|
PR VISIT TO DETERM LDCT ELIG
|
Professional
|
Both
|
$52.01
|
|
|
Service Code
|
HCPCS G0296
|
| Min. Negotiated Rate |
$22.51 |
| Max. Negotiated Rate |
$44.21 |
| Rate for Payer: AlohaCare Medicaid |
$25.52
|
| Rate for Payer: AlohaCare Medicare |
$22.51
|
| Rate for Payer: Cash Price |
$31.21
|
| Rate for Payer: Cash Price |
$31.21
|
| Rate for Payer: Devoted Health Medicare |
$24.76
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$25.52
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$22.51
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$25.52
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$30.77
|
| Rate for Payer: Health Management Network Commercial |
$44.21
|
| Rate for Payer: Kaiser Permanente Commercial |
$27.01
|
| Rate for Payer: Kaiser Permanente Medicaid |
$27.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$27.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$25.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$22.51
|
| Rate for Payer: UnitedHealthcare Medicaid |
$25.52
|
| Rate for Payer: UnitedHealthcare Medicare |
$22.51
|
|
|
PR VISUAL REINFORCEMENT AUDIOMETRY
|
Professional
|
Both
|
$79.96
|
|
|
Service Code
|
HCPCS 92579
|
| Min. Negotiated Rate |
$30.50 |
| Max. Negotiated Rate |
$67.97 |
| Rate for Payer: AlohaCare Medicaid |
$37.83
|
| Rate for Payer: AlohaCare Medicare |
$30.50
|
| Rate for Payer: Cash Price |
$47.98
|
| Rate for Payer: Cash Price |
$47.98
|
| Rate for Payer: Devoted Health Medicare |
$33.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$37.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$30.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$37.83
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$30.95
|
| Rate for Payer: Health Management Network Commercial |
$67.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$36.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$36.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$36.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$37.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$30.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$37.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$30.50
|
|
|
PR VNPNXR <3 YEARS PHY/QHP SKILL FEMORAL/JUGULAR VN
|
Professional
|
Both
|
$50.89
|
|
|
Service Code
|
HCPCS 36400
|
| Min. Negotiated Rate |
$10.92 |
| Max. Negotiated Rate |
$43.26 |
| Rate for Payer: AlohaCare Medicaid |
$18.56
|
| Rate for Payer: AlohaCare Medicare |
$15.78
|
| Rate for Payer: Cash Price |
$30.53
|
| Rate for Payer: Cash Price |
$30.53
|
| Rate for Payer: Devoted Health Medicare |
$17.36
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$18.56
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$29.63
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$15.78
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$18.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$10.92
|
| Rate for Payer: Health Management Network Commercial |
$43.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$18.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$18.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$18.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$18.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$15.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$18.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$15.78
|
| Rate for Payer: University Health Alliance Commercial |
$25.08
|
|
|
PR VNPNXR 3 YEARS/> PHYS/QHP SKILL DX/THER PURPOSES
|
Professional
|
Both
|
$35.79
|
|
|
Service Code
|
HCPCS 36410
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: AlohaCare Medicaid |
$9.04
|
| Rate for Payer: AlohaCare Medicare |
$7.92
|
| Rate for Payer: Cash Price |
$21.47
|
| Rate for Payer: Cash Price |
$21.47
|
| Rate for Payer: Devoted Health Medicare |
$8.71
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$9.04
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$14.30
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$7.92
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$9.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$16.38
|
| Rate for Payer: Health Management Network Commercial |
$30.42
|
| Rate for Payer: Kaiser Permanente Commercial |
$9.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$9.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$9.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$9.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$7.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.04
|
| Rate for Payer: UnitedHealthcare Medicare |
$7.92
|
| Rate for Payer: University Health Alliance Commercial |
$50.00
|
|
|
PR VOID PRESSURE STUDIES INTRAABDOMINAL
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS 51797 26
|
| Min. Negotiated Rate |
$39.94 |
| Max. Negotiated Rate |
$211.33 |
| Rate for Payer: AlohaCare Medicaid |
$211.33
|
| Rate for Payer: AlohaCare Medicare |
$39.94
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Devoted Health Medicare |
$43.93
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$39.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.16
|
| Rate for Payer: Health Management Network Commercial |
$59.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$47.93
|
| Rate for Payer: Kaiser Permanente Medicaid |
$47.93
|
| Rate for Payer: Kaiser Permanente Medicare |
$47.93
|
| Rate for Payer: Ohana Health Plan Medicaid |
$211.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$39.94
|
| Rate for Payer: UnitedHealthcare Medicaid |
$211.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$39.94
|
|
|
PR VOID PRESSURE STUDIES INTRAABDOMINAL
|
Professional
|
Both
|
$474.00
|
|
|
Service Code
|
HCPCS 51797 TC
|
| Min. Negotiated Rate |
$95.16 |
| Max. Negotiated Rate |
$402.90 |
| Rate for Payer: AlohaCare Medicaid |
$211.33
|
| Rate for Payer: AlohaCare Medicare |
$131.40
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Devoted Health Medicare |
$144.54
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$131.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.16
|
| Rate for Payer: Health Management Network Commercial |
$402.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$157.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$157.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$157.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$211.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$131.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$211.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$131.40
|
|
|
PR VOID PRESSURE STUDIES INTRAABDOMINAL
|
Professional
|
Both
|
$544.00
|
|
|
Service Code
|
HCPCS 51797
|
| Min. Negotiated Rate |
$95.16 |
| Max. Negotiated Rate |
$462.40 |
| Rate for Payer: AlohaCare Medicaid |
$211.33
|
| Rate for Payer: AlohaCare Medicare |
$171.34
|
| Rate for Payer: Cash Price |
$326.40
|
| Rate for Payer: Cash Price |
$326.40
|
| Rate for Payer: Devoted Health Medicare |
$188.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$171.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.16
|
| Rate for Payer: Health Management Network Commercial |
$462.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$205.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$205.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$205.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$211.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$171.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$211.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$171.34
|
|
|
PR VULVECTOMY SIMPLE PARTIAL
|
Professional
|
Both
|
$1,048.00
|
|
|
Service Code
|
HCPCS 56620
|
| Min. Negotiated Rate |
$544.18 |
| Max. Negotiated Rate |
$890.80 |
| Rate for Payer: AlohaCare Medicaid |
$618.98
|
| Rate for Payer: AlohaCare Medicare |
$559.95
|
| Rate for Payer: Cash Price |
$628.80
|
| Rate for Payer: Cash Price |
$628.80
|
| Rate for Payer: Devoted Health Medicare |
$615.95
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$559.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$544.18
|
| Rate for Payer: Health Management Network Commercial |
$890.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$671.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$671.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$671.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$618.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$559.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$618.98
|
| Rate for Payer: UnitedHealthcare Medicare |
$559.95
|
|
|
PR WEDGE EXCISION SKIN NAIL FOLD
|
Professional
|
Both
|
$311.85
|
|
|
Service Code
|
HCPCS 11765
|
| Min. Negotiated Rate |
$37.18 |
| Max. Negotiated Rate |
$265.07 |
| Rate for Payer: AlohaCare Medicaid |
$99.08
|
| Rate for Payer: AlohaCare Medicare |
$94.28
|
| Rate for Payer: Cash Price |
$187.11
|
| Rate for Payer: Cash Price |
$187.11
|
| Rate for Payer: Devoted Health Medicare |
$103.71
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$99.08
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$130.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$94.28
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$99.08
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$37.18
|
| Rate for Payer: Health Management Network Commercial |
$265.07
|
| Rate for Payer: Kaiser Permanente Commercial |
$113.14
|
| Rate for Payer: Kaiser Permanente Medicaid |
$113.14
|
| Rate for Payer: Kaiser Permanente Medicare |
$113.14
|
| Rate for Payer: Ohana Health Plan Medicaid |
$99.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$94.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$99.08
|
| Rate for Payer: UnitedHealthcare Medicare |
$94.28
|
| Rate for Payer: University Health Alliance Commercial |
$107.70
|
|
|
PR WET MOUNTS/ W PREPARATIONS
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS Q0111
|
| Min. Negotiated Rate |
$5.90 |
| Max. Negotiated Rate |
$27.20 |
| Rate for Payer: AlohaCare Medicaid |
$5.90
|
| Rate for Payer: AlohaCare Medicare |
$18.54
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Devoted Health Medicare |
$20.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$18.54
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$15.50
|
| Rate for Payer: Health Management Network Commercial |
$27.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$22.25
|
| Rate for Payer: Kaiser Permanente Medicaid |
$22.25
|
| Rate for Payer: Kaiser Permanente Medicare |
$22.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$5.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$18.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$5.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$18.54
|
|
|
PR WHFO W/O JOINTS PRE CST
|
Professional
|
Both
|
$468.00
|
|
|
Service Code
|
HCPCS L3807
|
| Min. Negotiated Rate |
$107.29 |
| Max. Negotiated Rate |
$397.80 |
| Rate for Payer: AlohaCare Medicaid |
$107.29
|
| Rate for Payer: AlohaCare Medicare |
$272.97
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Devoted Health Medicare |
$300.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$272.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$178.81
|
| Rate for Payer: Health Management Network Commercial |
$397.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$327.56
|
| Rate for Payer: Kaiser Permanente Medicaid |
$327.56
|
| Rate for Payer: Kaiser Permanente Medicare |
$327.56
|
| Rate for Payer: Ohana Health Plan Medicaid |
$107.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$272.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$107.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$272.97
|
|
|
PR WHFO W/O JOINTS PRE OTS
|
Professional
|
Both
|
$468.00
|
|
|
Service Code
|
HCPCS L3809
|
| Min. Negotiated Rate |
$209.46 |
| Max. Negotiated Rate |
$397.80 |
| Rate for Payer: AlohaCare Medicaid |
$209.46
|
| Rate for Payer: AlohaCare Medicare |
$272.97
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Devoted Health Medicare |
$300.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$272.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$209.46
|
| Rate for Payer: Health Management Network Commercial |
$397.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$327.56
|
| Rate for Payer: Kaiser Permanente Medicaid |
$327.56
|
| Rate for Payer: Kaiser Permanente Medicare |
$327.56
|
| Rate for Payer: Ohana Health Plan Medicaid |
$209.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$272.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$209.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$272.97
|
|
|
PR WHO COCK-UP NONMOLDE PRE OTS
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS L3908
|
| Min. Negotiated Rate |
$49.46 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: AlohaCare Medicaid |
$49.46
|
| Rate for Payer: AlohaCare Medicare |
$125.86
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Devoted Health Medicare |
$138.45
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$125.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$98.02
|
| Rate for Payer: Health Management Network Commercial |
$183.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$151.03
|
| Rate for Payer: Kaiser Permanente Medicaid |
$151.03
|
| Rate for Payer: Kaiser Permanente Medicare |
$151.03
|
| Rate for Payer: Ohana Health Plan Medicaid |
$49.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$125.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$49.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$125.86
|
|
|
PR WHO NONTORSION JNTS PRE CST
|
Professional
|
Both
|
$996.00
|
|
|
Service Code
|
HCPCS L3915
|
| Min. Negotiated Rate |
$35.68 |
| Max. Negotiated Rate |
$846.60 |
| Rate for Payer: AlohaCare Medicaid |
$35.68
|
| Rate for Payer: AlohaCare Medicare |
$580.28
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Devoted Health Medicare |
$638.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$580.28
|
| Rate for Payer: Health Management Network Commercial |
$846.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$696.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$696.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$696.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$35.68
|
| Rate for Payer: Ohana Health Plan Medicare |
$580.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$35.68
|
| Rate for Payer: UnitedHealthcare Medicare |
$580.28
|
|
|
PR WHO NONTORSION JNTS PRE OTS
|
Professional
|
Both
|
$996.00
|
|
|
Service Code
|
HCPCS L3916
|
| Min. Negotiated Rate |
$137.16 |
| Max. Negotiated Rate |
$846.60 |
| Rate for Payer: AlohaCare Medicaid |
$445.26
|
| Rate for Payer: AlohaCare Medicare |
$580.28
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Devoted Health Medicare |
$638.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$580.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$137.16
|
| Rate for Payer: Health Management Network Commercial |
$846.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$696.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$696.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$696.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$445.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$580.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$445.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$580.28
|
|
|
PR WINDOWING CAST
|
Professional
|
Both
|
$123.83
|
|
|
Service Code
|
HCPCS 29730
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$105.26 |
| Rate for Payer: AlohaCare Medicaid |
$44.99
|
| Rate for Payer: AlohaCare Medicare |
$38.48
|
| Rate for Payer: Cash Price |
$74.30
|
| Rate for Payer: Cash Price |
$74.30
|
| Rate for Payer: Devoted Health Medicare |
$42.33
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$44.99
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$69.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.48
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$44.99
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$20.80
|
| Rate for Payer: Health Management Network Commercial |
$105.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$46.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$46.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$46.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$44.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$44.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.48
|
| Rate for Payer: University Health Alliance Commercial |
$58.46
|
|
|
PR XTRNL CANNULA DECLTNG SPX W/O BALO CATH
|
Professional
|
Both
|
$482.07
|
|
|
Service Code
|
HCPCS 36860
|
| Min. Negotiated Rate |
$93.18 |
| Max. Negotiated Rate |
$409.76 |
| Rate for Payer: AlohaCare Medicaid |
$104.73
|
| Rate for Payer: AlohaCare Medicare |
$93.18
|
| Rate for Payer: Cash Price |
$289.24
|
| Rate for Payer: Cash Price |
$289.24
|
| Rate for Payer: Devoted Health Medicare |
$102.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$104.73
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$167.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$93.18
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$104.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$144.04
|
| Rate for Payer: Health Management Network Commercial |
$409.76
|
| Rate for Payer: Kaiser Permanente Commercial |
$111.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$111.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$111.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$104.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$93.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$104.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$93.18
|
| Rate for Payer: University Health Alliance Commercial |
$152.02
|
|
|
PR XTRNL ECG REC>48HR<7D RECORDING SCAN A/R R&I
|
Professional
|
Both
|
$551.00
|
|
|
Service Code
|
HCPCS 93241
|
| Min. Negotiated Rate |
$97.22 |
| Max. Negotiated Rate |
$468.35 |
| Rate for Payer: AlohaCare Medicaid |
$293.15
|
| Rate for Payer: AlohaCare Medicare |
$314.50
|
| Rate for Payer: Cash Price |
$330.60
|
| Rate for Payer: Cash Price |
$330.60
|
| Rate for Payer: Devoted Health Medicare |
$345.95
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$314.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$97.22
|
| Rate for Payer: Health Management Network Commercial |
$468.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$377.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$377.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$377.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$293.15
|
| Rate for Payer: Ohana Health Plan Medicare |
$314.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$293.15
|
| Rate for Payer: UnitedHealthcare Medicare |
$314.50
|
|
|
PR XTRNL ECG REC<48 HRS RECORDING
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 93225
|
| Min. Negotiated Rate |
$20.32 |
| Max. Negotiated Rate |
$52.62 |
| Rate for Payer: AlohaCare Medicaid |
$20.84
|
| Rate for Payer: AlohaCare Medicare |
$20.32
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Devoted Health Medicare |
$22.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$20.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$52.62
|
| Rate for Payer: Health Management Network Commercial |
$30.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$24.38
|
| Rate for Payer: Kaiser Permanente Medicaid |
$24.38
|
| Rate for Payer: Kaiser Permanente Medicare |
$24.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$20.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$20.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$20.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$20.32
|
|
|
PR XTRNL ECG REC<48 HRS RECORDING SCAN A/R R&I
|
Professional
|
Both
|
$136.20
|
|
|
Service Code
|
HCPCS 93224
|
| Min. Negotiated Rate |
$77.83 |
| Max. Negotiated Rate |
$183.11 |
| Rate for Payer: AlohaCare Medicaid |
$80.09
|
| Rate for Payer: AlohaCare Medicare |
$77.83
|
| Rate for Payer: Cash Price |
$81.72
|
| Rate for Payer: Cash Price |
$81.72
|
| Rate for Payer: Devoted Health Medicare |
$85.61
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$77.83
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$183.11
|
| Rate for Payer: Health Management Network Commercial |
$115.77
|
| Rate for Payer: Kaiser Permanente Commercial |
$93.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$93.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$93.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$80.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$77.83
|
| Rate for Payer: UnitedHealthcare Medicaid |
$80.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$77.83
|
|
|
PR XTRNL ECG REC<48 HRS RVW&INTERPJ PHYS/QHP
|
Professional
|
Both
|
$31.85
|
|
|
Service Code
|
HCPCS 93227
|
| Min. Negotiated Rate |
$18.20 |
| Max. Negotiated Rate |
$39.06 |
| Rate for Payer: AlohaCare Medicaid |
$18.52
|
| Rate for Payer: AlohaCare Medicare |
$18.20
|
| Rate for Payer: Cash Price |
$19.11
|
| Rate for Payer: Cash Price |
$19.11
|
| Rate for Payer: Devoted Health Medicare |
$20.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$18.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$39.06
|
| Rate for Payer: Health Management Network Commercial |
$27.07
|
| Rate for Payer: Kaiser Permanente Commercial |
$21.84
|
| Rate for Payer: Kaiser Permanente Medicaid |
$21.84
|
| Rate for Payer: Kaiser Permanente Medicare |
$21.84
|
| Rate for Payer: Ohana Health Plan Medicaid |
$18.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$18.20
|
| Rate for Payer: UnitedHealthcare Medicaid |
$18.52
|
| Rate for Payer: UnitedHealthcare Medicare |
$18.20
|
|
|
PR XTRNL MOBILE CV TELEMETRY W/I&REPORT 30 DAYS
|
Professional
|
Both
|
$45.10
|
|
|
Service Code
|
HCPCS 93228
|
| Min. Negotiated Rate |
$23.99 |
| Max. Negotiated Rate |
$38.34 |
| Rate for Payer: AlohaCare Medicaid |
$25.34
|
| Rate for Payer: AlohaCare Medicare |
$25.77
|
| Rate for Payer: Cash Price |
$27.06
|
| Rate for Payer: Cash Price |
$27.06
|
| Rate for Payer: Devoted Health Medicare |
$28.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$25.77
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$23.99
|
| Rate for Payer: Health Management Network Commercial |
$38.34
|
| Rate for Payer: Kaiser Permanente Commercial |
$30.92
|
| Rate for Payer: Kaiser Permanente Medicaid |
$30.92
|
| Rate for Payer: Kaiser Permanente Medicare |
$30.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$25.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$25.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$25.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$25.77
|
|
|
PR XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS
|
Professional
|
Both
|
$274.15
|
|
|
Service Code
|
HCPCS 93271
|
| Min. Negotiated Rate |
$101.38 |
| Max. Negotiated Rate |
$233.03 |
| Rate for Payer: AlohaCare Medicaid |
$163.89
|
| Rate for Payer: AlohaCare Medicare |
$156.28
|
| Rate for Payer: Cash Price |
$164.49
|
| Rate for Payer: Cash Price |
$164.49
|
| Rate for Payer: Devoted Health Medicare |
$171.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$156.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$101.38
|
| Rate for Payer: Health Management Network Commercial |
$233.03
|
| Rate for Payer: Kaiser Permanente Commercial |
$187.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$187.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$187.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$163.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$156.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$163.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$156.28
|
|
|
PR XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS
|
Professional
|
Both
|
$16.29
|
|
|
Service Code
|
HCPCS 93270
|
| Min. Negotiated Rate |
$9.31 |
| Max. Negotiated Rate |
$52.62 |
| Rate for Payer: AlohaCare Medicaid |
$9.37
|
| Rate for Payer: AlohaCare Medicare |
$9.31
|
| Rate for Payer: Cash Price |
$9.77
|
| Rate for Payer: Cash Price |
$9.77
|
| Rate for Payer: Devoted Health Medicare |
$10.24
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$52.62
|
| Rate for Payer: Health Management Network Commercial |
$13.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.17
|
| Rate for Payer: Kaiser Permanente Medicaid |
$11.17
|
| Rate for Payer: Kaiser Permanente Medicare |
$11.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$9.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.31
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.31
|
|
|
PR XTRNL PT ACTIV ECG TRANSMIS W/R&I </30 DAYS
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 93268
|
| Min. Negotiated Rate |
$120.23 |
| Max. Negotiated Rate |
$283.05 |
| Rate for Payer: AlohaCare Medicaid |
$197.44
|
| Rate for Payer: AlohaCare Medicare |
$189.84
|
| Rate for Payer: Cash Price |
$199.80
|
| Rate for Payer: Cash Price |
$199.80
|
| Rate for Payer: Devoted Health Medicare |
$208.82
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$189.84
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$120.23
|
| Rate for Payer: Health Management Network Commercial |
$283.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$227.81
|
| Rate for Payer: Kaiser Permanente Medicaid |
$227.81
|
| Rate for Payer: Kaiser Permanente Medicare |
$227.81
|
| Rate for Payer: Ohana Health Plan Medicaid |
$197.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$189.84
|
| Rate for Payer: UnitedHealthcare Medicaid |
$197.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$189.84
|
|
