|
PR BREAST RECONSTRUCTION BIPEDICLED TRAM FLAP
|
Professional
|
Both
|
$3,494.00
|
|
|
Service Code
|
HCPCS 19369
|
| Min. Negotiated Rate |
$1,474.20 |
| Max. Negotiated Rate |
$2,969.90 |
| Rate for Payer: AlohaCare Medicaid |
$2,035.02
|
| Rate for Payer: AlohaCare Medicare |
$1,750.88
|
| Rate for Payer: Cash Price |
$2,096.40
|
| Rate for Payer: Cash Price |
$2,096.40
|
| Rate for Payer: Devoted Health Medicare |
$1,925.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,750.88
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,474.20
|
| Rate for Payer: Health Management Network Commercial |
$2,969.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,101.06
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,101.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,101.06
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,035.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,750.88
|
| Rate for Payer: UnitedHealthcare Medicaid |
$2,035.02
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,750.88
|
|
|
PR BREAST RECONSTRUCTION SINGLE PEDICLED TRAM FLAP
|
Professional
|
Both
|
$3,089.00
|
|
|
Service Code
|
HCPCS 19367
|
| Min. Negotiated Rate |
$1,562.80 |
| Max. Negotiated Rate |
$2,625.65 |
| Rate for Payer: AlohaCare Medicaid |
$1,796.92
|
| Rate for Payer: AlohaCare Medicare |
$1,562.80
|
| Rate for Payer: Cash Price |
$1,853.40
|
| Rate for Payer: Cash Price |
$1,853.40
|
| Rate for Payer: Devoted Health Medicare |
$1,719.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,562.80
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,767.74
|
| Rate for Payer: Health Management Network Commercial |
$2,625.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,875.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,875.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,875.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,796.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,562.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,796.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,562.80
|
|
|
PR BREAST RECONSTRUCTION W/FREE FLAP
|
Professional
|
Both
|
$4,700.00
|
|
|
Service Code
|
HCPCS 19364
|
| Min. Negotiated Rate |
$1,716.78 |
| Max. Negotiated Rate |
$3,995.00 |
| Rate for Payer: AlohaCare Medicaid |
$2,738.67
|
| Rate for Payer: AlohaCare Medicare |
$2,356.29
|
| Rate for Payer: Cash Price |
$2,820.00
|
| Rate for Payer: Cash Price |
$2,820.00
|
| Rate for Payer: Devoted Health Medicare |
$2,591.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2,356.29
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,716.78
|
| Rate for Payer: Health Management Network Commercial |
$3,995.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,827.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,827.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,827.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,738.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,356.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$2,738.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,356.29
|
|
|
PR BREAST RECONSTRUCTION W/LATISSIMUS DORSI FLAP
|
Professional
|
Both
|
$2,722.00
|
|
|
Service Code
|
HCPCS 19361
|
| Min. Negotiated Rate |
$1,155.96 |
| Max. Negotiated Rate |
$2,313.70 |
| Rate for Payer: AlohaCare Medicaid |
$1,584.19
|
| Rate for Payer: AlohaCare Medicare |
$1,387.29
|
| Rate for Payer: Cash Price |
$1,633.20
|
| Rate for Payer: Cash Price |
$1,633.20
|
| Rate for Payer: Devoted Health Medicare |
$1,526.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,387.29
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,155.96
|
| Rate for Payer: Health Management Network Commercial |
$2,313.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,664.75
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,664.75
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,664.75
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,584.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,387.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,584.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,387.29
|
|
|
PR BREAST REDUCTION
|
Professional
|
Both
|
$1,921.00
|
|
|
Service Code
|
HCPCS 19318
|
| Min. Negotiated Rate |
$987.93 |
| Max. Negotiated Rate |
$1,632.85 |
| Rate for Payer: AlohaCare Medicaid |
$1,117.43
|
| Rate for Payer: AlohaCare Medicare |
$987.93
|
| Rate for Payer: Cash Price |
$1,152.60
|
| Rate for Payer: Cash Price |
$1,152.60
|
| Rate for Payer: Devoted Health Medicare |
$1,086.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$987.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,166.62
|
| Rate for Payer: Health Management Network Commercial |
$1,632.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,185.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,185.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,185.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,117.43
|
| Rate for Payer: Ohana Health Plan Medicare |
$987.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,117.43
|
| Rate for Payer: UnitedHealthcare Medicare |
$987.93
|
|
|
PR BRIEF CHKIN BY MD/QHP, 11-20
|
Professional
|
Both
|
$51.19
|
|
|
Service Code
|
HCPCS G2252
|
| Min. Negotiated Rate |
$22.41 |
| Max. Negotiated Rate |
$43.51 |
| Rate for Payer: AlohaCare Medicaid |
$25.24
|
| Rate for Payer: AlohaCare Medicare |
$22.41
|
| Rate for Payer: Cash Price |
$30.71
|
| Rate for Payer: Cash Price |
$30.71
|
| Rate for Payer: Devoted Health Medicare |
$24.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$25.24
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$22.41
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$25.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$29.59
|
| Rate for Payer: Health Management Network Commercial |
$43.51
|
| Rate for Payer: Kaiser Permanente Commercial |
$26.89
|
| Rate for Payer: Kaiser Permanente Medicaid |
$26.89
|
| Rate for Payer: Kaiser Permanente Medicare |
$26.89
|
| Rate for Payer: Ohana Health Plan Medicaid |
$25.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$22.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$25.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$22.41
|
|
|
PR BRIEF COMMUNICATION TECH-BSD SVC EST PT 5-10 MIN
|
Professional
|
Both
|
$31.50
|
|
|
Service Code
|
HCPCS 98016
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$26.77 |
| Rate for Payer: AlohaCare Medicaid |
$0.01
|
| Rate for Payer: AlohaCare Medicare |
$13.07
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Devoted Health Medicare |
$14.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$13.07
|
| Rate for Payer: Health Management Network Commercial |
$26.77
|
| Rate for Payer: Kaiser Permanente Commercial |
$15.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$15.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$15.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$0.01
|
| Rate for Payer: Ohana Health Plan Medicare |
$13.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$0.01
|
| Rate for Payer: UnitedHealthcare Medicare |
$13.07
|
|
|
PR BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 94060
|
| Min. Negotiated Rate |
$43.27 |
| Max. Negotiated Rate |
$106.25 |
| Rate for Payer: AlohaCare Medicaid |
$43.27
|
| Rate for Payer: AlohaCare Medicare |
$48.04
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Devoted Health Medicare |
$52.84
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$48.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$62.42
|
| Rate for Payer: Health Management Network Commercial |
$106.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$57.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$57.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$57.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$43.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$48.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$43.27
|
| Rate for Payer: UnitedHealthcare Medicare |
$48.04
|
|
|
PR BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 94060 26
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: AlohaCare Medicaid |
$43.27
|
| Rate for Payer: AlohaCare Medicare |
$10.63
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Devoted Health Medicare |
$11.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$10.63
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$62.42
|
| Rate for Payer: Health Management Network Commercial |
$16.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$12.76
|
| Rate for Payer: Kaiser Permanente Medicaid |
$12.76
|
| Rate for Payer: Kaiser Permanente Medicare |
$12.76
|
| Rate for Payer: Ohana Health Plan Medicaid |
$43.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$10.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$43.27
|
| Rate for Payer: UnitedHealthcare Medicare |
$10.63
|
|
|
PR BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 94060 TC
|
| Min. Negotiated Rate |
$37.41 |
| Max. Negotiated Rate |
$90.10 |
| Rate for Payer: AlohaCare Medicaid |
$43.27
|
| Rate for Payer: AlohaCare Medicare |
$37.41
|
| Rate for Payer: Cash Price |
$63.60
|
| Rate for Payer: Cash Price |
$63.60
|
| 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 |
$62.42
|
| Rate for Payer: Health Management Network Commercial |
$90.10
|
| 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 |
$43.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$37.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$43.27
|
| Rate for Payer: UnitedHealthcare Medicare |
$37.41
|
|
|
PR BRNCHSC BRUSHING/PROTECTED BRUSHINGS
|
Professional
|
Both
|
$574.46
|
|
|
Service Code
|
HCPCS 31623
|
| Min. Negotiated Rate |
$119.39 |
| Max. Negotiated Rate |
$488.29 |
| Rate for Payer: AlohaCare Medicaid |
$130.47
|
| Rate for Payer: AlohaCare Medicare |
$119.39
|
| Rate for Payer: Cash Price |
$344.68
|
| Rate for Payer: Cash Price |
$344.68
|
| Rate for Payer: Devoted Health Medicare |
$131.33
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$130.47
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$206.12
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$119.39
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$130.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$329.16
|
| Rate for Payer: Health Management Network Commercial |
$488.29
|
| Rate for Payer: Kaiser Permanente Commercial |
$143.27
|
| Rate for Payer: Kaiser Permanente Medicaid |
$143.27
|
| Rate for Payer: Kaiser Permanente Medicare |
$143.27
|
| Rate for Payer: Ohana Health Plan Medicaid |
$130.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$119.39
|
| Rate for Payer: UnitedHealthcare Medicaid |
$130.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$119.39
|
| Rate for Payer: University Health Alliance Commercial |
$174.51
|
|
|
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX
|
Professional
|
Both
|
$532.68
|
|
|
Service Code
|
HCPCS 31622
|
| Min. Negotiated Rate |
$119.82 |
| Max. Negotiated Rate |
$452.78 |
| Rate for Payer: AlohaCare Medicaid |
$130.55
|
| Rate for Payer: AlohaCare Medicare |
$119.82
|
| Rate for Payer: Cash Price |
$319.61
|
| Rate for Payer: Cash Price |
$319.61
|
| Rate for Payer: Devoted Health Medicare |
$131.80
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$130.55
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$204.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$119.82
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$130.55
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$231.14
|
| Rate for Payer: Health Management Network Commercial |
$452.78
|
| Rate for Payer: Kaiser Permanente Commercial |
$143.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$143.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$143.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$130.55
|
| Rate for Payer: Ohana Health Plan Medicare |
$119.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$130.55
|
| Rate for Payer: UnitedHealthcare Medicare |
$119.82
|
| Rate for Payer: University Health Alliance Commercial |
$172.86
|
|
|
PR BRNCHSC W/BRNCL ALVEOLAR LAVAGE
|
Professional
|
Both
|
$541.89
|
|
|
Service Code
|
HCPCS 31624
|
| Min. Negotiated Rate |
$121.29 |
| Max. Negotiated Rate |
$460.61 |
| Rate for Payer: AlohaCare Medicaid |
$132.19
|
| Rate for Payer: AlohaCare Medicare |
$121.29
|
| Rate for Payer: Cash Price |
$325.13
|
| Rate for Payer: Cash Price |
$325.13
|
| Rate for Payer: Devoted Health Medicare |
$133.42
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$132.19
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$208.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$121.29
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$132.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$226.20
|
| Rate for Payer: Health Management Network Commercial |
$460.61
|
| Rate for Payer: Kaiser Permanente Commercial |
$145.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$145.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$145.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$132.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$121.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$132.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$121.29
|
| Rate for Payer: University Health Alliance Commercial |
$176.31
|
|
|
PR BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 94070 TC
|
| Min. Negotiated Rate |
$46.34 |
| Max. Negotiated Rate |
$96.35 |
| Rate for Payer: AlohaCare Medicaid |
$68.53
|
| Rate for Payer: AlohaCare Medicare |
$46.34
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Devoted Health Medicare |
$50.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$46.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$96.35
|
| Rate for Payer: Health Management Network Commercial |
$68.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$55.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$55.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$55.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$68.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$46.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$68.53
|
| Rate for Payer: UnitedHealthcare Medicare |
$46.34
|
|
|
PR BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 94070
|
| Min. Negotiated Rate |
$68.53 |
| Max. Negotiated Rate |
$112.20 |
| Rate for Payer: AlohaCare Medicaid |
$68.53
|
| Rate for Payer: AlohaCare Medicare |
$75.74
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Devoted Health Medicare |
$83.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$75.74
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$96.35
|
| Rate for Payer: Health Management Network Commercial |
$112.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$90.89
|
| Rate for Payer: Kaiser Permanente Medicaid |
$90.89
|
| Rate for Payer: Kaiser Permanente Medicare |
$90.89
|
| Rate for Payer: Ohana Health Plan Medicaid |
$68.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$75.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$68.53
|
| Rate for Payer: UnitedHealthcare Medicare |
$75.74
|
|
|
PR BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 94070 26
|
| Min. Negotiated Rate |
$29.40 |
| Max. Negotiated Rate |
$96.35 |
| Rate for Payer: AlohaCare Medicaid |
$68.53
|
| Rate for Payer: AlohaCare Medicare |
$29.40
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Devoted Health Medicare |
$32.34
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$29.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$96.35
|
| Rate for Payer: Health Management Network Commercial |
$43.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$35.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$35.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$35.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$68.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$29.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$68.53
|
| Rate for Payer: UnitedHealthcare Medicare |
$29.40
|
|
|
PR BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES
|
Professional
|
Both
|
$730.90
|
|
|
Service Code
|
HCPCS 31625
|
| Min. Negotiated Rate |
$140.43 |
| Max. Negotiated Rate |
$621.26 |
| Rate for Payer: AlohaCare Medicaid |
$153.88
|
| Rate for Payer: AlohaCare Medicare |
$140.43
|
| Rate for Payer: Cash Price |
$438.54
|
| Rate for Payer: Cash Price |
$438.54
|
| Rate for Payer: Devoted Health Medicare |
$154.47
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$153.88
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$242.88
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$140.43
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$153.88
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$277.42
|
| Rate for Payer: Health Management Network Commercial |
$621.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$168.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$168.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$168.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$153.88
|
| Rate for Payer: Ohana Health Plan Medicare |
$140.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$153.88
|
| Rate for Payer: UnitedHealthcare Medicare |
$140.43
|
| Rate for Payer: University Health Alliance Commercial |
$205.64
|
|
|
PR BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON
|
Professional
|
Both
|
$948.54
|
|
|
Service Code
|
HCPCS 31629
|
| Min. Negotiated Rate |
$167.95 |
| Max. Negotiated Rate |
$806.26 |
| Rate for Payer: AlohaCare Medicaid |
$183.57
|
| Rate for Payer: AlohaCare Medicare |
$167.95
|
| Rate for Payer: Cash Price |
$569.12
|
| Rate for Payer: Cash Price |
$569.12
|
| Rate for Payer: Devoted Health Medicare |
$184.75
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$183.57
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$288.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$167.95
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$183.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$256.62
|
| Rate for Payer: Health Management Network Commercial |
$806.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$201.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$201.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$201.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$183.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$167.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$183.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$167.95
|
| Rate for Payer: University Health Alliance Commercial |
$244.56
|
|
|
PR BRONCHOSCOPY W/EXCISION TUMOR
|
Professional
|
Both
|
$413.00
|
|
|
Service Code
|
HCPCS 31640
|
| Min. Negotiated Rate |
$217.78 |
| Max. Negotiated Rate |
$351.05 |
| Rate for Payer: AlohaCare Medicaid |
$242.67
|
| Rate for Payer: AlohaCare Medicare |
$217.78
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Devoted Health Medicare |
$239.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$217.78
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$283.40
|
| Rate for Payer: Health Management Network Commercial |
$351.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$261.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$261.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$261.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$242.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$217.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$242.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$217.78
|
|
|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST
|
Professional
|
Both
|
$582.12
|
|
|
Service Code
|
HCPCS 31645
|
| Min. Negotiated Rate |
$133.26 |
| Max. Negotiated Rate |
$494.80 |
| Rate for Payer: AlohaCare Medicaid |
$145.27
|
| Rate for Payer: AlohaCare Medicare |
$133.26
|
| Rate for Payer: Cash Price |
$349.27
|
| Rate for Payer: Cash Price |
$349.27
|
| Rate for Payer: Devoted Health Medicare |
$146.59
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$145.27
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$227.99
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$133.26
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$145.27
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$240.76
|
| Rate for Payer: Health Management Network Commercial |
$494.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$159.91
|
| Rate for Payer: Kaiser Permanente Medicaid |
$159.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$159.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$145.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$133.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$145.27
|
| Rate for Payer: UnitedHealthcare Medicare |
$133.26
|
| Rate for Payer: University Health Alliance Commercial |
$193.03
|
|
|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 31646
|
| Min. Negotiated Rate |
$129.16 |
| Max. Negotiated Rate |
$236.41 |
| Rate for Payer: AlohaCare Medicaid |
$140.42
|
| Rate for Payer: AlohaCare Medicare |
$129.16
|
| Rate for Payer: Cash Price |
$144.60
|
| Rate for Payer: Cash Price |
$144.60
|
| Rate for Payer: Devoted Health Medicare |
$142.08
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$236.41
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$129.16
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$158.34
|
| Rate for Payer: Health Management Network Commercial |
$204.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$154.99
|
| Rate for Payer: Kaiser Permanente Medicaid |
$154.99
|
| Rate for Payer: Kaiser Permanente Medicare |
$154.99
|
| Rate for Payer: Ohana Health Plan Medicaid |
$140.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$129.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$140.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$129.16
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE
|
Professional
|
Both
|
$774.99
|
|
|
Service Code
|
HCPCS 31628
|
| Min. Negotiated Rate |
$158.41 |
| Max. Negotiated Rate |
$658.74 |
| Rate for Payer: AlohaCare Medicaid |
$173.30
|
| Rate for Payer: AlohaCare Medicare |
$158.41
|
| Rate for Payer: Cash Price |
$464.99
|
| Rate for Payer: Cash Price |
$464.99
|
| Rate for Payer: Devoted Health Medicare |
$174.25
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$173.30
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$273.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$158.41
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$173.30
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$307.58
|
| Rate for Payer: Health Management Network Commercial |
$658.74
|
| Rate for Payer: Kaiser Permanente Commercial |
$190.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$190.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$190.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$173.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$158.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$173.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$158.41
|
| Rate for Payer: University Health Alliance Commercial |
$231.19
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE
|
Professional
|
Both
|
$157.22
|
|
|
Service Code
|
HCPCS 31633
|
| Min. Negotiated Rate |
$55.66 |
| Max. Negotiated Rate |
$133.64 |
| Rate for Payer: AlohaCare Medicaid |
$61.28
|
| Rate for Payer: AlohaCare Medicare |
$55.66
|
| Rate for Payer: Cash Price |
$94.33
|
| Rate for Payer: Cash Price |
$94.33
|
| Rate for Payer: Devoted Health Medicare |
$61.23
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$61.28
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$97.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$55.66
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$61.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.16
|
| Rate for Payer: Health Management Network Commercial |
$133.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$66.79
|
| Rate for Payer: Kaiser Permanente Medicaid |
$66.79
|
| Rate for Payer: Kaiser Permanente Medicare |
$66.79
|
| Rate for Payer: Ohana Health Plan Medicaid |
$61.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$55.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$61.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$55.66
|
| Rate for Payer: University Health Alliance Commercial |
$82.45
|
|
|
PR BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE
|
Professional
|
Both
|
$319.53
|
|
|
Service Code
|
HCPCS 49180
|
| Min. Negotiated Rate |
$69.80 |
| Max. Negotiated Rate |
$271.60 |
| Rate for Payer: AlohaCare Medicaid |
$80.65
|
| Rate for Payer: AlohaCare Medicare |
$69.80
|
| Rate for Payer: Cash Price |
$191.72
|
| Rate for Payer: Cash Price |
$191.72
|
| Rate for Payer: Devoted Health Medicare |
$76.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$80.65
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$127.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$80.65
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$158.86
|
| Rate for Payer: Health Management Network Commercial |
$271.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$83.76
|
| Rate for Payer: Kaiser Permanente Medicaid |
$83.76
|
| Rate for Payer: Kaiser Permanente Medicare |
$83.76
|
| Rate for Payer: Ohana Health Plan Medicaid |
$80.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$80.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.80
|
| Rate for Payer: University Health Alliance Commercial |
$108.08
|
|
|
PR BX ANORECTAL WALL ANAL APPROACH
|
Professional
|
Both
|
$544.46
|
|
|
Service Code
|
HCPCS 45100
|
| Min. Negotiated Rate |
$234.00 |
| Max. Negotiated Rate |
$462.79 |
| Rate for Payer: AlohaCare Medicaid |
$316.39
|
| Rate for Payer: AlohaCare Medicare |
$311.12
|
| Rate for Payer: Cash Price |
$326.68
|
| Rate for Payer: Cash Price |
$326.68
|
| Rate for Payer: Devoted Health Medicare |
$342.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$311.12
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network Commercial |
$462.79
|
| Rate for Payer: Kaiser Permanente Commercial |
$373.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$373.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$373.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$316.39
|
| Rate for Payer: Ohana Health Plan Medicare |
$311.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$316.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$311.12
|
|
