|
PR CLTX TIBIAL FX PROXIMAL W/O MANIPULATION
|
Professional
|
Both
|
$656.55
|
|
|
Service Code
|
HCPCS 27530
|
| Min. Negotiated Rate |
$245.70 |
| Max. Negotiated Rate |
$558.07 |
| Rate for Payer: AlohaCare Medicaid |
$323.20
|
| Rate for Payer: AlohaCare Medicare |
$320.49
|
| Rate for Payer: Cash Price |
$393.93
|
| Rate for Payer: Cash Price |
$393.93
|
| Rate for Payer: Devoted Health Medicare |
$352.54
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$323.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$320.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$323.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$245.70
|
| Rate for Payer: Health Management Network Commercial |
$558.07
|
| Rate for Payer: Kaiser Permanente Commercial |
$384.59
|
| Rate for Payer: Kaiser Permanente Medicaid |
$384.59
|
| Rate for Payer: Kaiser Permanente Medicare |
$384.59
|
| Rate for Payer: Ohana Health Plan Medicaid |
$323.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$320.49
|
| Rate for Payer: UnitedHealthcare Medicaid |
$323.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$320.49
|
| Rate for Payer: University Health Alliance Commercial |
$411.45
|
|
|
PR CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ
|
Professional
|
Both
|
$1,241.96
|
|
|
Service Code
|
HCPCS 27532
|
| Min. Negotiated Rate |
$395.20 |
| Max. Negotiated Rate |
$1,055.67 |
| Rate for Payer: AlohaCare Medicaid |
$612.25
|
| Rate for Payer: AlohaCare Medicare |
$569.55
|
| Rate for Payer: Cash Price |
$745.18
|
| Rate for Payer: Cash Price |
$745.18
|
| Rate for Payer: Devoted Health Medicare |
$626.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$612.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$569.55
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$612.25
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$395.20
|
| Rate for Payer: Health Management Network Commercial |
$1,055.67
|
| Rate for Payer: Kaiser Permanente Commercial |
$683.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$683.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$683.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$612.25
|
| Rate for Payer: Ohana Health Plan Medicare |
$569.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$612.25
|
| Rate for Payer: UnitedHealthcare Medicare |
$569.55
|
| Rate for Payer: University Health Alliance Commercial |
$793.75
|
|
|
PR CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$1,118.25
|
|
|
Service Code
|
HCPCS 27752
|
| Min. Negotiated Rate |
$472.68 |
| Max. Negotiated Rate |
$950.51 |
| Rate for Payer: AlohaCare Medicaid |
$521.19
|
| Rate for Payer: AlohaCare Medicare |
$516.34
|
| Rate for Payer: Cash Price |
$670.95
|
| Rate for Payer: Cash Price |
$670.95
|
| Rate for Payer: Devoted Health Medicare |
$567.97
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$521.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$516.34
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$521.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$472.68
|
| Rate for Payer: Health Management Network Commercial |
$950.51
|
| Rate for Payer: Kaiser Permanente Commercial |
$619.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$619.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$619.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$521.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$516.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$521.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$516.34
|
| Rate for Payer: University Health Alliance Commercial |
$675.47
|
|
|
PR CLTX TIBIAL SHAFT FX W/O MANIPULATION
|
Professional
|
Both
|
$738.36
|
|
|
Service Code
|
HCPCS 27750
|
| Min. Negotiated Rate |
$299.78 |
| Max. Negotiated Rate |
$627.61 |
| Rate for Payer: AlohaCare Medicaid |
$356.47
|
| Rate for Payer: AlohaCare Medicare |
$351.66
|
| Rate for Payer: Cash Price |
$443.02
|
| Rate for Payer: Cash Price |
$443.02
|
| Rate for Payer: Devoted Health Medicare |
$386.83
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$356.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$351.66
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$356.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$299.78
|
| Rate for Payer: Health Management Network Commercial |
$627.61
|
| Rate for Payer: Kaiser Permanente Commercial |
$421.99
|
| Rate for Payer: Kaiser Permanente Medicaid |
$421.99
|
| Rate for Payer: Kaiser Permanente Medicare |
$421.99
|
| Rate for Payer: Ohana Health Plan Medicaid |
$356.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$351.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$356.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$351.66
|
| Rate for Payer: University Health Alliance Commercial |
$475.00
|
|
|
PR CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MNPJ
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 25680
|
| Min. Negotiated Rate |
$261.82 |
| Max. Negotiated Rate |
$833.85 |
| Rate for Payer: AlohaCare Medicaid |
$570.16
|
| Rate for Payer: AlohaCare Medicare |
$538.15
|
| Rate for Payer: Cash Price |
$588.60
|
| Rate for Payer: Cash Price |
$588.60
|
| Rate for Payer: Devoted Health Medicare |
$591.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$538.15
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$261.82
|
| Rate for Payer: Health Management Network Commercial |
$833.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$645.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$645.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$645.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$570.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$538.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$570.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$538.15
|
|
|
PR CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION
|
Professional
|
Both
|
$1,078.49
|
|
|
Service Code
|
HCPCS 27818
|
| Min. Negotiated Rate |
$378.30 |
| Max. Negotiated Rate |
$916.72 |
| Rate for Payer: AlohaCare Medicaid |
$470.19
|
| Rate for Payer: AlohaCare Medicare |
$492.86
|
| Rate for Payer: Cash Price |
$647.09
|
| Rate for Payer: Cash Price |
$647.09
|
| Rate for Payer: Devoted Health Medicare |
$542.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$470.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$492.86
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$470.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$378.30
|
| Rate for Payer: Health Management Network Commercial |
$916.72
|
| Rate for Payer: Kaiser Permanente Commercial |
$591.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$591.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$591.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$470.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$492.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$470.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$492.86
|
| Rate for Payer: University Health Alliance Commercial |
$602.28
|
|
|
PR CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION
|
Professional
|
Both
|
$716.80
|
|
|
Service Code
|
HCPCS 27816
|
| Min. Negotiated Rate |
$223.86 |
| Max. Negotiated Rate |
$609.28 |
| Rate for Payer: AlohaCare Medicaid |
$325.48
|
| Rate for Payer: AlohaCare Medicare |
$331.36
|
| Rate for Payer: Cash Price |
$430.08
|
| Rate for Payer: Cash Price |
$430.08
|
| Rate for Payer: Devoted Health Medicare |
$364.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$325.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$331.36
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$325.48
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$223.86
|
| Rate for Payer: Health Management Network Commercial |
$609.28
|
| Rate for Payer: Kaiser Permanente Commercial |
$397.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$397.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$397.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$325.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$331.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$325.48
|
| Rate for Payer: UnitedHealthcare Medicare |
$331.36
|
| Rate for Payer: University Health Alliance Commercial |
$414.29
|
|
|
PR CNSLT BEFORE SCREEN COLONOSC
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS S0285
|
| Min. Negotiated Rate |
$74.80 |
| Max. Negotiated Rate |
$74.80 |
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Health Management Network Commercial |
$74.80
|
|
|
PR CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX
|
Professional
|
Both
|
$332.73
|
|
|
Service Code
|
HCPCS 49424
|
| Min. Negotiated Rate |
$31.77 |
| Max. Negotiated Rate |
$282.82 |
| Rate for Payer: AlohaCare Medicaid |
$36.35
|
| Rate for Payer: AlohaCare Medicare |
$31.77
|
| Rate for Payer: Cash Price |
$199.64
|
| Rate for Payer: Cash Price |
$199.64
|
| Rate for Payer: Devoted Health Medicare |
$34.95
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$36.35
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$58.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$31.77
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$36.35
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$47.84
|
| Rate for Payer: Health Management Network Commercial |
$282.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$38.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$38.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$38.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$36.35
|
| Rate for Payer: Ohana Health Plan Medicare |
$31.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$36.35
|
| Rate for Payer: UnitedHealthcare Medicare |
$31.77
|
| Rate for Payer: University Health Alliance Commercial |
$59.00
|
|
|
PR CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT
|
Professional
|
Both
|
$223.23
|
|
|
Service Code
|
HCPCS 36598
|
| Min. Negotiated Rate |
$29.96 |
| Max. Negotiated Rate |
$189.75 |
| Rate for Payer: AlohaCare Medicaid |
$34.74
|
| Rate for Payer: AlohaCare Medicare |
$29.96
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Devoted Health Medicare |
$32.96
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$34.74
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$55.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$29.96
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$34.74
|
| Rate for Payer: Health Management Network Commercial |
$189.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$35.95
|
| Rate for Payer: Kaiser Permanente Medicaid |
$35.95
|
| Rate for Payer: Kaiser Permanente Medicare |
$35.95
|
| Rate for Payer: Ohana Health Plan Medicaid |
$34.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$29.96
|
| Rate for Payer: UnitedHealthcare Medicaid |
$34.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$29.96
|
| Rate for Payer: University Health Alliance Commercial |
$43.12
|
|
|
PR CO DIFFUSING CAPACITY
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS 94729 26
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$63.69 |
| Rate for Payer: AlohaCare Medicaid |
$63.69
|
| Rate for Payer: AlohaCare Medicare |
$9.58
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Devoted Health Medicare |
$10.54
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.58
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$60.47
|
| Rate for Payer: Health Management Network Commercial |
$14.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$11.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$11.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.58
|
| Rate for Payer: UnitedHealthcare Medicaid |
$63.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.58
|
|
|
PR CO DIFFUSING CAPACITY
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 94729 TC
|
| Min. Negotiated Rate |
$60.47 |
| Max. Negotiated Rate |
$148.75 |
| Rate for Payer: AlohaCare Medicaid |
$63.69
|
| Rate for Payer: AlohaCare Medicare |
$61.34
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Devoted Health Medicare |
$67.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$61.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$60.47
|
| Rate for Payer: Health Management Network Commercial |
$148.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$73.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$73.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$73.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$61.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$63.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$61.34
|
|
|
PR CO DIFFUSING CAPACITY
|
Professional
|
Both
|
$192.00
|
|
|
Service Code
|
HCPCS 94729
|
| Min. Negotiated Rate |
$60.47 |
| Max. Negotiated Rate |
$163.20 |
| Rate for Payer: AlohaCare Medicaid |
$63.69
|
| Rate for Payer: AlohaCare Medicare |
$70.91
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Devoted Health Medicare |
$78.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$70.91
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$60.47
|
| Rate for Payer: Health Management Network Commercial |
$163.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$85.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$85.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$70.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$63.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$70.91
|
|
|
PR COGNITIVE&BEHAVIORAL IMPAIRMENT SCRNG PERFORMED
|
Professional
|
Both
|
$643.00
|
|
|
Service Code
|
HCPCS 3755F
|
| Min. Negotiated Rate |
$546.55 |
| Max. Negotiated Rate |
$546.55 |
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Health Management Network Commercial |
$546.55
|
|
|
PR COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS
|
Professional
|
Both
|
$3,134.00
|
|
|
Service Code
|
HCPCS 44150
|
| Min. Negotiated Rate |
$1,069.90 |
| Max. Negotiated Rate |
$2,663.90 |
| Rate for Payer: AlohaCare Medicaid |
$1,832.90
|
| Rate for Payer: AlohaCare Medicare |
$1,706.36
|
| Rate for Payer: Cash Price |
$1,880.40
|
| Rate for Payer: Cash Price |
$1,880.40
|
| Rate for Payer: Devoted Health Medicare |
$1,877.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,706.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,069.90
|
| Rate for Payer: Health Management Network Commercial |
$2,663.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,047.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,047.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,047.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,832.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,706.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,832.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,706.36
|
|
|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$2,260.00
|
|
|
Service Code
|
HCPCS 44140
|
| Min. Negotiated Rate |
$1,142.18 |
| Max. Negotiated Rate |
$1,921.00 |
| Rate for Payer: AlohaCare Medicaid |
$1,320.02
|
| Rate for Payer: AlohaCare Medicare |
$1,220.02
|
| Rate for Payer: Cash Price |
$1,356.00
|
| Rate for Payer: Cash Price |
$1,356.00
|
| Rate for Payer: Devoted Health Medicare |
$1,342.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,220.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,142.18
|
| Rate for Payer: Health Management Network Commercial |
$1,921.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,464.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,464.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,464.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,320.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,220.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,320.02
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,220.02
|
|
|
PR COLECTOMY PRTL W/COLOPROCTOSTOMY
|
Professional
|
Both
|
$2,772.00
|
|
|
Service Code
|
HCPCS 44145
|
| Min. Negotiated Rate |
$1,068.08 |
| Max. Negotiated Rate |
$2,356.20 |
| Rate for Payer: AlohaCare Medicaid |
$1,620.80
|
| Rate for Payer: AlohaCare Medicare |
$1,480.48
|
| Rate for Payer: Cash Price |
$1,663.20
|
| Rate for Payer: Cash Price |
$1,663.20
|
| Rate for Payer: Devoted Health Medicare |
$1,628.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,480.48
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,068.08
|
| Rate for Payer: Health Management Network Commercial |
$2,356.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,776.58
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,776.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,776.58
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,620.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,480.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,620.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,480.48
|
|
|
PR COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY
|
Professional
|
Both
|
$3,530.00
|
|
|
Service Code
|
HCPCS 44146
|
| Min. Negotiated Rate |
$1,163.50 |
| Max. Negotiated Rate |
$3,000.50 |
| Rate for Payer: AlohaCare Medicaid |
$2,066.36
|
| Rate for Payer: AlohaCare Medicare |
$1,903.23
|
| Rate for Payer: Cash Price |
$2,118.00
|
| Rate for Payer: Cash Price |
$2,118.00
|
| Rate for Payer: Devoted Health Medicare |
$2,093.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,903.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,163.50
|
| Rate for Payer: Health Management Network Commercial |
$3,000.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,283.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,283.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,283.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,066.36
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,903.23
|
| Rate for Payer: UnitedHealthcare Medicaid |
$2,066.36
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,903.23
|
|
|
PR COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA
|
Professional
|
Both
|
$2,958.00
|
|
|
Service Code
|
HCPCS 44144
|
| Min. Negotiated Rate |
$1,209.52 |
| Max. Negotiated Rate |
$2,514.30 |
| Rate for Payer: AlohaCare Medicaid |
$1,729.92
|
| Rate for Payer: AlohaCare Medicare |
$1,594.32
|
| Rate for Payer: Cash Price |
$1,774.80
|
| Rate for Payer: Cash Price |
$1,774.80
|
| Rate for Payer: Devoted Health Medicare |
$1,753.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,594.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,209.52
|
| Rate for Payer: Health Management Network Commercial |
$2,514.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,913.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,913.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,913.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,729.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,594.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,729.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,594.32
|
|
|
PR COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT
|
Professional
|
Both
|
$2,769.00
|
|
|
Service Code
|
HCPCS 44143
|
| Min. Negotiated Rate |
$1,274.26 |
| Max. Negotiated Rate |
$2,353.65 |
| Rate for Payer: AlohaCare Medicaid |
$1,621.09
|
| Rate for Payer: AlohaCare Medicare |
$1,493.46
|
| Rate for Payer: Cash Price |
$1,661.40
|
| Rate for Payer: Cash Price |
$1,661.40
|
| Rate for Payer: Devoted Health Medicare |
$1,642.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,493.46
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,274.26
|
| Rate for Payer: Health Management Network Commercial |
$2,353.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,792.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,792.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,792.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,621.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,493.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,621.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,493.46
|
|
|
PR COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS
|
Professional
|
Both
|
$2,095.00
|
|
|
Service Code
|
HCPCS 44160
|
| Min. Negotiated Rate |
$831.22 |
| Max. Negotiated Rate |
$1,780.75 |
| Rate for Payer: AlohaCare Medicaid |
$1,223.11
|
| Rate for Payer: AlohaCare Medicare |
$1,131.36
|
| Rate for Payer: Cash Price |
$1,257.00
|
| Rate for Payer: Cash Price |
$1,257.00
|
| Rate for Payer: Devoted Health Medicare |
$1,244.50
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,131.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$831.22
|
| Rate for Payer: Health Management Network Commercial |
$1,780.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,357.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,357.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,357.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,223.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,131.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,223.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,131.36
|
|
|
PR COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY
|
Professional
|
Both
|
$3,047.00
|
|
|
Service Code
|
HCPCS 44141
|
| Min. Negotiated Rate |
$939.38 |
| Max. Negotiated Rate |
$2,589.95 |
| Rate for Payer: AlohaCare Medicaid |
$1,784.74
|
| Rate for Payer: AlohaCare Medicare |
$1,655.89
|
| Rate for Payer: Cash Price |
$1,828.20
|
| Rate for Payer: Cash Price |
$1,828.20
|
| Rate for Payer: Devoted Health Medicare |
$1,821.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,655.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$939.38
|
| Rate for Payer: Health Management Network Commercial |
$2,589.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,987.07
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,987.07
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,987.07
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,784.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,655.89
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,784.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,655.89
|
|
|
PR COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE
|
Professional
|
Both
|
$60.81
|
|
|
Service Code
|
HCPCS 36591
|
| Min. Negotiated Rate |
$31.55 |
| Max. Negotiated Rate |
$51.69 |
| Rate for Payer: AlohaCare Medicaid |
$31.55
|
| Rate for Payer: AlohaCare Medicare |
$34.37
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Devoted Health Medicare |
$37.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$34.37
|
| Rate for Payer: Health Management Network Commercial |
$51.69
|
| Rate for Payer: Kaiser Permanente Commercial |
$41.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$41.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$41.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$31.55
|
| Rate for Payer: Ohana Health Plan Medicare |
$34.37
|
| Rate for Payer: UnitedHealthcare Medicaid |
$31.55
|
| Rate for Payer: UnitedHealthcare Medicare |
$34.37
|
|
|
PR COLLECTION VENOUS BLOOD VENIPUNCTURE
|
Professional
|
Both
|
$16.00
|
|
|
Service Code
|
HCPCS 36415
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: AlohaCare Medicaid |
$3.00
|
| Rate for Payer: AlohaCare Medicare |
$9.34
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Devoted Health Medicare |
$10.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3.12
|
| Rate for Payer: Health Management Network Commercial |
$13.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$11.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$11.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.34
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Professional
|
Both
|
$713.82
|
|
|
Service Code
|
HCPCS G0121
|
| Min. Negotiated Rate |
$125.26 |
| Max. Negotiated Rate |
$606.75 |
| Rate for Payer: AlohaCare Medicaid |
$184.24
|
| Rate for Payer: AlohaCare Medicare |
$165.23
|
| Rate for Payer: Cash Price |
$428.29
|
| Rate for Payer: Cash Price |
$428.29
|
| Rate for Payer: Devoted Health Medicare |
$181.75
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$184.24
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$348.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$165.23
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$184.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$319.54
|
| Rate for Payer: Health Management Network Commercial |
$606.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$198.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$198.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$198.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$184.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$165.23
|
| Rate for Payer: UnitedHealthcare Medicaid |
$184.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$165.23
|
| Rate for Payer: University Health Alliance Commercial |
$125.26
|
|
