Kahuku Medical Center

All Charges

Charge

Type

Setting

Price

THERAPEUTIC ACT EA 15 MIN Occupational

Facility

$179.00

Service Code	HCPCS 97530 GO
Hospital Charge Code	426975300
Hospital Revenue Code	430
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$173.63
Rate for Payer: AlohaCare Medicaid	$89.50
Rate for Payer: AlohaCare Medicare	$75.18
Rate for Payer: Cash Price	$116.35
Rate for Payer: Cash Price	$116.35
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$164.68
Rate for Payer: Devoted Health Medicare	$75.18
Rate for Payer: Hawaii Medical Service Association Medicare	$75.18
Rate for Payer: Hawaii Western Management Group Commercial	$170.05
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Humana Medicare	$75.18
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: Kaiser Permanente Medicaid	$91.29
Rate for Payer: Kaiser Permanente Medicare	$75.18
Rate for Payer: MDX Hawaii PPO	$173.63
Rate for Payer: Ohana Health Plan Medicaid	$75.18
Rate for Payer: Ohana Health Plan Medicare	$75.18
Rate for Payer: UnitedHealthcare Medicaid	$18.32
Rate for Payer: UnitedHealthcare Medicare	$75.18
Rate for Payer: University Health Alliance Commercial	$130.47

THERAPEUTIC ACT EA 15 MIN Physical

Facility

$179.00

Service Code	HCPCS 97530 GP
Hospital Charge Code	432975300
Hospital Revenue Code	420
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$173.63
Rate for Payer: AlohaCare Medicaid	$89.50
Rate for Payer: AlohaCare Medicare	$75.18
Rate for Payer: Cash Price	$116.35
Rate for Payer: Cash Price	$116.35
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$164.68
Rate for Payer: Devoted Health Medicare	$75.18
Rate for Payer: Hawaii Medical Service Association Medicare	$75.18
Rate for Payer: Hawaii Western Management Group Commercial	$170.05
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Humana Medicare	$75.18
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: Kaiser Permanente Medicaid	$91.29
Rate for Payer: Kaiser Permanente Medicare	$75.18
Rate for Payer: MDX Hawaii PPO	$173.63
Rate for Payer: Ohana Health Plan Medicaid	$75.18
Rate for Payer: Ohana Health Plan Medicare	$75.18
Rate for Payer: UnitedHealthcare Medicaid	$18.32
Rate for Payer: UnitedHealthcare Medicare	$75.18
Rate for Payer: University Health Alliance Commercial	$130.47

THERAPEUTIC ACT EA 15 MIN Physical

Facility

$179.00

Service Code	HCPCS 97530 GP
Hospital Charge Code	432975300
Hospital Revenue Code	420
Min. Negotiated Rate	$152.15
Max. Negotiated Rate	$173.63
Rate for Payer: Cash Price	$116.35
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: MDX Hawaii PPO	$173.63

Therapeutic Activities Charge

Facility

$179.00

Service Code	HCPCS 97530 GP
Hospital Charge Code	432975300
Hospital Revenue Code	420
Min. Negotiated Rate	$152.15
Max. Negotiated Rate	$173.63
Rate for Payer: Cash Price	$116.35
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: MDX Hawaii PPO	$173.63

Therapeutic Activities Charge

Facility

$179.00

Service Code	HCPCS 97530 GP
Hospital Charge Code	432975300
Hospital Revenue Code	420
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$173.63
Rate for Payer: AlohaCare Medicaid	$89.50
Rate for Payer: AlohaCare Medicare	$75.18
Rate for Payer: Cash Price	$116.35
Rate for Payer: Cash Price	$116.35
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$164.68
Rate for Payer: Devoted Health Medicare	$75.18
Rate for Payer: Hawaii Medical Service Association Medicare	$75.18
Rate for Payer: Hawaii Western Management Group Commercial	$170.05
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Humana Medicare	$75.18
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: Kaiser Permanente Medicaid	$91.29
Rate for Payer: Kaiser Permanente Medicare	$75.18
Rate for Payer: MDX Hawaii PPO	$173.63
Rate for Payer: Ohana Health Plan Medicaid	$75.18
Rate for Payer: Ohana Health Plan Medicare	$75.18
Rate for Payer: UnitedHealthcare Medicaid	$18.32
Rate for Payer: UnitedHealthcare Medicare	$75.18
Rate for Payer: University Health Alliance Commercial	$130.47

Therapeutic Activities Charges

Facility

$179.00

Service Code	HCPCS 97530 GO
Hospital Charge Code	426975300
Hospital Revenue Code	430
Min. Negotiated Rate	$152.15
Max. Negotiated Rate	$173.63
Rate for Payer: Cash Price	$116.35
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: MDX Hawaii PPO	$173.63

Therapeutic Activities Charges

Facility

$179.00

Service Code	HCPCS 97530 GO
Hospital Charge Code	426975300
Hospital Revenue Code	430
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$173.63
Rate for Payer: AlohaCare Medicaid	$89.50
Rate for Payer: AlohaCare Medicare	$75.18
Rate for Payer: Cash Price	$116.35
Rate for Payer: Cash Price	$116.35
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$164.68
Rate for Payer: Devoted Health Medicare	$75.18
Rate for Payer: Hawaii Medical Service Association Medicare	$75.18
Rate for Payer: Hawaii Western Management Group Commercial	$170.05
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Humana Medicare	$75.18
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: Kaiser Permanente Medicaid	$91.29
Rate for Payer: Kaiser Permanente Medicare	$75.18
Rate for Payer: MDX Hawaii PPO	$173.63
Rate for Payer: Ohana Health Plan Medicaid	$75.18
Rate for Payer: Ohana Health Plan Medicare	$75.18
Rate for Payer: UnitedHealthcare Medicaid	$18.32
Rate for Payer: UnitedHealthcare Medicare	$75.18
Rate for Payer: University Health Alliance Commercial	$130.47

THERAPEUTIC EX EA 15 MIN Physical

Facility

$179.00

Service Code	HCPCS 97110 GP
Hospital Charge Code	432971100
Hospital Revenue Code	420
Min. Negotiated Rate	$17.65
Max. Negotiated Rate	$173.63
Rate for Payer: AlohaCare Medicaid	$89.50
Rate for Payer: AlohaCare Medicare	$75.18
Rate for Payer: Cash Price	$116.35
Rate for Payer: Cash Price	$116.35
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$164.68
Rate for Payer: Devoted Health Medicare	$75.18
Rate for Payer: Hawaii Medical Service Association Medicare	$75.18
Rate for Payer: Hawaii Western Management Group Commercial	$170.05
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Humana Medicare	$75.18
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: Kaiser Permanente Medicaid	$91.29
Rate for Payer: Kaiser Permanente Medicare	$75.18
Rate for Payer: MDX Hawaii PPO	$173.63
Rate for Payer: Ohana Health Plan Medicaid	$75.18
Rate for Payer: Ohana Health Plan Medicare	$75.18
Rate for Payer: UnitedHealthcare Medicaid	$17.65
Rate for Payer: UnitedHealthcare Medicare	$75.18
Rate for Payer: University Health Alliance Commercial	$130.47

THERAPEUTIC EX EA 15 MIN Physical

Facility

$179.00

Service Code	HCPCS 97110 GP
Hospital Charge Code	432971100
Hospital Revenue Code	420
Min. Negotiated Rate	$152.15
Max. Negotiated Rate	$173.63
Rate for Payer: Cash Price	$116.35
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: MDX Hawaii PPO	$173.63

Therapeutic Exercise Charges

Facility

$179.00

Service Code	HCPCS 97110 GO
Hospital Charge Code	426971100
Hospital Revenue Code	430
Min. Negotiated Rate	$17.65
Max. Negotiated Rate	$173.63
Rate for Payer: AlohaCare Medicaid	$89.50
Rate for Payer: AlohaCare Medicare	$75.18
Rate for Payer: Cash Price	$116.35
Rate for Payer: Cash Price	$116.35
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$164.68
Rate for Payer: Devoted Health Medicare	$75.18
Rate for Payer: Hawaii Medical Service Association Medicare	$75.18
Rate for Payer: Hawaii Western Management Group Commercial	$170.05
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Humana Medicare	$75.18
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: Kaiser Permanente Medicaid	$91.29
Rate for Payer: Kaiser Permanente Medicare	$75.18
Rate for Payer: MDX Hawaii PPO	$173.63
Rate for Payer: Ohana Health Plan Medicaid	$75.18
Rate for Payer: Ohana Health Plan Medicare	$75.18
Rate for Payer: UnitedHealthcare Medicaid	$17.65
Rate for Payer: UnitedHealthcare Medicare	$75.18
Rate for Payer: University Health Alliance Commercial	$130.47

Therapeutic Exercise Charges

Facility

$179.00

Service Code	HCPCS 97110 GP
Hospital Charge Code	432971100
Hospital Revenue Code	420
Min. Negotiated Rate	$152.15
Max. Negotiated Rate	$173.63
Rate for Payer: Cash Price	$116.35
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: MDX Hawaii PPO	$173.63

Therapeutic Exercise Charges

Facility

$179.00

Service Code	HCPCS 97110 GP
Hospital Charge Code	432971100
Hospital Revenue Code	420
Min. Negotiated Rate	$17.65
Max. Negotiated Rate	$173.63
Rate for Payer: AlohaCare Medicaid	$89.50
Rate for Payer: AlohaCare Medicare	$75.18
Rate for Payer: Cash Price	$116.35
Rate for Payer: Cash Price	$116.35
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$164.68
Rate for Payer: Devoted Health Medicare	$75.18
Rate for Payer: Hawaii Medical Service Association Medicare	$75.18
Rate for Payer: Hawaii Western Management Group Commercial	$170.05
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Humana Medicare	$75.18
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: Kaiser Permanente Medicaid	$91.29
Rate for Payer: Kaiser Permanente Medicare	$75.18
Rate for Payer: MDX Hawaii PPO	$173.63
Rate for Payer: Ohana Health Plan Medicaid	$75.18
Rate for Payer: Ohana Health Plan Medicare	$75.18
Rate for Payer: UnitedHealthcare Medicaid	$17.65
Rate for Payer: UnitedHealthcare Medicare	$75.18
Rate for Payer: University Health Alliance Commercial	$130.47

Therapeutic Exercise Charges

Facility

$179.00

Service Code	HCPCS 97110 GO
Hospital Charge Code	426971100
Hospital Revenue Code	430
Min. Negotiated Rate	$152.15
Max. Negotiated Rate	$173.63
Rate for Payer: Cash Price	$116.35
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: MDX Hawaii PPO	$173.63

THERAPEUTIC PROCD GROUP Occupational

Facility

$176.00

Service Code	HCPCS 97150 GO
Hospital Charge Code	426971500
Hospital Revenue Code	433
Min. Negotiated Rate	$149.60
Max. Negotiated Rate	$170.72
Rate for Payer: Cash Price	$114.40
Rate for Payer: Health Management Network Commercial	$149.60
Rate for Payer: Kaiser Permanente Commercial	$158.40
Rate for Payer: MDX Hawaii PPO	$170.72

THERAPEUTIC PROCD GROUP Occupational

Facility

$176.00

Service Code	HCPCS 97150 GO
Hospital Charge Code	426971500
Hospital Revenue Code	433
Min. Negotiated Rate	$14.78
Max. Negotiated Rate	$170.72
Rate for Payer: AlohaCare Medicaid	$88.00
Rate for Payer: AlohaCare Medicare	$73.92
Rate for Payer: Cash Price	$114.40
Rate for Payer: Cash Price	$114.40
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$161.92
Rate for Payer: Devoted Health Medicare	$73.92
Rate for Payer: Hawaii Medical Service Association Medicare	$73.92
Rate for Payer: Hawaii Western Management Group Commercial	$167.20
Rate for Payer: Health Management Network Commercial	$149.60
Rate for Payer: Humana Medicare	$73.92
Rate for Payer: Kaiser Permanente Commercial	$158.40
Rate for Payer: Kaiser Permanente Medicaid	$89.76
Rate for Payer: Kaiser Permanente Medicare	$73.92
Rate for Payer: MDX Hawaii PPO	$170.72
Rate for Payer: Ohana Health Plan Medicaid	$73.92
Rate for Payer: Ohana Health Plan Medicare	$73.92
Rate for Payer: UnitedHealthcare Medicaid	$14.78
Rate for Payer: UnitedHealthcare Medicare	$73.92
Rate for Payer: University Health Alliance Commercial	$128.29

THERAPEUTIC PROCD GROUP Physical

Facility

$179.00

Service Code	HCPCS 97150 GP
Hospital Charge Code	432971500
Hospital Revenue Code	420
Min. Negotiated Rate	$14.78
Max. Negotiated Rate	$173.63
Rate for Payer: AlohaCare Medicaid	$89.50
Rate for Payer: AlohaCare Medicare	$75.18
Rate for Payer: Cash Price	$116.35
Rate for Payer: Cash Price	$116.35
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$164.68
Rate for Payer: Devoted Health Medicare	$75.18
Rate for Payer: Hawaii Medical Service Association Medicare	$75.18
Rate for Payer: Hawaii Western Management Group Commercial	$170.05
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Humana Medicare	$75.18
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: Kaiser Permanente Medicaid	$91.29
Rate for Payer: Kaiser Permanente Medicare	$75.18
Rate for Payer: MDX Hawaii PPO	$173.63
Rate for Payer: Ohana Health Plan Medicaid	$75.18
Rate for Payer: Ohana Health Plan Medicare	$75.18
Rate for Payer: UnitedHealthcare Medicaid	$14.78
Rate for Payer: UnitedHealthcare Medicare	$75.18
Rate for Payer: University Health Alliance Commercial	$130.47

THERAPEUTIC PROCD GROUP Physical

Facility

$179.00

Service Code	HCPCS 97150 GP
Hospital Charge Code	432971500
Hospital Revenue Code	420
Min. Negotiated Rate	$152.15
Max. Negotiated Rate	$173.63
Rate for Payer: Cash Price	$116.35
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: MDX Hawaii PPO	$173.63

THERAPEUTIC PROCD STRG ENDUR

Professional

Both

$91.00

Service Code	HCPCS G0237
Hospital Revenue Code	410
Min. Negotiated Rate	$12.81
Max. Negotiated Rate	$77.35
Rate for Payer: AlohaCare Medicaid	$12.81
Rate for Payer: AlohaCare Medicare	$14.24
Rate for Payer: Cash Price	$59.15
Rate for Payer: Cash Price	$59.15
Rate for Payer: Devoted Health Medicare	$14.24
Rate for Payer: Hawaii Medical Service Association Medicare	$14.24
Rate for Payer: Health Management Network Commercial	$77.35
Rate for Payer: Kaiser Permanente Commercial	$17.09
Rate for Payer: Kaiser Permanente Medicaid	$17.09
Rate for Payer: Kaiser Permanente Medicare	$17.09
Rate for Payer: Ohana Health Plan Medicaid	$12.81
Rate for Payer: Ohana Health Plan Medicare	$14.24
Rate for Payer: UnitedHealthcare Medicaid	$12.81
Rate for Payer: UnitedHealthcare Medicare	$14.24

THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS

Professional

Both

$162.00

Service Code	HCPCS 97150
Hospital Revenue Code	420
Min. Negotiated Rate	$16.61
Max. Negotiated Rate	$137.70
Rate for Payer: AlohaCare Medicaid	$19.02
Rate for Payer: AlohaCare Medicare	$18.99
Rate for Payer: Cash Price	$105.30
Rate for Payer: Cash Price	$105.30
Rate for Payer: Devoted Health Medicare	$18.99
Rate for Payer: Hawaii Medical Service Association Medicare	$18.99
Rate for Payer: Hawaii Western Management Group Commercial	$16.61
Rate for Payer: Health Management Network Commercial	$137.70
Rate for Payer: Kaiser Permanente Commercial	$22.79
Rate for Payer: Kaiser Permanente Medicaid	$22.79
Rate for Payer: Kaiser Permanente Medicare	$22.79
Rate for Payer: Ohana Health Plan Medicaid	$19.02
Rate for Payer: Ohana Health Plan Medicare	$18.99
Rate for Payer: UnitedHealthcare Medicaid	$19.02
Rate for Payer: UnitedHealthcare Medicare	$18.99

Therapeutic procedures to increase strength and endurance of respiratory muscles

Facility

$95.00

Service Code	HCPCS G0237
Hospital Charge Code	429G02370
Hospital Revenue Code	410
Min. Negotiated Rate	$18.91
Max. Negotiated Rate	$92.15
Rate for Payer: AlohaCare Medicaid	$47.50
Rate for Payer: AlohaCare Medicare	$39.90
Rate for Payer: Cash Price	$61.75
Rate for Payer: Cash Price	$61.75
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$87.40
Rate for Payer: Devoted Health Medicare	$39.90
Rate for Payer: Hawaii Medical Service Association Commercial	$42.71
Rate for Payer: Hawaii Medical Service Association Medicare	$39.90
Rate for Payer: Hawaii Western Management Group Commercial	$90.25
Rate for Payer: Health Management Network Commercial	$80.75
Rate for Payer: Humana Medicare	$39.90
Rate for Payer: Kaiser Permanente Commercial	$85.50
Rate for Payer: Kaiser Permanente Medicaid	$48.45
Rate for Payer: Kaiser Permanente Medicare	$39.90
Rate for Payer: MDX Hawaii PPO	$92.15
Rate for Payer: Ohana Health Plan Medicaid	$39.90
Rate for Payer: Ohana Health Plan Medicare	$39.90
Rate for Payer: UnitedHealthcare Medicaid	$18.91
Rate for Payer: UnitedHealthcare Medicare	$39.90
Rate for Payer: University Health Alliance Commercial	$69.25

Therapeutic procedures to increase strength and endurance of respiratory muscles

Facility

$95.00

Service Code	HCPCS G0237
Hospital Charge Code	429G02370
Hospital Revenue Code	410
Min. Negotiated Rate	$80.75
Max. Negotiated Rate	$92.15
Rate for Payer: Cash Price	$61.75
Rate for Payer: Health Management Network Commercial	$80.75
Rate for Payer: Kaiser Permanente Commercial	$85.50
Rate for Payer: MDX Hawaii PPO	$92.15

Therapeutic procedures to increase strength and endurance of respiratory muscles (other than in G023

Facility

$95.00

Service Code	HCPCS G0238
Hospital Charge Code	429G02380
Hospital Revenue Code	410
Min. Negotiated Rate	$12.74
Max. Negotiated Rate	$92.15
Rate for Payer: AlohaCare Medicaid	$47.50
Rate for Payer: AlohaCare Medicare	$39.90
Rate for Payer: Cash Price	$61.75
Rate for Payer: Cash Price	$61.75
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$87.40
Rate for Payer: Devoted Health Medicare	$39.90
Rate for Payer: Hawaii Medical Service Association Commercial	$42.71
Rate for Payer: Hawaii Medical Service Association Medicare	$39.90
Rate for Payer: Hawaii Western Management Group Commercial	$90.25
Rate for Payer: Health Management Network Commercial	$80.75
Rate for Payer: Humana Medicare	$39.90
Rate for Payer: Kaiser Permanente Commercial	$85.50
Rate for Payer: Kaiser Permanente Medicaid	$48.45
Rate for Payer: Kaiser Permanente Medicare	$39.90
Rate for Payer: MDX Hawaii PPO	$92.15
Rate for Payer: Ohana Health Plan Medicaid	$39.90
Rate for Payer: Ohana Health Plan Medicare	$39.90
Rate for Payer: UnitedHealthcare Medicaid	$12.74
Rate for Payer: UnitedHealthcare Medicare	$39.90
Rate for Payer: University Health Alliance Commercial	$69.25

Therapeutic procedures to increase strength and endurance of respiratory muscles (other than in G023

Facility

$95.00

Service Code	HCPCS G0238
Hospital Charge Code	429G02380
Hospital Revenue Code	410
Min. Negotiated Rate	$80.75
Max. Negotiated Rate	$92.15
Rate for Payer: Cash Price	$61.75
Rate for Payer: Health Management Network Commercial	$80.75
Rate for Payer: Kaiser Permanente Commercial	$85.50
Rate for Payer: MDX Hawaii PPO	$92.15

Therapeutic procedures to increase strength and endurance of respiratory muscles (two or more)

Facility

$128.00

Service Code	HCPCS G0239
Hospital Charge Code	429G02390
Hospital Revenue Code	410
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$124.16
Rate for Payer: AlohaCare Medicaid	$64.00
Rate for Payer: AlohaCare Medicare	$53.76
Rate for Payer: Cash Price	$83.20
Rate for Payer: Cash Price	$83.20
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$117.76
Rate for Payer: Devoted Health Medicare	$53.76
Rate for Payer: Hawaii Medical Service Association Commercial	$55.15
Rate for Payer: Hawaii Medical Service Association Medicare	$53.76
Rate for Payer: Hawaii Western Management Group Commercial	$121.60
Rate for Payer: Health Management Network Commercial	$108.80
Rate for Payer: Humana Medicare	$53.76
Rate for Payer: Kaiser Permanente Commercial	$115.20
Rate for Payer: Kaiser Permanente Medicaid	$65.28
Rate for Payer: Kaiser Permanente Medicare	$53.76
Rate for Payer: MDX Hawaii PPO	$124.16
Rate for Payer: Ohana Health Plan Medicaid	$53.76
Rate for Payer: Ohana Health Plan Medicare	$53.76
Rate for Payer: UnitedHealthcare Medicaid	$8.70
Rate for Payer: UnitedHealthcare Medicare	$53.76
Rate for Payer: University Health Alliance Commercial	$93.30

Therapeutic procedures to increase strength and endurance of respiratory muscles (two or more)

Facility

$128.00

Service Code	HCPCS G0239
Hospital Charge Code	429G02390
Hospital Revenue Code	410
Min. Negotiated Rate	$108.80
Max. Negotiated Rate	$124.16
Rate for Payer: Cash Price	$83.20
Rate for Payer: Health Management Network Commercial	$108.80
Rate for Payer: Kaiser Permanente Commercial	$115.20
Rate for Payer: MDX Hawaii PPO	$124.16

Know your out-of-pocket cost for care.

All Charges