|
HC SLP EVAL,ORAL & PHARYNGEAL SWALLOW FUNCTION
|
Facility
|
IP
|
$328.00
|
|
|
Service Code
|
HCPCS 92610 GN
|
| Hospital Charge Code |
4449261001
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$278.80 |
| Max. Negotiated Rate |
$318.16 |
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Health Management Network Commercial |
$278.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$295.20
|
| Rate for Payer: MDX Hawaii PPO |
$318.16
|
|
|
HC SLP EVAL,ORAL & PHARYNGEAL SWALLOW FUNCTION
|
Facility
|
OP
|
$328.00
|
|
|
Service Code
|
HCPCS 92610 GN
|
| Hospital Charge Code |
4449261001
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$88.36 |
| Max. Negotiated Rate |
$318.16 |
| Rate for Payer: AlohaCare Medicaid |
$164.00
|
| Rate for Payer: AlohaCare Medicare |
$101.68
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Devoted Health Medicare |
$111.52
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$101.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$311.60
|
| Rate for Payer: Health Management Network Commercial |
$278.80
|
| Rate for Payer: Humana Medicare |
$101.68
|
| Rate for Payer: Kaiser Permanente Commercial |
$295.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$167.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$101.68
|
| Rate for Payer: MDX Hawaii PPO |
$318.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$101.68
|
| Rate for Payer: Ohana Health Plan Medicare |
$101.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$88.36
|
| Rate for Payer: UnitedHealthcare Medicare |
$101.68
|
| Rate for Payer: University Health Alliance Commercial |
$239.08
|
|
|
HC SLP EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)
|
Facility
|
OP
|
$639.00
|
|
|
Service Code
|
HCPCS 92521
|
| Hospital Charge Code |
4449252101
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$140.32 |
| Max. Negotiated Rate |
$619.83 |
| Rate for Payer: AlohaCare Medicaid |
$319.50
|
| Rate for Payer: AlohaCare Medicare |
$198.09
|
| Rate for Payer: Cash Price |
$383.40
|
| Rate for Payer: Cash Price |
$383.40
|
| Rate for Payer: Devoted Health Medicare |
$217.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$198.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$607.05
|
| Rate for Payer: Health Management Network Commercial |
$543.15
|
| Rate for Payer: Humana Medicare |
$198.09
|
| Rate for Payer: Kaiser Permanente Commercial |
$575.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$325.89
|
| Rate for Payer: Kaiser Permanente Medicare |
$198.09
|
| Rate for Payer: MDX Hawaii PPO |
$619.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$198.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$198.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$140.32
|
| Rate for Payer: UnitedHealthcare Medicare |
$198.09
|
| Rate for Payer: University Health Alliance Commercial |
$465.77
|
|
|
HC SLP EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)
|
Facility
|
IP
|
$639.00
|
|
|
Service Code
|
HCPCS 92521
|
| Hospital Charge Code |
4449252101
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$543.15 |
| Max. Negotiated Rate |
$619.83 |
| Rate for Payer: Cash Price |
$383.40
|
| Rate for Payer: Health Management Network Commercial |
$543.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$575.10
|
| Rate for Payer: MDX Hawaii PPO |
$619.83
|
|
|
HC SLP SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES
|
Facility
|
IP
|
$226.00
|
|
|
Service Code
|
HCPCS 97533
|
| Hospital Charge Code |
4409753301
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$192.10 |
| Max. Negotiated Rate |
$219.22 |
| Rate for Payer: Cash Price |
$135.60
|
| Rate for Payer: Health Management Network Commercial |
$192.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$203.40
|
| Rate for Payer: MDX Hawaii PPO |
$219.22
|
|
|
HC SLP SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES
|
Facility
|
OP
|
$226.00
|
|
|
Service Code
|
HCPCS 97533
|
| Hospital Charge Code |
4409753301
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$17.81 |
| Max. Negotiated Rate |
$219.22 |
| Rate for Payer: AlohaCare Medicaid |
$113.00
|
| Rate for Payer: AlohaCare Medicare |
$70.06
|
| Rate for Payer: Cash Price |
$135.60
|
| Rate for Payer: Cash Price |
$135.60
|
| Rate for Payer: Devoted Health Medicare |
$76.84
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$70.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$214.70
|
| Rate for Payer: Health Management Network Commercial |
$192.10
|
| Rate for Payer: Humana Medicare |
$70.06
|
| Rate for Payer: Kaiser Permanente Commercial |
$203.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$115.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$70.06
|
| Rate for Payer: MDX Hawaii PPO |
$219.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$70.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$70.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$70.06
|
| Rate for Payer: University Health Alliance Commercial |
$164.73
|
|
|
HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL
|
Facility
|
IP
|
$366.00
|
|
|
Service Code
|
HCPCS 92507 GN
|
| Hospital Charge Code |
4409250701
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$311.10 |
| Max. Negotiated Rate |
$355.02 |
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Health Management Network Commercial |
$311.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$329.40
|
| Rate for Payer: MDX Hawaii PPO |
$355.02
|
|
|
HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL
|
Facility
|
OP
|
$366.00
|
|
|
Service Code
|
HCPCS 92507 GN
|
| Hospital Charge Code |
4409250701
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$21.05 |
| Max. Negotiated Rate |
$355.02 |
| Rate for Payer: AlohaCare Medicaid |
$183.00
|
| Rate for Payer: AlohaCare Medicare |
$113.46
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Devoted Health Medicare |
$124.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$113.46
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$347.70
|
| Rate for Payer: Health Management Network Commercial |
$311.10
|
| Rate for Payer: Humana Medicare |
$113.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$329.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$186.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$113.46
|
| Rate for Payer: MDX Hawaii PPO |
$355.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$113.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$113.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$21.05
|
| Rate for Payer: UnitedHealthcare Medicare |
$113.46
|
| Rate for Payer: University Health Alliance Commercial |
$266.78
|
|
|
HC SMEAR COMPLEX W/INTERP O&P
|
Facility
|
IP
|
$151.00
|
|
|
Service Code
|
HCPCS 87209
|
| Hospital Charge Code |
3068720901
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$128.35 |
| Max. Negotiated Rate |
$146.47 |
| Rate for Payer: Cash Price |
$90.60
|
| Rate for Payer: Health Management Network Commercial |
$128.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$135.90
|
| Rate for Payer: MDX Hawaii PPO |
$146.47
|
|
|
HC SMEAR COMPLEX W/INTERP O&P
|
Facility
|
OP
|
$151.00
|
|
|
Service Code
|
HCPCS 87209
|
| Hospital Charge Code |
3068720901
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.57 |
| Max. Negotiated Rate |
$146.47 |
| Rate for Payer: AlohaCare Medicaid |
$75.50
|
| Rate for Payer: AlohaCare Medicare |
$46.81
|
| Rate for Payer: Cash Price |
$90.60
|
| Rate for Payer: Cash Price |
$90.60
|
| Rate for Payer: Devoted Health Medicare |
$51.34
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$17.57
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$22.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$46.81
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$24.82
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$17.98
|
| Rate for Payer: Health Management Network Commercial |
$128.35
|
| Rate for Payer: Humana Medicare |
$46.81
|
| Rate for Payer: Kaiser Permanente Commercial |
$135.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$77.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$46.81
|
| Rate for Payer: MDX Hawaii PPO |
$146.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$46.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$46.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$46.81
|
| Rate for Payer: University Health Alliance Commercial |
$46.45
|
|
|
HC SMEAR,STAIN,WET MNT,INTERP - WET PREP GENITAL
|
Facility
|
IP
|
$49.00
|
|
|
Service Code
|
HCPCS 87210
|
| Hospital Charge Code |
3068721001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$41.65 |
| Max. Negotiated Rate |
$47.53 |
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Health Management Network Commercial |
$41.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$44.10
|
| Rate for Payer: MDX Hawaii PPO |
$47.53
|
|
|
HC SMEAR,STAIN,WET MNT,INTERP - WET PREP GENITAL
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
HCPCS 87210
|
| Hospital Charge Code |
3068721001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.82 |
| Max. Negotiated Rate |
$47.53 |
| Rate for Payer: AlohaCare Medicaid |
$24.50
|
| Rate for Payer: AlohaCare Medicare |
$15.19
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Cash Price |
$29.40
|
| Rate for Payer: Devoted Health Medicare |
$16.66
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$5.90
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$7.28
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$15.19
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$6.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$5.82
|
| Rate for Payer: Health Management Network Commercial |
$41.65
|
| Rate for Payer: Humana Medicare |
$15.19
|
| Rate for Payer: Kaiser Permanente Commercial |
$44.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$24.99
|
| Rate for Payer: Kaiser Permanente Medicare |
$15.19
|
| Rate for Payer: MDX Hawaii PPO |
$47.53
|
| Rate for Payer: Ohana Health Plan Medicaid |
$15.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$15.19
|
| Rate for Payer: UnitedHealthcare Medicaid |
$5.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$15.19
|
| Rate for Payer: University Health Alliance Commercial |
$11.03
|
|
|
HC SNF WAITLIST ROOM DAILY
|
Facility
|
IP
|
$2,500.00
|
|
| Hospital Charge Code |
1200000003
|
|
Hospital Revenue Code
|
120
|
| Min. Negotiated Rate |
$486.76 |
| Max. Negotiated Rate |
$7,250.00 |
| Rate for Payer: AlohaCare Medicaid |
$486.76
|
| Rate for Payer: AlohaCare Medicare |
$6,253.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Devoted Health Medicare |
$7,175.30
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$486.76
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$6,523.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$486.76
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$7,250.00
|
| Rate for Payer: Health Management Network Commercial |
$2,125.00
|
| Rate for Payer: Humana Medicare |
$6,523.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,250.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$486.76
|
| Rate for Payer: Kaiser Permanente Medicare |
$6,523.00
|
| Rate for Payer: MDX Hawaii PPO |
$2,425.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$486.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$6,523.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$486.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$6,523.00
|
| Rate for Payer: University Health Alliance Commercial |
$2,320.00
|
|
|
HC SONO PELVIS LIMITED - US PELVIS LIMITED BLADDER
|
Facility
|
OP
|
$529.00
|
|
|
Service Code
|
HCPCS 76857
|
| Hospital Charge Code |
4027685701
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$44.29 |
| Max. Negotiated Rate |
$513.13 |
| Rate for Payer: AlohaCare Medicaid |
$264.50
|
| Rate for Payer: AlohaCare Medicare |
$163.99
|
| Rate for Payer: Cash Price |
$317.40
|
| Rate for Payer: Cash Price |
$317.40
|
| Rate for Payer: Devoted Health Medicare |
$179.86
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$44.29
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$163.99
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$69.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$106.81
|
| Rate for Payer: Health Management Network Commercial |
$449.65
|
| Rate for Payer: Humana Medicare |
$163.99
|
| Rate for Payer: Kaiser Permanente Commercial |
$476.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$269.79
|
| Rate for Payer: Kaiser Permanente Medicare |
$163.99
|
| Rate for Payer: MDX Hawaii PPO |
$513.13
|
| Rate for Payer: Ohana Health Plan Medicaid |
$163.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$163.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$44.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$163.99
|
| Rate for Payer: University Health Alliance Commercial |
$161.45
|
|
|
HC SONO PELVIS LIMITED - US PELVIS LIMITED BLADDER
|
Facility
|
IP
|
$529.00
|
|
|
Service Code
|
HCPCS 76857
|
| Hospital Charge Code |
4027685701
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$449.65 |
| Max. Negotiated Rate |
$513.13 |
| Rate for Payer: Cash Price |
$317.40
|
| Rate for Payer: Health Management Network Commercial |
$449.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$476.10
|
| Rate for Payer: MDX Hawaii PPO |
$513.13
|
|
|
HC SPECIAL STAINS,GROUP II - SPECIAL STAIN GRP 2 INT/RPT EA
|
Facility
|
OP
|
$1,277.00
|
|
|
Service Code
|
HCPCS 88313
|
| Hospital Charge Code |
3108831302
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.18 |
| Max. Negotiated Rate |
$1,238.69 |
| Rate for Payer: AlohaCare Medicaid |
$638.50
|
| Rate for Payer: AlohaCare Medicare |
$395.87
|
| Rate for Payer: Cash Price |
$766.20
|
| Rate for Payer: Cash Price |
$766.20
|
| Rate for Payer: Devoted Health Medicare |
$434.18
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$37.43
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$169.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$395.87
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$37.18
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$135.93
|
| Rate for Payer: Health Management Network Commercial |
$1,085.45
|
| Rate for Payer: Humana Medicare |
$395.87
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,149.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$651.27
|
| Rate for Payer: Kaiser Permanente Medicare |
$395.87
|
| Rate for Payer: MDX Hawaii PPO |
$1,238.69
|
| Rate for Payer: Ohana Health Plan Medicaid |
$395.87
|
| Rate for Payer: Ohana Health Plan Medicare |
$395.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$37.43
|
| Rate for Payer: UnitedHealthcare Medicare |
$395.87
|
| Rate for Payer: University Health Alliance Commercial |
$144.02
|
|
|
HC SPECIAL STAINS,GROUP II - SPECIAL STAIN GRP 2 INT/RPT EA
|
Facility
|
IP
|
$1,277.00
|
|
|
Service Code
|
HCPCS 88313
|
| Hospital Charge Code |
3108831302
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,085.45 |
| Max. Negotiated Rate |
$1,238.69 |
| Rate for Payer: Cash Price |
$766.20
|
| Rate for Payer: Health Management Network Commercial |
$1,085.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,149.30
|
| Rate for Payer: MDX Hawaii PPO |
$1,238.69
|
|
|
HC SPECIAL STAINS,GROUP I - SPECIAL STAIN GRP 1 INT/RPT EA
|
Facility
|
IP
|
$529.00
|
|
|
Service Code
|
HCPCS 88312
|
| Hospital Charge Code |
3108831202
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$449.65 |
| Max. Negotiated Rate |
$513.13 |
| Rate for Payer: Cash Price |
$317.40
|
| Rate for Payer: Health Management Network Commercial |
$449.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$476.10
|
| Rate for Payer: MDX Hawaii PPO |
$513.13
|
|
|
HC SPECIAL STAINS,GROUP I - SPECIAL STAIN GRP 1 INT/RPT EA
|
Facility
|
OP
|
$529.00
|
|
|
Service Code
|
HCPCS 88312
|
| Hospital Charge Code |
3108831202
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$32.77 |
| Max. Negotiated Rate |
$513.13 |
| Rate for Payer: AlohaCare Medicaid |
$264.50
|
| Rate for Payer: AlohaCare Medicare |
$163.99
|
| Rate for Payer: Cash Price |
$317.40
|
| Rate for Payer: Cash Price |
$317.40
|
| Rate for Payer: Devoted Health Medicare |
$179.86
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$32.77
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$66.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$163.99
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$41.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$53.24
|
| Rate for Payer: Health Management Network Commercial |
$449.65
|
| Rate for Payer: Humana Medicare |
$163.99
|
| Rate for Payer: Kaiser Permanente Commercial |
$476.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$269.79
|
| Rate for Payer: Kaiser Permanente Medicare |
$163.99
|
| Rate for Payer: MDX Hawaii PPO |
$513.13
|
| Rate for Payer: Ohana Health Plan Medicaid |
$163.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$163.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$32.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$163.99
|
| Rate for Payer: University Health Alliance Commercial |
$187.61
|
|
|
HC STOOL CULTURE, ADDL PATHOGENS - CULT STOOL ADD PATH EA
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
HCPCS 87046
|
| Hospital Charge Code |
3068704601
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.91 |
| Max. Negotiated Rate |
$76.63 |
| Rate for Payer: AlohaCare Medicaid |
$39.50
|
| Rate for Payer: AlohaCare Medicare |
$24.49
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Devoted Health Medicare |
$26.86
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$7.91
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$11.80
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$24.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$12.65
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$9.44
|
| Rate for Payer: Health Management Network Commercial |
$67.15
|
| Rate for Payer: Humana Medicare |
$24.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$71.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$40.29
|
| Rate for Payer: Kaiser Permanente Medicare |
$24.49
|
| Rate for Payer: MDX Hawaii PPO |
$76.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$24.49
|
| Rate for Payer: Ohana Health Plan Medicare |
$24.49
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.91
|
| Rate for Payer: UnitedHealthcare Medicare |
$24.49
|
| Rate for Payer: University Health Alliance Commercial |
$24.38
|
|
|
HC STOOL CULTURE, ADDL PATHOGENS - CULT STOOL ADD PATH EA
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
HCPCS 87046
|
| Hospital Charge Code |
3068704601
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$67.15 |
| Max. Negotiated Rate |
$76.63 |
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Health Management Network Commercial |
$67.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$71.10
|
| Rate for Payer: MDX Hawaii PPO |
$76.63
|
|
|
HC STRAP ELBOW/WRIST
|
Facility
|
OP
|
$236.00
|
|
|
Service Code
|
HCPCS 29260
|
| Hospital Charge Code |
4202926001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$73.16 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$118.00
|
| Rate for Payer: AlohaCare Medicare |
$73.16
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Devoted Health Medicare |
$80.24
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$73.16
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$224.20
|
| Rate for Payer: Health Management Network Commercial |
$200.60
|
| Rate for Payer: Humana Medicare |
$73.16
|
| Rate for Payer: Kaiser Permanente Commercial |
$212.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$73.16
|
| Rate for Payer: MDX Hawaii PPO |
$228.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$73.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$73.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$73.16
|
| Rate for Payer: University Health Alliance Commercial |
$172.02
|
|
|
HC STRAP ELBOW/WRIST
|
Facility
|
IP
|
$236.00
|
|
|
Service Code
|
HCPCS 29260
|
| Hospital Charge Code |
4202926001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$200.60 |
| Max. Negotiated Rate |
$228.92 |
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Health Management Network Commercial |
$200.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$212.40
|
| Rate for Payer: MDX Hawaii PPO |
$228.92
|
|
|
HC STRAP HAND/FINGER
|
Facility
|
OP
|
$236.00
|
|
|
Service Code
|
HCPCS 29280
|
| Hospital Charge Code |
4202928001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$73.16 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$118.00
|
| Rate for Payer: AlohaCare Medicare |
$73.16
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Devoted Health Medicare |
$80.24
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$73.16
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$224.20
|
| Rate for Payer: Health Management Network Commercial |
$200.60
|
| Rate for Payer: Humana Medicare |
$73.16
|
| Rate for Payer: Kaiser Permanente Commercial |
$212.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$73.16
|
| Rate for Payer: MDX Hawaii PPO |
$228.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$73.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$73.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$73.16
|
| Rate for Payer: University Health Alliance Commercial |
$172.02
|
|
|
HC STRAP HAND/FINGER
|
Facility
|
IP
|
$236.00
|
|
|
Service Code
|
HCPCS 29280
|
| Hospital Charge Code |
4202928001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$200.60 |
| Max. Negotiated Rate |
$228.92 |
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Health Management Network Commercial |
$200.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$212.40
|
| Rate for Payer: MDX Hawaii PPO |
$228.92
|
|
