|
PR TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART
|
Professional
|
Both
|
$1,145.41
|
|
|
Service Code
|
HCPCS 37247
|
| Min. Negotiated Rate |
$145.64 |
| Max. Negotiated Rate |
$982.54 |
| Rate for Payer: AlohaCare Medicaid |
$162.48
|
| Rate for Payer: AlohaCare Medicare |
$145.64
|
| Rate for Payer: Cash Price |
$687.25
|
| Rate for Payer: Cash Price |
$687.25
|
| Rate for Payer: Devoted Health Medicare |
$160.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$162.48
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$252.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$145.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$162.48
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$982.54
|
| Rate for Payer: Health Management Network Commercial |
$973.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$174.77
|
| Rate for Payer: Kaiser Permanente Medicaid |
$174.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$174.77
|
| Rate for Payer: Ohana Health Plan Medicaid |
$162.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$145.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$162.48
|
| Rate for Payer: UnitedHealthcare Medicare |
$145.64
|
| Rate for Payer: University Health Alliance Commercial |
$213.69
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN
|
Professional
|
Both
|
$2,522.05
|
|
|
Service Code
|
HCPCS 37248
|
| Min. Negotiated Rate |
$251.74 |
| Max. Negotiated Rate |
$2,143.74 |
| Rate for Payer: AlohaCare Medicaid |
$283.27
|
| Rate for Payer: AlohaCare Medicare |
$251.74
|
| Rate for Payer: Cash Price |
$1,513.23
|
| Rate for Payer: Cash Price |
$1,513.23
|
| Rate for Payer: Devoted Health Medicare |
$276.91
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$283.27
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$450.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$251.74
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$283.27
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,686.88
|
| Rate for Payer: Health Management Network Commercial |
$2,143.74
|
| Rate for Payer: Kaiser Permanente Commercial |
$302.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$302.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$302.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$283.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$251.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$283.27
|
| Rate for Payer: UnitedHealthcare Medicare |
$251.74
|
| Rate for Payer: University Health Alliance Commercial |
$450.92
|
|
|
PR TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I
|
Professional
|
Both
|
$1,113.60
|
|
|
Service Code
|
HCPCS 36907
|
| Min. Negotiated Rate |
$123.28 |
| Max. Negotiated Rate |
$946.56 |
| Rate for Payer: AlohaCare Medicaid |
$138.86
|
| Rate for Payer: AlohaCare Medicare |
$123.28
|
| Rate for Payer: Cash Price |
$668.16
|
| Rate for Payer: Cash Price |
$668.16
|
| Rate for Payer: Devoted Health Medicare |
$135.61
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$138.86
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$221.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$123.28
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$138.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$831.22
|
| Rate for Payer: Health Management Network Commercial |
$946.56
|
| Rate for Payer: Kaiser Permanente Commercial |
$147.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$147.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$147.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$138.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$123.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$138.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$123.28
|
| Rate for Payer: University Health Alliance Commercial |
$201.00
|
|
|
PR TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR
|
Professional
|
Both
|
$1,636.00
|
|
|
Service Code
|
HCPCS 26497
|
| Min. Negotiated Rate |
$586.30 |
| Max. Negotiated Rate |
$1,390.60 |
| Rate for Payer: AlohaCare Medicaid |
$964.05
|
| Rate for Payer: AlohaCare Medicare |
$918.73
|
| Rate for Payer: Cash Price |
$981.60
|
| Rate for Payer: Cash Price |
$981.60
|
| Rate for Payer: Devoted Health Medicare |
$1,010.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$918.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$586.30
|
| Rate for Payer: Health Management Network Commercial |
$1,390.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,102.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,102.48
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,102.48
|
| Rate for Payer: Ohana Health Plan Medicaid |
$964.05
|
| Rate for Payer: Ohana Health Plan Medicare |
$918.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$964.05
|
| Rate for Payer: UnitedHealthcare Medicare |
$918.73
|
|
|
PR TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 26480
|
| Min. Negotiated Rate |
$469.82 |
| Max. Negotiated Rate |
$1,102.45 |
| Rate for Payer: AlohaCare Medicaid |
$853.49
|
| Rate for Payer: AlohaCare Medicare |
$688.42
|
| Rate for Payer: Cash Price |
$778.20
|
| Rate for Payer: Cash Price |
$778.20
|
| Rate for Payer: Devoted Health Medicare |
$757.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$688.42
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$469.82
|
| Rate for Payer: Health Management Network Commercial |
$1,102.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$826.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$826.10
|
| Rate for Payer: Kaiser Permanente Medicare |
$826.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$853.49
|
| Rate for Payer: Ohana Health Plan Medicare |
$688.42
|
| Rate for Payer: UnitedHealthcare Medicaid |
$853.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$688.42
|
|
|
PR TRURL DRAINAGE PROSTATIC ABSCESS
|
Professional
|
Both
|
$777.00
|
|
|
Service Code
|
HCPCS 52700
|
| Min. Negotiated Rate |
$304.46 |
| Max. Negotiated Rate |
$660.45 |
| Rate for Payer: AlohaCare Medicaid |
$453.15
|
| Rate for Payer: AlohaCare Medicare |
$410.30
|
| Rate for Payer: Cash Price |
$466.20
|
| Rate for Payer: Cash Price |
$466.20
|
| Rate for Payer: Devoted Health Medicare |
$451.33
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$410.30
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$304.46
|
| Rate for Payer: Health Management Network Commercial |
$660.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$492.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$492.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$492.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$453.15
|
| Rate for Payer: Ohana Health Plan Medicare |
$410.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$453.15
|
| Rate for Payer: UnitedHealthcare Medicare |
$410.30
|
|
|
PR TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE
|
Professional
|
Both
|
$1,258.00
|
|
|
Service Code
|
HCPCS 52601
|
| Min. Negotiated Rate |
$530.04 |
| Max. Negotiated Rate |
$1,069.30 |
| Rate for Payer: AlohaCare Medicaid |
$734.33
|
| Rate for Payer: AlohaCare Medicare |
$530.04
|
| Rate for Payer: Cash Price |
$754.80
|
| Rate for Payer: Cash Price |
$754.80
|
| Rate for Payer: Devoted Health Medicare |
$583.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$530.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$906.62
|
| Rate for Payer: Health Management Network Commercial |
$1,069.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$636.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$636.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$636.05
|
| Rate for Payer: Ohana Health Plan Medicaid |
$734.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$530.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$734.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$530.04
|
|
|
PR TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE
|
Professional
|
Both
|
$580.00
|
|
|
Service Code
|
HCPCS 52640
|
| Min. Negotiated Rate |
$311.32 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: AlohaCare Medicaid |
$337.42
|
| Rate for Payer: AlohaCare Medicare |
$311.32
|
| Rate for Payer: Cash Price |
$348.00
|
| Rate for Payer: Cash Price |
$348.00
|
| Rate for Payer: Devoted Health Medicare |
$342.45
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$311.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$380.38
|
| Rate for Payer: Health Management Network Commercial |
$493.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$373.58
|
| Rate for Payer: Kaiser Permanente Medicaid |
$373.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$373.58
|
| Rate for Payer: Ohana Health Plan Medicaid |
$337.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$311.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$337.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$311.32
|
|
|
PR TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS
|
Professional
|
Both
|
$719.00
|
|
|
Service Code
|
HCPCS 52630
|
| Min. Negotiated Rate |
$382.91 |
| Max. Negotiated Rate |
$611.15 |
| Rate for Payer: AlohaCare Medicaid |
$418.67
|
| Rate for Payer: AlohaCare Medicare |
$382.91
|
| Rate for Payer: Cash Price |
$431.40
|
| Rate for Payer: Cash Price |
$431.40
|
| Rate for Payer: Devoted Health Medicare |
$421.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$382.91
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$449.28
|
| Rate for Payer: Health Management Network Commercial |
$611.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$459.49
|
| Rate for Payer: Kaiser Permanente Medicaid |
$459.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$459.49
|
| Rate for Payer: Ohana Health Plan Medicaid |
$418.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$382.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$418.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$382.91
|
|
|
PR TTE W OR W/O CONTR, CONT ECG
|
Professional
|
Both
|
$461.00
|
|
|
Service Code
|
HCPCS C8930
|
| Min. Negotiated Rate |
$391.85 |
| Max. Negotiated Rate |
$391.85 |
| Rate for Payer: Cash Price |
$276.60
|
| Rate for Payer: Health Management Network Commercial |
$391.85
|
|
|
PR TTE W OR WO FOL WCON,DOPPLER
|
Professional
|
Both
|
$408.00
|
|
|
Service Code
|
HCPCS C8929
|
| Min. Negotiated Rate |
$346.80 |
| Max. Negotiated Rate |
$346.80 |
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Health Management Network Commercial |
$346.80
|
|
|
PR TTE W OR W/O FOL W/CONT, COM
|
Professional
|
Both
|
$462.00
|
|
|
Service Code
|
HCPCS C8921
|
| Min. Negotiated Rate |
$392.70 |
| Max. Negotiated Rate |
$392.70 |
| Rate for Payer: Cash Price |
$277.20
|
| Rate for Payer: Health Management Network Commercial |
$392.70
|
|
|
PR TTE W OR W/O FOL W/CONT, F/U
|
Professional
|
Both
|
$462.00
|
|
|
Service Code
|
HCPCS C8922
|
| Min. Negotiated Rate |
$392.70 |
| Max. Negotiated Rate |
$392.70 |
| Rate for Payer: Cash Price |
$277.20
|
| Rate for Payer: Health Management Network Commercial |
$392.70
|
|
|
PR TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER
|
Professional
|
Both
|
$2,299.83
|
|
|
Service Code
|
HCPCS 31730
|
| Min. Negotiated Rate |
$128.56 |
| Max. Negotiated Rate |
$1,954.86 |
| Rate for Payer: AlohaCare Medicaid |
$142.42
|
| Rate for Payer: AlohaCare Medicare |
$128.56
|
| Rate for Payer: Cash Price |
$1,379.90
|
| Rate for Payer: Cash Price |
$1,379.90
|
| Rate for Payer: Devoted Health Medicare |
$141.42
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$142.42
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$228.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$128.56
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$142.42
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$152.36
|
| Rate for Payer: Health Management Network Commercial |
$1,954.86
|
| Rate for Payer: Kaiser Permanente Commercial |
$154.27
|
| Rate for Payer: Kaiser Permanente Medicaid |
$154.27
|
| Rate for Payer: Kaiser Permanente Medicare |
$154.27
|
| Rate for Payer: Ohana Health Plan Medicaid |
$142.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$128.56
|
| Rate for Payer: UnitedHealthcare Medicaid |
$142.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$128.56
|
| Rate for Payer: University Health Alliance Commercial |
$193.04
|
|
|
PR TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 44015
|
| Min. Negotiated Rate |
$120.71 |
| Max. Negotiated Rate |
$204.62 |
| Rate for Payer: AlohaCare Medicaid |
$134.73
|
| Rate for Payer: AlohaCare Medicare |
$120.71
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Devoted Health Medicare |
$132.78
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$120.71
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$204.62
|
| Rate for Payer: Health Management Network Commercial |
$195.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$144.85
|
| Rate for Payer: Kaiser Permanente Medicaid |
$144.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$144.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$134.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$120.71
|
| Rate for Payer: UnitedHealthcare Medicaid |
$134.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$120.71
|
|
|
PR TUBE THORACOSTOMY INCLUDES WATER SEAL
|
Professional
|
Both
|
$257.00
|
|
|
Service Code
|
HCPCS 32551
|
| Min. Negotiated Rate |
$138.75 |
| Max. Negotiated Rate |
$218.45 |
| Rate for Payer: AlohaCare Medicaid |
$150.10
|
| Rate for Payer: AlohaCare Medicare |
$138.75
|
| Rate for Payer: Cash Price |
$154.20
|
| Rate for Payer: Cash Price |
$154.20
|
| Rate for Payer: Devoted Health Medicare |
$152.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$138.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$160.16
|
| Rate for Payer: Health Management Network Commercial |
$218.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$166.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$166.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$166.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$150.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$138.75
|
| Rate for Payer: UnitedHealthcare Medicaid |
$150.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$138.75
|
|
|
PR TUBOTUBAL ANASTATOMOSIS
|
Professional
|
Both
|
$1,561.00
|
|
|
Service Code
|
HCPCS 58750
|
| Min. Negotiated Rate |
$622.44 |
| Max. Negotiated Rate |
$1,326.85 |
| Rate for Payer: AlohaCare Medicaid |
$919.30
|
| Rate for Payer: AlohaCare Medicare |
$792.28
|
| Rate for Payer: Cash Price |
$936.60
|
| Rate for Payer: Cash Price |
$936.60
|
| Rate for Payer: Devoted Health Medicare |
$871.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$792.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$622.44
|
| Rate for Payer: Health Management Network Commercial |
$1,326.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$950.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$950.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$950.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$919.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$792.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$919.30
|
| Rate for Payer: UnitedHealthcare Medicare |
$792.28
|
|
|
PR TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON
|
Professional
|
Both
|
$872.62
|
|
|
Service Code
|
HCPCS 46280
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$741.73 |
| Rate for Payer: AlohaCare Medicaid |
$501.92
|
| Rate for Payer: AlohaCare Medicare |
$498.64
|
| Rate for Payer: Cash Price |
$523.57
|
| Rate for Payer: Cash Price |
$523.57
|
| Rate for Payer: Devoted Health Medicare |
$548.50
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$498.64
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$465.40
|
| Rate for Payer: Health Management Network Commercial |
$741.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$598.37
|
| Rate for Payer: Kaiser Permanente Medicaid |
$598.37
|
| Rate for Payer: Kaiser Permanente Medicare |
$598.37
|
| Rate for Payer: Ohana Health Plan Medicaid |
$501.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$498.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$501.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$498.64
|
|
|
PR TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE
|
Professional
|
Both
|
$1,522.00
|
|
|
Service Code
|
HCPCS 24516
|
| Min. Negotiated Rate |
$647.66 |
| Max. Negotiated Rate |
$1,293.70 |
| Rate for Payer: AlohaCare Medicaid |
$886.77
|
| Rate for Payer: AlohaCare Medicare |
$805.88
|
| Rate for Payer: Cash Price |
$913.20
|
| Rate for Payer: Cash Price |
$913.20
|
| Rate for Payer: Devoted Health Medicare |
$886.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$805.88
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$647.66
|
| Rate for Payer: Health Management Network Commercial |
$1,293.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$967.06
|
| Rate for Payer: Kaiser Permanente Medicaid |
$967.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$967.06
|
| Rate for Payer: Ohana Health Plan Medicaid |
$886.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$805.88
|
| Rate for Payer: UnitedHealthcare Medicaid |
$886.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$805.88
|
|
|
PR TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL
|
Professional
|
Both
|
$635.74
|
|
|
Service Code
|
HCPCS 59812
|
| Min. Negotiated Rate |
$272.52 |
| Max. Negotiated Rate |
$540.38 |
| Rate for Payer: AlohaCare Medicaid |
$309.17
|
| Rate for Payer: AlohaCare Medicare |
$272.52
|
| Rate for Payer: Cash Price |
$381.44
|
| Rate for Payer: Cash Price |
$381.44
|
| Rate for Payer: Devoted Health Medicare |
$299.77
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$309.17
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$299.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$272.52
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$309.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$288.34
|
| Rate for Payer: Health Management Network Commercial |
$540.38
|
| Rate for Payer: Kaiser Permanente Commercial |
$327.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$327.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$327.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$309.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$272.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$309.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$272.52
|
| Rate for Payer: University Health Alliance Commercial |
$409.08
|
|
|
PR TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW
|
Professional
|
Both
|
$2,148.00
|
|
|
Service Code
|
HCPCS 27245
|
| Min. Negotiated Rate |
$1,095.90 |
| Max. Negotiated Rate |
$1,825.80 |
| Rate for Payer: AlohaCare Medicaid |
$1,250.65
|
| Rate for Payer: AlohaCare Medicare |
$1,121.19
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Devoted Health Medicare |
$1,233.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,121.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,095.90
|
| Rate for Payer: Health Management Network Commercial |
$1,825.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,345.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,345.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,345.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,250.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,121.19
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,250.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,121.19
|
|
|
PR TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 27244
|
| Min. Negotiated Rate |
$1,123.86 |
| Max. Negotiated Rate |
$1,827.50 |
| Rate for Payer: AlohaCare Medicaid |
$1,252.17
|
| Rate for Payer: AlohaCare Medicare |
$1,123.86
|
| Rate for Payer: Cash Price |
$1,290.00
|
| Rate for Payer: Cash Price |
$1,290.00
|
| Rate for Payer: Devoted Health Medicare |
$1,236.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,123.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,266.20
|
| Rate for Payer: Health Management Network Commercial |
$1,827.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,348.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,348.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,348.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,252.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,123.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,252.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,123.86
|
|
|
PR TX MISSED ABORTION FIRST TRIMESTER SURGICAL
|
Professional
|
Both
|
$772.61
|
|
|
Service Code
|
HCPCS 59820
|
| Min. Negotiated Rate |
$321.36 |
| Max. Negotiated Rate |
$656.72 |
| Rate for Payer: AlohaCare Medicaid |
$397.39
|
| Rate for Payer: AlohaCare Medicare |
$349.96
|
| Rate for Payer: Cash Price |
$463.57
|
| Rate for Payer: Cash Price |
$463.57
|
| Rate for Payer: Devoted Health Medicare |
$384.96
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$397.39
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$381.63
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$349.96
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$397.39
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$321.36
|
| Rate for Payer: Health Management Network Commercial |
$656.72
|
| Rate for Payer: Kaiser Permanente Commercial |
$419.95
|
| Rate for Payer: Kaiser Permanente Medicaid |
$419.95
|
| Rate for Payer: Kaiser Permanente Medicare |
$419.95
|
| Rate for Payer: Ohana Health Plan Medicaid |
$397.39
|
| Rate for Payer: Ohana Health Plan Medicare |
$349.96
|
| Rate for Payer: UnitedHealthcare Medicaid |
$397.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$349.96
|
| Rate for Payer: University Health Alliance Commercial |
$521.02
|
|
|
PR TX MISSED ABORTION SECOND TRIMESTER SURGICAL
|
Professional
|
Both
|
$759.76
|
|
|
Service Code
|
HCPCS 59821
|
| Min. Negotiated Rate |
$301.60 |
| Max. Negotiated Rate |
$645.80 |
| Rate for Payer: AlohaCare Medicaid |
$384.06
|
| Rate for Payer: AlohaCare Medicare |
$338.83
|
| Rate for Payer: Cash Price |
$455.86
|
| Rate for Payer: Cash Price |
$455.86
|
| Rate for Payer: Devoted Health Medicare |
$372.71
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$384.06
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$370.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$338.83
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$384.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$301.60
|
| Rate for Payer: Health Management Network Commercial |
$645.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$406.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$406.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$406.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$384.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$338.83
|
| Rate for Payer: UnitedHealthcare Medicaid |
$384.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$338.83
|
| Rate for Payer: University Health Alliance Commercial |
$505.16
|
|
|
PR TX SLP FEM EPIPHYSIS SINGLE/MULTIPL PINNING SITU
|
Professional
|
Both
|
$1,636.00
|
|
|
Service Code
|
HCPCS 27176
|
| Min. Negotiated Rate |
$667.16 |
| Max. Negotiated Rate |
$1,390.60 |
| Rate for Payer: AlohaCare Medicaid |
$952.29
|
| Rate for Payer: AlohaCare Medicare |
$866.50
|
| Rate for Payer: Cash Price |
$981.60
|
| Rate for Payer: Cash Price |
$981.60
|
| Rate for Payer: Devoted Health Medicare |
$953.15
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$866.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$667.16
|
| Rate for Payer: Health Management Network Commercial |
$1,390.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,039.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,039.80
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,039.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$952.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$866.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$952.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$866.50
|
|
