|
TISSUE RETRIEVAL TRS-ROBO-8
|
Facility
|
OP
|
$450.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.50 |
| Max. Negotiated Rate |
$436.50 |
| Rate for Payer: AlohaCare Medicaid |
$225.00
|
| Rate for Payer: AlohaCare Medicare |
$139.50
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Devoted Health Medicare |
$153.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$139.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$427.50
|
| Rate for Payer: Health Management Network Commercial |
$382.50
|
| Rate for Payer: Humana Medicare |
$139.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$405.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$229.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$139.50
|
| Rate for Payer: MDX Hawaii PPO |
$436.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$139.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$139.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$139.50
|
| Rate for Payer: University Health Alliance Commercial |
$328.00
|
|
|
TISSUE TRACE ALLOGRAFT 400145
|
Facility
|
OP
|
$996.00
|
|
|
Service Code
|
HCPCS C1762
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$308.76 |
| Max. Negotiated Rate |
$966.12 |
| Rate for Payer: AlohaCare Medicaid |
$498.00
|
| Rate for Payer: AlohaCare Medicare |
$308.76
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Devoted Health Medicare |
$338.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$308.76
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$697.20
|
| Rate for Payer: Health Management Network Commercial |
$846.60
|
| Rate for Payer: Humana Medicare |
$308.76
|
| Rate for Payer: Kaiser Permanente Commercial |
$896.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$507.96
|
| Rate for Payer: Kaiser Permanente Medicare |
$308.76
|
| Rate for Payer: MDX Hawaii PPO |
$966.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$308.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$308.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$308.76
|
| Rate for Payer: University Health Alliance Commercial |
$557.76
|
|
|
TISSUE TRACE ALLOGRAFT 400145
|
Facility
|
IP
|
$996.00
|
|
|
Service Code
|
HCPCS C1762
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$557.76 |
| Max. Negotiated Rate |
$966.12 |
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$697.20
|
| Rate for Payer: Health Management Network Commercial |
$846.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$896.40
|
| Rate for Payer: MDX Hawaii PPO |
$966.12
|
| Rate for Payer: University Health Alliance Commercial |
$557.76
|
|
|
TITAN END CAP T25 STARDR 0MM
|
Facility
|
OP
|
$910.00
|
|
|
Service Code
|
HCPCS C1713
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.10 |
| Max. Negotiated Rate |
$882.70 |
| Rate for Payer: AlohaCare Medicaid |
$455.00
|
| Rate for Payer: AlohaCare Medicare |
$282.10
|
| Rate for Payer: Cash Price |
$546.00
|
| Rate for Payer: Devoted Health Medicare |
$309.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$282.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$637.00
|
| Rate for Payer: Health Management Network Commercial |
$773.50
|
| Rate for Payer: Humana Medicare |
$282.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$819.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$464.10
|
| Rate for Payer: Kaiser Permanente Medicare |
$282.10
|
| Rate for Payer: MDX Hawaii PPO |
$882.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$282.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$282.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$282.10
|
| Rate for Payer: University Health Alliance Commercial |
$509.60
|
|
|
TITAN END CAP T25 STARDR 0MM
|
Facility
|
IP
|
$910.00
|
|
|
Service Code
|
HCPCS C1713
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$509.60 |
| Max. Negotiated Rate |
$882.70 |
| Rate for Payer: Cash Price |
$546.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$637.00
|
| Rate for Payer: Health Management Network Commercial |
$773.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$819.00
|
| Rate for Payer: MDX Hawaii PPO |
$882.70
|
| Rate for Payer: University Health Alliance Commercial |
$509.60
|
|
|
TIXAGEV AND CILGAV
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS Q0220
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$1.70 |
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Health Management Network Commercial |
$1.70
|
|
|
TIZANIDINE 4 MG TABLET [14793]
|
Facility
|
OP
|
$6.00
|
|
|
Service Code
|
NDC 68084064511
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.86 |
| Max. Negotiated Rate |
$5.82 |
| Rate for Payer: AlohaCare Medicaid |
$3.00
|
| Rate for Payer: AlohaCare Medicare |
$1.86
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Devoted Health Medicare |
$2.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$5.70
|
| Rate for Payer: Health Management Network Commercial |
$5.10
|
| Rate for Payer: Humana Medicare |
$1.86
|
| Rate for Payer: Kaiser Permanente Commercial |
$5.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$3.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.86
|
| Rate for Payer: MDX Hawaii PPO |
$5.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.86
|
| Rate for Payer: University Health Alliance Commercial |
$4.37
|
|
|
TIZANIDINE 4 MG TABLET [14793]
|
Facility
|
IP
|
$6.00
|
|
|
Service Code
|
NDC 68084064511
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$5.82 |
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Health Management Network Commercial |
$5.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$5.40
|
| Rate for Payer: MDX Hawaii PPO |
$5.82
|
|
|
TIZANIDINE 4 MG TABLET [14793]
|
Facility
|
IP
|
$6.00
|
|
|
Service Code
|
NDC 68084064501
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$5.82 |
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Health Management Network Commercial |
$5.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$5.40
|
| Rate for Payer: MDX Hawaii PPO |
$5.82
|
|
|
TIZANIDINE 4 MG TABLET [14793]
|
Facility
|
IP
|
$3.00
|
|
|
Service Code
|
NDC 68084064565
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$2.91 |
| Rate for Payer: Cash Price |
$1.80
|
| Rate for Payer: Health Management Network Commercial |
$2.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.70
|
| Rate for Payer: MDX Hawaii PPO |
$2.91
|
|
|
TIZANIDINE 4 MG TABLET [14793]
|
Facility
|
OP
|
$6.00
|
|
|
Service Code
|
NDC 68084064501
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.86 |
| Max. Negotiated Rate |
$5.82 |
| Rate for Payer: AlohaCare Medicaid |
$3.00
|
| Rate for Payer: AlohaCare Medicare |
$1.86
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Devoted Health Medicare |
$2.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$5.70
|
| Rate for Payer: Health Management Network Commercial |
$5.10
|
| Rate for Payer: Humana Medicare |
$1.86
|
| Rate for Payer: Kaiser Permanente Commercial |
$5.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$3.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.86
|
| Rate for Payer: MDX Hawaii PPO |
$5.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.86
|
| Rate for Payer: University Health Alliance Commercial |
$4.37
|
|
|
TIZANIDINE 4 MG TABLET [14793]
|
Facility
|
OP
|
$3.00
|
|
|
Service Code
|
NDC 68084064565
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$2.91 |
| Rate for Payer: AlohaCare Medicaid |
$1.50
|
| Rate for Payer: AlohaCare Medicare |
$0.93
|
| Rate for Payer: Cash Price |
$1.80
|
| Rate for Payer: Devoted Health Medicare |
$1.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$0.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2.85
|
| Rate for Payer: Health Management Network Commercial |
$2.55
|
| Rate for Payer: Humana Medicare |
$0.93
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$0.93
|
| Rate for Payer: MDX Hawaii PPO |
$2.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$0.93
|
| Rate for Payer: Ohana Health Plan Medicare |
$0.93
|
| Rate for Payer: UnitedHealthcare Medicare |
$0.93
|
| Rate for Payer: University Health Alliance Commercial |
$2.19
|
|
|
TL 1-HOLE POST 54-11600
|
Facility
|
OP
|
$489.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$151.59 |
| Max. Negotiated Rate |
$474.33 |
| Rate for Payer: AlohaCare Medicaid |
$244.50
|
| Rate for Payer: AlohaCare Medicare |
$151.59
|
| Rate for Payer: Cash Price |
$293.40
|
| Rate for Payer: Devoted Health Medicare |
$166.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$151.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$464.55
|
| Rate for Payer: Health Management Network Commercial |
$415.65
|
| Rate for Payer: Humana Medicare |
$151.59
|
| Rate for Payer: Kaiser Permanente Commercial |
$440.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$249.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$151.59
|
| Rate for Payer: MDX Hawaii PPO |
$474.33
|
| Rate for Payer: Ohana Health Plan Medicaid |
$151.59
|
| Rate for Payer: Ohana Health Plan Medicare |
$151.59
|
| Rate for Payer: UnitedHealthcare Medicare |
$151.59
|
| Rate for Payer: University Health Alliance Commercial |
$356.43
|
|
|
TL 1-HOLE POST 54-11600
|
Facility
|
IP
|
$489.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$415.65 |
| Max. Negotiated Rate |
$474.33 |
| Rate for Payer: Cash Price |
$293.40
|
| Rate for Payer: Health Management Network Commercial |
$415.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$440.10
|
| Rate for Payer: MDX Hawaii PPO |
$474.33
|
|
|
TNSN BND NR2X2H/MAL 04.503.701
|
Facility
|
IP
|
$1,962.00
|
|
|
Service Code
|
HCPCS C1713
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,098.72 |
| Max. Negotiated Rate |
$1,903.14 |
| Rate for Payer: Cash Price |
$1,177.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,373.40
|
| Rate for Payer: Health Management Network Commercial |
$1,667.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,765.80
|
| Rate for Payer: MDX Hawaii PPO |
$1,903.14
|
| Rate for Payer: University Health Alliance Commercial |
$1,098.72
|
|
|
TNSN BND NR2X2H/MAL 04.503.701
|
Facility
|
OP
|
$1,962.00
|
|
|
Service Code
|
HCPCS C1713
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$608.22 |
| Max. Negotiated Rate |
$1,903.14 |
| Rate for Payer: AlohaCare Medicaid |
$981.00
|
| Rate for Payer: AlohaCare Medicare |
$608.22
|
| Rate for Payer: Cash Price |
$1,177.20
|
| Rate for Payer: Devoted Health Medicare |
$667.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$608.22
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,373.40
|
| Rate for Payer: Health Management Network Commercial |
$1,667.70
|
| Rate for Payer: Humana Medicare |
$608.22
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,765.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,000.62
|
| Rate for Payer: Kaiser Permanente Medicare |
$608.22
|
| Rate for Payer: MDX Hawaii PPO |
$1,903.14
|
| Rate for Payer: Ohana Health Plan Medicaid |
$608.22
|
| Rate for Payer: Ohana Health Plan Medicare |
$608.22
|
| Rate for Payer: UnitedHealthcare Medicare |
$608.22
|
| Rate for Payer: University Health Alliance Commercial |
$1,098.72
|
|
|
TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION [11567]
|
Facility
|
IP
|
$229.00
|
|
|
Service Code
|
NDC 00574403105
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$194.65 |
| Max. Negotiated Rate |
$222.13 |
| Rate for Payer: Cash Price |
$137.40
|
| Rate for Payer: Health Management Network Commercial |
$194.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$206.10
|
| Rate for Payer: MDX Hawaii PPO |
$222.13
|
|
|
TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION [11567]
|
Facility
|
OP
|
$229.00
|
|
|
Service Code
|
NDC 00574403105
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$70.99 |
| Max. Negotiated Rate |
$222.13 |
| Rate for Payer: AlohaCare Medicaid |
$114.50
|
| Rate for Payer: AlohaCare Medicare |
$70.99
|
| Rate for Payer: Cash Price |
$137.40
|
| Rate for Payer: Devoted Health Medicare |
$77.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$70.99
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$217.55
|
| Rate for Payer: Health Management Network Commercial |
$194.65
|
| Rate for Payer: Humana Medicare |
$70.99
|
| Rate for Payer: Kaiser Permanente Commercial |
$206.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$116.79
|
| Rate for Payer: Kaiser Permanente Medicare |
$70.99
|
| Rate for Payer: MDX Hawaii PPO |
$222.13
|
| Rate for Payer: Ohana Health Plan Medicaid |
$70.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$70.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$70.99
|
| Rate for Payer: University Health Alliance Commercial |
$166.92
|
|
|
TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION [11567]
|
Facility
|
IP
|
$305.00
|
|
|
Service Code
|
NDC 24208029505
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$259.25 |
| Max. Negotiated Rate |
$295.85 |
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Health Management Network Commercial |
$259.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$274.50
|
| Rate for Payer: MDX Hawaii PPO |
$295.85
|
|
|
TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION [11567]
|
Facility
|
OP
|
$305.00
|
|
|
Service Code
|
NDC 24208029505
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$94.55 |
| Max. Negotiated Rate |
$295.85 |
| Rate for Payer: AlohaCare Medicaid |
$152.50
|
| Rate for Payer: AlohaCare Medicare |
$94.55
|
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Devoted Health Medicare |
$103.70
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$94.55
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$289.75
|
| Rate for Payer: Health Management Network Commercial |
$259.25
|
| Rate for Payer: Humana Medicare |
$94.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$274.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$155.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$94.55
|
| Rate for Payer: MDX Hawaii PPO |
$295.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$94.55
|
| Rate for Payer: Ohana Health Plan Medicare |
$94.55
|
| Rate for Payer: UnitedHealthcare Medicare |
$94.55
|
| Rate for Payer: University Health Alliance Commercial |
$222.31
|
|
|
TOBRAMYCIN 0.3 % EYE DROPS [124422]
|
Facility
|
IP
|
$50.00
|
|
|
Service Code
|
NDC 24208029005
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$42.50 |
| Max. Negotiated Rate |
$48.50 |
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Health Management Network Commercial |
$42.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$45.00
|
| Rate for Payer: MDX Hawaii PPO |
$48.50
|
|
|
TOBRAMYCIN 0.3 % EYE DROPS [124422]
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
NDC 24208029005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$15.50 |
| Max. Negotiated Rate |
$48.50 |
| Rate for Payer: AlohaCare Medicaid |
$25.00
|
| Rate for Payer: AlohaCare Medicare |
$15.50
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Devoted Health Medicare |
$17.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$15.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$47.50
|
| Rate for Payer: Health Management Network Commercial |
$42.50
|
| Rate for Payer: Humana Medicare |
$15.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$45.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$25.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$15.50
|
| Rate for Payer: MDX Hawaii PPO |
$48.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$15.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$15.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$15.50
|
| Rate for Payer: University Health Alliance Commercial |
$36.45
|
|
|
TOBRAMYCIN 0.3 % EYE OINTMENT [125508]
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
NDC 00078081301
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$499.80 |
| Max. Negotiated Rate |
$570.36 |
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Health Management Network Commercial |
$499.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$529.20
|
| Rate for Payer: MDX Hawaii PPO |
$570.36
|
|
|
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION [11565]
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
HCPCS J3260
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$170.00 |
| Max. Negotiated Rate |
$194.00 |
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Health Management Network Commercial |
$170.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$180.00
|
| Rate for Payer: MDX Hawaii PPO |
$194.00
|
|
|
TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION [11565]
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
HCPCS J3260
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$194.00 |
| Rate for Payer: AlohaCare Medicaid |
$100.00
|
| Rate for Payer: AlohaCare Medicare |
$62.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Devoted Health Medicare |
$68.00
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$2.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$62.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$2.46
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$190.00
|
| Rate for Payer: Health Management Network Commercial |
$170.00
|
| Rate for Payer: Humana Medicare |
$62.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$180.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$102.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$62.00
|
| Rate for Payer: MDX Hawaii PPO |
$194.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$62.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$62.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$120.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$62.00
|
| Rate for Payer: University Health Alliance Commercial |
$145.78
|
|
