|
PR HOME/RES VISIT EST PATIENT HIGH MDM 60 MINUTES
|
Professional
|
Both
|
$347.48
|
|
|
Service Code
|
HCPCS 99350
|
| Min. Negotiated Rate |
$178.08 |
| Max. Negotiated Rate |
$295.36 |
| Rate for Payer: AlohaCare Medicaid |
$188.57
|
| Rate for Payer: AlohaCare Medicare |
$198.56
|
| Rate for Payer: Cash Price |
$208.49
|
| Rate for Payer: Cash Price |
$208.49
|
| Rate for Payer: Devoted Health Medicare |
$218.42
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$198.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$178.08
|
| Rate for Payer: Health Management Network Commercial |
$295.36
|
| Rate for Payer: Kaiser Permanente Commercial |
$238.27
|
| Rate for Payer: Kaiser Permanente Medicaid |
$238.27
|
| Rate for Payer: Kaiser Permanente Medicare |
$238.27
|
| Rate for Payer: Ohana Health Plan Medicaid |
$188.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$198.56
|
| Rate for Payer: UnitedHealthcare Medicaid |
$188.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$198.56
|
|
|
PR HOME/RES VISIT EST PATIENT LOW MDM 30 MINUTES
|
Professional
|
Both
|
$142.56
|
|
|
Service Code
|
HCPCS 99348
|
| Min. Negotiated Rate |
$47.38 |
| Max. Negotiated Rate |
$121.18 |
| Rate for Payer: AlohaCare Medicaid |
$78.20
|
| Rate for Payer: AlohaCare Medicare |
$81.46
|
| Rate for Payer: Cash Price |
$85.54
|
| Rate for Payer: Cash Price |
$85.54
|
| Rate for Payer: Devoted Health Medicare |
$89.61
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$81.46
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$47.38
|
| Rate for Payer: Health Management Network Commercial |
$121.18
|
| Rate for Payer: Kaiser Permanente Commercial |
$97.75
|
| Rate for Payer: Kaiser Permanente Medicaid |
$97.75
|
| Rate for Payer: Kaiser Permanente Medicare |
$97.75
|
| Rate for Payer: Ohana Health Plan Medicaid |
$78.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$81.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$78.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$81.46
|
|
|
PR HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES
|
Professional
|
Both
|
$238.42
|
|
|
Service Code
|
HCPCS 99349
|
| Min. Negotiated Rate |
$96.63 |
| Max. Negotiated Rate |
$202.66 |
| Rate for Payer: AlohaCare Medicaid |
$129.72
|
| Rate for Payer: AlohaCare Medicare |
$136.24
|
| Rate for Payer: Cash Price |
$143.05
|
| Rate for Payer: Cash Price |
$143.05
|
| Rate for Payer: Devoted Health Medicare |
$149.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$136.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$96.63
|
| Rate for Payer: Health Management Network Commercial |
$202.66
|
| Rate for Payer: Kaiser Permanente Commercial |
$163.49
|
| Rate for Payer: Kaiser Permanente Medicaid |
$163.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$163.49
|
| Rate for Payer: Ohana Health Plan Medicaid |
$129.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$136.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$129.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$136.24
|
|
|
PR HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES
|
Professional
|
Both
|
$83.20
|
|
|
Service Code
|
HCPCS 99347
|
| Min. Negotiated Rate |
$44.79 |
| Max. Negotiated Rate |
$70.72 |
| Rate for Payer: AlohaCare Medicaid |
$46.19
|
| Rate for Payer: AlohaCare Medicare |
$47.54
|
| Rate for Payer: Cash Price |
$49.92
|
| Rate for Payer: Cash Price |
$49.92
|
| Rate for Payer: Devoted Health Medicare |
$52.29
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$47.54
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$44.79
|
| Rate for Payer: Health Management Network Commercial |
$70.72
|
| Rate for Payer: Kaiser Permanente Commercial |
$57.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$57.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$57.05
|
| Rate for Payer: Ohana Health Plan Medicaid |
$46.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$47.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$46.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$47.54
|
|
|
PR HOME/RES VISIT NEW PATIENT HIGH MDM 75 MINUTES
|
Professional
|
Both
|
$378.80
|
|
|
Service Code
|
HCPCS 99345
|
| Min. Negotiated Rate |
$205.73 |
| Max. Negotiated Rate |
$321.98 |
| Rate for Payer: AlohaCare Medicaid |
$205.73
|
| Rate for Payer: AlohaCare Medicare |
$216.46
|
| Rate for Payer: Cash Price |
$227.28
|
| Rate for Payer: Cash Price |
$227.28
|
| Rate for Payer: Devoted Health Medicare |
$238.11
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$216.46
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$220.97
|
| Rate for Payer: Health Management Network Commercial |
$321.98
|
| Rate for Payer: Kaiser Permanente Commercial |
$259.75
|
| Rate for Payer: Kaiser Permanente Medicaid |
$259.75
|
| Rate for Payer: Kaiser Permanente Medicare |
$259.75
|
| Rate for Payer: Ohana Health Plan Medicaid |
$205.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$216.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$205.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$216.46
|
|
|
PR HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES
|
Professional
|
Both
|
$141.35
|
|
|
Service Code
|
HCPCS 99342
|
| Min. Negotiated Rate |
$78.09 |
| Max. Negotiated Rate |
$120.15 |
| Rate for Payer: AlohaCare Medicaid |
$79.37
|
| Rate for Payer: AlohaCare Medicare |
$80.77
|
| Rate for Payer: Cash Price |
$84.81
|
| Rate for Payer: Cash Price |
$84.81
|
| Rate for Payer: Devoted Health Medicare |
$88.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$80.77
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$78.09
|
| Rate for Payer: Health Management Network Commercial |
$120.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$96.92
|
| Rate for Payer: Kaiser Permanente Medicaid |
$96.92
|
| Rate for Payer: Kaiser Permanente Medicare |
$96.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$79.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$80.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$79.37
|
| Rate for Payer: UnitedHealthcare Medicare |
$80.77
|
|
|
PR HOME/RES VISIT NEW PATIENT MOD MDM 60 MINUTES
|
Professional
|
Both
|
$263.55
|
|
|
Service Code
|
HCPCS 99344
|
| Min. Negotiated Rate |
$136.23 |
| Max. Negotiated Rate |
$224.02 |
| Rate for Payer: AlohaCare Medicaid |
$144.42
|
| Rate for Payer: AlohaCare Medicare |
$150.60
|
| Rate for Payer: Cash Price |
$158.13
|
| Rate for Payer: Cash Price |
$158.13
|
| Rate for Payer: Devoted Health Medicare |
$165.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$150.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$136.23
|
| Rate for Payer: Health Management Network Commercial |
$224.02
|
| Rate for Payer: Kaiser Permanente Commercial |
$180.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$180.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$180.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$144.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$150.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$144.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$150.60
|
|
|
PR HOME/RES VISIT NEW PATIENT SF MDM 15 MINUTES
|
Professional
|
Both
|
$88.38
|
|
|
Service Code
|
HCPCS 99341
|
| Min. Negotiated Rate |
$50.29 |
| Max. Negotiated Rate |
$75.12 |
| Rate for Payer: AlohaCare Medicaid |
$50.29
|
| Rate for Payer: AlohaCare Medicare |
$50.50
|
| Rate for Payer: Cash Price |
$53.03
|
| Rate for Payer: Cash Price |
$53.03
|
| Rate for Payer: Devoted Health Medicare |
$55.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$50.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$56.66
|
| Rate for Payer: Health Management Network Commercial |
$75.12
|
| Rate for Payer: Kaiser Permanente Commercial |
$60.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$60.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$60.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$50.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$50.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$50.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$50.50
|
|
|
PR HOME VISIT WOUND CARE
|
Professional
|
Both
|
$324.00
|
|
|
Service Code
|
HCPCS S9097
|
| Min. Negotiated Rate |
$275.40 |
| Max. Negotiated Rate |
$275.40 |
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Health Management Network Commercial |
$275.40
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 99236
|
| Min. Negotiated Rate |
$164.50 |
| Max. Negotiated Rate |
$300.90 |
| Rate for Payer: AlohaCare Medicaid |
$208.78
|
| Rate for Payer: AlohaCare Medicare |
$189.32
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Devoted Health Medicare |
$208.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$189.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$164.50
|
| Rate for Payer: Health Management Network Commercial |
$300.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$227.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$227.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$227.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$208.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$189.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$208.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$189.32
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 99235
|
| Min. Negotiated Rate |
$117.50 |
| Max. Negotiated Rate |
$231.20 |
| Rate for Payer: AlohaCare Medicaid |
$160.14
|
| Rate for Payer: AlohaCare Medicare |
$143.06
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Devoted Health Medicare |
$157.37
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$143.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$117.50
|
| Rate for Payer: Health Management Network Commercial |
$231.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$171.67
|
| Rate for Payer: Kaiser Permanente Medicaid |
$171.67
|
| Rate for Payer: Kaiser Permanente Medicare |
$171.67
|
| Rate for Payer: Ohana Health Plan Medicaid |
$160.14
|
| Rate for Payer: Ohana Health Plan Medicare |
$143.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$160.14
|
| Rate for Payer: UnitedHealthcare Medicare |
$143.06
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 99234
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$141.10 |
| Rate for Payer: AlohaCare Medicaid |
$97.67
|
| Rate for Payer: AlohaCare Medicare |
$87.75
|
| Rate for Payer: Cash Price |
$99.60
|
| Rate for Payer: Cash Price |
$99.60
|
| Rate for Payer: Devoted Health Medicare |
$96.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$87.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$70.50
|
| Rate for Payer: Health Management Network Commercial |
$141.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$105.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$105.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$105.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$97.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$87.75
|
| Rate for Payer: UnitedHealthcare Medicaid |
$97.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$87.75
|
|
|
PR HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN
|
Professional
|
Both
|
$199.00
|
|
|
Service Code
|
HCPCS 99239
|
| Min. Negotiated Rate |
$78.33 |
| Max. Negotiated Rate |
$169.15 |
| Rate for Payer: AlohaCare Medicaid |
$116.44
|
| Rate for Payer: AlohaCare Medicare |
$108.33
|
| Rate for Payer: Cash Price |
$119.40
|
| Rate for Payer: Cash Price |
$119.40
|
| Rate for Payer: Devoted Health Medicare |
$119.16
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$108.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$78.33
|
| Rate for Payer: Health Management Network Commercial |
$169.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$130.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$130.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$130.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$116.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$108.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$116.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$108.33
|
|
|
PR HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<
|
Professional
|
Both
|
$141.00
|
|
|
Service Code
|
HCPCS 99238
|
| Min. Negotiated Rate |
$64.63 |
| Max. Negotiated Rate |
$119.85 |
| Rate for Payer: AlohaCare Medicaid |
$82.58
|
| Rate for Payer: AlohaCare Medicare |
$75.97
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Devoted Health Medicare |
$83.57
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$75.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$64.63
|
| Rate for Payer: Health Management Network Commercial |
$119.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$91.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$91.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$91.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$82.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$75.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$75.97
|
|
|
PR HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU
|
Professional
|
Both
|
$940.00
|
|
|
Service Code
|
HCPCS 46261
|
| Min. Negotiated Rate |
$524.50 |
| Max. Negotiated Rate |
$799.00 |
| Rate for Payer: AlohaCare Medicaid |
$549.49
|
| Rate for Payer: AlohaCare Medicare |
$524.50
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Devoted Health Medicare |
$576.95
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$524.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$569.40
|
| Rate for Payer: Health Management Network Commercial |
$799.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$629.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$629.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$629.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$549.49
|
| Rate for Payer: Ohana Health Plan Medicare |
$524.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$549.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$524.50
|
|
|
PR HYPNOTHERAPY
|
Professional
|
Both
|
$188.49
|
|
|
Service Code
|
HCPCS 90880
|
| Min. Negotiated Rate |
$79.99 |
| Max. Negotiated Rate |
$160.22 |
| Rate for Payer: AlohaCare Medicaid |
$86.26
|
| Rate for Payer: AlohaCare Medicare |
$79.99
|
| Rate for Payer: Cash Price |
$113.09
|
| Rate for Payer: Cash Price |
$113.09
|
| Rate for Payer: Devoted Health Medicare |
$87.99
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$86.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$79.99
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$86.26
|
| Rate for Payer: Health Management Network Commercial |
$160.22
|
| Rate for Payer: Kaiser Permanente Commercial |
$95.99
|
| Rate for Payer: Kaiser Permanente Medicaid |
$95.99
|
| Rate for Payer: Kaiser Permanente Medicare |
$95.99
|
| Rate for Payer: Ohana Health Plan Medicaid |
$86.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$79.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$86.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$79.99
|
| Rate for Payer: University Health Alliance Commercial |
$106.84
|
|
|
PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C
|
Professional
|
Both
|
$2,472.70
|
|
|
Service Code
|
HCPCS 58558
|
| Min. Negotiated Rate |
$200.38 |
| Max. Negotiated Rate |
$2,101.80 |
| Rate for Payer: AlohaCare Medicaid |
$230.09
|
| Rate for Payer: AlohaCare Medicare |
$200.38
|
| Rate for Payer: Cash Price |
$1,483.62
|
| Rate for Payer: Cash Price |
$1,483.62
|
| Rate for Payer: Devoted Health Medicare |
$220.42
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$230.09
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$358.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$200.38
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$230.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$278.20
|
| Rate for Payer: Health Management Network Commercial |
$2,101.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$240.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$240.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$240.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$230.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$200.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$230.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$200.38
|
|
|
PR HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM
|
Professional
|
Both
|
$527.00
|
|
|
Service Code
|
HCPCS 58560
|
| Min. Negotiated Rate |
$268.24 |
| Max. Negotiated Rate |
$447.95 |
| Rate for Payer: AlohaCare Medicaid |
$309.91
|
| Rate for Payer: AlohaCare Medicare |
$268.24
|
| Rate for Payer: Cash Price |
$316.20
|
| Rate for Payer: Cash Price |
$316.20
|
| Rate for Payer: Devoted Health Medicare |
$295.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$268.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$375.70
|
| Rate for Payer: Health Management Network Commercial |
$447.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$321.89
|
| Rate for Payer: Kaiser Permanente Medicaid |
$321.89
|
| Rate for Payer: Kaiser Permanente Medicare |
$321.89
|
| Rate for Payer: Ohana Health Plan Medicaid |
$309.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$268.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$309.91
|
| Rate for Payer: UnitedHealthcare Medicare |
$268.24
|
|
|
PR HYSTEROSCOPY ENDOMETRIAL ABLATION
|
Professional
|
Both
|
$3,940.51
|
|
|
Service Code
|
HCPCS 58563
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$3,349.43 |
| Rate for Payer: AlohaCare Medicaid |
$244.27
|
| Rate for Payer: AlohaCare Medicare |
$212.36
|
| Rate for Payer: Cash Price |
$2,364.31
|
| Rate for Payer: Cash Price |
$2,364.31
|
| Rate for Payer: Devoted Health Medicare |
$233.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$244.27
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$444.76
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$212.36
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$244.27
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$355.68
|
| Rate for Payer: Health Management Network Commercial |
$3,349.43
|
| Rate for Payer: Kaiser Permanente Commercial |
$254.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$254.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$254.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$244.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$212.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$244.27
|
| Rate for Payer: UnitedHealthcare Medicare |
$212.36
|
|
|
PR HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY
|
Professional
|
Both
|
$740.11
|
|
|
Service Code
|
HCPCS 58562
|
| Min. Negotiated Rate |
$191.26 |
| Max. Negotiated Rate |
$629.09 |
| Rate for Payer: AlohaCare Medicaid |
$220.43
|
| Rate for Payer: AlohaCare Medicare |
$191.26
|
| Rate for Payer: Cash Price |
$444.07
|
| Rate for Payer: Cash Price |
$444.07
|
| Rate for Payer: Devoted Health Medicare |
$210.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$220.43
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$377.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$191.26
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$220.43
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$271.44
|
| Rate for Payer: Health Management Network Commercial |
$629.09
|
| Rate for Payer: Kaiser Permanente Commercial |
$229.51
|
| Rate for Payer: Kaiser Permanente Medicaid |
$229.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$229.51
|
| Rate for Payer: Ohana Health Plan Medicaid |
$220.43
|
| Rate for Payer: Ohana Health Plan Medicare |
$191.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$220.43
|
| Rate for Payer: UnitedHealthcare Medicare |
$191.26
|
|
|
PR HYSTEROSCOPY REMOVAL LEIOMYOMATA
|
Professional
|
Both
|
$603.00
|
|
|
Service Code
|
HCPCS 58561
|
| Min. Negotiated Rate |
$306.08 |
| Max. Negotiated Rate |
$550.16 |
| Rate for Payer: AlohaCare Medicaid |
$354.39
|
| Rate for Payer: AlohaCare Medicare |
$306.08
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Cash Price |
$361.80
|
| Rate for Payer: Devoted Health Medicare |
$336.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$306.08
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$550.16
|
| Rate for Payer: Health Management Network Commercial |
$512.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$367.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$367.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$367.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$354.39
|
| Rate for Payer: Ohana Health Plan Medicare |
$306.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$354.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$306.08
|
|
|
PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS 90750
|
| Min. Negotiated Rate |
$163.52 |
| Max. Negotiated Rate |
$289.00 |
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$163.52
|
| Rate for Payer: Health Management Network Commercial |
$289.00
|
|
|
PR I&D ABSCESS PERITONSILLAR
|
Professional
|
Both
|
$374.57
|
|
|
Service Code
|
HCPCS 42700
|
| Min. Negotiated Rate |
$109.72 |
| Max. Negotiated Rate |
$318.38 |
| Rate for Payer: AlohaCare Medicaid |
$144.40
|
| Rate for Payer: AlohaCare Medicare |
$133.53
|
| Rate for Payer: Cash Price |
$224.74
|
| Rate for Payer: Cash Price |
$224.74
|
| Rate for Payer: Devoted Health Medicare |
$146.88
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$144.40
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$219.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$133.53
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$144.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$109.72
|
| Rate for Payer: Health Management Network Commercial |
$318.38
|
| Rate for Payer: Kaiser Permanente Commercial |
$160.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$160.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$160.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$144.40
|
| Rate for Payer: Ohana Health Plan Medicare |
$133.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$144.40
|
| Rate for Payer: UnitedHealthcare Medicare |
$133.53
|
| Rate for Payer: University Health Alliance Commercial |
$274.00
|
|
|
PR I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL
|
Professional
|
Both
|
$809.64
|
|
|
Service Code
|
HCPCS 42720
|
| Min. Negotiated Rate |
$200.72 |
| Max. Negotiated Rate |
$688.19 |
| Rate for Payer: AlohaCare Medicaid |
$394.56
|
| Rate for Payer: AlohaCare Medicare |
$334.67
|
| Rate for Payer: Cash Price |
$485.78
|
| Rate for Payer: Cash Price |
$485.78
|
| Rate for Payer: Devoted Health Medicare |
$368.14
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$394.56
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$612.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$334.67
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$394.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$200.72
|
| Rate for Payer: Health Management Network Commercial |
$688.19
|
| Rate for Payer: Kaiser Permanente Commercial |
$401.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$401.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$401.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$394.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$334.67
|
| Rate for Payer: UnitedHealthcare Medicaid |
$394.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$334.67
|
| Rate for Payer: University Health Alliance Commercial |
$518.49
|
|
|
PR I&D BELOW FASCIA FOOT 1 BURSAL SPACE
|
Professional
|
Both
|
$451.90
|
|
|
Service Code
|
HCPCS 28002
|
| Min. Negotiated Rate |
$127.59 |
| Max. Negotiated Rate |
$516.00 |
| Rate for Payer: AlohaCare Medicaid |
$141.53
|
| Rate for Payer: AlohaCare Medicare |
$127.59
|
| Rate for Payer: Cash Price |
$271.14
|
| Rate for Payer: Cash Price |
$271.14
|
| Rate for Payer: Devoted Health Medicare |
$140.35
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$141.53
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$515.21
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$127.59
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$141.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$190.84
|
| Rate for Payer: Health Management Network Commercial |
$384.12
|
| Rate for Payer: Kaiser Permanente Commercial |
$153.11
|
| Rate for Payer: Kaiser Permanente Medicaid |
$153.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$153.11
|
| Rate for Payer: Ohana Health Plan Medicaid |
$141.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$127.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$141.53
|
| Rate for Payer: UnitedHealthcare Medicare |
$127.59
|
| Rate for Payer: University Health Alliance Commercial |
$516.00
|
|
