|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 45 MIN
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 99403
|
| Min. Negotiated Rate |
$38.78 |
| Max. Negotiated Rate |
$136.85 |
| Rate for Payer: Cash Price |
$96.60
|
| Rate for Payer: Cash Price |
$96.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$72.08
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$72.08
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$38.78
|
| Rate for Payer: Health Management Network Commercial |
$136.85
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 60 MIN
|
Professional
|
Both
|
$206.00
|
|
|
Service Code
|
HCPCS 99404
|
| Min. Negotiated Rate |
$43.71 |
| Max. Negotiated Rate |
$175.10 |
| Rate for Payer: Cash Price |
$123.60
|
| Rate for Payer: Cash Price |
$123.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$96.22
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$96.22
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$43.71
|
| Rate for Payer: Health Management Network Commercial |
$175.10
|
|
|
PR PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 93279 26
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$73.07 |
| Rate for Payer: AlohaCare Medicaid |
$73.07
|
| Rate for Payer: AlohaCare Medicare |
$31.68
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Devoted Health Medicare |
$34.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$31.68
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$52.55
|
| Rate for Payer: Health Management Network Commercial |
$46.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$38.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$38.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$38.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$73.07
|
| Rate for Payer: Ohana Health Plan Medicare |
$31.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$73.07
|
| Rate for Payer: UnitedHealthcare Medicare |
$31.68
|
|
|
PR PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 93279 TC
|
| Min. Negotiated Rate |
$40.83 |
| Max. Negotiated Rate |
$112.20 |
| Rate for Payer: AlohaCare Medicaid |
$73.07
|
| Rate for Payer: AlohaCare Medicare |
$40.83
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Devoted Health Medicare |
$44.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$40.83
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$52.55
|
| Rate for Payer: Health Management Network Commercial |
$112.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$49.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$49.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$49.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$73.07
|
| Rate for Payer: Ohana Health Plan Medicare |
$40.83
|
| Rate for Payer: UnitedHealthcare Medicaid |
$73.07
|
| Rate for Payer: UnitedHealthcare Medicare |
$40.83
|
|
|
PR PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 93279
|
| Min. Negotiated Rate |
$52.55 |
| Max. Negotiated Rate |
$158.95 |
| Rate for Payer: AlohaCare Medicaid |
$73.07
|
| Rate for Payer: AlohaCare Medicare |
$72.51
|
| Rate for Payer: Cash Price |
$112.20
|
| Rate for Payer: Cash Price |
$112.20
|
| Rate for Payer: Devoted Health Medicare |
$79.76
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$72.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$52.55
|
| Rate for Payer: Health Management Network Commercial |
$158.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$87.01
|
| Rate for Payer: Kaiser Permanente Medicaid |
$87.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$87.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$73.07
|
| Rate for Payer: Ohana Health Plan Medicare |
$72.51
|
| Rate for Payer: UnitedHealthcare Medicaid |
$73.07
|
| Rate for Payer: UnitedHealthcare Medicare |
$72.51
|
|
|
PR PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
HCPCS 93260
|
| Min. Negotiated Rate |
$72.92 |
| Max. Negotiated Rate |
$120.70 |
| Rate for Payer: AlohaCare Medicaid |
$81.44
|
| Rate for Payer: AlohaCare Medicare |
$81.28
|
| Rate for Payer: Cash Price |
$85.20
|
| Rate for Payer: Cash Price |
$85.20
|
| Rate for Payer: Devoted Health Medicare |
$89.41
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$81.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$72.92
|
| Rate for Payer: Health Management Network Commercial |
$120.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$97.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$97.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$97.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$81.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$81.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$81.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$81.28
|
|
|
PR PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 93260 TC
|
| Min. Negotiated Rate |
$39.31 |
| Max. Negotiated Rate |
$81.44 |
| Rate for Payer: AlohaCare Medicaid |
$81.44
|
| Rate for Payer: AlohaCare Medicare |
$39.31
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Devoted Health Medicare |
$43.24
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$39.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$72.92
|
| Rate for Payer: Health Management Network Commercial |
$58.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$47.17
|
| Rate for Payer: Kaiser Permanente Medicaid |
$47.17
|
| Rate for Payer: Kaiser Permanente Medicare |
$47.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$81.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$39.31
|
| Rate for Payer: UnitedHealthcare Medicaid |
$81.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$39.31
|
|
|
PR PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 93260 26
|
| Min. Negotiated Rate |
$41.97 |
| Max. Negotiated Rate |
$81.44 |
| Rate for Payer: AlohaCare Medicaid |
$81.44
|
| Rate for Payer: AlohaCare Medicare |
$41.97
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Devoted Health Medicare |
$46.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$41.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$72.92
|
| Rate for Payer: Health Management Network Commercial |
$62.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$50.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$50.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$50.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$81.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$41.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$81.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$41.97
|
|
|
PR PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 93285
|
| Min. Negotiated Rate |
$64.71 |
| Max. Negotiated Rate |
$144.50 |
| Rate for Payer: AlohaCare Medicaid |
$65.30
|
| Rate for Payer: AlohaCare Medicare |
$64.71
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Devoted Health Medicare |
$71.18
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$64.71
|
| Rate for Payer: Health Management Network Commercial |
$144.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$77.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$77.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$77.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$65.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$64.71
|
| Rate for Payer: UnitedHealthcare Medicaid |
$65.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$64.71
|
|
|
PR PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 93285 26
|
| Min. Negotiated Rate |
$25.78 |
| Max. Negotiated Rate |
$65.30 |
| Rate for Payer: AlohaCare Medicaid |
$65.30
|
| Rate for Payer: AlohaCare Medicare |
$25.78
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Devoted Health Medicare |
$28.36
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$25.78
|
| Rate for Payer: Health Management Network Commercial |
$38.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$30.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$30.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$30.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$65.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$25.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$65.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$25.78
|
|
|
PR PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 93285 TC
|
| Min. Negotiated Rate |
$38.93 |
| Max. Negotiated Rate |
$106.25 |
| Rate for Payer: AlohaCare Medicaid |
$65.30
|
| Rate for Payer: AlohaCare Medicare |
$38.93
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Devoted Health Medicare |
$42.82
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$38.93
|
| Rate for Payer: Health Management Network Commercial |
$106.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$46.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$46.72
|
| Rate for Payer: Kaiser Permanente Medicare |
$46.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$65.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$65.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$38.93
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB
|
Professional
|
Both
|
$164.00
|
|
|
Service Code
|
HCPCS 93284 TC
|
| Min. Negotiated Rate |
$51.08 |
| Max. Negotiated Rate |
$139.40 |
| Rate for Payer: AlohaCare Medicaid |
$112.92
|
| Rate for Payer: AlohaCare Medicare |
$51.08
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Devoted Health Medicare |
$56.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$51.08
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$99.64
|
| Rate for Payer: Health Management Network Commercial |
$139.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$61.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$61.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$61.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$112.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$51.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$112.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$51.08
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB
|
Professional
|
Both
|
$271.00
|
|
|
Service Code
|
HCPCS 93284
|
| Min. Negotiated Rate |
$99.64 |
| Max. Negotiated Rate |
$230.35 |
| Rate for Payer: AlohaCare Medicaid |
$112.92
|
| Rate for Payer: AlohaCare Medicare |
$111.97
|
| Rate for Payer: Cash Price |
$162.60
|
| Rate for Payer: Cash Price |
$162.60
|
| Rate for Payer: Devoted Health Medicare |
$123.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$111.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$99.64
|
| Rate for Payer: Health Management Network Commercial |
$230.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$134.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$134.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$134.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$112.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$111.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$112.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$111.97
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB
|
Professional
|
Both
|
$107.00
|
|
|
Service Code
|
HCPCS 93284 26
|
| Min. Negotiated Rate |
$60.89 |
| Max. Negotiated Rate |
$112.92 |
| Rate for Payer: AlohaCare Medicaid |
$112.92
|
| Rate for Payer: AlohaCare Medicare |
$60.89
|
| Rate for Payer: Cash Price |
$64.20
|
| Rate for Payer: Cash Price |
$64.20
|
| Rate for Payer: Devoted Health Medicare |
$66.98
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$60.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$99.64
|
| Rate for Payer: Health Management Network Commercial |
$90.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$73.07
|
| Rate for Payer: Kaiser Permanente Medicaid |
$73.07
|
| Rate for Payer: Kaiser Permanente Medicare |
$73.07
|
| Rate for Payer: Ohana Health Plan Medicaid |
$112.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$60.89
|
| Rate for Payer: UnitedHealthcare Medicaid |
$112.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$60.89
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
HCPCS 93283 26
|
| Min. Negotiated Rate |
$56.03 |
| Max. Negotiated Rate |
$104.62 |
| Rate for Payer: AlohaCare Medicaid |
$104.62
|
| Rate for Payer: AlohaCare Medicare |
$56.03
|
| Rate for Payer: Cash Price |
$58.80
|
| Rate for Payer: Cash Price |
$58.80
|
| Rate for Payer: Devoted Health Medicare |
$61.63
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$56.03
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$85.07
|
| Rate for Payer: Health Management Network Commercial |
$83.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$67.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$67.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$67.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$104.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$56.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$104.62
|
| Rate for Payer: UnitedHealthcare Medicare |
$56.03
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 93283
|
| Min. Negotiated Rate |
$85.07 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: AlohaCare Medicaid |
$104.62
|
| Rate for Payer: AlohaCare Medicare |
$103.70
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Devoted Health Medicare |
$114.07
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$103.70
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$85.07
|
| Rate for Payer: Health Management Network Commercial |
$214.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$124.44
|
| Rate for Payer: Kaiser Permanente Medicaid |
$124.44
|
| Rate for Payer: Kaiser Permanente Medicare |
$124.44
|
| Rate for Payer: Ohana Health Plan Medicaid |
$104.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$103.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$104.62
|
| Rate for Payer: UnitedHealthcare Medicare |
$103.70
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB
|
Professional
|
Both
|
$154.00
|
|
|
Service Code
|
HCPCS 93283 TC
|
| Min. Negotiated Rate |
$47.66 |
| Max. Negotiated Rate |
$130.90 |
| Rate for Payer: AlohaCare Medicaid |
$104.62
|
| Rate for Payer: AlohaCare Medicare |
$47.66
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Devoted Health Medicare |
$52.43
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$47.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$85.07
|
| Rate for Payer: Health Management Network Commercial |
$130.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$57.19
|
| Rate for Payer: Kaiser Permanente Medicaid |
$57.19
|
| Rate for Payer: Kaiser Permanente Medicare |
$57.19
|
| Rate for Payer: Ohana Health Plan Medicaid |
$104.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$47.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$104.62
|
| Rate for Payer: UnitedHealthcare Medicare |
$47.66
|
|
|
PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 93282 TC
|
| Min. Negotiated Rate |
$43.11 |
| Max. Negotiated Rate |
$119.00 |
| Rate for Payer: AlohaCare Medicaid |
$85.65
|
| Rate for Payer: AlohaCare Medicare |
$43.11
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Devoted Health Medicare |
$47.42
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$43.11
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$69.89
|
| Rate for Payer: Health Management Network Commercial |
$119.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$51.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$51.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$51.73
|
| Rate for Payer: Ohana Health Plan Medicaid |
$85.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$43.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$85.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$43.11
|
|
|
PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 93282 26
|
| Min. Negotiated Rate |
$41.59 |
| Max. Negotiated Rate |
$85.65 |
| Rate for Payer: AlohaCare Medicaid |
$85.65
|
| Rate for Payer: AlohaCare Medicare |
$41.59
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Devoted Health Medicare |
$45.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$41.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$69.89
|
| Rate for Payer: Health Management Network Commercial |
$62.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$49.91
|
| Rate for Payer: Kaiser Permanente Medicaid |
$49.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$49.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$85.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$41.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$85.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$41.59
|
|
|
PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 93282
|
| Min. Negotiated Rate |
$69.89 |
| Max. Negotiated Rate |
$181.05 |
| Rate for Payer: AlohaCare Medicaid |
$85.65
|
| Rate for Payer: AlohaCare Medicare |
$84.70
|
| Rate for Payer: Cash Price |
$127.80
|
| Rate for Payer: Cash Price |
$127.80
|
| Rate for Payer: Devoted Health Medicare |
$93.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$84.70
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$69.89
|
| Rate for Payer: Health Management Network Commercial |
$181.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$101.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$101.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$101.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$85.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$84.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$85.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$84.70
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST
|
Professional
|
Both
|
$3,132.29
|
|
|
Service Code
|
HCPCS 37184
|
| Min. Negotiated Rate |
$362.33 |
| Max. Negotiated Rate |
$2,662.45 |
| Rate for Payer: AlohaCare Medicaid |
$407.56
|
| Rate for Payer: AlohaCare Medicare |
$362.33
|
| Rate for Payer: Cash Price |
$1,879.37
|
| Rate for Payer: Cash Price |
$1,879.37
|
| Rate for Payer: Devoted Health Medicare |
$398.56
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$407.56
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$647.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$362.33
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$407.56
|
| Rate for Payer: Health Management Network Commercial |
$2,662.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$434.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.80
|
| Rate for Payer: Kaiser Permanente Medicare |
$434.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$407.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$362.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$407.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$362.33
|
| Rate for Payer: University Health Alliance Commercial |
$642.00
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ
|
Professional
|
Both
|
$868.94
|
|
|
Service Code
|
HCPCS 37185
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$738.60 |
| Rate for Payer: AlohaCare Medicaid |
$152.69
|
| Rate for Payer: AlohaCare Medicare |
$135.00
|
| Rate for Payer: Cash Price |
$521.36
|
| Rate for Payer: Cash Price |
$521.36
|
| Rate for Payer: Devoted Health Medicare |
$148.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$152.69
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$242.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$135.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$152.69
|
| Rate for Payer: Health Management Network Commercial |
$738.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$162.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$162.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$162.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$152.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$135.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$152.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$135.00
|
| Rate for Payer: University Health Alliance Commercial |
$243.00
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Professional
|
Both
|
$285.25
|
|
|
Service Code
|
HCPCS 45300
|
| Min. Negotiated Rate |
$45.28 |
| Max. Negotiated Rate |
$242.46 |
| Rate for Payer: AlohaCare Medicaid |
$48.56
|
| Rate for Payer: AlohaCare Medicare |
$45.28
|
| Rate for Payer: Cash Price |
$171.15
|
| Rate for Payer: Cash Price |
$171.15
|
| Rate for Payer: Devoted Health Medicare |
$49.81
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$48.56
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$53.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$45.28
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$48.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.50
|
| Rate for Payer: Health Management Network Commercial |
$242.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$54.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$54.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$54.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$48.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$45.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$48.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$45.28
|
| Rate for Payer: University Health Alliance Commercial |
$68.00
|
|
|
PR PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$379.28
|
|
|
Service Code
|
HCPCS 45305
|
| Min. Negotiated Rate |
$69.76 |
| Max. Negotiated Rate |
$322.39 |
| Rate for Payer: AlohaCare Medicaid |
$73.76
|
| Rate for Payer: AlohaCare Medicare |
$69.76
|
| Rate for Payer: Cash Price |
$227.57
|
| Rate for Payer: Cash Price |
$227.57
|
| Rate for Payer: Devoted Health Medicare |
$76.74
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$73.76
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$112.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.76
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$73.76
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$74.10
|
| Rate for Payer: Health Management Network Commercial |
$322.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$83.71
|
| Rate for Payer: Kaiser Permanente Medicaid |
$83.71
|
| Rate for Payer: Kaiser Permanente Medicare |
$83.71
|
| Rate for Payer: Ohana Health Plan Medicaid |
$73.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.76
|
| Rate for Payer: UnitedHealthcare Medicaid |
$73.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.76
|
| Rate for Payer: University Health Alliance Commercial |
$96.67
|
|
|
PR PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$444.34
|
|
|
Service Code
|
HCPCS 45307
|
| Min. Negotiated Rate |
$94.03 |
| Max. Negotiated Rate |
$377.69 |
| Rate for Payer: AlohaCare Medicaid |
$99.36
|
| Rate for Payer: AlohaCare Medicare |
$94.03
|
| Rate for Payer: Cash Price |
$266.60
|
| Rate for Payer: Cash Price |
$266.60
|
| Rate for Payer: Devoted Health Medicare |
$103.43
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$99.36
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$106.61
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$94.03
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$99.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$117.26
|
| Rate for Payer: Health Management Network Commercial |
$377.69
|
| Rate for Payer: Kaiser Permanente Commercial |
$112.84
|
| Rate for Payer: Kaiser Permanente Medicaid |
$112.84
|
| Rate for Payer: Kaiser Permanente Medicare |
$112.84
|
| Rate for Payer: Ohana Health Plan Medicaid |
$99.36
|
| Rate for Payer: Ohana Health Plan Medicare |
$94.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$99.36
|
| Rate for Payer: UnitedHealthcare Medicare |
$94.03
|
| Rate for Payer: University Health Alliance Commercial |
$132.12
|
|
