|
PR DIR RPR ANEURYSM ABDOMINAL AORTA
|
Professional
|
Both
|
$2,740.00
|
|
|
Service Code
|
HCPCS 35081
|
| Min. Negotiated Rate |
$1,484.63 |
| Max. Negotiated Rate |
$2,459.38 |
| Rate for Payer: AlohaCare Medicaid |
$1,608.65
|
| Rate for Payer: AlohaCare Medicare |
$1,484.63
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Devoted Health Medicare |
$1,633.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,484.63
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,779.96
|
| Rate for Payer: Health Management Network Commercial |
$2,329.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,781.56
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,781.56
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,781.56
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,608.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,484.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,608.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,484.63
|
| Rate for Payer: University Health Alliance Commercial |
$2,459.38
|
|
|
PR DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION
|
Professional
|
Both
|
$1,619.00
|
|
|
Service Code
|
HCPCS 35011
|
| Min. Negotiated Rate |
$717.60 |
| Max. Negotiated Rate |
$1,427.05 |
| Rate for Payer: AlohaCare Medicaid |
$952.01
|
| Rate for Payer: AlohaCare Medicare |
$869.10
|
| Rate for Payer: Cash Price |
$971.40
|
| Rate for Payer: Cash Price |
$971.40
|
| Rate for Payer: Devoted Health Medicare |
$956.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$869.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$717.60
|
| Rate for Payer: Health Management Network Commercial |
$1,376.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,042.92
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,042.92
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,042.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$952.01
|
| Rate for Payer: Ohana Health Plan Medicare |
$869.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$952.01
|
| Rate for Payer: UnitedHealthcare Medicare |
$869.10
|
| Rate for Payer: University Health Alliance Commercial |
$1,427.05
|
|
|
PR DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY
|
Professional
|
Both
|
$1,737.00
|
|
|
Service Code
|
HCPCS 35141
|
| Min. Negotiated Rate |
$854.10 |
| Max. Negotiated Rate |
$1,476.45 |
| Rate for Payer: AlohaCare Medicaid |
$1,018.62
|
| Rate for Payer: AlohaCare Medicare |
$936.73
|
| Rate for Payer: Cash Price |
$1,042.20
|
| Rate for Payer: Cash Price |
$1,042.20
|
| Rate for Payer: Devoted Health Medicare |
$1,030.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$936.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$854.10
|
| Rate for Payer: Health Management Network Commercial |
$1,476.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,124.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,124.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,124.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,018.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$936.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,018.62
|
| Rate for Payer: UnitedHealthcare Medicare |
$936.73
|
|
|
PR DIR RPR ANEURYSM & GRAFT ILIAC ARTERY
|
Professional
|
Both
|
$2,208.00
|
|
|
Service Code
|
HCPCS 35131
|
| Min. Negotiated Rate |
$1,010.62 |
| Max. Negotiated Rate |
$1,876.80 |
| Rate for Payer: AlohaCare Medicaid |
$1,288.91
|
| Rate for Payer: AlohaCare Medicare |
$1,191.68
|
| Rate for Payer: Cash Price |
$1,324.80
|
| Rate for Payer: Cash Price |
$1,324.80
|
| Rate for Payer: Devoted Health Medicare |
$1,310.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,191.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,010.62
|
| Rate for Payer: Health Management Network Commercial |
$1,876.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,430.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,430.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,430.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,288.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,191.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,288.91
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,191.68
|
|
|
PR DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS
|
Professional
|
Both
|
$4,102.00
|
|
|
Service Code
|
HCPCS 35092
|
| Min. Negotiated Rate |
$1,883.44 |
| Max. Negotiated Rate |
$3,662.69 |
| Rate for Payer: AlohaCare Medicaid |
$2,403.13
|
| Rate for Payer: AlohaCare Medicare |
$2,140.90
|
| Rate for Payer: Cash Price |
$2,461.20
|
| Rate for Payer: Cash Price |
$2,461.20
|
| Rate for Payer: Devoted Health Medicare |
$2,354.99
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2,140.90
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,883.44
|
| Rate for Payer: Health Management Network Commercial |
$3,486.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,569.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,569.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,569.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,403.13
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,140.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$2,403.13
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,140.90
|
| Rate for Payer: University Health Alliance Commercial |
$3,662.69
|
|
|
PR DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS
|
Professional
|
Both
|
$3,405.00
|
|
|
Service Code
|
HCPCS 35103
|
| Min. Negotiated Rate |
$1,737.32 |
| Max. Negotiated Rate |
$2,894.25 |
| Rate for Payer: AlohaCare Medicaid |
$2,050.65
|
| Rate for Payer: AlohaCare Medicare |
$1,838.12
|
| Rate for Payer: Cash Price |
$2,043.00
|
| Rate for Payer: Cash Price |
$2,043.00
|
| Rate for Payer: Devoted Health Medicare |
$2,021.93
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,838.12
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,737.32
|
| Rate for Payer: Health Management Network Commercial |
$2,894.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,205.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,205.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,205.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,050.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,838.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$2,050.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,838.12
|
|
|
PR DIR RPR RUPTD ANEURYSM & GRF POPLITEAL ARTERY
|
Professional
|
Both
|
$2,210.00
|
|
|
Service Code
|
HCPCS 35152
|
| Min. Negotiated Rate |
$773.50 |
| Max. Negotiated Rate |
$1,878.50 |
| Rate for Payer: AlohaCare Medicaid |
$1,294.19
|
| Rate for Payer: AlohaCare Medicare |
$1,193.56
|
| Rate for Payer: Cash Price |
$1,326.00
|
| Rate for Payer: Cash Price |
$1,326.00
|
| Rate for Payer: Devoted Health Medicare |
$1,312.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,193.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$773.50
|
| Rate for Payer: Health Management Network Commercial |
$1,878.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,432.27
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,432.27
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,432.27
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,294.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,193.56
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,294.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,193.56
|
|
|
PR DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 35045
|
| Min. Negotiated Rate |
$692.12 |
| Max. Negotiated Rate |
$1,408.25 |
| Rate for Payer: AlohaCare Medicaid |
$914.81
|
| Rate for Payer: AlohaCare Medicare |
$828.08
|
| Rate for Payer: Cash Price |
$934.20
|
| Rate for Payer: Cash Price |
$934.20
|
| Rate for Payer: Devoted Health Medicare |
$910.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$828.08
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$692.12
|
| Rate for Payer: Health Management Network Commercial |
$1,323.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$993.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$993.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$993.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$914.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$828.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$914.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$828.08
|
| Rate for Payer: University Health Alliance Commercial |
$1,408.25
|
|
|
PR DISE DYN EVAL SLEEP DISORDERED BREATHING FLX DX
|
Professional
|
Both
|
$169.00
|
|
|
Service Code
|
HCPCS 42975
|
| Min. Negotiated Rate |
$83.98 |
| Max. Negotiated Rate |
$143.65 |
| Rate for Payer: AlohaCare Medicaid |
$98.96
|
| Rate for Payer: AlohaCare Medicare |
$83.98
|
| Rate for Payer: Cash Price |
$101.40
|
| Rate for Payer: Cash Price |
$101.40
|
| Rate for Payer: Devoted Health Medicare |
$92.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$83.98
|
| Rate for Payer: Health Management Network Commercial |
$143.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$100.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$100.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$100.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$98.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$83.98
|
| Rate for Payer: UnitedHealthcare Medicaid |
$98.96
|
| Rate for Payer: UnitedHealthcare Medicare |
$83.98
|
|
|
PR DIS SITE TELE SVCS RHC/FQHC
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS G2025
|
| Min. Negotiated Rate |
$96.30 |
| Max. Negotiated Rate |
$147.90 |
| Rate for Payer: AlohaCare Medicaid |
$102.20
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$96.30
|
| Rate for Payer: Health Management Network Commercial |
$147.90
|
| Rate for Payer: Ohana Health Plan Medicaid |
$102.20
|
| Rate for Payer: UnitedHealthcare Medicaid |
$102.20
|
|
|
PR DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 92587
|
| Min. Negotiated Rate |
$22.35 |
| Max. Negotiated Rate |
$43.71 |
| Rate for Payer: AlohaCare Medicaid |
$22.35
|
| Rate for Payer: AlohaCare Medicare |
$23.09
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Devoted Health Medicare |
$25.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$23.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$43.71
|
| Rate for Payer: Health Management Network Commercial |
$38.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$27.71
|
| Rate for Payer: Kaiser Permanente Medicaid |
$27.71
|
| Rate for Payer: Kaiser Permanente Medicare |
$27.71
|
| Rate for Payer: Ohana Health Plan Medicaid |
$22.35
|
| Rate for Payer: Ohana Health Plan Medicare |
$23.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.35
|
| Rate for Payer: UnitedHealthcare Medicare |
$23.09
|
|
|
PR DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 92587 TC
|
| Min. Negotiated Rate |
$3.99 |
| Max. Negotiated Rate |
$43.71 |
| Rate for Payer: AlohaCare Medicaid |
$22.35
|
| Rate for Payer: AlohaCare Medicare |
$3.99
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Devoted Health Medicare |
$4.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3.99
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$43.71
|
| Rate for Payer: Health Management Network Commercial |
$10.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$4.79
|
| Rate for Payer: Kaiser Permanente Medicaid |
$4.79
|
| Rate for Payer: Kaiser Permanente Medicare |
$4.79
|
| Rate for Payer: Ohana Health Plan Medicaid |
$22.35
|
| Rate for Payer: Ohana Health Plan Medicare |
$3.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.35
|
| Rate for Payer: UnitedHealthcare Medicare |
$3.99
|
|
|
PR DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 92587 26
|
| Min. Negotiated Rate |
$19.10 |
| Max. Negotiated Rate |
$43.71 |
| Rate for Payer: AlohaCare Medicaid |
$22.35
|
| Rate for Payer: AlohaCare Medicare |
$19.10
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Devoted Health Medicare |
$21.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$19.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$43.71
|
| Rate for Payer: Health Management Network Commercial |
$28.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$22.92
|
| Rate for Payer: Kaiser Permanente Medicaid |
$22.92
|
| Rate for Payer: Kaiser Permanente Medicare |
$22.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$22.35
|
| Rate for Payer: Ohana Health Plan Medicare |
$19.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.35
|
| Rate for Payer: UnitedHealthcare Medicare |
$19.10
|
|
|
PR DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 92588
|
| Min. Negotiated Rate |
$34.75 |
| Max. Negotiated Rate |
$68.95 |
| Rate for Payer: AlohaCare Medicaid |
$34.75
|
| Rate for Payer: AlohaCare Medicare |
$35.47
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Devoted Health Medicare |
$39.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$35.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$68.95
|
| Rate for Payer: Health Management Network Commercial |
$57.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$42.56
|
| Rate for Payer: Kaiser Permanente Medicaid |
$42.56
|
| Rate for Payer: Kaiser Permanente Medicare |
$42.56
|
| Rate for Payer: Ohana Health Plan Medicaid |
$34.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$35.47
|
| Rate for Payer: UnitedHealthcare Medicaid |
$34.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$35.47
|
|
|
PR DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL
|
Professional
|
Both
|
$16.00
|
|
|
Service Code
|
HCPCS 92588 TC
|
| Min. Negotiated Rate |
$5.51 |
| Max. Negotiated Rate |
$68.95 |
| Rate for Payer: AlohaCare Medicaid |
$34.75
|
| Rate for Payer: AlohaCare Medicare |
$5.51
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Devoted Health Medicare |
$6.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$5.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$68.95
|
| Rate for Payer: Health Management Network Commercial |
$13.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$6.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$6.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$6.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$34.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$5.51
|
| Rate for Payer: UnitedHealthcare Medicaid |
$34.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$5.51
|
|
|
PR DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 92588 26
|
| Min. Negotiated Rate |
$29.96 |
| Max. Negotiated Rate |
$68.95 |
| Rate for Payer: AlohaCare Medicaid |
$34.75
|
| Rate for Payer: AlohaCare Medicare |
$29.96
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Devoted Health Medicare |
$32.96
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$29.96
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$68.95
|
| Rate for Payer: Health Management Network Commercial |
$44.20
|
| 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 |
$34.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$29.96
|
| Rate for Payer: UnitedHealthcare Medicaid |
$34.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$29.96
|
|
|
PR DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR
|
Professional
|
Both
|
$1,377.00
|
|
|
Service Code
|
HCPCS 43130
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$1,170.45 |
| Rate for Payer: AlohaCare Medicaid |
$807.92
|
| Rate for Payer: AlohaCare Medicare |
$715.03
|
| Rate for Payer: Cash Price |
$826.20
|
| Rate for Payer: Cash Price |
$826.20
|
| Rate for Payer: Devoted Health Medicare |
$786.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$715.03
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$676.00
|
| Rate for Payer: Health Management Network Commercial |
$1,170.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$858.04
|
| Rate for Payer: Kaiser Permanente Medicaid |
$858.04
|
| Rate for Payer: Kaiser Permanente Medicare |
$858.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$807.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$715.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$807.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$715.03
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS 93325 26
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$91.09 |
| Rate for Payer: AlohaCare Medicaid |
$26.43
|
| Rate for Payer: AlohaCare Medicare |
$3.48
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Devoted Health Medicare |
$3.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3.48
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$91.09
|
| Rate for Payer: Health Management Network Commercial |
$5.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$4.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$4.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$4.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$26.43
|
| Rate for Payer: Ohana Health Plan Medicare |
$3.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$26.43
|
| Rate for Payer: UnitedHealthcare Medicare |
$3.48
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 93325
|
| Min. Negotiated Rate |
$26.43 |
| Max. Negotiated Rate |
$91.09 |
| Rate for Payer: AlohaCare Medicaid |
$26.43
|
| Rate for Payer: AlohaCare Medicare |
$26.64
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Cash Price |
$47.40
|
| Rate for Payer: Devoted Health Medicare |
$29.30
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$26.64
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$91.09
|
| Rate for Payer: Health Management Network Commercial |
$67.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$31.97
|
| Rate for Payer: Kaiser Permanente Medicaid |
$31.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$31.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$26.43
|
| Rate for Payer: Ohana Health Plan Medicare |
$26.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$26.43
|
| Rate for Payer: UnitedHealthcare Medicare |
$26.64
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 93325 TC
|
| Min. Negotiated Rate |
$23.17 |
| Max. Negotiated Rate |
$91.09 |
| Rate for Payer: AlohaCare Medicaid |
$26.43
|
| Rate for Payer: AlohaCare Medicare |
$23.17
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Devoted Health Medicare |
$25.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$23.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$91.09
|
| Rate for Payer: Health Management Network Commercial |
$62.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$27.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$27.80
|
| Rate for Payer: Kaiser Permanente Medicare |
$27.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$26.43
|
| Rate for Payer: Ohana Health Plan Medicare |
$23.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$26.43
|
| Rate for Payer: UnitedHealthcare Medicare |
$23.17
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$152.00
|
|
|
Service Code
|
HCPCS 93320
|
| Min. Negotiated Rate |
$55.86 |
| Max. Negotiated Rate |
$129.20 |
| Rate for Payer: AlohaCare Medicaid |
$55.86
|
| Rate for Payer: AlohaCare Medicare |
$56.42
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Devoted Health Medicare |
$62.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$56.42
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$101.71
|
| Rate for Payer: Health Management Network Commercial |
$129.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$67.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$67.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$67.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$55.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$56.42
|
| Rate for Payer: UnitedHealthcare Medicaid |
$55.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$56.42
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 93320 26
|
| Min. Negotiated Rate |
$17.87 |
| Max. Negotiated Rate |
$101.71 |
| Rate for Payer: AlohaCare Medicaid |
$55.86
|
| Rate for Payer: AlohaCare Medicare |
$17.87
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Cash Price |
$18.60
|
| Rate for Payer: Devoted Health Medicare |
$19.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$17.87
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$101.71
|
| Rate for Payer: Health Management Network Commercial |
$26.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$21.44
|
| Rate for Payer: Kaiser Permanente Medicaid |
$21.44
|
| Rate for Payer: Kaiser Permanente Medicare |
$21.44
|
| Rate for Payer: Ohana Health Plan Medicaid |
$55.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$17.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$55.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$17.87
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 93320 TC
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$102.85 |
| Rate for Payer: AlohaCare Medicaid |
$55.86
|
| Rate for Payer: AlohaCare Medicare |
$38.55
|
| Rate for Payer: Cash Price |
$72.60
|
| Rate for Payer: Cash Price |
$72.60
|
| Rate for Payer: Devoted Health Medicare |
$42.41
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.55
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$101.71
|
| Rate for Payer: Health Management Network Commercial |
$102.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$46.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$46.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$46.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$55.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$55.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.55
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL F-UP/LMTD STD
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 93321 TC
|
| Min. Negotiated Rate |
$20.51 |
| Max. Negotiated Rate |
$59.01 |
| Rate for Payer: AlohaCare Medicaid |
$27.75
|
| Rate for Payer: AlohaCare Medicare |
$20.51
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Devoted Health Medicare |
$22.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$20.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$59.01
|
| Rate for Payer: Health Management Network Commercial |
$55.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$24.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$24.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$24.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$27.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$20.51
|
| Rate for Payer: UnitedHealthcare Medicaid |
$27.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$20.51
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL F-UP/LMTD STD
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
HCPCS 93321
|
| Min. Negotiated Rate |
$27.75 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: AlohaCare Medicaid |
$27.75
|
| Rate for Payer: AlohaCare Medicare |
$27.99
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Devoted Health Medicare |
$30.79
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$27.99
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$59.01
|
| Rate for Payer: Health Management Network Commercial |
$66.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$33.59
|
| Rate for Payer: Kaiser Permanente Medicaid |
$33.59
|
| Rate for Payer: Kaiser Permanente Medicare |
$33.59
|
| Rate for Payer: Ohana Health Plan Medicaid |
$27.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$27.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$27.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$27.99
|
|
