|
PR SCREENING TSTS DIABETES MELLITUS RVWD RQSTD ORD
|
Professional
|
Both
|
$1,969.00
|
|
|
Service Code
|
HCPCS 3754F
|
| Min. Negotiated Rate |
$1,673.65 |
| Max. Negotiated Rate |
$1,673.65 |
| Rate for Payer: Cash Price |
$1,181.40
|
| Rate for Payer: Health Management Network Commercial |
$1,673.65
|
|
|
PR SCROTAL EXPLORATION
|
Professional
|
Both
|
$687.00
|
|
|
Service Code
|
HCPCS 55110
|
| Min. Negotiated Rate |
$266.24 |
| Max. Negotiated Rate |
$583.95 |
| Rate for Payer: AlohaCare Medicaid |
$399.86
|
| Rate for Payer: AlohaCare Medicare |
$368.55
|
| Rate for Payer: Cash Price |
$412.20
|
| Rate for Payer: Cash Price |
$412.20
|
| Rate for Payer: Devoted Health Medicare |
$405.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$368.55
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$266.24
|
| Rate for Payer: Health Management Network Commercial |
$583.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$442.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$442.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$442.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$399.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$368.55
|
| Rate for Payer: UnitedHealthcare Medicaid |
$399.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$368.55
|
|
|
PR SCROTOPLASTY SIMPLE
|
Professional
|
Both
|
$648.00
|
|
|
Service Code
|
HCPCS 55175
|
| Min. Negotiated Rate |
$281.58 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: AlohaCare Medicaid |
$377.12
|
| Rate for Payer: AlohaCare Medicare |
$346.07
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Devoted Health Medicare |
$380.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$346.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$281.58
|
| Rate for Payer: Health Management Network Commercial |
$550.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$415.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$415.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$415.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$377.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$346.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$377.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$346.07
|
|
|
PR SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN
|
Professional
|
Both
|
$1,428.00
|
|
|
Service Code
|
HCPCS 49900
|
| Min. Negotiated Rate |
$222.82 |
| Max. Negotiated Rate |
$1,213.80 |
| Rate for Payer: AlohaCare Medicaid |
$831.15
|
| Rate for Payer: AlohaCare Medicare |
$797.90
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Devoted Health Medicare |
$877.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$797.90
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$222.82
|
| Rate for Payer: Health Management Network Commercial |
$1,213.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$957.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$957.48
|
| Rate for Payer: Kaiser Permanente Medicare |
$957.48
|
| Rate for Payer: Ohana Health Plan Medicaid |
$831.15
|
| Rate for Payer: Ohana Health Plan Medicare |
$797.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$831.15
|
| Rate for Payer: UnitedHealthcare Medicare |
$797.90
|
|
|
PR SECONDARY CLOSURE SURG WOUND/DEHSN XTNSV/COMP
|
Professional
|
Both
|
$1,399.00
|
|
|
Service Code
|
HCPCS 13160
|
| Min. Negotiated Rate |
$312.00 |
| Max. Negotiated Rate |
$1,189.15 |
| Rate for Payer: AlohaCare Medicaid |
$813.50
|
| Rate for Payer: AlohaCare Medicare |
$749.47
|
| Rate for Payer: Cash Price |
$839.40
|
| Rate for Payer: Cash Price |
$839.40
|
| Rate for Payer: Devoted Health Medicare |
$824.42
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$749.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$312.00
|
| Rate for Payer: Health Management Network Commercial |
$1,189.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$899.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$899.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$899.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$813.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$749.47
|
| Rate for Payer: UnitedHealthcare Medicaid |
$813.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$749.47
|
| Rate for Payer: University Health Alliance Commercial |
$935.34
|
|
|
PR SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL
|
Professional
|
Both
|
$2,231.14
|
|
|
Service Code
|
HCPCS 37186
|
| Min. Negotiated Rate |
$205.89 |
| Max. Negotiated Rate |
$1,896.47 |
| Rate for Payer: AlohaCare Medicaid |
$227.38
|
| Rate for Payer: AlohaCare Medicare |
$205.89
|
| Rate for Payer: Cash Price |
$1,338.68
|
| Rate for Payer: Cash Price |
$1,338.68
|
| Rate for Payer: Devoted Health Medicare |
$226.48
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$227.38
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$364.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$205.89
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$227.38
|
| Rate for Payer: Health Management Network Commercial |
$1,896.47
|
| Rate for Payer: Kaiser Permanente Commercial |
$247.07
|
| Rate for Payer: Kaiser Permanente Medicaid |
$247.07
|
| Rate for Payer: Kaiser Permanente Medicare |
$247.07
|
| Rate for Payer: Ohana Health Plan Medicaid |
$227.38
|
| Rate for Payer: Ohana Health Plan Medicare |
$205.89
|
| Rate for Payer: UnitedHealthcare Medicaid |
$227.38
|
| Rate for Payer: UnitedHealthcare Medicare |
$205.89
|
| Rate for Payer: University Health Alliance Commercial |
$365.00
|
|
|
PR SELECT PICTURE AUDIOMETRY
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 92583
|
| Min. Negotiated Rate |
$32.31 |
| Max. Negotiated Rate |
$200.60 |
| Rate for Payer: AlohaCare Medicaid |
$65.21
|
| Rate for Payer: AlohaCare Medicare |
$69.69
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Devoted Health Medicare |
$76.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$32.31
|
| Rate for Payer: Health Management Network Commercial |
$200.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$83.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$83.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$83.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$65.21
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$65.21
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.69
|
|
|
PR SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF
|
Professional
|
Both
|
$1,221.00
|
|
|
Service Code
|
HCPCS 30520
|
| Min. Negotiated Rate |
$479.18 |
| Max. Negotiated Rate |
$1,037.85 |
| Rate for Payer: AlohaCare Medicaid |
$726.27
|
| Rate for Payer: AlohaCare Medicare |
$647.18
|
| Rate for Payer: Cash Price |
$732.60
|
| Rate for Payer: Cash Price |
$732.60
|
| Rate for Payer: Devoted Health Medicare |
$711.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$647.18
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$479.18
|
| Rate for Payer: Health Management Network Commercial |
$1,037.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$776.62
|
| Rate for Payer: Kaiser Permanente Medicaid |
$776.62
|
| Rate for Payer: Kaiser Permanente Medicare |
$776.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$726.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$647.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$726.27
|
| Rate for Payer: UnitedHealthcare Medicare |
$647.18
|
|
|
PR SEQUESTRECTOMY FOREARM &/WRIST
|
Professional
|
Both
|
$950.00
|
|
|
Service Code
|
HCPCS 25145
|
| Min. Negotiated Rate |
$430.30 |
| Max. Negotiated Rate |
$807.50 |
| Rate for Payer: AlohaCare Medicaid |
$552.71
|
| Rate for Payer: AlohaCare Medicare |
$517.00
|
| Rate for Payer: Cash Price |
$570.00
|
| Rate for Payer: Cash Price |
$570.00
|
| Rate for Payer: Devoted Health Medicare |
$568.70
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$517.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$430.30
|
| Rate for Payer: Health Management Network Commercial |
$807.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$620.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$620.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$620.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$552.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$517.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$552.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$517.00
|
|
|
PR SESAMOIDECTOMY FIRST TOE SPX
|
Professional
|
Both
|
$901.65
|
|
|
Service Code
|
HCPCS 28315
|
| Min. Negotiated Rate |
$321.17 |
| Max. Negotiated Rate |
$766.40 |
| Rate for Payer: AlohaCare Medicaid |
$342.72
|
| Rate for Payer: AlohaCare Medicare |
$321.17
|
| Rate for Payer: Cash Price |
$540.99
|
| Rate for Payer: Cash Price |
$540.99
|
| Rate for Payer: Devoted Health Medicare |
$353.29
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$342.72
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$523.14
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$321.17
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$342.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$367.38
|
| Rate for Payer: Health Management Network Commercial |
$766.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$385.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$385.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$385.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$342.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$321.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$342.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$321.17
|
| Rate for Payer: University Health Alliance Commercial |
$428.14
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$640.64
|
|
|
Service Code
|
HCPCS 45335
|
| Min. Negotiated Rate |
$63.79 |
| Max. Negotiated Rate |
$544.54 |
| Rate for Payer: AlohaCare Medicaid |
$68.21
|
| Rate for Payer: AlohaCare Medicare |
$63.79
|
| Rate for Payer: Cash Price |
$384.38
|
| Rate for Payer: Cash Price |
$384.38
|
| Rate for Payer: Devoted Health Medicare |
$70.17
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$68.21
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$127.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$63.79
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$68.21
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$143.52
|
| Rate for Payer: Health Management Network Commercial |
$544.54
|
| Rate for Payer: Kaiser Permanente Commercial |
$76.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$76.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$76.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$68.21
|
| Rate for Payer: Ohana Health Plan Medicare |
$63.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$68.21
|
| Rate for Payer: UnitedHealthcare Medicare |
$63.79
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$643.09
|
|
|
Service Code
|
HCPCS 45338
|
| Min. Negotiated Rate |
$109.99 |
| Max. Negotiated Rate |
$546.63 |
| Rate for Payer: AlohaCare Medicaid |
$120.90
|
| Rate for Payer: AlohaCare Medicare |
$109.99
|
| Rate for Payer: Cash Price |
$385.85
|
| Rate for Payer: Cash Price |
$385.85
|
| Rate for Payer: Devoted Health Medicare |
$120.99
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$120.90
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$194.16
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$109.99
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$120.90
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$165.36
|
| Rate for Payer: Health Management Network Commercial |
$546.63
|
| Rate for Payer: Kaiser Permanente Commercial |
$131.99
|
| Rate for Payer: Kaiser Permanente Medicaid |
$131.99
|
| Rate for Payer: Kaiser Permanente Medicare |
$131.99
|
| Rate for Payer: Ohana Health Plan Medicaid |
$120.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$109.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$120.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$109.99
|
|
|
PR SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 45337
|
| Min. Negotiated Rate |
$99.70 |
| Max. Negotiated Rate |
$164.90 |
| Rate for Payer: AlohaCare Medicaid |
$113.58
|
| Rate for Payer: AlohaCare Medicare |
$99.70
|
| Rate for Payer: Cash Price |
$116.40
|
| Rate for Payer: Cash Price |
$116.40
|
| Rate for Payer: Devoted Health Medicare |
$109.67
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$99.70
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$139.36
|
| Rate for Payer: Health Management Network Commercial |
$164.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$119.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$119.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$119.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$113.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$99.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$113.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$99.70
|
|
|
PR SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$337.00
|
|
|
Service Code
|
HCPCS 45349
|
| Min. Negotiated Rate |
$176.41 |
| Max. Negotiated Rate |
$286.45 |
| Rate for Payer: AlohaCare Medicare |
$176.41
|
| Rate for Payer: Cash Price |
$202.20
|
| Rate for Payer: Cash Price |
$202.20
|
| Rate for Payer: Devoted Health Medicare |
$194.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$176.41
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$212.42
|
| Rate for Payer: Health Management Network Commercial |
$286.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$211.69
|
| Rate for Payer: Kaiser Permanente Medicaid |
$211.69
|
| Rate for Payer: Kaiser Permanente Medicare |
$211.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$176.41
|
| Rate for Payer: UnitedHealthcare Medicare |
$176.41
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<
|
Professional
|
Both
|
$213.45
|
|
|
Service Code
|
HCPCS 11310
|
| Min. Negotiated Rate |
$36.52 |
| Max. Negotiated Rate |
$181.43 |
| Rate for Payer: AlohaCare Medicaid |
$45.90
|
| Rate for Payer: AlohaCare Medicare |
$36.52
|
| Rate for Payer: Cash Price |
$128.07
|
| Rate for Payer: Cash Price |
$128.07
|
| Rate for Payer: Devoted Health Medicare |
$40.17
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$45.90
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$71.21
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$36.52
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$45.90
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$58.24
|
| Rate for Payer: Health Management Network Commercial |
$181.43
|
| Rate for Payer: Kaiser Permanente Commercial |
$43.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$43.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$43.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$45.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$36.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$45.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$36.52
|
| Rate for Payer: University Health Alliance Commercial |
$52.69
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM
|
Professional
|
Both
|
$332.88
|
|
|
Service Code
|
HCPCS 11313
|
| Min. Negotiated Rate |
$77.05 |
| Max. Negotiated Rate |
$282.95 |
| Rate for Payer: AlohaCare Medicaid |
$96.95
|
| Rate for Payer: AlohaCare Medicare |
$77.05
|
| Rate for Payer: Cash Price |
$199.73
|
| Rate for Payer: Cash Price |
$199.73
|
| Rate for Payer: Devoted Health Medicare |
$84.75
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$96.95
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$150.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$77.05
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$96.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$85.80
|
| Rate for Payer: Health Management Network Commercial |
$282.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$92.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$92.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$92.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$96.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$77.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$96.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$77.05
|
| Rate for Payer: University Health Alliance Commercial |
$111.38
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<
|
Professional
|
Both
|
$192.85
|
|
|
Service Code
|
HCPCS 11305
|
| Min. Negotiated Rate |
$32.34 |
| Max. Negotiated Rate |
$163.92 |
| Rate for Payer: AlohaCare Medicaid |
$37.12
|
| Rate for Payer: AlohaCare Medicare |
$32.34
|
| Rate for Payer: Cash Price |
$115.71
|
| Rate for Payer: Cash Price |
$115.71
|
| Rate for Payer: Devoted Health Medicare |
$35.57
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$37.12
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$58.98
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$32.34
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$37.12
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$47.58
|
| Rate for Payer: Health Management Network Commercial |
$163.92
|
| Rate for Payer: Kaiser Permanente Commercial |
$38.81
|
| Rate for Payer: Kaiser Permanente Medicaid |
$38.81
|
| Rate for Payer: Kaiser Permanente Medicare |
$38.81
|
| Rate for Payer: Ohana Health Plan Medicaid |
$37.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$32.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$37.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$32.34
|
| Rate for Payer: University Health Alliance Commercial |
$43.65
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$223.81
|
|
|
Service Code
|
HCPCS 11306
|
| Min. Negotiated Rate |
$40.54 |
| Max. Negotiated Rate |
$190.24 |
| Rate for Payer: AlohaCare Medicaid |
$48.94
|
| Rate for Payer: AlohaCare Medicare |
$40.54
|
| Rate for Payer: Cash Price |
$134.29
|
| Rate for Payer: Cash Price |
$134.29
|
| Rate for Payer: Devoted Health Medicare |
$44.59
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$48.94
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$76.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$40.54
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$48.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$47.58
|
| Rate for Payer: Health Management Network Commercial |
$190.24
|
| Rate for Payer: Kaiser Permanente Commercial |
$48.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$48.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$48.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$48.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$40.54
|
| Rate for Payer: UnitedHealthcare Medicaid |
$48.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$40.54
|
| Rate for Payer: University Health Alliance Commercial |
$56.70
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 11307
|
| Min. Negotiated Rate |
$51.08 |
| Max. Negotiated Rate |
$213.35 |
| Rate for Payer: AlohaCare Medicaid |
$62.46
|
| Rate for Payer: AlohaCare Medicare |
$51.08
|
| Rate for Payer: Cash Price |
$150.60
|
| Rate for Payer: Cash Price |
$150.60
|
| Rate for Payer: Devoted Health Medicare |
$56.19
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$62.46
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$98.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$51.08
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$62.46
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.50
|
| Rate for Payer: Health Management Network Commercial |
$213.35
|
| 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 |
$62.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$51.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$62.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$51.08
|
| Rate for Payer: University Health Alliance Commercial |
$72.68
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM
|
Professional
|
Both
|
$264.18
|
|
|
Service Code
|
HCPCS 11308
|
| Min. Negotiated Rate |
$59.06 |
| Max. Negotiated Rate |
$224.55 |
| Rate for Payer: AlohaCare Medicaid |
$69.39
|
| Rate for Payer: AlohaCare Medicare |
$59.06
|
| Rate for Payer: Cash Price |
$158.51
|
| Rate for Payer: Cash Price |
$158.51
|
| Rate for Payer: Devoted Health Medicare |
$64.97
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$69.39
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$109.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$59.06
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$69.39
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$66.82
|
| Rate for Payer: Health Management Network Commercial |
$224.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$70.87
|
| Rate for Payer: Kaiser Permanente Medicaid |
$70.87
|
| Rate for Payer: Kaiser Permanente Medicare |
$70.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$69.39
|
| Rate for Payer: Ohana Health Plan Medicare |
$59.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$69.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$59.06
|
| Rate for Payer: University Health Alliance Commercial |
$81.27
|
|
|
PR SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<
|
Professional
|
Both
|
$185.38
|
|
|
Service Code
|
HCPCS 11300
|
| Min. Negotiated Rate |
$27.70 |
| Max. Negotiated Rate |
$157.57 |
| Rate for Payer: AlohaCare Medicaid |
$34.28
|
| Rate for Payer: AlohaCare Medicare |
$27.70
|
| Rate for Payer: Cash Price |
$111.23
|
| Rate for Payer: Cash Price |
$111.23
|
| Rate for Payer: Devoted Health Medicare |
$30.47
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$34.28
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$54.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$27.70
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$34.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$44.46
|
| Rate for Payer: Health Management Network Commercial |
$157.57
|
| Rate for Payer: Kaiser Permanente Commercial |
$33.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$33.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$33.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$34.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$27.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$34.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$27.70
|
| Rate for Payer: University Health Alliance Commercial |
$39.58
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$251.02
|
|
|
Service Code
|
HCPCS 11311
|
| Min. Negotiated Rate |
$50.78 |
| Max. Negotiated Rate |
$213.37 |
| Rate for Payer: AlohaCare Medicaid |
$63.34
|
| Rate for Payer: AlohaCare Medicare |
$50.78
|
| Rate for Payer: Cash Price |
$150.61
|
| Rate for Payer: Cash Price |
$150.61
|
| Rate for Payer: Devoted Health Medicare |
$55.86
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$63.34
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$97.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$50.78
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$63.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$75.40
|
| Rate for Payer: Health Management Network Commercial |
$213.37
|
| Rate for Payer: Kaiser Permanente Commercial |
$60.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$60.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$60.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$50.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$63.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$50.78
|
| Rate for Payer: University Health Alliance Commercial |
$72.32
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$285.32
|
|
|
Service Code
|
HCPCS 11312
|
| Min. Negotiated Rate |
$60.50 |
| Max. Negotiated Rate |
$242.52 |
| Rate for Payer: AlohaCare Medicaid |
$74.96
|
| Rate for Payer: AlohaCare Medicare |
$60.50
|
| Rate for Payer: Cash Price |
$171.19
|
| Rate for Payer: Cash Price |
$171.19
|
| Rate for Payer: Devoted Health Medicare |
$66.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$74.96
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$115.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$60.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$74.96
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$91.26
|
| Rate for Payer: Health Management Network Commercial |
$242.52
|
| Rate for Payer: Kaiser Permanente Commercial |
$72.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$72.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$72.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$74.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$60.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$74.96
|
| Rate for Payer: UnitedHealthcare Medicare |
$60.50
|
| Rate for Payer: University Health Alliance Commercial |
$85.60
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$223.00
|
|
|
Service Code
|
HCPCS 11301
|
| Min. Negotiated Rate |
$41.95 |
| Max. Negotiated Rate |
$189.55 |
| Rate for Payer: AlohaCare Medicaid |
$51.71
|
| Rate for Payer: AlohaCare Medicare |
$41.95
|
| Rate for Payer: Cash Price |
$133.80
|
| Rate for Payer: Cash Price |
$133.80
|
| Rate for Payer: Devoted Health Medicare |
$46.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$51.71
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$80.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$41.95
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$51.71
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$61.62
|
| Rate for Payer: Health Management Network Commercial |
$189.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$50.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$50.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$50.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$51.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$41.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$51.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$41.95
|
| Rate for Payer: University Health Alliance Commercial |
$59.21
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM
|
Professional
|
Both
|
$279.07
|
|
|
Service Code
|
HCPCS 11303
|
| Min. Negotiated Rate |
$57.69 |
| Max. Negotiated Rate |
$237.21 |
| Rate for Payer: AlohaCare Medicaid |
$71.76
|
| Rate for Payer: AlohaCare Medicare |
$57.69
|
| Rate for Payer: Cash Price |
$167.44
|
| Rate for Payer: Cash Price |
$167.44
|
| Rate for Payer: Devoted Health Medicare |
$63.46
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$71.76
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$110.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$57.69
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$71.76
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.42
|
| Rate for Payer: Health Management Network Commercial |
$237.21
|
| Rate for Payer: Kaiser Permanente Commercial |
$69.23
|
| Rate for Payer: Kaiser Permanente Medicaid |
$69.23
|
| Rate for Payer: Kaiser Permanente Medicare |
$69.23
|
| Rate for Payer: Ohana Health Plan Medicaid |
$71.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$57.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$71.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$57.69
|
| Rate for Payer: University Health Alliance Commercial |
$81.91
|
|
