|
HC ASSAY OF CREATININE - CREATININE BLOOD
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
HCPCS 82565
|
| Hospital Charge Code |
3018256501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.55 |
| Max. Negotiated Rate |
$41.71 |
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Health Management Network Commercial |
$36.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$38.70
|
| Rate for Payer: MDX Hawaii PPO |
$41.71
|
|
|
HC ASSAY OF CREATININE - CREATININE BLOOD
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
HCPCS 82565
|
| Hospital Charge Code |
3018256501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$41.71 |
| Rate for Payer: AlohaCare Medicaid |
$21.50
|
| Rate for Payer: AlohaCare Medicare |
$13.33
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Devoted Health Medicare |
$14.62
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$7.07
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$6.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$13.33
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$7.42
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$5.12
|
| Rate for Payer: Health Management Network Commercial |
$36.55
|
| Rate for Payer: Humana Medicare |
$13.33
|
| Rate for Payer: Kaiser Permanente Commercial |
$38.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$21.93
|
| Rate for Payer: Kaiser Permanente Medicare |
$13.33
|
| Rate for Payer: MDX Hawaii PPO |
$41.71
|
| Rate for Payer: Ohana Health Plan Medicaid |
$13.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$13.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.07
|
| Rate for Payer: UnitedHealthcare Medicare |
$13.33
|
| Rate for Payer: University Health Alliance Commercial |
$13.25
|
|
|
HC ASSAY OF CREATININE - CREATININE BLOOD POCT
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
HCPCS 82565
|
| Hospital Charge Code |
3018256502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.55 |
| Max. Negotiated Rate |
$41.71 |
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Health Management Network Commercial |
$36.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$38.70
|
| Rate for Payer: MDX Hawaii PPO |
$41.71
|
|
|
HC ASSAY OF CREATININE - CREATININE BLOOD POCT
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
HCPCS 82565
|
| Hospital Charge Code |
3018256502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$41.71 |
| Rate for Payer: AlohaCare Medicaid |
$21.50
|
| Rate for Payer: AlohaCare Medicare |
$13.33
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Devoted Health Medicare |
$14.62
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$7.07
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$6.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$13.33
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$7.42
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$5.12
|
| Rate for Payer: Health Management Network Commercial |
$36.55
|
| Rate for Payer: Humana Medicare |
$13.33
|
| Rate for Payer: Kaiser Permanente Commercial |
$38.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$21.93
|
| Rate for Payer: Kaiser Permanente Medicare |
$13.33
|
| Rate for Payer: MDX Hawaii PPO |
$41.71
|
| Rate for Payer: Ohana Health Plan Medicaid |
$13.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$13.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.07
|
| Rate for Payer: UnitedHealthcare Medicare |
$13.33
|
| Rate for Payer: University Health Alliance Commercial |
$13.25
|
|
|
HC ASSAY OF ESTRADIOL - ESTRADIOL
|
Facility
|
IP
|
$234.00
|
|
|
Service Code
|
HCPCS 82670
|
| Hospital Charge Code |
3018267001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$198.90 |
| Max. Negotiated Rate |
$226.98 |
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Health Management Network Commercial |
$198.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$210.60
|
| Rate for Payer: MDX Hawaii PPO |
$226.98
|
|
|
HC ASSAY OF ESTRADIOL - ESTRADIOL
|
Facility
|
OP
|
$234.00
|
|
|
Service Code
|
HCPCS 82670
|
| Hospital Charge Code |
3018267001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.94 |
| Max. Negotiated Rate |
$226.98 |
| Rate for Payer: AlohaCare Medicaid |
$117.00
|
| Rate for Payer: AlohaCare Medicare |
$72.54
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Devoted Health Medicare |
$79.56
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$38.62
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$34.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$72.54
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$40.55
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$27.94
|
| Rate for Payer: Health Management Network Commercial |
$198.90
|
| Rate for Payer: Humana Medicare |
$72.54
|
| Rate for Payer: Kaiser Permanente Commercial |
$210.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$119.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$72.54
|
| Rate for Payer: MDX Hawaii PPO |
$226.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$72.54
|
| Rate for Payer: Ohana Health Plan Medicare |
$72.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$38.62
|
| Rate for Payer: UnitedHealthcare Medicare |
$72.54
|
| Rate for Payer: University Health Alliance Commercial |
$72.22
|
|
|
HC ASSAY OF FERRITIN - FERRITIN
|
Facility
|
OP
|
$114.00
|
|
|
Service Code
|
HCPCS 82728
|
| Hospital Charge Code |
3018272801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$110.58 |
| Rate for Payer: AlohaCare Medicaid |
$57.00
|
| Rate for Payer: AlohaCare Medicare |
$35.34
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Devoted Health Medicare |
$38.76
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$15.81
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$17.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$35.34
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$16.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$13.63
|
| Rate for Payer: Health Management Network Commercial |
$96.90
|
| Rate for Payer: Humana Medicare |
$35.34
|
| Rate for Payer: Kaiser Permanente Commercial |
$102.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$58.14
|
| Rate for Payer: Kaiser Permanente Medicare |
$35.34
|
| Rate for Payer: MDX Hawaii PPO |
$110.58
|
| Rate for Payer: Ohana Health Plan Medicaid |
$35.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$35.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$35.34
|
| Rate for Payer: University Health Alliance Commercial |
$29.56
|
|
|
HC ASSAY OF FERRITIN - FERRITIN
|
Facility
|
IP
|
$114.00
|
|
|
Service Code
|
HCPCS 82728
|
| Hospital Charge Code |
3018272801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$96.90 |
| Max. Negotiated Rate |
$110.58 |
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Health Management Network Commercial |
$96.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$102.60
|
| Rate for Payer: MDX Hawaii PPO |
$110.58
|
|
|
HC ASSAY OF FREE THYROXINE - T4 FREE
|
Facility
|
IP
|
$76.00
|
|
|
Service Code
|
HCPCS 84439
|
| Hospital Charge Code |
3018443901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.60 |
| Max. Negotiated Rate |
$73.72 |
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Health Management Network Commercial |
$64.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$68.40
|
| Rate for Payer: MDX Hawaii PPO |
$73.72
|
|
|
HC ASSAY OF FREE THYROXINE - T4 FREE
|
Facility
|
OP
|
$76.00
|
|
|
Service Code
|
HCPCS 84439
|
| Hospital Charge Code |
3018443901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.02 |
| Max. Negotiated Rate |
$73.72 |
| Rate for Payer: AlohaCare Medicaid |
$38.00
|
| Rate for Payer: AlohaCare Medicare |
$23.56
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Devoted Health Medicare |
$25.84
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$12.46
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$11.28
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$23.56
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$13.08
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$9.02
|
| Rate for Payer: Health Management Network Commercial |
$64.60
|
| Rate for Payer: Humana Medicare |
$23.56
|
| Rate for Payer: Kaiser Permanente Commercial |
$68.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$38.76
|
| Rate for Payer: Kaiser Permanente Medicare |
$23.56
|
| Rate for Payer: MDX Hawaii PPO |
$73.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$23.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$23.56
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$23.56
|
| Rate for Payer: University Health Alliance Commercial |
$23.31
|
|
|
HC ASSAY OF GGT - GAMMA GT
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
HCPCS 82977
|
| Hospital Charge Code |
3018297701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$58.20 |
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Health Management Network Commercial |
$51.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$54.00
|
| Rate for Payer: MDX Hawaii PPO |
$58.20
|
|
|
HC ASSAY OF GGT - GAMMA GT
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
HCPCS 82977
|
| Hospital Charge Code |
3018297701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$58.20 |
| Rate for Payer: AlohaCare Medicaid |
$30.00
|
| Rate for Payer: AlohaCare Medicare |
$18.60
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Devoted Health Medicare |
$20.40
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$9.95
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$9.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$18.60
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$10.45
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network Commercial |
$51.00
|
| Rate for Payer: Humana Medicare |
$18.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$54.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$30.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$18.60
|
| Rate for Payer: MDX Hawaii PPO |
$58.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$18.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$18.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$18.60
|
| Rate for Payer: University Health Alliance Commercial |
$18.61
|
|
|
HC ASSAY OF INORGANIC PHOSPHORUS - PHOSPHORUS BLOOD
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
HCPCS 84100
|
| Hospital Charge Code |
3018410001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$38.80 |
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Health Management Network Commercial |
$34.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$36.00
|
| Rate for Payer: MDX Hawaii PPO |
$38.80
|
|
|
HC ASSAY OF INORGANIC PHOSPHORUS - PHOSPHORUS BLOOD
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
HCPCS 84100
|
| Hospital Charge Code |
3018410001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$38.80 |
| Rate for Payer: AlohaCare Medicaid |
$20.00
|
| Rate for Payer: AlohaCare Medicare |
$12.40
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Devoted Health Medicare |
$13.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$6.56
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$5.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$12.40
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$6.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4.74
|
| Rate for Payer: Health Management Network Commercial |
$34.00
|
| Rate for Payer: Humana Medicare |
$12.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$36.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$20.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$12.40
|
| Rate for Payer: MDX Hawaii PPO |
$38.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$12.40
|
| Rate for Payer: Ohana Health Plan Medicare |
$12.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$12.40
|
| Rate for Payer: University Health Alliance Commercial |
$12.27
|
|
|
HC ASSAY OF IRON - IRON BLOOD
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
HCPCS 83540
|
| Hospital Charge Code |
3018354001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.90 |
| Max. Negotiated Rate |
$52.38 |
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Health Management Network Commercial |
$45.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$48.60
|
| Rate for Payer: MDX Hawaii PPO |
$52.38
|
|
|
HC ASSAY OF IRON - IRON BLOOD
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
HCPCS 83540
|
| Hospital Charge Code |
3018354001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.47 |
| Max. Negotiated Rate |
$52.38 |
| Rate for Payer: AlohaCare Medicaid |
$27.00
|
| Rate for Payer: AlohaCare Medicare |
$16.74
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Devoted Health Medicare |
$18.36
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$8.95
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$8.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$16.74
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$9.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6.47
|
| Rate for Payer: Health Management Network Commercial |
$45.90
|
| Rate for Payer: Humana Medicare |
$16.74
|
| Rate for Payer: Kaiser Permanente Commercial |
$48.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$27.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$16.74
|
| Rate for Payer: MDX Hawaii PPO |
$52.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$16.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$16.74
|
| Rate for Payer: University Health Alliance Commercial |
$16.74
|
|
|
HC ASSAY OF LACTIC ACID - LACTATE
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
HCPCS 83605
|
| Hospital Charge Code |
3018360502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$82.45 |
| Max. Negotiated Rate |
$94.09 |
| Rate for Payer: Cash Price |
$58.20
|
| Rate for Payer: Health Management Network Commercial |
$82.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$87.30
|
| Rate for Payer: MDX Hawaii PPO |
$94.09
|
|
|
HC ASSAY OF LACTIC ACID - LACTATE
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
HCPCS 83605
|
| Hospital Charge Code |
3018360502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.57 |
| Max. Negotiated Rate |
$94.09 |
| Rate for Payer: AlohaCare Medicaid |
$48.50
|
| Rate for Payer: AlohaCare Medicare |
$30.07
|
| Rate for Payer: Cash Price |
$58.20
|
| Rate for Payer: Cash Price |
$58.20
|
| Rate for Payer: Devoted Health Medicare |
$32.98
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$14.76
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$14.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$30.07
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$15.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$11.57
|
| Rate for Payer: Health Management Network Commercial |
$82.45
|
| Rate for Payer: Humana Medicare |
$30.07
|
| Rate for Payer: Kaiser Permanente Commercial |
$87.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$49.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$30.07
|
| Rate for Payer: MDX Hawaii PPO |
$94.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$30.07
|
| Rate for Payer: Ohana Health Plan Medicare |
$30.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$14.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$30.07
|
| Rate for Payer: University Health Alliance Commercial |
$27.60
|
|
|
HC ASSAY OF LIPASE - LIPASE
|
Facility
|
IP
|
$58.00
|
|
|
Service Code
|
HCPCS 83690
|
| Hospital Charge Code |
3018369001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.30 |
| Max. Negotiated Rate |
$56.26 |
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Health Management Network Commercial |
$49.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$52.20
|
| Rate for Payer: MDX Hawaii PPO |
$56.26
|
|
|
HC ASSAY OF LIPASE - LIPASE
|
Facility
|
OP
|
$58.00
|
|
|
Service Code
|
HCPCS 83690
|
| Hospital Charge Code |
3018369001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$56.26 |
| Rate for Payer: AlohaCare Medicaid |
$29.00
|
| Rate for Payer: AlohaCare Medicare |
$17.98
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Devoted Health Medicare |
$19.72
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$9.52
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$8.61
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$17.98
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$10.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6.89
|
| Rate for Payer: Health Management Network Commercial |
$49.30
|
| Rate for Payer: Humana Medicare |
$17.98
|
| Rate for Payer: Kaiser Permanente Commercial |
$52.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$29.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$17.98
|
| Rate for Payer: MDX Hawaii PPO |
$56.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$17.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$17.98
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.52
|
| Rate for Payer: UnitedHealthcare Medicare |
$17.98
|
| Rate for Payer: University Health Alliance Commercial |
$17.80
|
|
|
HC ASSAY OF MAGNESIUM - MAGNESIUM
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
HCPCS 83735
|
| Hospital Charge Code |
3018373501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$54.32 |
| Rate for Payer: AlohaCare Medicaid |
$28.00
|
| Rate for Payer: AlohaCare Medicare |
$17.36
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Devoted Health Medicare |
$19.04
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$9.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$8.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$17.36
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$9.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6.70
|
| Rate for Payer: Health Management Network Commercial |
$47.60
|
| Rate for Payer: Humana Medicare |
$17.36
|
| Rate for Payer: Kaiser Permanente Commercial |
$50.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$28.56
|
| Rate for Payer: Kaiser Permanente Medicare |
$17.36
|
| Rate for Payer: MDX Hawaii PPO |
$54.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$17.36
|
| Rate for Payer: Ohana Health Plan Medicare |
$17.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$17.36
|
| Rate for Payer: University Health Alliance Commercial |
$17.32
|
|
|
HC ASSAY OF MAGNESIUM - MAGNESIUM
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
HCPCS 83735
|
| Hospital Charge Code |
3018373501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$54.32 |
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Health Management Network Commercial |
$47.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$50.40
|
| Rate for Payer: MDX Hawaii PPO |
$54.32
|
|
|
HC ASSAY OF PARATHORMONE - PTH INTACT
|
Facility
|
OP
|
$346.00
|
|
|
Service Code
|
HCPCS 83970
|
| Hospital Charge Code |
3018397001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.28 |
| Max. Negotiated Rate |
$335.62 |
| Rate for Payer: AlohaCare Medicaid |
$173.00
|
| Rate for Payer: AlohaCare Medicare |
$107.26
|
| Rate for Payer: Cash Price |
$207.60
|
| Rate for Payer: Cash Price |
$207.60
|
| Rate for Payer: Devoted Health Medicare |
$117.64
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$57.04
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$51.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$107.26
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$59.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$41.28
|
| Rate for Payer: Health Management Network Commercial |
$294.10
|
| Rate for Payer: Humana Medicare |
$107.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$311.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$176.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$107.26
|
| Rate for Payer: MDX Hawaii PPO |
$335.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$107.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$107.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$57.04
|
| Rate for Payer: UnitedHealthcare Medicare |
$107.26
|
| Rate for Payer: University Health Alliance Commercial |
$106.69
|
|
|
HC ASSAY OF PARATHORMONE - PTH INTACT
|
Facility
|
IP
|
$346.00
|
|
|
Service Code
|
HCPCS 83970
|
| Hospital Charge Code |
3018397001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$294.10 |
| Max. Negotiated Rate |
$335.62 |
| Rate for Payer: Cash Price |
$207.60
|
| Rate for Payer: Health Management Network Commercial |
$294.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$311.40
|
| Rate for Payer: MDX Hawaii PPO |
$335.62
|
|
|
HC ASSAY OF PREALBUMIN - PREALBUMIN
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
HCPCS 84134
|
| Hospital Charge Code |
3018413401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$103.70 |
| Max. Negotiated Rate |
$118.34 |
| Rate for Payer: Cash Price |
$73.20
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
|
