|
CHG RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 74280 26
|
| Min. Negotiated Rate |
$58.77 |
| Max. Negotiated Rate |
$152.40 |
| Rate for Payer: AlohaCare Medicaid |
$146.42
|
| Rate for Payer: AlohaCare Medicare |
$58.77
|
| Rate for Payer: Cash Price |
$61.80
|
| Rate for Payer: Cash Price |
$61.80
|
| Rate for Payer: Devoted Health Medicare |
$64.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$58.77
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network Commercial |
$87.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$70.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$70.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$70.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$146.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$58.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$146.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$58.77
|
|
|
CHG RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY
|
Professional
|
Both
|
$584.00
|
|
|
Service Code
|
HCPCS 74280 TC
|
| Min. Negotiated Rate |
$146.42 |
| Max. Negotiated Rate |
$496.40 |
| Rate for Payer: AlohaCare Medicaid |
$146.42
|
| Rate for Payer: AlohaCare Medicare |
$174.32
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Devoted Health Medicare |
$191.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$174.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network Commercial |
$496.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$209.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$146.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$174.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$146.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$174.32
|
|
|
CHG RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY
|
Professional
|
Both
|
$687.00
|
|
|
Service Code
|
HCPCS 74280
|
| Min. Negotiated Rate |
$146.42 |
| Max. Negotiated Rate |
$583.95 |
| Rate for Payer: AlohaCare Medicaid |
$146.42
|
| Rate for Payer: AlohaCare Medicare |
$233.09
|
| Rate for Payer: Cash Price |
$412.20
|
| Rate for Payer: Cash Price |
$412.20
|
| Rate for Payer: Devoted Health Medicare |
$256.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$233.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$152.40
|
| Rate for Payer: Health Management Network Commercial |
$583.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$279.71
|
| Rate for Payer: Kaiser Permanente Medicaid |
$279.71
|
| Rate for Payer: Kaiser Permanente Medicare |
$279.71
|
| Rate for Payer: Ohana Health Plan Medicaid |
$146.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$233.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$146.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$233.09
|
|
|
CHG RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 74270 TC
|
| Min. Negotiated Rate |
$101.76 |
| Max. Negotiated Rate |
$325.55 |
| Rate for Payer: AlohaCare Medicaid |
$101.76
|
| Rate for Payer: AlohaCare Medicare |
$114.50
|
| Rate for Payer: Cash Price |
$229.80
|
| Rate for Payer: Cash Price |
$229.80
|
| Rate for Payer: Devoted Health Medicare |
$125.95
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$114.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$113.38
|
| Rate for Payer: Health Management Network Commercial |
$325.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$137.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$137.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$137.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$101.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$114.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$101.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$114.50
|
|
|
CHG RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 74270 26
|
| Min. Negotiated Rate |
$48.57 |
| Max. Negotiated Rate |
$113.38 |
| Rate for Payer: AlohaCare Medicaid |
$101.76
|
| Rate for Payer: AlohaCare Medicare |
$48.57
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Devoted Health Medicare |
$53.43
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$48.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$113.38
|
| Rate for Payer: Health Management Network Commercial |
$72.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$58.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$58.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$58.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$101.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$48.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$101.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$48.57
|
|
|
CHG RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$468.00
|
|
|
Service Code
|
HCPCS 74270
|
| Min. Negotiated Rate |
$101.76 |
| Max. Negotiated Rate |
$397.80 |
| Rate for Payer: AlohaCare Medicaid |
$101.76
|
| Rate for Payer: AlohaCare Medicare |
$163.07
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Devoted Health Medicare |
$179.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$163.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$113.38
|
| Rate for Payer: Health Management Network Commercial |
$397.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$195.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$195.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$195.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$101.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$163.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$101.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$163.07
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 74022 TC
|
| Min. Negotiated Rate |
$33.12 |
| Max. Negotiated Rate |
$57.80 |
| Rate for Payer: AlohaCare Medicaid |
$33.12
|
| Rate for Payer: AlohaCare Medicare |
$38.93
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Devoted Health Medicare |
$42.82
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$49.96
|
| Rate for Payer: Health Management Network Commercial |
$57.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$46.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$46.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$46.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$33.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$33.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.93
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 74022 26
|
| Min. Negotiated Rate |
$15.30 |
| Max. Negotiated Rate |
$49.96 |
| Rate for Payer: AlohaCare Medicaid |
$33.12
|
| Rate for Payer: AlohaCare Medicare |
$15.30
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Devoted Health Medicare |
$16.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$15.30
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$49.96
|
| Rate for Payer: Health Management Network Commercial |
$22.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$18.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$18.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$18.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$33.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$15.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$33.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$15.30
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 74022
|
| Min. Negotiated Rate |
$33.12 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: AlohaCare Medicaid |
$33.12
|
| Rate for Payer: AlohaCare Medicare |
$54.23
|
| Rate for Payer: Cash Price |
$57.00
|
| Rate for Payer: Cash Price |
$57.00
|
| Rate for Payer: Devoted Health Medicare |
$59.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$54.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$49.96
|
| Rate for Payer: Health Management Network Commercial |
$80.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$65.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$65.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$65.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$33.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$54.23
|
| Rate for Payer: UnitedHealthcare Medicaid |
$33.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$54.23
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 74221
|
| Min. Negotiated Rate |
$72.83 |
| Max. Negotiated Rate |
$287.30 |
| Rate for Payer: AlohaCare Medicaid |
$72.83
|
| Rate for Payer: AlohaCare Medicare |
$115.96
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Devoted Health Medicare |
$127.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$115.96
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$122.12
|
| Rate for Payer: Health Management Network Commercial |
$287.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$139.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$139.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$139.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$72.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$115.96
|
| Rate for Payer: UnitedHealthcare Medicaid |
$72.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$115.96
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 74221 26
|
| Min. Negotiated Rate |
$32.60 |
| Max. Negotiated Rate |
$122.12 |
| Rate for Payer: AlohaCare Medicaid |
$72.83
|
| Rate for Payer: AlohaCare Medicare |
$32.60
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Devoted Health Medicare |
$35.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$32.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$122.12
|
| Rate for Payer: Health Management Network Commercial |
$48.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$39.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$39.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$39.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$72.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$32.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$72.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$32.60
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
HCPCS 74221 TC
|
| Min. Negotiated Rate |
$72.83 |
| Max. Negotiated Rate |
$238.85 |
| Rate for Payer: AlohaCare Medicaid |
$72.83
|
| Rate for Payer: AlohaCare Medicare |
$83.36
|
| Rate for Payer: Cash Price |
$168.60
|
| Rate for Payer: Cash Price |
$168.60
|
| Rate for Payer: Devoted Health Medicare |
$91.70
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$83.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$122.12
|
| Rate for Payer: Health Management Network Commercial |
$238.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$100.03
|
| Rate for Payer: Kaiser Permanente Medicaid |
$100.03
|
| Rate for Payer: Kaiser Permanente Medicare |
$100.03
|
| Rate for Payer: Ohana Health Plan Medicaid |
$72.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$83.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$72.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$83.36
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 74220 TC
|
| Min. Negotiated Rate |
$64.75 |
| Max. Negotiated Rate |
$215.90 |
| Rate for Payer: AlohaCare Medicaid |
$64.75
|
| Rate for Payer: AlohaCare Medicare |
$75.39
|
| Rate for Payer: Cash Price |
$152.40
|
| Rate for Payer: Cash Price |
$152.40
|
| Rate for Payer: Devoted Health Medicare |
$82.93
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$75.39
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$77.11
|
| Rate for Payer: Health Management Network Commercial |
$215.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$90.47
|
| Rate for Payer: Kaiser Permanente Medicaid |
$90.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$90.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$64.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$75.39
|
| Rate for Payer: UnitedHealthcare Medicaid |
$64.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$75.39
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 74220 26
|
| Min. Negotiated Rate |
$28.26 |
| Max. Negotiated Rate |
$77.11 |
| Rate for Payer: AlohaCare Medicaid |
$64.75
|
| Rate for Payer: AlohaCare Medicare |
$28.26
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Devoted Health Medicare |
$31.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$28.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$77.11
|
| Rate for Payer: Health Management Network Commercial |
$41.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$33.91
|
| Rate for Payer: Kaiser Permanente Medicaid |
$33.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$33.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$64.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$28.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$64.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$28.26
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 74220
|
| Min. Negotiated Rate |
$64.75 |
| Max. Negotiated Rate |
$257.55 |
| Rate for Payer: AlohaCare Medicaid |
$64.75
|
| Rate for Payer: AlohaCare Medicare |
$103.65
|
| Rate for Payer: Cash Price |
$181.80
|
| Rate for Payer: Cash Price |
$181.80
|
| Rate for Payer: Devoted Health Medicare |
$114.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$103.65
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$77.11
|
| Rate for Payer: Health Management Network Commercial |
$257.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$124.38
|
| Rate for Payer: Kaiser Permanente Medicaid |
$124.38
|
| Rate for Payer: Kaiser Permanente Medicare |
$124.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$64.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$103.65
|
| Rate for Payer: UnitedHealthcare Medicaid |
$64.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$103.65
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 73552
|
| Min. Negotiated Rate |
$23.78 |
| Max. Negotiated Rate |
$58.65 |
| Rate for Payer: AlohaCare Medicaid |
$23.78
|
| Rate for Payer: AlohaCare Medicare |
$39.44
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Devoted Health Medicare |
$43.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$39.44
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$36.46
|
| Rate for Payer: Health Management Network Commercial |
$58.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$47.33
|
| Rate for Payer: Kaiser Permanente Medicaid |
$47.33
|
| Rate for Payer: Kaiser Permanente Medicare |
$47.33
|
| Rate for Payer: Ohana Health Plan Medicaid |
$23.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$39.44
|
| Rate for Payer: UnitedHealthcare Medicaid |
$23.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$39.44
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 73552 TC
|
| Min. Negotiated Rate |
$23.78 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: AlohaCare Medicaid |
$23.78
|
| Rate for Payer: AlohaCare Medicare |
$30.57
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Devoted Health Medicare |
$33.63
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$30.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$36.46
|
| Rate for Payer: Health Management Network Commercial |
$45.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$36.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$36.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$36.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$23.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$30.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$23.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$30.57
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 73552 26
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$36.46 |
| Rate for Payer: AlohaCare Medicaid |
$23.78
|
| Rate for Payer: AlohaCare Medicare |
$8.86
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Devoted Health Medicare |
$9.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$8.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$36.46
|
| Rate for Payer: Health Management Network Commercial |
$12.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$10.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$10.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$10.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$23.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$8.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$23.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$8.86
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 73560 26
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$32.16 |
| Rate for Payer: AlohaCare Medicaid |
$22.93
|
| Rate for Payer: AlohaCare Medicare |
$8.20
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Devoted Health Medicare |
$9.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$8.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$32.16
|
| Rate for Payer: Health Management Network Commercial |
$11.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$9.84
|
| Rate for Payer: Kaiser Permanente Medicaid |
$9.84
|
| Rate for Payer: Kaiser Permanente Medicare |
$9.84
|
| Rate for Payer: Ohana Health Plan Medicaid |
$22.93
|
| Rate for Payer: Ohana Health Plan Medicare |
$8.20
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.93
|
| Rate for Payer: UnitedHealthcare Medicare |
$8.20
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 73560 TC
|
| Min. Negotiated Rate |
$22.93 |
| Max. Negotiated Rate |
$45.05 |
| Rate for Payer: AlohaCare Medicaid |
$22.93
|
| Rate for Payer: AlohaCare Medicare |
$29.82
|
| Rate for Payer: Cash Price |
$31.80
|
| Rate for Payer: Cash Price |
$31.80
|
| Rate for Payer: Devoted Health Medicare |
$32.80
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$29.82
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$32.16
|
| Rate for Payer: Health Management Network Commercial |
$45.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$35.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$35.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$35.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$22.93
|
| Rate for Payer: Ohana Health Plan Medicare |
$29.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.93
|
| Rate for Payer: UnitedHealthcare Medicare |
$29.82
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 73560
|
| Min. Negotiated Rate |
$22.93 |
| Max. Negotiated Rate |
$56.95 |
| Rate for Payer: AlohaCare Medicaid |
$22.93
|
| Rate for Payer: AlohaCare Medicare |
$38.01
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Devoted Health Medicare |
$41.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$32.16
|
| Rate for Payer: Health Management Network Commercial |
$56.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$45.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$45.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$45.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$22.93
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.93
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.01
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 3 VIEWS
|
Professional
|
Both
|
$134.00
|
|
|
Service Code
|
HCPCS 73562
|
| Min. Negotiated Rate |
$27.46 |
| Max. Negotiated Rate |
$113.90 |
| Rate for Payer: AlohaCare Medicaid |
$27.46
|
| Rate for Payer: AlohaCare Medicare |
$47.03
|
| Rate for Payer: Cash Price |
$80.40
|
| Rate for Payer: Cash Price |
$80.40
|
| Rate for Payer: Devoted Health Medicare |
$51.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$47.03
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$35.40
|
| Rate for Payer: Health Management Network Commercial |
$113.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$56.44
|
| Rate for Payer: Kaiser Permanente Medicaid |
$56.44
|
| Rate for Payer: Kaiser Permanente Medicare |
$56.44
|
| Rate for Payer: Ohana Health Plan Medicaid |
$27.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$47.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$27.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$47.03
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 3 VIEWS
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 73562 TC
|
| Min. Negotiated Rate |
$27.46 |
| Max. Negotiated Rate |
$99.45 |
| Rate for Payer: AlohaCare Medicaid |
$27.46
|
| Rate for Payer: AlohaCare Medicare |
$37.41
|
| Rate for Payer: Cash Price |
$70.20
|
| Rate for Payer: Cash Price |
$70.20
|
| Rate for Payer: Devoted Health Medicare |
$41.15
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$37.41
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$35.40
|
| Rate for Payer: Health Management Network Commercial |
$99.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$44.89
|
| Rate for Payer: Kaiser Permanente Medicaid |
$44.89
|
| Rate for Payer: Kaiser Permanente Medicare |
$44.89
|
| Rate for Payer: Ohana Health Plan Medicaid |
$27.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$37.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$27.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$37.41
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 3 VIEWS
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS 73562 26
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$35.40 |
| Rate for Payer: AlohaCare Medicaid |
$27.46
|
| Rate for Payer: AlohaCare Medicare |
$9.62
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Devoted Health Medicare |
$10.58
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.62
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$35.40
|
| Rate for Payer: Health Management Network Commercial |
$14.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$11.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$11.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$27.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$27.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.62
|
|
|
CHG RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 72170 26
|
| Min. Negotiated Rate |
$8.53 |
| Max. Negotiated Rate |
$32.05 |
| Rate for Payer: AlohaCare Medicaid |
$18.54
|
| Rate for Payer: AlohaCare Medicare |
$8.53
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Devoted Health Medicare |
$9.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$8.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$32.05
|
| Rate for Payer: Health Management Network Commercial |
$11.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$10.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$10.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$10.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$18.54
|
| Rate for Payer: Ohana Health Plan Medicare |
$8.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$18.54
|
| Rate for Payer: UnitedHealthcare Medicare |
$8.53
|
|
