|
PR OSTEOTOMY METACARPAL EACH
|
Professional
|
Both
|
$1,307.00
|
|
|
Service Code
|
HCPCS 26565
|
| Min. Negotiated Rate |
$426.92 |
| Max. Negotiated Rate |
$1,110.95 |
| Rate for Payer: AlohaCare Medicaid |
$767.19
|
| Rate for Payer: AlohaCare Medicare |
$729.72
|
| Rate for Payer: Cash Price |
$784.20
|
| Rate for Payer: Cash Price |
$784.20
|
| Rate for Payer: Devoted Health Medicare |
$802.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$729.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$426.92
|
| Rate for Payer: Health Management Network Commercial |
$1,110.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$875.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$875.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$875.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$767.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$729.72
|
| Rate for Payer: UnitedHealthcare Medicaid |
$767.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$729.72
|
|
|
PR OSTEOTOMY RADIUS DISTAL THIRD
|
Professional
|
Both
|
$1,217.00
|
|
|
Service Code
|
HCPCS 25350
|
| Min. Negotiated Rate |
$544.96 |
| Max. Negotiated Rate |
$1,034.45 |
| Rate for Payer: AlohaCare Medicaid |
$707.61
|
| Rate for Payer: AlohaCare Medicare |
$640.23
|
| Rate for Payer: Cash Price |
$730.20
|
| Rate for Payer: Cash Price |
$730.20
|
| Rate for Payer: Devoted Health Medicare |
$704.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$640.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$544.96
|
| Rate for Payer: Health Management Network Commercial |
$1,034.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$768.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$768.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$768.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$707.61
|
| Rate for Payer: Ohana Health Plan Medicare |
$640.23
|
| Rate for Payer: UnitedHealthcare Medicaid |
$707.61
|
| Rate for Payer: UnitedHealthcare Medicare |
$640.23
|
|
|
PROSTHESIS PENILE 13MM MALLBLE
|
Facility
|
IP
|
$24,631.00
|
|
|
Service Code
|
HCPCS C2622
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,793.36 |
| Max. Negotiated Rate |
$23,892.07 |
| Rate for Payer: Cash Price |
$14,778.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$17,241.70
|
| Rate for Payer: Health Management Network Commercial |
$20,936.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$22,167.90
|
| Rate for Payer: MDX Hawaii PPO |
$23,892.07
|
| Rate for Payer: University Health Alliance Commercial |
$13,793.36
|
|
|
PROSTHESIS PENILE 13MM MALLBLE
|
Facility
|
OP
|
$24,631.00
|
|
|
Service Code
|
HCPCS C2622
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,315.50 |
| Max. Negotiated Rate |
$23,892.07 |
| Rate for Payer: AlohaCare Medicaid |
$12,315.50
|
| Rate for Payer: AlohaCare Medicare |
$18,719.56
|
| Rate for Payer: Cash Price |
$14,778.60
|
| Rate for Payer: Devoted Health Medicare |
$20,690.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$18,719.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$17,241.70
|
| Rate for Payer: Health Management Network Commercial |
$20,936.35
|
| Rate for Payer: Humana Medicare |
$18,719.56
|
| Rate for Payer: Kaiser Permanente Commercial |
$22,167.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$12,561.81
|
| Rate for Payer: Kaiser Permanente Medicare |
$18,719.56
|
| Rate for Payer: MDX Hawaii PPO |
$23,892.07
|
| Rate for Payer: Ohana Health Plan Medicaid |
$18,719.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$18,719.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$18,719.56
|
| Rate for Payer: University Health Alliance Commercial |
$13,793.36
|
|
|
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION [6677]
|
Facility
|
OP
|
$33.00
|
|
|
Service Code
|
HCPCS J2720
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.64 |
| Max. Negotiated Rate |
$32.01 |
| Rate for Payer: AlohaCare Medicaid |
$16.50
|
| Rate for Payer: AlohaCare Medicaid |
$33.00
|
| Rate for Payer: AlohaCare Medicare |
$50.16
|
| Rate for Payer: AlohaCare Medicare |
$25.08
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Devoted Health Medicare |
$27.72
|
| Rate for Payer: Devoted Health Medicare |
$55.44
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$1.64
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$1.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$50.16
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$25.08
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$1.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$1.64
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$31.35
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$62.70
|
| Rate for Payer: Health Management Network Commercial |
$56.10
|
| Rate for Payer: Health Management Network Commercial |
$28.05
|
| Rate for Payer: Humana Medicare |
$25.08
|
| Rate for Payer: Humana Medicare |
$50.16
|
| Rate for Payer: Kaiser Permanente Commercial |
$29.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$59.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$33.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$16.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$25.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$50.16
|
| Rate for Payer: MDX Hawaii PPO |
$32.01
|
| Rate for Payer: MDX Hawaii PPO |
$64.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$50.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$25.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$25.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$50.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$39.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$19.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$25.08
|
| Rate for Payer: UnitedHealthcare Medicare |
$50.16
|
| Rate for Payer: University Health Alliance Commercial |
$24.05
|
| Rate for Payer: University Health Alliance Commercial |
$48.11
|
|
|
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION [6677]
|
Facility
|
IP
|
$33.00
|
|
|
Service Code
|
HCPCS J2720
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$28.05 |
| Max. Negotiated Rate |
$32.01 |
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Health Management Network Commercial |
$28.05
|
| Rate for Payer: Health Management Network Commercial |
$56.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$29.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$59.40
|
| Rate for Payer: MDX Hawaii PPO |
$64.02
|
| Rate for Payer: MDX Hawaii PPO |
$32.01
|
|
|
PROTECTOR ARM 1STEP STND 40433
|
Facility
|
IP
|
$163.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$138.55 |
| Max. Negotiated Rate |
$158.11 |
| Rate for Payer: Cash Price |
$97.80
|
| Rate for Payer: Health Management Network Commercial |
$138.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$146.70
|
| Rate for Payer: MDX Hawaii PPO |
$158.11
|
|
|
PROTECTOR ARM 1STEP STND 40433
|
Facility
|
OP
|
$163.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.50 |
| Max. Negotiated Rate |
$158.11 |
| Rate for Payer: AlohaCare Medicaid |
$81.50
|
| Rate for Payer: AlohaCare Medicare |
$123.88
|
| Rate for Payer: Cash Price |
$97.80
|
| Rate for Payer: Devoted Health Medicare |
$136.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$123.88
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$154.85
|
| Rate for Payer: Health Management Network Commercial |
$138.55
|
| Rate for Payer: Humana Medicare |
$123.88
|
| Rate for Payer: Kaiser Permanente Commercial |
$146.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$83.13
|
| Rate for Payer: Kaiser Permanente Medicare |
$123.88
|
| Rate for Payer: MDX Hawaii PPO |
$158.11
|
| Rate for Payer: Ohana Health Plan Medicaid |
$123.88
|
| Rate for Payer: Ohana Health Plan Medicare |
$123.88
|
| Rate for Payer: UnitedHealthcare Medicare |
$123.88
|
| Rate for Payer: University Health Alliance Commercial |
$118.81
|
|
|
PROTECTOR HEEL PREVALON
|
Facility
|
IP
|
$225.00
|
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$218.25 |
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$157.50
|
| Rate for Payer: Health Management Network Commercial |
$191.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$202.50
|
| Rate for Payer: MDX Hawaii PPO |
$218.25
|
| Rate for Payer: University Health Alliance Commercial |
$126.00
|
|
|
PROTECTOR HEEL PREVALON
|
Facility
|
OP
|
$225.00
|
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$218.25 |
| Rate for Payer: AlohaCare Medicaid |
$112.50
|
| Rate for Payer: AlohaCare Medicare |
$171.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Devoted Health Medicare |
$189.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$171.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$157.50
|
| Rate for Payer: Health Management Network Commercial |
$191.25
|
| Rate for Payer: Humana Medicare |
$171.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$202.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$114.75
|
| Rate for Payer: Kaiser Permanente Medicare |
$171.00
|
| Rate for Payer: MDX Hawaii PPO |
$218.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$171.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$171.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$171.00
|
| Rate for Payer: University Health Alliance Commercial |
$126.00
|
|
|
PR OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 92502
|
| Min. Negotiated Rate |
$76.47 |
| Max. Negotiated Rate |
$144.50 |
| Rate for Payer: AlohaCare Medicaid |
$99.56
|
| Rate for Payer: AlohaCare Medicare |
$89.58
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Devoted Health Medicare |
$98.54
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$89.58
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$76.47
|
| Rate for Payer: Health Management Network Commercial |
$144.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$107.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$107.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$107.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$99.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$89.58
|
| Rate for Payer: UnitedHealthcare Medicaid |
$99.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$89.58
|
|
|
PR OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ
|
Professional
|
Both
|
$1,217.37
|
|
|
Service Code
|
HCPCS 69300
|
| Min. Negotiated Rate |
$346.32 |
| Max. Negotiated Rate |
$1,034.76 |
| Rate for Payer: AlohaCare Medicaid |
$493.54
|
| Rate for Payer: AlohaCare Medicare |
$438.92
|
| Rate for Payer: Cash Price |
$730.42
|
| Rate for Payer: Cash Price |
$730.42
|
| Rate for Payer: Devoted Health Medicare |
$482.81
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$493.54
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$752.93
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$438.92
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$493.54
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$346.32
|
| Rate for Payer: Health Management Network Commercial |
$1,034.76
|
| Rate for Payer: Kaiser Permanente Commercial |
$526.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$526.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$526.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$493.54
|
| Rate for Payer: Ohana Health Plan Medicare |
$438.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$493.54
|
| Rate for Payer: UnitedHealthcare Medicare |
$438.92
|
| Rate for Payer: University Health Alliance Commercial |
$637.48
|
|
|
PROVENA SOLO 3FR SINGLE LUMEN
|
Facility
|
OP
|
$1,096.00
|
|
|
Service Code
|
HCPCS C1751
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$548.00 |
| Max. Negotiated Rate |
$1,063.12 |
| Rate for Payer: AlohaCare Medicaid |
$548.00
|
| Rate for Payer: AlohaCare Medicare |
$832.96
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Devoted Health Medicare |
$920.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$832.96
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,041.20
|
| Rate for Payer: Health Management Network Commercial |
$931.60
|
| Rate for Payer: Humana Medicare |
$832.96
|
| Rate for Payer: Kaiser Permanente Commercial |
$986.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$558.96
|
| Rate for Payer: Kaiser Permanente Medicare |
$832.96
|
| Rate for Payer: MDX Hawaii PPO |
$1,063.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$832.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$832.96
|
| Rate for Payer: UnitedHealthcare Medicare |
$832.96
|
| Rate for Payer: University Health Alliance Commercial |
$798.87
|
|
|
PROVENA SOLO 3FR SINGLE LUMEN
|
Facility
|
IP
|
$1,096.00
|
|
|
Service Code
|
HCPCS C1751
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$931.60 |
| Max. Negotiated Rate |
$1,063.12 |
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Health Management Network Commercial |
$931.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$986.40
|
| Rate for Payer: MDX Hawaii PPO |
$1,063.12
|
|
|
PROXIMAL BODY PTC ARS741702
|
Facility
|
IP
|
$13,112.00
|
|
|
Service Code
|
HCPCS C1776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,342.72 |
| Max. Negotiated Rate |
$12,718.64 |
| Rate for Payer: Cash Price |
$7,867.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$9,178.40
|
| Rate for Payer: Health Management Network Commercial |
$11,145.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$11,800.80
|
| Rate for Payer: MDX Hawaii PPO |
$12,718.64
|
| Rate for Payer: University Health Alliance Commercial |
$7,342.72
|
|
|
PROXIMAL BODY PTC ARS741702
|
Facility
|
OP
|
$13,112.00
|
|
|
Service Code
|
HCPCS C1776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,556.00 |
| Max. Negotiated Rate |
$12,718.64 |
| Rate for Payer: AlohaCare Medicaid |
$6,556.00
|
| Rate for Payer: AlohaCare Medicare |
$9,965.12
|
| Rate for Payer: Cash Price |
$7,867.20
|
| Rate for Payer: Devoted Health Medicare |
$11,014.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9,965.12
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$9,178.40
|
| Rate for Payer: Health Management Network Commercial |
$11,145.20
|
| Rate for Payer: Humana Medicare |
$9,965.12
|
| Rate for Payer: Kaiser Permanente Commercial |
$11,800.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$6,687.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$9,965.12
|
| Rate for Payer: MDX Hawaii PPO |
$12,718.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$9,965.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$9,965.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$9,965.12
|
| Rate for Payer: University Health Alliance Commercial |
$7,342.72
|
|
|
PROXIMAL OLECRANON PLATE
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
HCPCS C1713
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,150.00 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: AlohaCare Medicaid |
$1,150.00
|
| Rate for Payer: AlohaCare Medicare |
$1,748.00
|
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Devoted Health Medicare |
$1,932.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,748.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,610.00
|
| Rate for Payer: Health Management Network Commercial |
$1,955.00
|
| Rate for Payer: Humana Medicare |
$1,748.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,070.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,173.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,748.00
|
| Rate for Payer: MDX Hawaii PPO |
$2,231.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,748.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,748.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,748.00
|
| Rate for Payer: University Health Alliance Commercial |
$1,288.00
|
|
|
PROXIMAL OLECRANON PLATE
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
HCPCS C1713
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,288.00 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,610.00
|
| Rate for Payer: Health Management Network Commercial |
$1,955.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,070.00
|
| Rate for Payer: MDX Hawaii PPO |
$2,231.00
|
| Rate for Payer: University Health Alliance Commercial |
$1,288.00
|
|
|
PROXMAL HUMERUS 4 HOLE 627205
|
Facility
|
IP
|
$3,774.00
|
|
|
Service Code
|
HCPCS C1713
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,113.44 |
| Max. Negotiated Rate |
$3,660.78 |
| Rate for Payer: Cash Price |
$2,264.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,641.80
|
| Rate for Payer: Health Management Network Commercial |
$3,207.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,396.60
|
| Rate for Payer: MDX Hawaii PPO |
$3,660.78
|
| Rate for Payer: University Health Alliance Commercial |
$2,113.44
|
|
|
PROXMAL HUMERUS 4 HOLE 627205
|
Facility
|
OP
|
$3,774.00
|
|
|
Service Code
|
HCPCS C1713
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,887.00 |
| Max. Negotiated Rate |
$3,660.78 |
| Rate for Payer: AlohaCare Medicaid |
$1,887.00
|
| Rate for Payer: AlohaCare Medicare |
$2,868.24
|
| Rate for Payer: Cash Price |
$2,264.40
|
| Rate for Payer: Devoted Health Medicare |
$3,170.16
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2,868.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,641.80
|
| Rate for Payer: Health Management Network Commercial |
$3,207.90
|
| Rate for Payer: Humana Medicare |
$2,868.24
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,396.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,924.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,868.24
|
| Rate for Payer: MDX Hawaii PPO |
$3,660.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,868.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,868.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,868.24
|
| Rate for Payer: University Health Alliance Commercial |
$2,113.44
|
|
|
PR PALATOPHARYNGOPLASTY
|
Professional
|
Both
|
$1,222.00
|
|
|
Service Code
|
HCPCS 42145
|
| Min. Negotiated Rate |
$622.38 |
| Max. Negotiated Rate |
$1,038.70 |
| Rate for Payer: AlohaCare Medicaid |
$718.47
|
| Rate for Payer: AlohaCare Medicare |
$622.38
|
| Rate for Payer: Cash Price |
$733.20
|
| Rate for Payer: Cash Price |
$733.20
|
| Rate for Payer: Devoted Health Medicare |
$684.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$622.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$671.32
|
| Rate for Payer: Health Management Network Commercial |
$1,038.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$746.86
|
| Rate for Payer: Kaiser Permanente Medicaid |
$746.86
|
| Rate for Payer: Kaiser Permanente Medicare |
$746.86
|
| Rate for Payer: Ohana Health Plan Medicaid |
$718.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$622.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$718.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$622.38
|
|
|
PR PARATHYROID AUTOTRANSPLANTATION ADD-ON
|
Professional
|
Both
|
$401.00
|
|
|
Service Code
|
HCPCS 60512
|
| Min. Negotiated Rate |
$197.34 |
| Max. Negotiated Rate |
$340.85 |
| Rate for Payer: AlohaCare Medicaid |
$234.77
|
| Rate for Payer: AlohaCare Medicare |
$203.24
|
| Rate for Payer: Cash Price |
$240.60
|
| Rate for Payer: Cash Price |
$240.60
|
| Rate for Payer: Devoted Health Medicare |
$223.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$203.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$197.34
|
| Rate for Payer: Health Management Network Commercial |
$340.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$243.89
|
| Rate for Payer: Kaiser Permanente Medicaid |
$243.89
|
| Rate for Payer: Kaiser Permanente Medicare |
$243.89
|
| Rate for Payer: Ohana Health Plan Medicaid |
$234.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$203.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$234.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$203.24
|
|
|
PR PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 60500
|
| Min. Negotiated Rate |
$808.34 |
| Max. Negotiated Rate |
$1,414.40 |
| Rate for Payer: AlohaCare Medicaid |
$972.70
|
| Rate for Payer: AlohaCare Medicare |
$880.82
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Devoted Health Medicare |
$968.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$880.82
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$808.34
|
| Rate for Payer: Health Management Network Commercial |
$1,414.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,056.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,056.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,056.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$972.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$880.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$972.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$880.82
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1
|
Professional
|
Both
|
$135.87
|
|
|
Service Code
|
HCPCS 11055
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$115.49 |
| Rate for Payer: AlohaCare Medicaid |
$15.27
|
| Rate for Payer: AlohaCare Medicare |
$13.46
|
| Rate for Payer: Cash Price |
$81.52
|
| Rate for Payer: Cash Price |
$81.52
|
| Rate for Payer: Devoted Health Medicare |
$14.81
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$15.27
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$29.76
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$13.46
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$15.27
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$21.32
|
| Rate for Payer: Health Management Network Commercial |
$115.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$16.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$16.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$16.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$15.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$13.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.27
|
| Rate for Payer: UnitedHealthcare Medicare |
$13.46
|
| Rate for Payer: University Health Alliance Commercial |
$16.47
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4
|
Professional
|
Both
|
$156.28
|
|
|
Service Code
|
HCPCS 11056
|
| Min. Negotiated Rate |
$19.42 |
| Max. Negotiated Rate |
$132.84 |
| Rate for Payer: AlohaCare Medicaid |
$21.60
|
| Rate for Payer: AlohaCare Medicare |
$19.42
|
| Rate for Payer: Cash Price |
$93.77
|
| Rate for Payer: Cash Price |
$93.77
|
| Rate for Payer: Devoted Health Medicare |
$21.36
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$21.60
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$42.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$19.42
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$21.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$28.86
|
| Rate for Payer: Health Management Network Commercial |
$132.84
|
| Rate for Payer: Kaiser Permanente Commercial |
$23.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$23.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$23.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$21.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$19.42
|
| Rate for Payer: UnitedHealthcare Medicaid |
$21.60
|
| Rate for Payer: UnitedHealthcare Medicare |
$19.42
|
| Rate for Payer: University Health Alliance Commercial |
$23.71
|
|
