|
PR PYLOROPLASTY
|
Professional
|
Both
|
$1,569.00
|
|
|
Service Code
|
HCPCS 43800
|
| Min. Negotiated Rate |
$511.16 |
| Max. Negotiated Rate |
$1,333.65 |
| Rate for Payer: AlohaCare Medicaid |
$916.34
|
| Rate for Payer: AlohaCare Medicare |
$851.91
|
| Rate for Payer: Cash Price |
$941.40
|
| Rate for Payer: Cash Price |
$941.40
|
| Rate for Payer: Devoted Health Medicare |
$937.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$851.91
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$511.16
|
| Rate for Payer: Health Management Network Commercial |
$1,333.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,022.29
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,022.29
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,022.29
|
| Rate for Payer: Ohana Health Plan Medicaid |
$916.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$851.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$916.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$851.91
|
|
|
PR RADIESSE INJECTION
|
Professional
|
Both
|
$583.00
|
|
|
Service Code
|
HCPCS Q2026
|
| Min. Negotiated Rate |
$495.55 |
| Max. Negotiated Rate |
$495.55 |
| Rate for Payer: Cash Price |
$349.80
|
| Rate for Payer: Health Management Network Commercial |
$495.55
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/>
|
Professional
|
Both
|
$2,275.00
|
|
|
Service Code
|
HCPCS 22905
|
| Min. Negotiated Rate |
$1,220.74 |
| Max. Negotiated Rate |
$1,933.75 |
| Rate for Payer: AlohaCare Medicaid |
$1,322.29
|
| Rate for Payer: AlohaCare Medicare |
$1,220.74
|
| Rate for Payer: Cash Price |
$1,365.00
|
| Rate for Payer: Cash Price |
$1,365.00
|
| Rate for Payer: Devoted Health Medicare |
$1,342.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,220.74
|
| Rate for Payer: Health Management Network Commercial |
$1,933.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,464.89
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,464.89
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,464.89
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,322.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,220.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,322.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,220.74
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM
|
Professional
|
Both
|
$1,751.00
|
|
|
Service Code
|
HCPCS 21935
|
| Min. Negotiated Rate |
$738.14 |
| Max. Negotiated Rate |
$1,488.35 |
| Rate for Payer: AlohaCare Medicaid |
$1,026.47
|
| Rate for Payer: AlohaCare Medicare |
$949.47
|
| Rate for Payer: Cash Price |
$1,050.60
|
| Rate for Payer: Cash Price |
$1,050.60
|
| Rate for Payer: Devoted Health Medicare |
$1,044.42
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$949.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$738.14
|
| Rate for Payer: Health Management Network Commercial |
$1,488.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,139.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,139.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,139.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,026.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$949.47
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,026.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$949.47
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Professional
|
Both
|
$1,329.00
|
|
|
Service Code
|
HCPCS 27422
|
| Min. Negotiated Rate |
$710.18 |
| Max. Negotiated Rate |
$1,129.65 |
| Rate for Payer: AlohaCare Medicaid |
$771.90
|
| Rate for Payer: AlohaCare Medicare |
$710.18
|
| Rate for Payer: Cash Price |
$797.40
|
| Rate for Payer: Cash Price |
$797.40
|
| Rate for Payer: Devoted Health Medicare |
$781.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$710.18
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$815.10
|
| Rate for Payer: Health Management Network Commercial |
$1,129.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$852.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$852.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$852.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$771.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$710.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$771.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$710.18
|
|
|
PR RCNSTJ MIDFACE LEFORT III W/O LEFORT I
|
Professional
|
Both
|
$3,381.00
|
|
|
Service Code
|
HCPCS 21154
|
| Min. Negotiated Rate |
$1,680.28 |
| Max. Negotiated Rate |
$2,873.85 |
| Rate for Payer: AlohaCare Medicaid |
$1,986.90
|
| Rate for Payer: AlohaCare Medicare |
$1,680.28
|
| Rate for Payer: Cash Price |
$2,028.60
|
| Rate for Payer: Cash Price |
$2,028.60
|
| Rate for Payer: Devoted Health Medicare |
$1,848.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,680.28
|
| Rate for Payer: Health Management Network Commercial |
$2,873.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,016.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,016.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,016.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,986.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,680.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,986.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,680.28
|
|
|
PR RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE
|
Professional
|
Both
|
$371.19
|
|
|
Service Code
|
HCPCS 45900
|
| Min. Negotiated Rate |
$71.76 |
| Max. Negotiated Rate |
$315.51 |
| Rate for Payer: AlohaCare Medicaid |
$215.84
|
| Rate for Payer: AlohaCare Medicare |
$212.31
|
| Rate for Payer: Cash Price |
$222.71
|
| Rate for Payer: Cash Price |
$222.71
|
| Rate for Payer: Devoted Health Medicare |
$233.54
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$212.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.76
|
| Rate for Payer: Health Management Network Commercial |
$315.51
|
| Rate for Payer: Kaiser Permanente Commercial |
$254.77
|
| Rate for Payer: Kaiser Permanente Medicaid |
$254.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$254.77
|
| Rate for Payer: Ohana Health Plan Medicaid |
$215.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$212.31
|
| Rate for Payer: UnitedHealthcare Medicaid |
$215.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$212.31
|
|
|
PR RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS
|
Professional
|
Both
|
$796.00
|
|
|
Service Code
|
HCPCS 54600
|
| Min. Negotiated Rate |
$334.88 |
| Max. Negotiated Rate |
$676.60 |
| Rate for Payer: AlohaCare Medicaid |
$464.64
|
| Rate for Payer: AlohaCare Medicare |
$422.35
|
| Rate for Payer: Cash Price |
$477.60
|
| Rate for Payer: Cash Price |
$477.60
|
| Rate for Payer: Devoted Health Medicare |
$464.58
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$422.35
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$334.88
|
| Rate for Payer: Health Management Network Commercial |
$676.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$506.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$506.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$506.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$464.64
|
| Rate for Payer: Ohana Health Plan Medicare |
$422.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$464.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$422.35
|
|
|
PR RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT
|
Professional
|
Both
|
$1,583.00
|
|
|
Service Code
|
HCPCS 44050
|
| Min. Negotiated Rate |
$563.94 |
| Max. Negotiated Rate |
$1,345.55 |
| Rate for Payer: AlohaCare Medicaid |
$923.77
|
| Rate for Payer: AlohaCare Medicare |
$860.85
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Cash Price |
$949.80
|
| Rate for Payer: Devoted Health Medicare |
$946.93
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$860.85
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$563.94
|
| Rate for Payer: Health Management Network Commercial |
$1,345.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,033.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,033.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,033.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$923.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$860.85
|
| Rate for Payer: UnitedHealthcare Medicaid |
$923.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$860.85
|
|
|
PR REALIGNMENT EXTENSOR TENDON HAND EACH TENDON
|
Professional
|
Both
|
$1,228.00
|
|
|
Service Code
|
HCPCS 26437
|
| Min. Negotiated Rate |
$347.10 |
| Max. Negotiated Rate |
$1,043.80 |
| Rate for Payer: AlohaCare Medicaid |
$724.40
|
| Rate for Payer: AlohaCare Medicare |
$691.05
|
| Rate for Payer: Cash Price |
$736.80
|
| Rate for Payer: Cash Price |
$736.80
|
| Rate for Payer: Devoted Health Medicare |
$760.15
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$691.05
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$347.10
|
| Rate for Payer: Health Management Network Commercial |
$1,043.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$829.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$829.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$829.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$724.40
|
| Rate for Payer: Ohana Health Plan Medicare |
$691.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$724.40
|
| Rate for Payer: UnitedHealthcare Medicare |
$691.05
|
|
|
PR RECONSTRUCTION NAIL BED W/GRAFT
|
Professional
|
Both
|
$551.44
|
|
|
Service Code
|
HCPCS 11762
|
| Min. Negotiated Rate |
$156.78 |
| Max. Negotiated Rate |
$468.72 |
| Rate for Payer: AlohaCare Medicaid |
$193.53
|
| Rate for Payer: AlohaCare Medicare |
$179.53
|
| Rate for Payer: Cash Price |
$330.86
|
| Rate for Payer: Cash Price |
$330.86
|
| Rate for Payer: Devoted Health Medicare |
$197.48
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$193.53
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$300.74
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$179.53
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$193.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$156.78
|
| Rate for Payer: Health Management Network Commercial |
$468.72
|
| Rate for Payer: Kaiser Permanente Commercial |
$215.44
|
| Rate for Payer: Kaiser Permanente Medicaid |
$215.44
|
| Rate for Payer: Kaiser Permanente Medicare |
$215.44
|
| Rate for Payer: Ohana Health Plan Medicaid |
$193.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$179.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$193.53
|
| Rate for Payer: UnitedHealthcare Medicare |
$179.53
|
| Rate for Payer: University Health Alliance Commercial |
$222.54
|
|
|
PR RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC
|
Professional
|
Both
|
$1,146.00
|
|
|
Service Code
|
HCPCS 0184T
|
| Min. Negotiated Rate |
$974.10 |
| Max. Negotiated Rate |
$974.10 |
| Rate for Payer: Cash Price |
$687.60
|
| Rate for Payer: Health Management Network Commercial |
$974.10
|
|
|
PR RELEASE THENAR MUSCLE
|
Professional
|
Both
|
$1,244.00
|
|
|
Service Code
|
HCPCS 26508
|
| Min. Negotiated Rate |
$355.42 |
| Max. Negotiated Rate |
$1,057.40 |
| Rate for Payer: AlohaCare Medicaid |
$735.50
|
| Rate for Payer: AlohaCare Medicare |
$682.18
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Devoted Health Medicare |
$750.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$682.18
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$355.42
|
| Rate for Payer: Health Management Network Commercial |
$1,057.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$818.62
|
| Rate for Payer: Kaiser Permanente Medicaid |
$818.62
|
| Rate for Payer: Kaiser Permanente Medicare |
$818.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$735.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$682.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$735.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$682.18
|
|
|
PR RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR
|
Professional
|
Both
|
$688.00
|
|
|
Service Code
|
HCPCS 33223
|
| Min. Negotiated Rate |
$359.01 |
| Max. Negotiated Rate |
$584.80 |
| Rate for Payer: AlohaCare Medicaid |
$402.78
|
| Rate for Payer: AlohaCare Medicare |
$359.01
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Devoted Health Medicare |
$394.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$359.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$369.72
|
| Rate for Payer: Health Management Network Commercial |
$584.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$430.81
|
| Rate for Payer: Kaiser Permanente Medicaid |
$430.81
|
| Rate for Payer: Kaiser Permanente Medicare |
$430.81
|
| Rate for Payer: Ohana Health Plan Medicaid |
$402.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$359.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$402.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$359.01
|
|
|
PR RELOCATION OF SKIN POCKET FOR PACEMAKER
|
Professional
|
Both
|
$587.00
|
|
|
Service Code
|
HCPCS 33222
|
| Min. Negotiated Rate |
$310.29 |
| Max. Negotiated Rate |
$498.95 |
| Rate for Payer: AlohaCare Medicaid |
$343.38
|
| Rate for Payer: AlohaCare Medicare |
$310.29
|
| Rate for Payer: Cash Price |
$352.20
|
| Rate for Payer: Cash Price |
$352.20
|
| Rate for Payer: Devoted Health Medicare |
$341.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$310.29
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$313.04
|
| Rate for Payer: Health Management Network Commercial |
$498.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$372.35
|
| Rate for Payer: Kaiser Permanente Medicaid |
$372.35
|
| Rate for Payer: Kaiser Permanente Medicare |
$372.35
|
| Rate for Payer: Ohana Health Plan Medicaid |
$343.38
|
| Rate for Payer: Ohana Health Plan Medicare |
$310.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$343.38
|
| Rate for Payer: UnitedHealthcare Medicare |
$310.29
|
|
|
PR REM INTERROG ICPMS <30 D PHYS/QHP
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 93297 26
|
| Min. Negotiated Rate |
$23.99 |
| Max. Negotiated Rate |
$66.06 |
| Rate for Payer: AlohaCare Medicaid |
$66.06
|
| Rate for Payer: AlohaCare Medicare |
$25.02
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Devoted Health Medicare |
$27.52
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$25.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$23.99
|
| Rate for Payer: Health Management Network Commercial |
$37.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$30.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$30.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$30.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$66.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$25.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$66.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$25.02
|
|
|
PR REM INTERROG ICPMS <30 D PHYS/QHP
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 93297 TC
|
| Min. Negotiated Rate |
$23.99 |
| Max. Negotiated Rate |
$111.35 |
| Rate for Payer: AlohaCare Medicaid |
$66.06
|
| Rate for Payer: AlohaCare Medicare |
$41.21
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Devoted Health Medicare |
$45.33
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$41.21
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$23.99
|
| Rate for Payer: Health Management Network Commercial |
$111.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$49.45
|
| Rate for Payer: Kaiser Permanente Medicaid |
$49.45
|
| Rate for Payer: Kaiser Permanente Medicare |
$49.45
|
| Rate for Payer: Ohana Health Plan Medicaid |
$66.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$41.21
|
| Rate for Payer: UnitedHealthcare Medicaid |
$66.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$41.21
|
|
|
PR REM INTERROG ICPMS <30 D PHYS/QHP
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 93297
|
| Min. Negotiated Rate |
$23.99 |
| Max. Negotiated Rate |
$148.75 |
| Rate for Payer: AlohaCare Medicaid |
$66.06
|
| Rate for Payer: AlohaCare Medicare |
$66.22
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Devoted Health Medicare |
$72.84
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$66.22
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$23.99
|
| Rate for Payer: Health Management Network Commercial |
$148.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$79.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$79.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$79.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$66.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$66.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$66.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$66.22
|
|
|
PR REM INTERROG PM/LDLS PM <90 D PHYS/QHP
|
Professional
|
Both
|
$52.45
|
|
|
Service Code
|
HCPCS 93294
|
| Min. Negotiated Rate |
$29.52 |
| Max. Negotiated Rate |
$44.58 |
| Rate for Payer: AlohaCare Medicaid |
$29.52
|
| Rate for Payer: AlohaCare Medicare |
$29.97
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Devoted Health Medicare |
$32.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$29.97
|
| Rate for Payer: Health Management Network Commercial |
$44.58
|
| Rate for Payer: Kaiser Permanente Commercial |
$35.96
|
| Rate for Payer: Kaiser Permanente Medicaid |
$35.96
|
| Rate for Payer: Kaiser Permanente Medicare |
$35.96
|
| Rate for Payer: Ohana Health Plan Medicaid |
$29.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$29.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$29.52
|
| Rate for Payer: UnitedHealthcare Medicare |
$29.97
|
|
|
PR REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW
|
Professional
|
Both
|
$148.00
|
|
|
Service Code
|
HCPCS 93296
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$125.80 |
| Rate for Payer: AlohaCare Medicaid |
$24.28
|
| Rate for Payer: AlohaCare Medicare |
$35.89
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Devoted Health Medicare |
$39.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$35.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$38.35
|
| Rate for Payer: Health Management Network Commercial |
$125.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$43.07
|
| Rate for Payer: Kaiser Permanente Medicaid |
$43.07
|
| Rate for Payer: Kaiser Permanente Medicare |
$43.07
|
| Rate for Payer: Ohana Health Plan Medicaid |
$24.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$35.89
|
| Rate for Payer: UnitedHealthcare Medicaid |
$24.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$35.89
|
|
|
PR REM INTERROG SCRMS <30 D PHYS/QHP
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 93298 26
|
| Min. Negotiated Rate |
$25.02 |
| Max. Negotiated Rate |
$113.29 |
| Rate for Payer: AlohaCare Medicaid |
$113.29
|
| Rate for Payer: AlohaCare Medicare |
$25.02
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Devoted Health Medicare |
$27.52
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$25.02
|
| Rate for Payer: Health Management Network Commercial |
$37.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$30.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$30.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$30.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$113.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$25.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$113.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$25.02
|
|
|
PR REM INTERROG SCRMS <30 D PHYS/QHP
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 93298
|
| Min. Negotiated Rate |
$113.29 |
| Max. Negotiated Rate |
$278.80 |
| Rate for Payer: AlohaCare Medicaid |
$113.29
|
| Rate for Payer: AlohaCare Medicare |
$114.27
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Devoted Health Medicare |
$125.70
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$114.27
|
| Rate for Payer: Health Management Network Commercial |
$278.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$137.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$137.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$137.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$113.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$114.27
|
| Rate for Payer: UnitedHealthcare Medicaid |
$113.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$114.27
|
|
|
PR REM INTERROG SCRMS <30 D PHYS/QHP
|
Professional
|
Both
|
$284.00
|
|
|
Service Code
|
HCPCS 93298 TC
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$241.40 |
| Rate for Payer: AlohaCare Medicaid |
$113.29
|
| Rate for Payer: AlohaCare Medicare |
$89.25
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Devoted Health Medicare |
$98.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$89.25
|
| Rate for Payer: Health Management Network Commercial |
$241.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$107.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$107.10
|
| Rate for Payer: Kaiser Permanente Medicare |
$107.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$113.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$89.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$113.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$89.25
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING 1ST 20 MIN MONTH
|
Professional
|
Both
|
$96.83
|
|
|
Service Code
|
HCPCS 99457
|
| Min. Negotiated Rate |
$26.46 |
| Max. Negotiated Rate |
$82.31 |
| Rate for Payer: AlohaCare Medicaid |
$30.23
|
| Rate for Payer: AlohaCare Medicare |
$26.46
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Devoted Health Medicare |
$29.11
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$30.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$26.46
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$30.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$55.11
|
| Rate for Payer: Health Management Network Commercial |
$82.31
|
| Rate for Payer: Kaiser Permanente Commercial |
$31.75
|
| Rate for Payer: Kaiser Permanente Medicaid |
$31.75
|
| Rate for Payer: Kaiser Permanente Medicare |
$31.75
|
| Rate for Payer: Ohana Health Plan Medicaid |
$30.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$26.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$30.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$26.46
|
| Rate for Payer: University Health Alliance Commercial |
$37.28
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO
|
Professional
|
Both
|
$76.21
|
|
|
Service Code
|
HCPCS 99458
|
| Min. Negotiated Rate |
$26.46 |
| Max. Negotiated Rate |
$64.78 |
| Rate for Payer: AlohaCare Medicaid |
$30.23
|
| Rate for Payer: AlohaCare Medicare |
$26.46
|
| Rate for Payer: Cash Price |
$45.73
|
| Rate for Payer: Cash Price |
$45.73
|
| Rate for Payer: Devoted Health Medicare |
$29.11
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$30.23
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$36.99
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$26.46
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$30.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$44.37
|
| Rate for Payer: Health Management Network Commercial |
$64.78
|
| Rate for Payer: Kaiser Permanente Commercial |
$31.75
|
| Rate for Payer: Kaiser Permanente Medicaid |
$31.75
|
| Rate for Payer: Kaiser Permanente Medicare |
$31.75
|
| Rate for Payer: Ohana Health Plan Medicaid |
$30.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$26.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$30.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$26.46
|
| Rate for Payer: University Health Alliance Commercial |
$37.28
|
|
