|
PR SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION
|
Professional
|
Both
|
$1,827.00
|
|
|
Service Code
|
HCPCS 29807
|
| Min. Negotiated Rate |
$939.90 |
| Max. Negotiated Rate |
$1,552.95 |
| Rate for Payer: AlohaCare Medicaid |
$1,065.88
|
| Rate for Payer: AlohaCare Medicare |
$962.30
|
| Rate for Payer: Cash Price |
$1,096.20
|
| Rate for Payer: Cash Price |
$1,096.20
|
| Rate for Payer: Devoted Health Medicare |
$1,058.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$962.30
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$939.90
|
| Rate for Payer: Health Management Network Commercial |
$1,552.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,154.76
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,154.76
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,154.76
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,065.88
|
| Rate for Payer: Ohana Health Plan Medicare |
$962.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,065.88
|
| Rate for Payer: UnitedHealthcare Medicare |
$962.30
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS
|
Professional
|
Both
|
$1,055.00
|
|
|
Service Code
|
HCPCS 29825
|
| Min. Negotiated Rate |
$505.44 |
| Max. Negotiated Rate |
$896.75 |
| Rate for Payer: AlohaCare Medicaid |
$613.56
|
| Rate for Payer: AlohaCare Medicare |
$566.17
|
| Rate for Payer: Cash Price |
$633.00
|
| Rate for Payer: Cash Price |
$633.00
|
| Rate for Payer: Devoted Health Medicare |
$622.79
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$566.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$505.44
|
| Rate for Payer: Health Management Network Commercial |
$896.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$679.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$679.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$679.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$613.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$566.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$613.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$566.17
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR
|
Professional
|
Both
|
$1,880.00
|
|
|
Service Code
|
HCPCS 29827
|
| Min. Negotiated Rate |
$983.66 |
| Max. Negotiated Rate |
$1,598.00 |
| Rate for Payer: AlohaCare Medicaid |
$1,096.45
|
| Rate for Payer: AlohaCare Medicare |
$983.66
|
| Rate for Payer: Cash Price |
$1,128.00
|
| Rate for Payer: Cash Price |
$1,128.00
|
| Rate for Payer: Devoted Health Medicare |
$1,082.03
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$983.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,246.18
|
| Rate for Payer: Health Management Network Commercial |
$1,598.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,180.39
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,180.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,180.39
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,096.45
|
| Rate for Payer: Ohana Health Plan Medicare |
$983.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,096.45
|
| Rate for Payer: UnitedHealthcare Medicare |
$983.66
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+
|
Professional
|
Both
|
$1,063.00
|
|
|
Service Code
|
HCPCS 29823
|
| Min. Negotiated Rate |
$570.68 |
| Max. Negotiated Rate |
$903.55 |
| Rate for Payer: AlohaCare Medicaid |
$619.67
|
| Rate for Payer: AlohaCare Medicare |
$570.68
|
| Rate for Payer: Cash Price |
$637.80
|
| Rate for Payer: Cash Price |
$637.80
|
| Rate for Payer: Devoted Health Medicare |
$627.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$570.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$712.14
|
| Rate for Payer: Health Management Network Commercial |
$903.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$684.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$684.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$684.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$619.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$570.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$619.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$570.68
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 29826
|
| Min. Negotiated Rate |
$143.64 |
| Max. Negotiated Rate |
$774.28 |
| Rate for Payer: AlohaCare Medicaid |
$168.83
|
| Rate for Payer: AlohaCare Medicare |
$143.64
|
| Rate for Payer: Cash Price |
$174.00
|
| Rate for Payer: Cash Price |
$174.00
|
| Rate for Payer: Devoted Health Medicare |
$158.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$143.64
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$774.28
|
| Rate for Payer: Health Management Network Commercial |
$246.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$172.37
|
| Rate for Payer: Kaiser Permanente Medicaid |
$172.37
|
| Rate for Payer: Kaiser Permanente Medicare |
$172.37
|
| Rate for Payer: Ohana Health Plan Medicaid |
$168.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$143.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$168.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$143.64
|
|
|
PR SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI
|
Professional
|
Both
|
$5,244.59
|
|
|
Service Code
|
HCPCS 69706
|
| Min. Negotiated Rate |
$203.34 |
| Max. Negotiated Rate |
$4,457.90 |
| Rate for Payer: AlohaCare Medicaid |
$243.98
|
| Rate for Payer: AlohaCare Medicare |
$203.34
|
| Rate for Payer: Cash Price |
$3,146.75
|
| Rate for Payer: Cash Price |
$3,146.75
|
| Rate for Payer: Devoted Health Medicare |
$223.67
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$243.98
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$379.58
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$203.34
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$243.98
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3,453.58
|
| Rate for Payer: Health Management Network Commercial |
$4,457.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$244.01
|
| Rate for Payer: Kaiser Permanente Medicaid |
$244.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$244.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$243.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$203.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$243.98
|
| Rate for Payer: UnitedHealthcare Medicare |
$203.34
|
| Rate for Payer: University Health Alliance Commercial |
$321.37
|
|
|
PR SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI
|
Professional
|
Both
|
$5,078.55
|
|
|
Service Code
|
HCPCS 69705
|
| Min. Negotiated Rate |
$147.20 |
| Max. Negotiated Rate |
$4,316.77 |
| Rate for Payer: AlohaCare Medicaid |
$175.21
|
| Rate for Payer: AlohaCare Medicare |
$147.20
|
| Rate for Payer: Cash Price |
$3,047.13
|
| Rate for Payer: Cash Price |
$3,047.13
|
| Rate for Payer: Devoted Health Medicare |
$161.92
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$175.21
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$272.28
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$147.20
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$175.21
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3,359.72
|
| Rate for Payer: Health Management Network Commercial |
$4,316.77
|
| Rate for Payer: Kaiser Permanente Commercial |
$176.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$176.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$176.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$175.21
|
| Rate for Payer: Ohana Health Plan Medicare |
$147.20
|
| Rate for Payer: UnitedHealthcare Medicaid |
$175.21
|
| Rate for Payer: UnitedHealthcare Medicare |
$147.20
|
|
|
PR SURG TX ANAL FISTULA 2ND STAGE
|
Professional
|
Both
|
$1,180.85
|
|
|
Service Code
|
HCPCS 46285
|
| Min. Negotiated Rate |
$162.24 |
| Max. Negotiated Rate |
$1,003.72 |
| Rate for Payer: AlohaCare Medicaid |
$444.65
|
| Rate for Payer: AlohaCare Medicare |
$442.73
|
| Rate for Payer: Cash Price |
$708.51
|
| Rate for Payer: Cash Price |
$708.51
|
| Rate for Payer: Devoted Health Medicare |
$487.00
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$444.65
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$675.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$442.73
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$444.65
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$162.24
|
| Rate for Payer: Health Management Network Commercial |
$1,003.72
|
| Rate for Payer: Kaiser Permanente Commercial |
$531.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$531.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$531.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$444.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$442.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$444.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$442.73
|
| Rate for Payer: University Health Alliance Commercial |
$581.44
|
|
|
PR SURG TX ANAL FISTULA INTERSPHINCTERIC
|
Professional
|
Both
|
$1,181.18
|
|
|
Service Code
|
HCPCS 46275
|
| Min. Negotiated Rate |
$382.98 |
| Max. Negotiated Rate |
$1,004.00 |
| Rate for Payer: AlohaCare Medicaid |
$443.51
|
| Rate for Payer: AlohaCare Medicare |
$441.02
|
| Rate for Payer: Cash Price |
$708.71
|
| Rate for Payer: Cash Price |
$708.71
|
| Rate for Payer: Devoted Health Medicare |
$485.12
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$443.51
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$680.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$441.02
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$443.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$382.98
|
| Rate for Payer: Health Management Network Commercial |
$1,004.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$529.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$529.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$529.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$443.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$441.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$443.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$441.02
|
| Rate for Payer: University Health Alliance Commercial |
$553.48
|
|
|
PR SURG TX ANAL FISTULA SUBQ
|
Professional
|
Both
|
$1,123.55
|
|
|
Service Code
|
HCPCS 46270
|
| Min. Negotiated Rate |
$233.74 |
| Max. Negotiated Rate |
$955.02 |
| Rate for Payer: AlohaCare Medicaid |
$421.12
|
| Rate for Payer: AlohaCare Medicare |
$423.66
|
| Rate for Payer: Cash Price |
$674.13
|
| Rate for Payer: Cash Price |
$674.13
|
| Rate for Payer: Devoted Health Medicare |
$466.03
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$421.12
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$635.93
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$423.66
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$421.12
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$233.74
|
| Rate for Payer: Health Management Network Commercial |
$955.02
|
| Rate for Payer: Kaiser Permanente Commercial |
$508.39
|
| Rate for Payer: Kaiser Permanente Medicaid |
$508.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$508.39
|
| Rate for Payer: Ohana Health Plan Medicaid |
$421.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$423.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$421.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$423.66
|
| Rate for Payer: University Health Alliance Commercial |
$546.43
|
|
|
PR SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV
|
Professional
|
Both
|
$562.00
|
|
|
Service Code
|
HCPCS 64832
|
| Min. Negotiated Rate |
$178.88 |
| Max. Negotiated Rate |
$477.70 |
| Rate for Payer: AlohaCare Medicaid |
$328.34
|
| Rate for Payer: AlohaCare Medicare |
$274.99
|
| Rate for Payer: Cash Price |
$337.20
|
| Rate for Payer: Cash Price |
$337.20
|
| Rate for Payer: Devoted Health Medicare |
$302.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$274.99
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$178.88
|
| Rate for Payer: Health Management Network Commercial |
$477.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$329.99
|
| Rate for Payer: Kaiser Permanente Medicaid |
$329.99
|
| Rate for Payer: Kaiser Permanente Medicare |
$329.99
|
| Rate for Payer: Ohana Health Plan Medicaid |
$328.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$274.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$328.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$274.99
|
|
|
PR SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF
|
Professional
|
Both
|
$1,468.00
|
|
|
Service Code
|
HCPCS 27381
|
| Min. Negotiated Rate |
$651.04 |
| Max. Negotiated Rate |
$1,247.80 |
| Rate for Payer: AlohaCare Medicaid |
$856.90
|
| Rate for Payer: AlohaCare Medicare |
$792.62
|
| Rate for Payer: Cash Price |
$880.80
|
| Rate for Payer: Cash Price |
$880.80
|
| Rate for Payer: Devoted Health Medicare |
$871.88
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$792.62
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$651.04
|
| Rate for Payer: Health Management Network Commercial |
$1,247.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$951.14
|
| Rate for Payer: Kaiser Permanente Medicaid |
$951.14
|
| Rate for Payer: Kaiser Permanente Medicare |
$951.14
|
| Rate for Payer: Ohana Health Plan Medicaid |
$856.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$792.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$856.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$792.62
|
|
|
PR SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY
|
Professional
|
Both
|
$1,768.00
|
|
|
Service Code
|
HCPCS 44604
|
| Min. Negotiated Rate |
$653.12 |
| Max. Negotiated Rate |
$1,502.80 |
| Rate for Payer: AlohaCare Medicaid |
$1,033.66
|
| Rate for Payer: AlohaCare Medicare |
$947.54
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Devoted Health Medicare |
$1,042.29
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$947.54
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$653.12
|
| Rate for Payer: Health Management Network Commercial |
$1,502.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,137.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,137.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,137.05
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,033.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$947.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,033.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$947.54
|
|
|
PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK
|
Professional
|
Both
|
$1,138.01
|
|
|
Service Code
|
HCPCS 67935
|
| Min. Negotiated Rate |
$335.92 |
| Max. Negotiated Rate |
$967.31 |
| Rate for Payer: AlohaCare Medicaid |
$454.32
|
| Rate for Payer: AlohaCare Medicare |
$379.89
|
| Rate for Payer: Cash Price |
$682.81
|
| Rate for Payer: Cash Price |
$682.81
|
| Rate for Payer: Devoted Health Medicare |
$417.88
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$454.32
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$698.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$379.89
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$454.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$335.92
|
| Rate for Payer: Health Management Network Commercial |
$967.31
|
| Rate for Payer: Kaiser Permanente Commercial |
$455.87
|
| Rate for Payer: Kaiser Permanente Medicaid |
$455.87
|
| Rate for Payer: Kaiser Permanente Medicare |
$455.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$454.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$379.89
|
| Rate for Payer: UnitedHealthcare Medicaid |
$454.32
|
| Rate for Payer: UnitedHealthcare Medicare |
$379.89
|
| Rate for Payer: University Health Alliance Commercial |
$591.59
|
|
|
PR SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE
|
Professional
|
Both
|
$1,329.00
|
|
|
Service Code
|
HCPCS 64834
|
| Min. Negotiated Rate |
$541.58 |
| Max. Negotiated Rate |
$1,129.65 |
| Rate for Payer: AlohaCare Medicaid |
$771.12
|
| Rate for Payer: AlohaCare Medicare |
$669.59
|
| Rate for Payer: Cash Price |
$797.40
|
| Rate for Payer: Cash Price |
$797.40
|
| Rate for Payer: Devoted Health Medicare |
$736.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$669.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$541.58
|
| Rate for Payer: Health Management Network Commercial |
$1,129.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$803.51
|
| Rate for Payer: Kaiser Permanente Medicaid |
$803.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$803.51
|
| Rate for Payer: Ohana Health Plan Medicaid |
$771.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$669.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$771.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$669.59
|
|
|
PR SUTURE 1 NERVE MEDIAN MOTOR THENAR
|
Professional
|
Both
|
$1,440.00
|
|
|
Service Code
|
HCPCS 64835
|
| Min. Negotiated Rate |
$665.34 |
| Max. Negotiated Rate |
$1,224.00 |
| Rate for Payer: AlohaCare Medicaid |
$838.98
|
| Rate for Payer: AlohaCare Medicare |
$760.83
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Devoted Health Medicare |
$836.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$760.83
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$665.34
|
| Rate for Payer: Health Management Network Commercial |
$1,224.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$913.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$913.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$913.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$838.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$760.83
|
| Rate for Payer: UnitedHealthcare Medicaid |
$838.98
|
| Rate for Payer: UnitedHealthcare Medicare |
$760.83
|
|
|
PR SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE
|
Professional
|
Both
|
$1,251.00
|
|
|
Service Code
|
HCPCS 64831
|
| Min. Negotiated Rate |
$357.50 |
| Max. Negotiated Rate |
$1,063.35 |
| Rate for Payer: AlohaCare Medicaid |
$726.20
|
| Rate for Payer: AlohaCare Medicare |
$659.27
|
| Rate for Payer: Cash Price |
$750.60
|
| Rate for Payer: Cash Price |
$750.60
|
| Rate for Payer: Devoted Health Medicare |
$725.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$659.27
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$357.50
|
| Rate for Payer: Health Management Network Commercial |
$1,063.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$791.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$791.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$791.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$726.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$659.27
|
| Rate for Payer: UnitedHealthcare Medicaid |
$726.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$659.27
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$1,127.00
|
|
|
Service Code
|
HCPCS 27380
|
| Min. Negotiated Rate |
$462.80 |
| Max. Negotiated Rate |
$957.95 |
| Rate for Payer: AlohaCare Medicaid |
$659.81
|
| Rate for Payer: AlohaCare Medicare |
$618.61
|
| Rate for Payer: Cash Price |
$676.20
|
| Rate for Payer: Cash Price |
$676.20
|
| Rate for Payer: Devoted Health Medicare |
$680.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$618.61
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$462.80
|
| Rate for Payer: Health Management Network Commercial |
$957.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$742.33
|
| Rate for Payer: Kaiser Permanente Medicaid |
$742.33
|
| Rate for Payer: Kaiser Permanente Medicare |
$742.33
|
| Rate for Payer: Ohana Health Plan Medicaid |
$659.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$618.61
|
| Rate for Payer: UnitedHealthcare Medicaid |
$659.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$618.61
|
|
|
PR SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY
|
Professional
|
Both
|
$1,105.00
|
|
|
Service Code
|
HCPCS 27385
|
| Min. Negotiated Rate |
$612.68 |
| Max. Negotiated Rate |
$939.25 |
| Rate for Payer: AlohaCare Medicaid |
$647.34
|
| Rate for Payer: AlohaCare Medicare |
$612.68
|
| Rate for Payer: Cash Price |
$663.00
|
| Rate for Payer: Cash Price |
$663.00
|
| Rate for Payer: Devoted Health Medicare |
$673.95
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$612.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$656.24
|
| Rate for Payer: Health Management Network Commercial |
$939.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$735.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$735.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$735.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$647.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$612.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$647.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$612.68
|
|
|
PR SUTURE/REPAIR TESTICULAR INJURY
|
Professional
|
Both
|
$723.00
|
|
|
Service Code
|
HCPCS 54670
|
| Min. Negotiated Rate |
$310.70 |
| Max. Negotiated Rate |
$614.55 |
| Rate for Payer: AlohaCare Medicaid |
$422.37
|
| Rate for Payer: AlohaCare Medicare |
$385.35
|
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Cash Price |
$433.80
|
| Rate for Payer: Devoted Health Medicare |
$423.88
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$385.35
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$310.70
|
| Rate for Payer: Health Management Network Commercial |
$614.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$462.42
|
| Rate for Payer: Kaiser Permanente Medicaid |
$462.42
|
| Rate for Payer: Kaiser Permanente Medicare |
$462.42
|
| Rate for Payer: Ohana Health Plan Medicaid |
$422.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$385.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$422.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$385.35
|
|
|
PR SYMPATHECTOMY LUMBAR
|
Professional
|
Both
|
$1,370.00
|
|
|
Service Code
|
HCPCS 64818
|
| Min. Negotiated Rate |
$554.58 |
| Max. Negotiated Rate |
$1,164.50 |
| Rate for Payer: AlohaCare Medicaid |
$797.73
|
| Rate for Payer: AlohaCare Medicare |
$723.05
|
| Rate for Payer: Cash Price |
$822.00
|
| Rate for Payer: Cash Price |
$822.00
|
| Rate for Payer: Devoted Health Medicare |
$795.36
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$723.05
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$554.58
|
| Rate for Payer: Health Management Network Commercial |
$1,164.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$867.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$867.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$867.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$797.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$723.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$797.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$723.05
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT EST HIGH MDM 40 MIN
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 98015
|
| Min. Negotiated Rate |
$212.50 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Health Management Network Commercial |
$212.50
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT EST LOW MDM 20 MIN
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 98013
|
| Min. Negotiated Rate |
$101.15 |
| Max. Negotiated Rate |
$101.15 |
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Health Management Network Commercial |
$101.15
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT EST MOD MDM 30 MIN
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 98014
|
| Min. Negotiated Rate |
$146.20 |
| Max. Negotiated Rate |
$146.20 |
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Health Management Network Commercial |
$146.20
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT EST SF MDM 10 MIN
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 98012
|
| Min. Negotiated Rate |
$58.65 |
| Max. Negotiated Rate |
$58.65 |
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Health Management Network Commercial |
$58.65
|
|
