|
PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG
|
Professional
|
Both
|
$1,115.00
|
|
|
Service Code
|
HCPCS 29877
|
| Min. Negotiated Rate |
$599.29 |
| Max. Negotiated Rate |
$947.75 |
| Rate for Payer: AlohaCare Medicaid |
$648.83
|
| Rate for Payer: AlohaCare Medicare |
$599.29
|
| Rate for Payer: Cash Price |
$669.00
|
| Rate for Payer: Cash Price |
$669.00
|
| Rate for Payer: Devoted Health Medicare |
$659.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$599.29
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$628.16
|
| Rate for Payer: Health Management Network Commercial |
$947.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$719.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$719.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$719.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$648.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$599.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$648.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$599.29
|
|
|
PR ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION
|
Professional
|
Both
|
$1,145.00
|
|
|
Service Code
|
HCPCS 29886
|
| Min. Negotiated Rate |
$579.80 |
| Max. Negotiated Rate |
$973.25 |
| Rate for Payer: AlohaCare Medicaid |
$665.83
|
| Rate for Payer: AlohaCare Medicare |
$617.07
|
| Rate for Payer: Cash Price |
$687.00
|
| Rate for Payer: Cash Price |
$687.00
|
| Rate for Payer: Devoted Health Medicare |
$678.78
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$617.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$579.80
|
| Rate for Payer: Health Management Network Commercial |
$973.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$740.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$740.48
|
| Rate for Payer: Kaiser Permanente Medicare |
$740.48
|
| Rate for Payer: Ohana Health Plan Medicaid |
$665.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$617.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$665.83
|
| Rate for Payer: UnitedHealthcare Medicare |
$617.07
|
|
|
PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING
|
Professional
|
Both
|
$1,011.00
|
|
|
Service Code
|
HCPCS 29880
|
| Min. Negotiated Rate |
$545.72 |
| Max. Negotiated Rate |
$859.35 |
| Rate for Payer: AlohaCare Medicaid |
$589.17
|
| Rate for Payer: AlohaCare Medicare |
$545.72
|
| Rate for Payer: Cash Price |
$606.60
|
| Rate for Payer: Cash Price |
$606.60
|
| Rate for Payer: Devoted Health Medicare |
$600.29
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$545.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$724.62
|
| Rate for Payer: Health Management Network Commercial |
$859.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$654.86
|
| Rate for Payer: Kaiser Permanente Medicaid |
$654.86
|
| Rate for Payer: Kaiser Permanente Medicare |
$654.86
|
| Rate for Payer: Ohana Health Plan Medicaid |
$589.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$545.72
|
| Rate for Payer: UnitedHealthcare Medicaid |
$589.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$545.72
|
|
|
PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG
|
Professional
|
Both
|
$977.00
|
|
|
Service Code
|
HCPCS 29881
|
| Min. Negotiated Rate |
$528.92 |
| Max. Negotiated Rate |
$830.45 |
| Rate for Payer: AlohaCare Medicaid |
$568.81
|
| Rate for Payer: AlohaCare Medicare |
$528.92
|
| Rate for Payer: Cash Price |
$586.20
|
| Rate for Payer: Cash Price |
$586.20
|
| Rate for Payer: Devoted Health Medicare |
$581.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$528.92
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$658.84
|
| Rate for Payer: Health Management Network Commercial |
$830.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$634.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$634.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$634.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$568.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$528.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$568.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$528.92
|
|
|
PR ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$813.00
|
|
|
Service Code
|
HCPCS 27620
|
| Min. Negotiated Rate |
$372.58 |
| Max. Negotiated Rate |
$691.05 |
| Rate for Payer: AlohaCare Medicaid |
$472.79
|
| Rate for Payer: AlohaCare Medicare |
$448.57
|
| Rate for Payer: Cash Price |
$487.80
|
| Rate for Payer: Cash Price |
$487.80
|
| Rate for Payer: Devoted Health Medicare |
$493.43
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$448.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$372.58
|
| Rate for Payer: Health Management Network Commercial |
$691.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$538.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$538.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$538.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$472.79
|
| Rate for Payer: Ohana Health Plan Medicare |
$448.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$472.79
|
| Rate for Payer: UnitedHealthcare Medicare |
$448.57
|
|
|
PR ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 24000
|
| Min. Negotiated Rate |
$378.04 |
| Max. Negotiated Rate |
$741.20 |
| Rate for Payer: AlohaCare Medicaid |
$507.05
|
| Rate for Payer: AlohaCare Medicare |
$474.59
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Devoted Health Medicare |
$522.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$474.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$378.04
|
| Rate for Payer: Health Management Network Commercial |
$741.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$569.51
|
| Rate for Payer: Kaiser Permanente Medicaid |
$569.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$569.51
|
| Rate for Payer: Ohana Health Plan Medicaid |
$507.05
|
| Rate for Payer: Ohana Health Plan Medicare |
$474.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$507.05
|
| Rate for Payer: UnitedHealthcare Medicare |
$474.59
|
|
|
PR ARTHRT ELBOW W/JT EXPL W/WOBX W/O RMVL LOOSE/FB
|
Professional
|
Both
|
$919.00
|
|
|
Service Code
|
HCPCS 24101
|
| Min. Negotiated Rate |
$395.98 |
| Max. Negotiated Rate |
$781.15 |
| Rate for Payer: AlohaCare Medicaid |
$534.45
|
| Rate for Payer: AlohaCare Medicare |
$497.37
|
| Rate for Payer: Cash Price |
$551.40
|
| Rate for Payer: Cash Price |
$551.40
|
| Rate for Payer: Devoted Health Medicare |
$547.11
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$497.37
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$395.98
|
| Rate for Payer: Health Management Network Commercial |
$781.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$596.84
|
| Rate for Payer: Kaiser Permanente Medicaid |
$596.84
|
| Rate for Payer: Kaiser Permanente Medicare |
$596.84
|
| Rate for Payer: Ohana Health Plan Medicaid |
$534.45
|
| Rate for Payer: Ohana Health Plan Medicare |
$497.37
|
| Rate for Payer: UnitedHealthcare Medicaid |
$534.45
|
| Rate for Payer: UnitedHealthcare Medicare |
$497.37
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT
|
Professional
|
Both
|
$598.00
|
|
|
Service Code
|
HCPCS 26070
|
| Min. Negotiated Rate |
$238.68 |
| Max. Negotiated Rate |
$508.30 |
| Rate for Payer: AlohaCare Medicaid |
$348.35
|
| Rate for Payer: AlohaCare Medicare |
$326.19
|
| Rate for Payer: Cash Price |
$358.80
|
| Rate for Payer: Cash Price |
$358.80
|
| Rate for Payer: Devoted Health Medicare |
$358.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$326.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$238.68
|
| Rate for Payer: Health Management Network Commercial |
$508.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$391.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$391.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$391.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$348.35
|
| Rate for Payer: Ohana Health Plan Medicare |
$326.19
|
| Rate for Payer: UnitedHealthcare Medicaid |
$348.35
|
| Rate for Payer: UnitedHealthcare Medicare |
$326.19
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA
|
Professional
|
Both
|
$742.00
|
|
|
Service Code
|
HCPCS 26080
|
| Min. Negotiated Rate |
$262.86 |
| Max. Negotiated Rate |
$630.70 |
| Rate for Payer: AlohaCare Medicaid |
$431.25
|
| Rate for Payer: AlohaCare Medicare |
$405.30
|
| Rate for Payer: Cash Price |
$445.20
|
| Rate for Payer: Cash Price |
$445.20
|
| Rate for Payer: Devoted Health Medicare |
$445.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$405.30
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$262.86
|
| Rate for Payer: Health Management Network Commercial |
$630.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$486.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$486.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$486.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$431.25
|
| Rate for Payer: Ohana Health Plan Medicare |
$405.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$431.25
|
| Rate for Payer: UnitedHealthcare Medicare |
$405.30
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA
|
Professional
|
Both
|
$628.00
|
|
|
Service Code
|
HCPCS 26075
|
| Min. Negotiated Rate |
$277.42 |
| Max. Negotiated Rate |
$533.80 |
| Rate for Payer: AlohaCare Medicaid |
$365.04
|
| Rate for Payer: AlohaCare Medicare |
$344.17
|
| Rate for Payer: Cash Price |
$376.80
|
| Rate for Payer: Cash Price |
$376.80
|
| Rate for Payer: Devoted Health Medicare |
$378.59
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$344.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$277.42
|
| Rate for Payer: Health Management Network Commercial |
$533.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$413.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$413.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$413.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$365.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$344.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$365.04
|
| Rate for Payer: UnitedHealthcare Medicare |
$344.17
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$1,311.00
|
|
|
Service Code
|
HCPCS 27310
|
| Min. Negotiated Rate |
$575.90 |
| Max. Negotiated Rate |
$1,114.35 |
| Rate for Payer: AlohaCare Medicaid |
$763.01
|
| Rate for Payer: AlohaCare Medicare |
$700.64
|
| Rate for Payer: Cash Price |
$786.60
|
| Rate for Payer: Cash Price |
$786.60
|
| Rate for Payer: Devoted Health Medicare |
$770.70
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$700.64
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$575.90
|
| Rate for Payer: Health Management Network Commercial |
$1,114.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$840.77
|
| Rate for Payer: Kaiser Permanente Medicaid |
$840.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$840.77
|
| Rate for Payer: Ohana Health Plan Medicaid |
$763.01
|
| Rate for Payer: Ohana Health Plan Medicare |
$700.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$763.01
|
| Rate for Payer: UnitedHealthcare Medicare |
$700.64
|
|
|
PR ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB
|
Professional
|
Both
|
$870.00
|
|
|
Service Code
|
HCPCS 27331
|
| Min. Negotiated Rate |
$390.26 |
| Max. Negotiated Rate |
$739.50 |
| Rate for Payer: AlohaCare Medicaid |
$504.86
|
| Rate for Payer: AlohaCare Medicare |
$472.78
|
| Rate for Payer: Cash Price |
$522.00
|
| Rate for Payer: Cash Price |
$522.00
|
| Rate for Payer: Devoted Health Medicare |
$520.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$472.78
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$390.26
|
| Rate for Payer: Health Management Network Commercial |
$739.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$567.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$567.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$567.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$504.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$472.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$504.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$472.78
|
|
|
PR ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$1,010.00
|
|
|
Service Code
|
HCPCS 25040
|
| Min. Negotiated Rate |
$404.56 |
| Max. Negotiated Rate |
$858.50 |
| Rate for Payer: AlohaCare Medicaid |
$586.72
|
| Rate for Payer: AlohaCare Medicare |
$536.14
|
| Rate for Payer: Cash Price |
$606.00
|
| Rate for Payer: Cash Price |
$606.00
|
| Rate for Payer: Devoted Health Medicare |
$589.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$536.14
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$404.56
|
| Rate for Payer: Health Management Network Commercial |
$858.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$643.37
|
| Rate for Payer: Kaiser Permanente Medicaid |
$643.37
|
| Rate for Payer: Kaiser Permanente Medicare |
$643.37
|
| Rate for Payer: Ohana Health Plan Medicaid |
$586.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$536.14
|
| Rate for Payer: UnitedHealthcare Medicaid |
$586.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$536.14
|
|
|
PR ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT
|
Professional
|
Both
|
$1,166.00
|
|
|
Service Code
|
HCPCS 27332
|
| Min. Negotiated Rate |
$442.00 |
| Max. Negotiated Rate |
$991.10 |
| Rate for Payer: AlohaCare Medicaid |
$678.03
|
| Rate for Payer: AlohaCare Medicare |
$628.79
|
| Rate for Payer: Cash Price |
$699.60
|
| Rate for Payer: Cash Price |
$699.60
|
| Rate for Payer: Devoted Health Medicare |
$691.67
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$628.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$442.00
|
| Rate for Payer: Health Management Network Commercial |
$991.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$754.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$754.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$754.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$678.03
|
| Rate for Payer: Ohana Health Plan Medicare |
$628.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$678.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$628.79
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT
|
Professional
|
Both
|
$935.41
|
|
|
Service Code
|
HCPCS 28022
|
| Min. Negotiated Rate |
$235.04 |
| Max. Negotiated Rate |
$795.10 |
| Rate for Payer: AlohaCare Medicaid |
$345.37
|
| Rate for Payer: AlohaCare Medicare |
$325.27
|
| Rate for Payer: Cash Price |
$561.25
|
| Rate for Payer: Cash Price |
$561.25
|
| Rate for Payer: Devoted Health Medicare |
$357.80
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$345.37
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$523.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$325.27
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$345.37
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$235.04
|
| Rate for Payer: Health Management Network Commercial |
$795.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$390.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$390.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$390.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$345.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$325.27
|
| Rate for Payer: UnitedHealthcare Medicaid |
$345.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$325.27
|
| Rate for Payer: University Health Alliance Commercial |
$443.33
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT
|
Professional
|
Both
|
$1,059.47
|
|
|
Service Code
|
HCPCS 28020
|
| Min. Negotiated Rate |
$303.16 |
| Max. Negotiated Rate |
$900.55 |
| Rate for Payer: AlohaCare Medicaid |
$385.12
|
| Rate for Payer: AlohaCare Medicare |
$363.12
|
| Rate for Payer: Cash Price |
$635.68
|
| Rate for Payer: Cash Price |
$635.68
|
| Rate for Payer: Devoted Health Medicare |
$399.43
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$385.12
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$595.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$363.12
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$385.12
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$303.16
|
| Rate for Payer: Health Management Network Commercial |
$900.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$435.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$435.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$435.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$385.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$363.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$385.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$363.12
|
| Rate for Payer: University Health Alliance Commercial |
$503.95
|
|
|
PR ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 25101
|
| Min. Negotiated Rate |
$316.94 |
| Max. Negotiated Rate |
$637.50 |
| Rate for Payer: AlohaCare Medicaid |
$435.54
|
| Rate for Payer: AlohaCare Medicare |
$407.15
|
| Rate for Payer: Cash Price |
$450.00
|
| Rate for Payer: Cash Price |
$450.00
|
| Rate for Payer: Devoted Health Medicare |
$447.87
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$407.15
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$316.94
|
| Rate for Payer: Health Management Network Commercial |
$637.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$488.58
|
| Rate for Payer: Kaiser Permanente Medicaid |
$488.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$488.58
|
| Rate for Payer: Ohana Health Plan Medicaid |
$435.54
|
| Rate for Payer: Ohana Health Plan Medicare |
$407.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$435.54
|
| Rate for Payer: UnitedHealthcare Medicare |
$407.15
|
|
|
PR ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 36620
|
| Min. Negotiated Rate |
$40.36 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: AlohaCare Medicaid |
$43.00
|
| Rate for Payer: AlohaCare Medicare |
$40.36
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Devoted Health Medicare |
$44.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$40.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$67.86
|
| Rate for Payer: Health Management Network Commercial |
$62.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$48.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$48.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$48.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$43.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$40.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$43.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$40.36
|
| Rate for Payer: University Health Alliance Commercial |
$55.00
|
|
|
PR ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS 93050 TC
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$17.12 |
| Rate for Payer: AlohaCare Medicaid |
$17.12
|
| Rate for Payer: AlohaCare Medicare |
$9.69
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Devoted Health Medicare |
$10.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.69
|
| Rate for Payer: Health Management Network Commercial |
$14.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$11.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$11.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$17.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.69
|
|
|
PR ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 93050 26
|
| Min. Negotiated Rate |
$8.53 |
| Max. Negotiated Rate |
$17.12 |
| Rate for Payer: AlohaCare Medicaid |
$17.12
|
| Rate for Payer: AlohaCare Medicare |
$8.53
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Devoted Health Medicare |
$9.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$8.53
|
| Rate for Payer: Health Management Network Commercial |
$12.75
|
| 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 |
$17.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$8.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$8.53
|
|
|
PR ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 93050
|
| Min. Negotiated Rate |
$17.12 |
| Max. Negotiated Rate |
$27.20 |
| Rate for Payer: AlohaCare Medicaid |
$17.12
|
| Rate for Payer: AlohaCare Medicare |
$18.22
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Devoted Health Medicare |
$20.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$18.22
|
| Rate for Payer: Health Management Network Commercial |
$27.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$21.86
|
| Rate for Payer: Kaiser Permanente Medicaid |
$21.86
|
| Rate for Payer: Kaiser Permanente Medicare |
$21.86
|
| Rate for Payer: Ohana Health Plan Medicaid |
$17.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$18.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$18.22
|
|
|
PR ARVEN ANAST OPN F/ARM VEIN TRPOS
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 36820
|
| Min. Negotiated Rate |
$635.92 |
| Max. Negotiated Rate |
$1,003.00 |
| Rate for Payer: AlohaCare Medicaid |
$688.15
|
| Rate for Payer: AlohaCare Medicare |
$635.92
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Devoted Health Medicare |
$699.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$635.92
|
| Rate for Payer: Health Management Network Commercial |
$1,003.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$763.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$763.10
|
| Rate for Payer: Kaiser Permanente Medicare |
$763.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$688.15
|
| Rate for Payer: Ohana Health Plan Medicare |
$635.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$688.15
|
| Rate for Payer: UnitedHealthcare Medicare |
$635.92
|
| Rate for Payer: University Health Alliance Commercial |
$930.00
|
|
|
PR ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS
|
Professional
|
Both
|
$1,174.00
|
|
|
Service Code
|
HCPCS 36819
|
| Min. Negotiated Rate |
$633.60 |
| Max. Negotiated Rate |
$997.90 |
| Rate for Payer: AlohaCare Medicaid |
$689.70
|
| Rate for Payer: AlohaCare Medicare |
$633.60
|
| Rate for Payer: Cash Price |
$704.40
|
| Rate for Payer: Cash Price |
$704.40
|
| Rate for Payer: Devoted Health Medicare |
$696.96
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$633.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$783.64
|
| Rate for Payer: Health Management Network Commercial |
$997.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$760.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$760.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$760.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$689.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$633.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$689.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$633.60
|
|
|
PR ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 36818
|
| Min. Negotiated Rate |
$602.60 |
| Max. Negotiated Rate |
$946.90 |
| Rate for Payer: AlohaCare Medicaid |
$653.74
|
| Rate for Payer: AlohaCare Medicare |
$602.60
|
| Rate for Payer: Cash Price |
$668.40
|
| Rate for Payer: Cash Price |
$668.40
|
| Rate for Payer: Devoted Health Medicare |
$662.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$602.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$695.76
|
| Rate for Payer: Health Management Network Commercial |
$946.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$723.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$723.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$723.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$653.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$602.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$653.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$602.60
|
| Rate for Payer: University Health Alliance Commercial |
$910.00
|
|
|
PR ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER
|
Professional
|
Both
|
$448.02
|
|
|
Service Code
|
HCPCS 51102
|
| Min. Negotiated Rate |
$124.99 |
| Max. Negotiated Rate |
$380.82 |
| Rate for Payer: AlohaCare Medicaid |
$141.94
|
| Rate for Payer: AlohaCare Medicare |
$124.99
|
| Rate for Payer: Cash Price |
$268.81
|
| Rate for Payer: Cash Price |
$268.81
|
| Rate for Payer: Devoted Health Medicare |
$137.49
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$141.94
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$355.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$124.99
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$141.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$331.24
|
| Rate for Payer: Health Management Network Commercial |
$380.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$149.99
|
| Rate for Payer: Kaiser Permanente Medicaid |
$149.99
|
| Rate for Payer: Kaiser Permanente Medicare |
$149.99
|
| Rate for Payer: Ohana Health Plan Medicaid |
$141.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$124.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$141.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$124.99
|
| Rate for Payer: University Health Alliance Commercial |
$189.74
|
|
