|
PR INTRODUCTION NEEDLE/INTRACATHETER VEIN
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 36000
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$49.30 |
| Rate for Payer: AlohaCare Medicaid |
$9.04
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$9.04
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$16.62
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$9.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$19.24
|
| Rate for Payer: Health Management Network Commercial |
$49.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$9.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.04
|
|
|
PR INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY
|
Professional
|
Both
|
$969.06
|
|
|
Service Code
|
HCPCS 36140
|
| Min. Negotiated Rate |
$74.86 |
| Max. Negotiated Rate |
$823.70 |
| Rate for Payer: AlohaCare Medicaid |
$83.67
|
| Rate for Payer: AlohaCare Medicare |
$74.86
|
| Rate for Payer: Cash Price |
$581.44
|
| Rate for Payer: Cash Price |
$581.44
|
| Rate for Payer: Devoted Health Medicare |
$82.35
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$83.67
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$142.93
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$74.86
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$83.67
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$134.94
|
| Rate for Payer: Health Management Network Commercial |
$823.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$89.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$89.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$89.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$83.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$74.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$83.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$74.86
|
| Rate for Payer: University Health Alliance Commercial |
$113.63
|
|
|
PR INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ
|
Professional
|
Both
|
$1,805.00
|
|
|
Service Code
|
HCPCS 44615
|
| Min. Negotiated Rate |
$620.62 |
| Max. Negotiated Rate |
$1,534.25 |
| Rate for Payer: AlohaCare Medicaid |
$1,052.87
|
| Rate for Payer: AlohaCare Medicare |
$973.13
|
| Rate for Payer: Cash Price |
$1,083.00
|
| Rate for Payer: Cash Price |
$1,083.00
|
| Rate for Payer: Devoted Health Medicare |
$1,070.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$973.13
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$620.62
|
| Rate for Payer: Health Management Network Commercial |
$1,534.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,167.76
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,167.76
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,167.76
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,052.87
|
| Rate for Payer: Ohana Health Plan Medicare |
$973.13
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,052.87
|
| Rate for Payer: UnitedHealthcare Medicare |
$973.13
|
|
|
PR INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 31500
|
| Min. Negotiated Rate |
$119.08 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: AlohaCare Medicaid |
$136.20
|
| Rate for Payer: AlohaCare Medicare |
$128.79
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Devoted Health Medicare |
$141.67
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$128.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$119.08
|
| Rate for Payer: Health Management Network Commercial |
$198.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$154.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$154.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$154.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$136.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$128.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$136.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$128.79
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES
|
Professional
|
Both
|
$329.00
|
|
|
Service Code
|
HCPCS 99255
|
| Min. Negotiated Rate |
$190.80 |
| Max. Negotiated Rate |
$279.65 |
| Rate for Payer: Cash Price |
$197.40
|
| Rate for Payer: Cash Price |
$197.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$190.80
|
| Rate for Payer: Health Management Network Commercial |
$279.65
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 99253
|
| Min. Negotiated Rate |
$102.55 |
| Max. Negotiated Rate |
$150.45 |
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$102.55
|
| Rate for Payer: Health Management Network Commercial |
$150.45
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 99254
|
| Min. Negotiated Rate |
$141.07 |
| Max. Negotiated Rate |
$209.10 |
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$141.07
|
| Rate for Payer: Health Management Network Commercial |
$209.10
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 99252
|
| Min. Negotiated Rate |
$77.22 |
| Max. Negotiated Rate |
$106.25 |
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$77.22
|
| Rate for Payer: Health Management Network Commercial |
$106.25
|
|
|
PR IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST
|
Professional
|
Both
|
$51.19
|
|
|
Service Code
|
HCPCS 96523
|
| Min. Negotiated Rate |
$16.97 |
| Max. Negotiated Rate |
$43.51 |
| Rate for Payer: AlohaCare Medicaid |
$16.97
|
| Rate for Payer: AlohaCare Medicare |
$29.25
|
| Rate for Payer: Cash Price |
$30.71
|
| Rate for Payer: Cash Price |
$30.71
|
| Rate for Payer: Devoted Health Medicare |
$32.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$29.25
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$26.86
|
| Rate for Payer: Health Management Network Commercial |
$43.51
|
| Rate for Payer: Kaiser Permanente Commercial |
$35.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$35.10
|
| Rate for Payer: Kaiser Permanente Medicare |
$35.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$16.97
|
| Rate for Payer: Ohana Health Plan Medicare |
$29.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$29.25
|
|
|
PR IRRIGATION CORPORA CAVERNOSA PRIAPISM
|
Professional
|
Both
|
$468.84
|
|
|
Service Code
|
HCPCS 54220
|
| Min. Negotiated Rate |
$95.16 |
| Max. Negotiated Rate |
$398.51 |
| Rate for Payer: AlohaCare Medicaid |
$133.92
|
| Rate for Payer: AlohaCare Medicare |
$128.54
|
| Rate for Payer: Cash Price |
$281.30
|
| Rate for Payer: Cash Price |
$281.30
|
| Rate for Payer: Devoted Health Medicare |
$141.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$133.92
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$205.70
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$128.54
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$133.92
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.16
|
| Rate for Payer: Health Management Network Commercial |
$398.51
|
| Rate for Payer: Kaiser Permanente Commercial |
$154.25
|
| Rate for Payer: Kaiser Permanente Medicaid |
$154.25
|
| Rate for Payer: Kaiser Permanente Medicare |
$154.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$133.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$128.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$133.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$128.54
|
| Rate for Payer: University Health Alliance Commercial |
$174.16
|
|
|
PR IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL
|
Professional
|
Both
|
$159.00
|
|
|
Service Code
|
HCPCS 93571 26
|
| Min. Negotiated Rate |
$90.81 |
| Max. Negotiated Rate |
$219.12 |
| Rate for Payer: AlohaCare Medicaid |
$219.12
|
| Rate for Payer: AlohaCare Medicare |
$90.81
|
| Rate for Payer: Cash Price |
$95.40
|
| Rate for Payer: Cash Price |
$95.40
|
| Rate for Payer: Devoted Health Medicare |
$99.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$90.81
|
| Rate for Payer: Health Management Network Commercial |
$135.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$108.97
|
| Rate for Payer: Kaiser Permanente Medicaid |
$108.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$108.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$219.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$90.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$219.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$90.81
|
|
|
PR IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 93572 26
|
| Min. Negotiated Rate |
$72.11 |
| Max. Negotiated Rate |
$170.28 |
| Rate for Payer: AlohaCare Medicaid |
$170.28
|
| Rate for Payer: AlohaCare Medicare |
$72.11
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Devoted Health Medicare |
$79.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$72.11
|
| Rate for Payer: Health Management Network Commercial |
$107.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$86.53
|
| Rate for Payer: Kaiser Permanente Medicaid |
$86.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$86.53
|
| Rate for Payer: Ohana Health Plan Medicaid |
$170.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$72.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$170.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$72.11
|
|
|
PR IV INFUSION HYDRATION EACH ADDITIONAL HOUR
|
Professional
|
Both
|
$24.87
|
|
|
Service Code
|
HCPCS 96361
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$21.14 |
| Rate for Payer: AlohaCare Medicaid |
$8.11
|
| Rate for Payer: AlohaCare Medicare |
$14.21
|
| Rate for Payer: Cash Price |
$14.92
|
| Rate for Payer: Cash Price |
$14.92
|
| Rate for Payer: Devoted Health Medicare |
$15.63
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$14.21
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$18.68
|
| Rate for Payer: Health Management Network Commercial |
$21.14
|
| Rate for Payer: Kaiser Permanente Commercial |
$17.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$17.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$17.05
|
| Rate for Payer: Ohana Health Plan Medicaid |
$8.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$14.21
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.11
|
| Rate for Payer: UnitedHealthcare Medicare |
$14.21
|
|
|
PR IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR
|
Professional
|
Both
|
$64.77
|
|
|
Service Code
|
HCPCS 96360
|
| Min. Negotiated Rate |
$21.64 |
| Max. Negotiated Rate |
$59.83 |
| Rate for Payer: AlohaCare Medicaid |
$21.64
|
| Rate for Payer: AlohaCare Medicare |
$37.01
|
| Rate for Payer: Cash Price |
$38.86
|
| Rate for Payer: Cash Price |
$38.86
|
| Rate for Payer: Devoted Health Medicare |
$40.71
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$37.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$59.83
|
| Rate for Payer: Health Management Network Commercial |
$55.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$44.41
|
| Rate for Payer: Kaiser Permanente Medicaid |
$44.41
|
| Rate for Payer: Kaiser Permanente Medicare |
$44.41
|
| Rate for Payer: Ohana Health Plan Medicaid |
$21.64
|
| Rate for Payer: Ohana Health Plan Medicare |
$37.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$21.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$37.01
|
|
|
PR IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR
|
Professional
|
Both
|
$130.60
|
|
|
Service Code
|
HCPCS 96365
|
| Min. Negotiated Rate |
$42.05 |
| Max. Negotiated Rate |
$111.01 |
| Rate for Payer: AlohaCare Medicaid |
$42.05
|
| Rate for Payer: AlohaCare Medicare |
$74.63
|
| Rate for Payer: Cash Price |
$78.36
|
| Rate for Payer: Cash Price |
$78.36
|
| Rate for Payer: Devoted Health Medicare |
$82.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$74.63
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$73.23
|
| Rate for Payer: Health Management Network Commercial |
$111.01
|
| Rate for Payer: Kaiser Permanente Commercial |
$89.56
|
| Rate for Payer: Kaiser Permanente Medicaid |
$89.56
|
| Rate for Payer: Kaiser Permanente Medicare |
$89.56
|
| Rate for Payer: Ohana Health Plan Medicaid |
$42.05
|
| Rate for Payer: Ohana Health Plan Medicare |
$74.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$42.05
|
| Rate for Payer: UnitedHealthcare Medicare |
$74.63
|
|
|
PR KO ELASTIC W/JOINTS PRE OTS
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS L1812
|
| Min. Negotiated Rate |
$126.23 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: AlohaCare Medicaid |
$127.95
|
| Rate for Payer: AlohaCare Medicare |
$126.23
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Devoted Health Medicare |
$138.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$126.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$129.87
|
| Rate for Payer: Health Management Network Commercial |
$183.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$151.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$151.48
|
| Rate for Payer: Kaiser Permanente Medicare |
$151.48
|
| Rate for Payer: Ohana Health Plan Medicaid |
$127.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$126.23
|
| Rate for Payer: UnitedHealthcare Medicaid |
$127.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$126.23
|
|
|
PR KO ELAS W/ CONDYLE PADS OTF
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS L1821
|
| Min. Negotiated Rate |
$194.23 |
| Max. Negotiated Rate |
$289.00 |
| Rate for Payer: AlohaCare Medicare |
$194.23
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Devoted Health Medicare |
$213.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$194.23
|
| Rate for Payer: Health Management Network Commercial |
$289.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$233.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$233.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$233.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$194.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$194.23
|
|
|
PR KO IMMOB CANVAS LONG PRE OTS
|
Professional
|
Both
|
$257.00
|
|
|
Service Code
|
HCPCS L1830
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$218.45 |
| Rate for Payer: AlohaCare Medicaid |
$87.51
|
| Rate for Payer: AlohaCare Medicare |
$149.93
|
| Rate for Payer: Cash Price |
$154.20
|
| Rate for Payer: Cash Price |
$154.20
|
| Rate for Payer: Devoted Health Medicare |
$164.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$149.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$28.00
|
| Rate for Payer: Health Management Network Commercial |
$218.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$179.92
|
| Rate for Payer: Kaiser Permanente Medicaid |
$179.92
|
| Rate for Payer: Kaiser Permanente Medicare |
$179.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$87.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$149.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$87.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$149.93
|
|
|
PR LABYRINTHOTOMY TRANSCANAL
|
Professional
|
Both
|
$418.39
|
|
|
Service Code
|
HCPCS 69801
|
| Min. Negotiated Rate |
$107.68 |
| Max. Negotiated Rate |
$355.63 |
| Rate for Payer: AlohaCare Medicaid |
$126.57
|
| Rate for Payer: AlohaCare Medicare |
$107.68
|
| Rate for Payer: Cash Price |
$251.03
|
| Rate for Payer: Cash Price |
$251.03
|
| Rate for Payer: Devoted Health Medicare |
$118.45
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$126.57
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$107.68
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$126.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$190.84
|
| Rate for Payer: Health Management Network Commercial |
$355.63
|
| Rate for Payer: Kaiser Permanente Commercial |
$129.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$129.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$129.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$126.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$107.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$126.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$107.68
|
| Rate for Payer: University Health Alliance Commercial |
$157.39
|
|
|
PR LAPAROSCOPIC APPENDECTOMY
|
Professional
|
Both
|
$1,033.00
|
|
|
Service Code
|
HCPCS 44970
|
| Min. Negotiated Rate |
$485.68 |
| Max. Negotiated Rate |
$878.05 |
| Rate for Payer: AlohaCare Medicaid |
$602.67
|
| Rate for Payer: AlohaCare Medicare |
$570.88
|
| Rate for Payer: Cash Price |
$619.80
|
| Rate for Payer: Cash Price |
$619.80
|
| Rate for Payer: Devoted Health Medicare |
$627.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$570.88
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$485.68
|
| Rate for Payer: Health Management Network Commercial |
$878.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$685.06
|
| Rate for Payer: Kaiser Permanente Medicaid |
$685.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$685.06
|
| Rate for Payer: Ohana Health Plan Medicaid |
$602.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$570.88
|
| Rate for Payer: UnitedHealthcare Medicaid |
$602.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$570.88
|
|
|
PR LAPAROSCOPY ADRENALECTOMY PRTL/COMPL TABDL
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 60650
|
| Min. Negotiated Rate |
$1,071.46 |
| Max. Negotiated Rate |
$1,712.75 |
| Rate for Payer: AlohaCare Medicaid |
$1,174.36
|
| Rate for Payer: AlohaCare Medicare |
$1,076.92
|
| Rate for Payer: Cash Price |
$1,209.00
|
| Rate for Payer: Cash Price |
$1,209.00
|
| Rate for Payer: Devoted Health Medicare |
$1,184.61
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,076.92
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,071.46
|
| Rate for Payer: Health Management Network Commercial |
$1,712.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,292.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,292.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,292.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,174.36
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,076.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,174.36
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,076.92
|
|
|
PR LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$2,581.00
|
|
|
Service Code
|
HCPCS 44204
|
| Min. Negotiated Rate |
$1,359.80 |
| Max. Negotiated Rate |
$2,193.85 |
| Rate for Payer: AlohaCare Medicaid |
$1,508.54
|
| Rate for Payer: AlohaCare Medicare |
$1,381.76
|
| Rate for Payer: Cash Price |
$1,548.60
|
| Rate for Payer: Cash Price |
$1,548.60
|
| Rate for Payer: Devoted Health Medicare |
$1,519.94
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,381.76
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,359.80
|
| Rate for Payer: Health Management Network Commercial |
$2,193.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,658.11
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,658.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,658.11
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,508.54
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,381.76
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,508.54
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,381.76
|
|
|
PR LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX
|
Professional
|
Both
|
$1,671.00
|
|
|
Service Code
|
HCPCS 57425
|
| Min. Negotiated Rate |
$850.69 |
| Max. Negotiated Rate |
$1,420.35 |
| Rate for Payer: AlohaCare Medicaid |
$982.39
|
| Rate for Payer: AlohaCare Medicare |
$850.69
|
| Rate for Payer: Cash Price |
$1,002.60
|
| Rate for Payer: Cash Price |
$1,002.60
|
| Rate for Payer: Devoted Health Medicare |
$935.76
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$850.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$924.30
|
| Rate for Payer: Health Management Network Commercial |
$1,420.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,020.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,020.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,020.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$982.39
|
| Rate for Payer: Ohana Health Plan Medicare |
$850.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$982.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$850.69
|
|
|
PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,556.00
|
|
|
Service Code
|
HCPCS 44180
|
| Min. Negotiated Rate |
$806.26 |
| Max. Negotiated Rate |
$1,322.60 |
| Rate for Payer: AlohaCare Medicaid |
$907.45
|
| Rate for Payer: AlohaCare Medicare |
$844.07
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Devoted Health Medicare |
$928.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$844.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$806.26
|
| Rate for Payer: Health Management Network Commercial |
$1,322.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,012.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,012.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,012.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$907.45
|
| Rate for Payer: Ohana Health Plan Medicare |
$844.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$907.45
|
| Rate for Payer: UnitedHealthcare Medicare |
$844.07
|
|
|
PR LAPAROSCOPY FULGURATION OVIDUCTS
|
Professional
|
Both
|
$647.00
|
|
|
Service Code
|
HCPCS 58670
|
| Min. Negotiated Rate |
$333.26 |
| Max. Negotiated Rate |
$549.95 |
| Rate for Payer: AlohaCare Medicaid |
$381.20
|
| Rate for Payer: AlohaCare Medicare |
$333.26
|
| Rate for Payer: Cash Price |
$388.20
|
| Rate for Payer: Cash Price |
$388.20
|
| Rate for Payer: Devoted Health Medicare |
$366.59
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$333.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$377.78
|
| Rate for Payer: Health Management Network Commercial |
$549.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$399.91
|
| Rate for Payer: Kaiser Permanente Medicaid |
$399.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$399.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$381.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$333.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$381.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$333.26
|
|
