
|
| Rate for Payer: Cash Price |
$1,122.00
|
| Rate for Payer: Devoted Health Medicare |
$1,024.12
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$931.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$886.60
|
| Rate for Payer: Health Management Network Commercial |
$1,589.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,117.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,117.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,117.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,095.88
|
| Rate for Payer: Ohana Health Plan Medicare |
$931.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,095.88
|
| Rate for Payer: UnitedHealthcare Medicare |
$931.02
|
|
|
PR NERVE REPAIR W/NERVE ALLOGRAFT FIRST STRAND
|
Professional
|
Both
|
$1,585.00
|
|
|
Service Code
|
HCPCS 64912
|
| Min. Negotiated Rate |
$825.24 |
| Max. Negotiated Rate |
$1,347.25 |
| Rate for Payer: AlohaCare Medicaid |
$926.22
|
| Rate for Payer: AlohaCare Medicare |
$835.53
|
| Rate for Payer: Cash Price |
$951.00
|
| Rate for Payer: Cash Price |
$951.00
|
| Rate for Payer: Devoted Health Medicare |
$919.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$835.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$825.24
|
| Rate for Payer: Health Management Network Commercial |
$1,347.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,002.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,002.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,002.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$926.22
|
| Rate for Payer: Ohana Health Plan Medicare |
$835.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$926.22
|
| Rate for Payer: UnitedHealthcare Medicare |
$835.53
|
|
|
PR NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 95937 26
|
| Min. Negotiated Rate |
$35.29 |
| Max. Negotiated Rate |
$115.32 |
| Rate for Payer: AlohaCare Medicaid |
$115.32
|
| Rate for Payer: AlohaCare Medicare |
$35.29
|
| Rate for Payer: Cash Price |
$37.20
|
| Rate for Payer: Cash Price |
$37.20
|
| Rate for Payer: Devoted Health Medicare |
$38.82
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$35.29
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$41.05
|
| Rate for Payer: Health Management Network Commercial |
$52.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$42.35
|
| Rate for Payer: Kaiser Permanente Medicaid |
$42.35
|
| Rate for Payer: Kaiser Permanente Medicare |
$42.35
|
| Rate for Payer: Ohana Health Plan Medicaid |
$115.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$35.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$115.32
|
| Rate for Payer: UnitedHealthcare Medicare |
$35.29
|
|
|
PR NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH
|
Professional
|
Both
|
$313.00
|
|
|
Service Code
|
HCPCS 95937
|
| Min. Negotiated Rate |
$41.05 |
| Max. Negotiated Rate |
$266.05 |
| Rate for Payer: AlohaCare Medicaid |
$115.32
|
| Rate for Payer: AlohaCare Medicare |
$117.52
|
| Rate for Payer: Cash Price |
$187.80
|
| Rate for Payer: Cash Price |
$187.80
|
| Rate for Payer: Devoted Health Medicare |
$129.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$117.52
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$41.05
|
| Rate for Payer: Health Management Network Commercial |
$266.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$141.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$141.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$141.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$115.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$117.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$115.32
|
| Rate for Payer: UnitedHealthcare Medicare |
$117.52
|
|
|
PR NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 95937 TC
|
| Min. Negotiated Rate |
$41.05 |
| Max. Negotiated Rate |
$213.35 |
| Rate for Payer: AlohaCare Medicaid |
$115.32
|
| Rate for Payer: AlohaCare Medicare |
$82.22
|
| Rate for Payer: Cash Price |
$150.60
|
| Rate for Payer: Cash Price |
$150.60
|
| Rate for Payer: Devoted Health Medicare |
$90.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$82.22
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$41.05
|
| Rate for Payer: Health Management Network Commercial |
$213.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$98.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$98.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$98.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$115.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$82.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$115.32
|
| Rate for Payer: UnitedHealthcare Medicare |
$82.22
|
|
|
PR NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT
|
Professional
|
Both
|
$939.00
|
|
|
Service Code
|
HCPCS 64702
|
| Min. Negotiated Rate |
$196.82 |
| Max. Negotiated Rate |
$798.15 |
| Rate for Payer: AlohaCare Medicaid |
$545.97
|
| Rate for Payer: AlohaCare Medicare |
$507.37
|
| Rate for Payer: Cash Price |
$563.40
|
| Rate for Payer: Cash Price |
$563.40
|
| Rate for Payer: Devoted Health Medicare |
$558.11
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$507.37
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$196.82
|
| Rate for Payer: Health Management Network Commercial |
$798.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$608.84
|
| Rate for Payer: Kaiser Permanente Medicaid |
$608.84
|
| Rate for Payer: Kaiser Permanente Medicare |
$608.84
|
| Rate for Payer: Ohana Health Plan Medicaid |
$545.97
|
| Rate for Payer: Ohana Health Plan Medicare |
$507.37
|
| Rate for Payer: UnitedHealthcare Medicaid |
$545.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$507.37
|
|
|
PR NEUROPLASTY NERVE HAND/FOOT
|
Professional
|
Both
|
$588.00
|
|
|
Service Code
|
HCPCS 64704
|
| Min. Negotiated Rate |
$319.18 |
| Max. Negotiated Rate |
$499.80 |
| Rate for Payer: AlohaCare Medicaid |
$342.33
|
| Rate for Payer: AlohaCare Medicare |
$319.18
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Devoted Health Medicare |
$351.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$319.18
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$367.64
|
| Rate for Payer: Health Management Network Commercial |
$499.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$383.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$383.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$383.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$342.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$319.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$342.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$319.18
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Professional
|
Both
|
$1,100.00
|
|
|
Service Code
|
HCPCS 64718
|
| Min. Negotiated Rate |
$495.82 |
| Max. Negotiated Rate |
$935.00 |
| Rate for Payer: AlohaCare Medicaid |
$639.16
|
| Rate for Payer: AlohaCare Medicare |
$594.91
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Devoted Health Medicare |
$654.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$594.91
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$495.82
|
| Rate for Payer: Health Management Network Commercial |
$935.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$713.89
|
| Rate for Payer: Kaiser Permanente Medicaid |
$713.89
|
| Rate for Payer: Kaiser Permanente Medicare |
$713.89
|
| Rate for Payer: Ohana Health Plan Medicaid |
$639.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$594.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$639.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$594.91
|
|
