|
PR EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I
|
Professional
|
Both
|
$1,101.14
|
|
|
Service Code
|
HCPCS 50435
|
| Min. Negotiated Rate |
$88.05 |
| Max. Negotiated Rate |
$935.97 |
| Rate for Payer: AlohaCare Medicaid |
$98.94
|
| Rate for Payer: AlohaCare Medicare |
$88.05
|
| Rate for Payer: Cash Price |
$660.68
|
| Rate for Payer: Cash Price |
$660.68
|
| Rate for Payer: Devoted Health Medicare |
$96.86
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$98.94
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$154.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$88.05
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$98.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$545.22
|
| Rate for Payer: Health Management Network Commercial |
$935.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$105.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$105.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$105.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$98.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$88.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$98.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$88.05
|
|
|
PR EXCHNG ABSC/CST DRG CATH RAD GID SPX
|
Professional
|
Both
|
$1,077.34
|
|
|
Service Code
|
HCPCS 49423
|
| Min. Negotiated Rate |
$59.64 |
| Max. Negotiated Rate |
$915.74 |
| Rate for Payer: AlohaCare Medicaid |
$68.42
|
| Rate for Payer: AlohaCare Medicare |
$59.64
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Devoted Health Medicare |
$65.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$68.42
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$107.45
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$59.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$68.42
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$91.78
|
| Rate for Payer: Health Management Network Commercial |
$915.74
|
| Rate for Payer: Kaiser Permanente Commercial |
$71.57
|
| Rate for Payer: Kaiser Permanente Medicaid |
$71.57
|
| Rate for Payer: Kaiser Permanente Medicare |
$71.57
|
| Rate for Payer: Ohana Health Plan Medicaid |
$68.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$59.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$68.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$59.64
|
| Rate for Payer: University Health Alliance Commercial |
$110.00
|
|
|
PR EXC HYDROCELE SPRMATIC CORD UNI SPX
|
Professional
|
Both
|
$690.00
|
|
|
Service Code
|
HCPCS 55500
|
| Min. Negotiated Rate |
$373.06 |
| Max. Negotiated Rate |
$586.50 |
| Rate for Payer: AlohaCare Medicaid |
$402.84
|
| Rate for Payer: AlohaCare Medicare |
$373.06
|
| Rate for Payer: Cash Price |
$414.00
|
| Rate for Payer: Cash Price |
$414.00
|
| Rate for Payer: Devoted Health Medicare |
$410.37
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$373.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$376.22
|
| Rate for Payer: Health Management Network Commercial |
$586.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$447.67
|
| Rate for Payer: Kaiser Permanente Medicaid |
$447.67
|
| Rate for Payer: Kaiser Permanente Medicare |
$447.67
|
| Rate for Payer: Ohana Health Plan Medicaid |
$402.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$373.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$402.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$373.06
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,244.00
|
|
|
Service Code
|
HCPCS 15940
|
| Min. Negotiated Rate |
$384.02 |
| Max. Negotiated Rate |
$1,057.40 |
| Rate for Payer: AlohaCare Medicaid |
$723.69
|
| Rate for Payer: AlohaCare Medicare |
$667.52
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Devoted Health Medicare |
$734.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$667.52
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$384.02
|
| Rate for Payer: Health Management Network Commercial |
$1,057.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$801.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$801.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$801.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$723.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$667.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$723.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$667.52
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 15944
|
| Min. Negotiated Rate |
$618.02 |
| Max. Negotiated Rate |
$1,414.40 |
| Rate for Payer: AlohaCare Medicaid |
$968.99
|
| Rate for Payer: AlohaCare Medicare |
$870.21
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Devoted Health Medicare |
$957.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$870.21
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$618.02
|
| Rate for Payer: Health Management Network Commercial |
$1,414.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,044.25
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,044.25
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,044.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$968.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$870.21
|
| Rate for Payer: UnitedHealthcare Medicaid |
$968.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$870.21
|
|
|
PR EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT
|
Professional
|
Both
|
$1,690.00
|
|
|
Service Code
|
HCPCS 15941
|
| Min. Negotiated Rate |
$560.82 |
| Max. Negotiated Rate |
$1,436.50 |
| Rate for Payer: AlohaCare Medicaid |
$959.91
|
| Rate for Payer: AlohaCare Medicare |
$887.44
|
| Rate for Payer: Cash Price |
$1,014.00
|
| Rate for Payer: Cash Price |
$1,014.00
|
| Rate for Payer: Devoted Health Medicare |
$976.18
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$887.44
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$560.82
|
| Rate for Payer: Health Management Network Commercial |
$1,436.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,064.93
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,064.93
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,064.93
|
| Rate for Payer: Ohana Health Plan Medicaid |
$959.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$887.44
|
| Rate for Payer: UnitedHealthcare Medicaid |
$959.91
|
| Rate for Payer: UnitedHealthcare Medicare |
$887.44
|
|
|
PR EXCISION BARTHOLINS GLAND OR CYST
|
Professional
|
Both
|
$547.00
|
|
|
Service Code
|
HCPCS 56740
|
| Min. Negotiated Rate |
$264.94 |
| Max. Negotiated Rate |
$464.95 |
| Rate for Payer: AlohaCare Medicaid |
$323.67
|
| Rate for Payer: AlohaCare Medicare |
$283.67
|
| Rate for Payer: Cash Price |
$328.20
|
| Rate for Payer: Cash Price |
$328.20
|
| Rate for Payer: Devoted Health Medicare |
$312.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$283.67
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$264.94
|
| Rate for Payer: Health Management Network Commercial |
$464.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$340.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$340.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$340.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$323.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$283.67
|
| Rate for Payer: UnitedHealthcare Medicaid |
$323.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$283.67
|
|
|
PR EXCISION BONE MANDIBLE
|
Professional
|
Both
|
$1,550.41
|
|
|
Service Code
|
HCPCS 21025
|
| Min. Negotiated Rate |
$423.80 |
| Max. Negotiated Rate |
$1,317.85 |
| Rate for Payer: AlohaCare Medicaid |
$689.66
|
| Rate for Payer: AlohaCare Medicare |
$628.47
|
| Rate for Payer: Cash Price |
$930.25
|
| Rate for Payer: Cash Price |
$930.25
|
| Rate for Payer: Devoted Health Medicare |
$691.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$689.66
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,121.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$628.47
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$689.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$423.80
|
| Rate for Payer: Health Management Network Commercial |
$1,317.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$754.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$754.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$754.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$689.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$628.47
|
| Rate for Payer: UnitedHealthcare Medicaid |
$689.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$628.47
|
| Rate for Payer: University Health Alliance Commercial |
$896.57
|
|
|
PR EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA
|
Professional
|
Both
|
$1,036.00
|
|
|
Service Code
|
HCPCS 27635
|
| Min. Negotiated Rate |
$492.18 |
| Max. Negotiated Rate |
$880.60 |
| Rate for Payer: AlohaCare Medicaid |
$605.91
|
| Rate for Payer: AlohaCare Medicare |
$558.81
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Devoted Health Medicare |
$614.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$558.81
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$492.18
|
| Rate for Payer: Health Management Network Commercial |
$880.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$670.57
|
| Rate for Payer: Kaiser Permanente Medicaid |
$670.57
|
| Rate for Payer: Kaiser Permanente Medicare |
$670.57
|
| Rate for Payer: Ohana Health Plan Medicaid |
$605.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$558.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$605.91
|
| Rate for Payer: UnitedHealthcare Medicare |
$558.81
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT
|
Professional
|
Both
|
$1,456.00
|
|
|
Service Code
|
HCPCS 27357
|
| Min. Negotiated Rate |
$593.58 |
| Max. Negotiated Rate |
$1,237.60 |
| Rate for Payer: AlohaCare Medicaid |
$850.65
|
| Rate for Payer: AlohaCare Medicare |
$778.73
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Devoted Health Medicare |
$856.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$778.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$593.58
|
| Rate for Payer: Health Management Network Commercial |
$1,237.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$934.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$934.48
|
| Rate for Payer: Kaiser Permanente Medicare |
$934.48
|
| Rate for Payer: Ohana Health Plan Medicaid |
$850.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$778.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$850.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$778.73
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER
|
Professional
|
Both
|
$828.00
|
|
|
Service Code
|
HCPCS 26210
|
| Min. Negotiated Rate |
$323.44 |
| Max. Negotiated Rate |
$703.80 |
| Rate for Payer: AlohaCare Medicaid |
$480.89
|
| Rate for Payer: AlohaCare Medicare |
$444.86
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Devoted Health Medicare |
$489.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$444.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$323.44
|
| Rate for Payer: Health Management Network Commercial |
$703.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$533.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$533.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$533.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$480.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$444.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$480.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$444.86
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA
|
Professional
|
Both
|
$918.00
|
|
|
Service Code
|
HCPCS 25120
|
| Min. Negotiated Rate |
$429.52 |
| Max. Negotiated Rate |
$780.30 |
| Rate for Payer: AlohaCare Medicaid |
$533.84
|
| Rate for Payer: AlohaCare Medicare |
$490.09
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Devoted Health Medicare |
$539.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$490.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$429.52
|
| Rate for Payer: Health Management Network Commercial |
$780.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$588.11
|
| Rate for Payer: Kaiser Permanente Medicaid |
$588.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$588.11
|
| Rate for Payer: Ohana Health Plan Medicaid |
$533.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$490.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$533.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$490.09
|
|
|
PR EXCISION/DESTRUCTION INTRANASAL LESION INT APPR
|
Professional
|
Both
|
$1,845.64
|
|
|
Service Code
|
HCPCS 30117
|
| Min. Negotiated Rate |
$185.90 |
| Max. Negotiated Rate |
$1,568.79 |
| Rate for Payer: AlohaCare Medicaid |
$447.74
|
| Rate for Payer: AlohaCare Medicare |
$398.04
|
| Rate for Payer: Cash Price |
$1,107.38
|
| Rate for Payer: Cash Price |
$1,107.38
|
| Rate for Payer: Devoted Health Medicare |
$437.84
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$447.74
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$553.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$398.04
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$447.74
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$185.90
|
| Rate for Payer: Health Management Network Commercial |
$1,568.79
|
| Rate for Payer: Kaiser Permanente Commercial |
$477.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$477.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$477.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$447.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$398.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$447.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$398.04
|
| Rate for Payer: University Health Alliance Commercial |
$545.95
|
|
|
PR EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD
|
Professional
|
Both
|
$436.80
|
|
|
Service Code
|
HCPCS 42808
|
| Min. Negotiated Rate |
$151.62 |
| Max. Negotiated Rate |
$371.28 |
| Rate for Payer: AlohaCare Medicaid |
$174.07
|
| Rate for Payer: AlohaCare Medicare |
$151.62
|
| Rate for Payer: Cash Price |
$262.08
|
| Rate for Payer: Cash Price |
$262.08
|
| Rate for Payer: Devoted Health Medicare |
$166.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$174.07
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$265.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$151.62
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$174.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$154.44
|
| Rate for Payer: Health Management Network Commercial |
$371.28
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$181.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$174.07
|
| Rate for Payer: Ohana Health Plan Medicare |
$151.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$174.07
|
| Rate for Payer: UnitedHealthcare Medicare |
$151.62
|
| Rate for Payer: University Health Alliance Commercial |
$225.12
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE ABDOMEN
|
Professional
|
Both
|
$1,670.00
|
|
|
Service Code
|
HCPCS 15847
|
| Min. Negotiated Rate |
$1,419.50 |
| Max. Negotiated Rate |
$1,419.50 |
| Rate for Payer: Cash Price |
$1,002.00
|
| Rate for Payer: Health Management Network Commercial |
$1,419.50
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM
|
Professional
|
Both
|
$1,422.00
|
|
|
Service Code
|
HCPCS 15836
|
| Min. Negotiated Rate |
$446.68 |
| Max. Negotiated Rate |
$1,208.70 |
| Rate for Payer: AlohaCare Medicaid |
$826.95
|
| Rate for Payer: AlohaCare Medicare |
$745.55
|
| Rate for Payer: Cash Price |
$853.20
|
| Rate for Payer: Cash Price |
$853.20
|
| Rate for Payer: Devoted Health Medicare |
$820.11
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$745.55
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$446.68
|
| Rate for Payer: Health Management Network Commercial |
$1,208.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$894.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$894.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$894.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$826.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$745.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$826.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$745.55
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK
|
Professional
|
Both
|
$1,651.00
|
|
|
Service Code
|
HCPCS 15835
|
| Min. Negotiated Rate |
$546.78 |
| Max. Negotiated Rate |
$1,403.35 |
| Rate for Payer: AlohaCare Medicaid |
$959.34
|
| Rate for Payer: AlohaCare Medicare |
$858.66
|
| Rate for Payer: Cash Price |
$990.60
|
| Rate for Payer: Cash Price |
$990.60
|
| Rate for Payer: Devoted Health Medicare |
$944.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$858.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$546.78
|
| Rate for Payer: Health Management Network Commercial |
$1,403.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,030.39
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,030.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,030.39
|
| Rate for Payer: Ohana Health Plan Medicaid |
$959.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$858.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$959.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$858.66
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 15834
|
| Min. Negotiated Rate |
$532.22 |
| Max. Negotiated Rate |
$1,350.65 |
| Rate for Payer: AlohaCare Medicaid |
$923.12
|
| Rate for Payer: AlohaCare Medicare |
$827.70
|
| Rate for Payer: Cash Price |
$953.40
|
| Rate for Payer: Cash Price |
$953.40
|
| Rate for Payer: Devoted Health Medicare |
$910.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$827.70
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$532.22
|
| Rate for Payer: Health Management Network Commercial |
$1,350.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$993.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$993.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$993.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$923.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$827.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$923.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$827.70
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE LEG
|
Professional
|
Both
|
$1,561.00
|
|
|
Service Code
|
HCPCS 15833
|
| Min. Negotiated Rate |
$494.52 |
| Max. Negotiated Rate |
$1,326.85 |
| Rate for Payer: AlohaCare Medicaid |
$907.26
|
| Rate for Payer: AlohaCare Medicare |
$814.11
|
| Rate for Payer: Cash Price |
$936.60
|
| Rate for Payer: Cash Price |
$936.60
|
| Rate for Payer: Devoted Health Medicare |
$895.52
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$814.11
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$494.52
|
| Rate for Payer: Health Management Network Commercial |
$1,326.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$976.93
|
| Rate for Payer: Kaiser Permanente Medicaid |
$976.93
|
| Rate for Payer: Kaiser Permanente Medicare |
$976.93
|
| Rate for Payer: Ohana Health Plan Medicaid |
$907.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$814.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$907.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$814.11
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA
|
Professional
|
Both
|
$1,763.77
|
|
|
Service Code
|
HCPCS 15839
|
| Min. Negotiated Rate |
$474.76 |
| Max. Negotiated Rate |
$1,499.20 |
| Rate for Payer: AlohaCare Medicaid |
$761.53
|
| Rate for Payer: AlohaCare Medicare |
$692.66
|
| Rate for Payer: Cash Price |
$1,058.26
|
| Rate for Payer: Cash Price |
$1,058.26
|
| Rate for Payer: Devoted Health Medicare |
$761.93
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$761.53
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,177.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$692.66
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$761.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$474.76
|
| Rate for Payer: Health Management Network Commercial |
$1,499.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$831.19
|
| Rate for Payer: Kaiser Permanente Medicaid |
$831.19
|
| Rate for Payer: Kaiser Permanente Medicare |
$831.19
|
| Rate for Payer: Ohana Health Plan Medicaid |
$761.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$692.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$761.53
|
| Rate for Payer: UnitedHealthcare Medicare |
$692.66
|
| Rate for Payer: University Health Alliance Commercial |
$871.44
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH
|
Professional
|
Both
|
$1,644.00
|
|
|
Service Code
|
HCPCS 15832
|
| Min. Negotiated Rate |
$580.32 |
| Max. Negotiated Rate |
$1,397.40 |
| Rate for Payer: AlohaCare Medicaid |
$949.11
|
| Rate for Payer: AlohaCare Medicare |
$856.45
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Devoted Health Medicare |
$942.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$856.45
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$580.32
|
| Rate for Payer: Health Management Network Commercial |
$1,397.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,027.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,027.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,027.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$949.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$856.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$949.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$856.45
|
|
|
PR EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$1,652.00
|
|
|
Service Code
|
HCPCS 69140
|
| Min. Negotiated Rate |
$638.56 |
| Max. Negotiated Rate |
$1,404.20 |
| Rate for Payer: AlohaCare Medicaid |
$976.65
|
| Rate for Payer: AlohaCare Medicare |
$900.20
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Devoted Health Medicare |
$990.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$900.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$638.56
|
| Rate for Payer: Health Management Network Commercial |
$1,404.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,080.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,080.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,080.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$976.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$900.20
|
| Rate for Payer: UnitedHealthcare Medicaid |
$976.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$900.20
|
|
|
PR EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Professional
|
Both
|
$889.89
|
|
|
Service Code
|
HCPCS 69110
|
| Min. Negotiated Rate |
$182.52 |
| Max. Negotiated Rate |
$756.41 |
| Rate for Payer: AlohaCare Medicaid |
$351.34
|
| Rate for Payer: AlohaCare Medicare |
$316.73
|
| Rate for Payer: Cash Price |
$533.93
|
| Rate for Payer: Cash Price |
$533.93
|
| Rate for Payer: Devoted Health Medicare |
$348.40
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$351.34
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$543.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$316.73
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$351.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$182.52
|
| Rate for Payer: Health Management Network Commercial |
$756.41
|
| Rate for Payer: Kaiser Permanente Commercial |
$380.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$380.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$380.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$351.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$316.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$351.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$316.73
|
| Rate for Payer: University Health Alliance Commercial |
$460.17
|
|
|
PR EXCISION FACIAL BONE
|
Professional
|
Both
|
$1,078.10
|
|
|
Service Code
|
HCPCS 21026
|
| Min. Negotiated Rate |
$247.78 |
| Max. Negotiated Rate |
$916.38 |
| Rate for Payer: AlohaCare Medicaid |
$453.95
|
| Rate for Payer: AlohaCare Medicare |
$430.73
|
| Rate for Payer: Cash Price |
$646.86
|
| Rate for Payer: Cash Price |
$646.86
|
| Rate for Payer: Devoted Health Medicare |
$473.80
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$453.95
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$694.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$430.73
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$453.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$247.78
|
| Rate for Payer: Health Management Network Commercial |
$916.38
|
| Rate for Payer: Kaiser Permanente Commercial |
$516.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$516.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$516.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$453.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$453.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$430.73
|
| Rate for Payer: University Health Alliance Commercial |
$632.17
|
|
|
PR EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY
|
Professional
|
Both
|
$609.00
|
|
|
Service Code
|
HCPCS 25111
|
| Min. Negotiated Rate |
$285.48 |
| Max. Negotiated Rate |
$517.65 |
| Rate for Payer: AlohaCare Medicaid |
$353.19
|
| Rate for Payer: AlohaCare Medicare |
$336.92
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Devoted Health Medicare |
$370.61
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$336.92
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$285.48
|
| Rate for Payer: Health Management Network Commercial |
$517.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$404.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$404.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$404.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$353.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$336.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$353.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$336.92
|
|
