|
Hemoglobin POC_HHSC
|
Facility
|
OP
|
$16.00
|
|
|
Service Code
|
HCPCS 85018 QW
|
| Hospital Charge Code |
9468755
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$15.52 |
| Rate for Payer: AlohaCare Medicaid |
$8.00
|
| Rate for Payer: AlohaCare Medicare |
$8.00
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Devoted Health Medicare |
$8.80
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$3.27
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$2.96
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$8.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$3.43
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2.37
|
| Rate for Payer: Health Management Network Commercial |
$13.60
|
| Rate for Payer: Humana Medicare |
$8.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$14.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$8.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$8.00
|
| Rate for Payer: MDX Hawaii PPO |
$15.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$8.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$8.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3.27
|
| Rate for Payer: UnitedHealthcare Medicare |
$8.00
|
| Rate for Payer: University Health Alliance Commercial |
$6.12
|
|
|
HEMORR/EXCISE LIVER† - 00792
|
Professional
|
Both
|
$191.00
|
|
| Hospital Charge Code |
8970873
|
|
Hospital Revenue Code
|
963
|
| Min. Negotiated Rate |
$162.35 |
| Max. Negotiated Rate |
$162.35 |
| Rate for Payer: Cash Price |
$124.15
|
| Rate for Payer: Health Management Network Commercial |
$162.35
|
|
|
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS;
|
Facility
|
OP
|
$7,085.00
|
|
|
Service Code
|
CPT 46260
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$7,085.00 |
| Rate for Payer: AlohaCare Medicaid |
$1,030.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$848.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$7,085.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$849.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,837.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: University Health Alliance Commercial |
$6,743.44
|
|
|
HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THAN RUBBER BAND; 2 OR MORE HEMORRHOID COLUMNS/GROUPS, WITHOUT IMAGING GUIDANCE
|
Facility
|
OP
|
$3,544.72
|
|
|
Service Code
|
CPT 46946
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$3,544.72 |
| Rate for Payer: AlohaCare Medicaid |
$672.48
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$3,544.72
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,837.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
|
|
heparin 1000 units/1ml vial [HHSC]
|
Facility
|
OP
|
$25.82
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
2500374
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$25.05 |
| Rate for Payer: AlohaCare Medicaid |
$12.91
|
| Rate for Payer: AlohaCare Medicaid |
$13.38
|
| Rate for Payer: AlohaCare Medicare |
$13.38
|
| Rate for Payer: AlohaCare Medicare |
$12.91
|
| Rate for Payer: Cash Price |
$17.39
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$17.39
|
| Rate for Payer: Devoted Health Medicare |
$14.20
|
| Rate for Payer: Devoted Health Medicare |
$14.72
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$13.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$12.91
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.22
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$24.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$25.42
|
| Rate for Payer: Health Management Network Commercial |
$22.75
|
| Rate for Payer: Health Management Network Commercial |
$21.95
|
| Rate for Payer: Humana Medicare |
$12.91
|
| Rate for Payer: Humana Medicare |
$13.38
|
| Rate for Payer: Kaiser Permanente Commercial |
$23.24
|
| Rate for Payer: Kaiser Permanente Commercial |
$24.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$13.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$13.17
|
| Rate for Payer: Kaiser Permanente Medicare |
$12.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$13.38
|
| Rate for Payer: MDX Hawaii PPO |
$25.05
|
| Rate for Payer: MDX Hawaii PPO |
$25.96
|
| Rate for Payer: Ohana Health Plan Medicaid |
$13.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$12.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$12.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$13.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$12.91
|
| Rate for Payer: UnitedHealthcare Medicare |
$13.38
|
| Rate for Payer: University Health Alliance Commercial |
$18.82
|
| Rate for Payer: University Health Alliance Commercial |
$19.51
|
|
|
heparin 1000 units/1ml vial [HHSC]
|
Facility
|
IP
|
$25.82
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
2500374
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.95 |
| Max. Negotiated Rate |
$25.05 |
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$17.39
|
| Rate for Payer: Health Management Network Commercial |
$21.95
|
| Rate for Payer: Health Management Network Commercial |
$22.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$23.24
|
| Rate for Payer: Kaiser Permanente Commercial |
$24.08
|
| Rate for Payer: MDX Hawaii PPO |
$25.96
|
| Rate for Payer: MDX Hawaii PPO |
$25.05
|
|
|
heparin 5000 units/ml vial [HHSC]
|
Facility
|
IP
|
$6.47
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
2500377
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.50 |
| Max. Negotiated Rate |
$6.28 |
| Rate for Payer: Cash Price |
$4.21
|
| Rate for Payer: Cash Price |
$18.04
|
| Rate for Payer: Cash Price |
$5.52
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Cash Price |
$11.28
|
| Rate for Payer: Health Management Network Commercial |
$24.57
|
| Rate for Payer: Health Management Network Commercial |
$5.50
|
| Rate for Payer: Health Management Network Commercial |
$7.22
|
| Rate for Payer: Health Management Network Commercial |
$23.60
|
| Rate for Payer: Health Management Network Commercial |
$14.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$15.62
|
| Rate for Payer: Kaiser Permanente Commercial |
$24.98
|
| Rate for Payer: Kaiser Permanente Commercial |
$26.02
|
| Rate for Payer: Kaiser Permanente Commercial |
$5.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$7.64
|
| Rate for Payer: MDX Hawaii PPO |
$6.28
|
| Rate for Payer: MDX Hawaii PPO |
$26.93
|
| Rate for Payer: MDX Hawaii PPO |
$16.83
|
| Rate for Payer: MDX Hawaii PPO |
$28.04
|
| Rate for Payer: MDX Hawaii PPO |
$8.24
|
|
|
heparin 5000 units/ml vial [HHSC]
|
Facility
|
OP
|
$28.91
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
2500377
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$28.04 |
| Rate for Payer: AlohaCare Medicaid |
$14.46
|
| Rate for Payer: AlohaCare Medicaid |
$13.88
|
| Rate for Payer: AlohaCare Medicaid |
$3.23
|
| Rate for Payer: AlohaCare Medicaid |
$4.25
|
| Rate for Payer: AlohaCare Medicaid |
$8.68
|
| Rate for Payer: AlohaCare Medicare |
$14.46
|
| Rate for Payer: AlohaCare Medicare |
$3.23
|
| Rate for Payer: AlohaCare Medicare |
$4.25
|
| Rate for Payer: AlohaCare Medicare |
$8.68
|
| Rate for Payer: AlohaCare Medicare |
$13.88
|
| Rate for Payer: Cash Price |
$18.04
|
| Rate for Payer: Cash Price |
$4.21
|
| Rate for Payer: Cash Price |
$11.28
|
| Rate for Payer: Cash Price |
$11.28
|
| Rate for Payer: Cash Price |
$18.04
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Cash Price |
$5.52
|
| Rate for Payer: Cash Price |
$5.52
|
| Rate for Payer: Cash Price |
$4.21
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Devoted Health Medicare |
$15.90
|
| Rate for Payer: Devoted Health Medicare |
$9.54
|
| Rate for Payer: Devoted Health Medicare |
$3.56
|
| Rate for Payer: Devoted Health Medicare |
$4.67
|
| Rate for Payer: Devoted Health Medicare |
$15.27
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3.23
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$13.88
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$8.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$14.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$4.25
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.22
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$27.46
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$16.48
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$26.37
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6.15
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$8.07
|
| Rate for Payer: Health Management Network Commercial |
$24.57
|
| Rate for Payer: Health Management Network Commercial |
$23.60
|
| Rate for Payer: Health Management Network Commercial |
$14.75
|
| Rate for Payer: Health Management Network Commercial |
$7.22
|
| Rate for Payer: Health Management Network Commercial |
$5.50
|
| Rate for Payer: Humana Medicare |
$14.46
|
| Rate for Payer: Humana Medicare |
$8.68
|
| Rate for Payer: Humana Medicare |
$13.88
|
| Rate for Payer: Humana Medicare |
$3.23
|
| Rate for Payer: Humana Medicare |
$4.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$5.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$7.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$26.02
|
| Rate for Payer: Kaiser Permanente Commercial |
$15.62
|
| Rate for Payer: Kaiser Permanente Commercial |
$24.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$14.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$3.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$8.85
|
| Rate for Payer: Kaiser Permanente Medicaid |
$14.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$4.33
|
| Rate for Payer: Kaiser Permanente Medicare |
$13.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$8.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$3.23
|
| Rate for Payer: Kaiser Permanente Medicare |
$14.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$4.25
|
| Rate for Payer: MDX Hawaii PPO |
$28.04
|
| Rate for Payer: MDX Hawaii PPO |
$6.28
|
| Rate for Payer: MDX Hawaii PPO |
$26.93
|
| Rate for Payer: MDX Hawaii PPO |
$16.83
|
| Rate for Payer: MDX Hawaii PPO |
$8.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$8.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$13.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3.23
|
| Rate for Payer: Ohana Health Plan Medicaid |
$4.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$14.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$4.25
|
| Rate for Payer: Ohana Health Plan Medicare |
$3.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$14.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$13.88
|
| Rate for Payer: Ohana Health Plan Medicare |
$8.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$5.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3.88
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$3.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$8.68
|
| Rate for Payer: UnitedHealthcare Medicare |
$13.88
|
| Rate for Payer: UnitedHealthcare Medicare |
$4.25
|
| Rate for Payer: UnitedHealthcare Medicare |
$14.46
|
| Rate for Payer: University Health Alliance Commercial |
$12.65
|
| Rate for Payer: University Health Alliance Commercial |
$21.07
|
| Rate for Payer: University Health Alliance Commercial |
$4.72
|
| Rate for Payer: University Health Alliance Commercial |
$20.23
|
| Rate for Payer: University Health Alliance Commercial |
$6.19
|
|
|
heparin-d5w 25000 units/500 ml [HHSC]
|
Facility
|
OP
|
$63.20
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
2500375
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$61.30 |
| Rate for Payer: AlohaCare Medicaid |
$31.60
|
| Rate for Payer: AlohaCare Medicaid |
$32.53
|
| Rate for Payer: AlohaCare Medicare |
$32.53
|
| Rate for Payer: AlohaCare Medicare |
$31.60
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$41.08
|
| Rate for Payer: Cash Price |
$41.08
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Devoted Health Medicare |
$34.76
|
| Rate for Payer: Devoted Health Medicare |
$35.79
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$32.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$31.60
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.22
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.22
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$60.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$61.82
|
| Rate for Payer: Health Management Network Commercial |
$55.31
|
| Rate for Payer: Health Management Network Commercial |
$53.72
|
| Rate for Payer: Humana Medicare |
$31.60
|
| Rate for Payer: Humana Medicare |
$32.53
|
| Rate for Payer: Kaiser Permanente Commercial |
$56.88
|
| Rate for Payer: Kaiser Permanente Commercial |
$58.56
|
| Rate for Payer: Kaiser Permanente Medicaid |
$33.19
|
| Rate for Payer: Kaiser Permanente Medicaid |
$32.23
|
| Rate for Payer: Kaiser Permanente Medicare |
$31.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$32.53
|
| Rate for Payer: MDX Hawaii PPO |
$61.30
|
| Rate for Payer: MDX Hawaii PPO |
$63.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$32.53
|
| Rate for Payer: Ohana Health Plan Medicaid |
$31.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$31.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$32.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$39.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$37.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$31.60
|
| Rate for Payer: UnitedHealthcare Medicare |
$32.53
|
| Rate for Payer: University Health Alliance Commercial |
$46.07
|
| Rate for Payer: University Health Alliance Commercial |
$47.43
|
|
|
heparin-d5w 25000 units/500 ml [HHSC]
|
Facility
|
IP
|
$63.20
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
2500375
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$53.72 |
| Max. Negotiated Rate |
$61.30 |
| Rate for Payer: Cash Price |
$41.08
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Health Management Network Commercial |
$53.72
|
| Rate for Payer: Health Management Network Commercial |
$55.31
|
| Rate for Payer: Kaiser Permanente Commercial |
$56.88
|
| Rate for Payer: Kaiser Permanente Commercial |
$58.56
|
| Rate for Payer: MDX Hawaii PPO |
$63.12
|
| Rate for Payer: MDX Hawaii PPO |
$61.30
|
|
|
heparin lock (PF) 50 units/5ml [HHSC]
|
Facility
|
IP
|
$15.23
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
2500378
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$14.77 |
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$2.06
|
| Rate for Payer: Health Management Network Commercial |
$12.95
|
| Rate for Payer: Health Management Network Commercial |
$2.69
|
| Rate for Payer: Kaiser Permanente Commercial |
$13.71
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.85
|
| Rate for Payer: MDX Hawaii PPO |
$3.07
|
| Rate for Payer: MDX Hawaii PPO |
$14.77
|
|
|
heparin lock (PF) 50 units/5ml [HHSC]
|
Facility
|
OP
|
$15.23
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
2500378
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$14.77 |
| Rate for Payer: AlohaCare Medicaid |
$7.62
|
| Rate for Payer: AlohaCare Medicaid |
$1.58
|
| Rate for Payer: AlohaCare Medicare |
$1.58
|
| Rate for Payer: AlohaCare Medicare |
$7.62
|
| Rate for Payer: Cash Price |
$2.06
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$2.06
|
| Rate for Payer: Devoted Health Medicare |
$8.38
|
| Rate for Payer: Devoted Health Medicare |
$1.74
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.02
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.58
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$7.62
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.02
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$14.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3.01
|
| Rate for Payer: Health Management Network Commercial |
$2.69
|
| Rate for Payer: Health Management Network Commercial |
$12.95
|
| Rate for Payer: Humana Medicare |
$7.62
|
| Rate for Payer: Humana Medicare |
$1.58
|
| Rate for Payer: Kaiser Permanente Commercial |
$13.71
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.85
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1.62
|
| Rate for Payer: Kaiser Permanente Medicaid |
$7.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$7.62
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.58
|
| Rate for Payer: MDX Hawaii PPO |
$14.77
|
| Rate for Payer: MDX Hawaii PPO |
$3.07
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.58
|
| Rate for Payer: Ohana Health Plan Medicaid |
$7.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$7.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.58
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.14
|
| Rate for Payer: UnitedHealthcare Medicare |
$7.62
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.58
|
| Rate for Payer: University Health Alliance Commercial |
$11.10
|
| Rate for Payer: University Health Alliance Commercial |
$2.31
|
|
|
heparin (PF) 500 units/5 mL flush [HHSC]
|
Facility
|
IP
|
$4.60
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
2501176
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.91 |
| Max. Negotiated Rate |
$4.46 |
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Health Management Network Commercial |
$3.91
|
| Rate for Payer: Kaiser Permanente Commercial |
$4.14
|
| Rate for Payer: MDX Hawaii PPO |
$4.46
|
|
|
heparin (PF) 500 units/5 mL flush [HHSC]
|
Facility
|
OP
|
$4.60
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
2501176
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$4.46 |
| Rate for Payer: AlohaCare Medicaid |
$2.30
|
| Rate for Payer: AlohaCare Medicare |
$2.30
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Devoted Health Medicare |
$2.53
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2.30
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4.37
|
| Rate for Payer: Health Management Network Commercial |
$3.91
|
| Rate for Payer: Humana Medicare |
$2.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$4.14
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2.35
|
| Rate for Payer: Kaiser Permanente Medicare |
$2.30
|
| Rate for Payer: MDX Hawaii PPO |
$4.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$2.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$2.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$2.30
|
| Rate for Payer: University Health Alliance Commercial |
$3.35
|
|
|
Hepatic Function Panel FSI
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
HCPCS 80076
|
| Hospital Charge Code |
8117942
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$116.40 |
| Rate for Payer: Cash Price |
$78.00
|
| Rate for Payer: Health Management Network Commercial |
$102.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$108.00
|
| Rate for Payer: MDX Hawaii PPO |
$116.40
|
|
|
Hepatic Function Panel FSI
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
HCPCS 80076
|
| Hospital Charge Code |
8117942
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$116.40 |
| Rate for Payer: AlohaCare Medicaid |
$60.00
|
| Rate for Payer: AlohaCare Medicare |
$60.00
|
| Rate for Payer: Cash Price |
$78.00
|
| Rate for Payer: Cash Price |
$78.00
|
| Rate for Payer: Devoted Health Medicare |
$66.00
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$11.29
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$10.21
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$60.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$11.85
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$8.17
|
| Rate for Payer: Health Management Network Commercial |
$102.00
|
| Rate for Payer: Humana Medicare |
$60.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$108.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$61.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$60.00
|
| Rate for Payer: MDX Hawaii PPO |
$116.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$60.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$60.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$60.00
|
| Rate for Payer: University Health Alliance Commercial |
$21.13
|
|
|
Hepatitis A Antibody IgM FSI
|
Facility
|
IP
|
$131.00
|
|
|
Service Code
|
HCPCS 86709
|
| Hospital Charge Code |
8117943
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$111.35 |
| Max. Negotiated Rate |
$127.07 |
| Rate for Payer: Cash Price |
$85.15
|
| Rate for Payer: Health Management Network Commercial |
$111.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$117.90
|
| Rate for Payer: MDX Hawaii PPO |
$127.07
|
|
|
Hepatitis A Antibody IgM FSI
|
Facility
|
OP
|
$131.00
|
|
|
Service Code
|
HCPCS 86709
|
| Hospital Charge Code |
8117943
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.26 |
| Max. Negotiated Rate |
$127.07 |
| Rate for Payer: AlohaCare Medicaid |
$65.50
|
| Rate for Payer: AlohaCare Medicare |
$65.50
|
| Rate for Payer: Cash Price |
$85.15
|
| Rate for Payer: Cash Price |
$85.15
|
| Rate for Payer: Devoted Health Medicare |
$72.05
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$15.55
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$14.07
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$65.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$16.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$11.26
|
| Rate for Payer: Health Management Network Commercial |
$111.35
|
| Rate for Payer: Humana Medicare |
$65.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$117.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$66.81
|
| Rate for Payer: Kaiser Permanente Medicare |
$65.50
|
| Rate for Payer: MDX Hawaii PPO |
$127.07
|
| Rate for Payer: Ohana Health Plan Medicaid |
$65.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$65.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.55
|
| Rate for Payer: UnitedHealthcare Medicare |
$65.50
|
| Rate for Payer: University Health Alliance Commercial |
$29.10
|
|
|
Hepatitis A Antibody Total FSI
|
Facility
|
IP
|
$143.00
|
|
|
Service Code
|
HCPCS 86708
|
| Hospital Charge Code |
8117944
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$121.55 |
| Max. Negotiated Rate |
$138.71 |
| Rate for Payer: Cash Price |
$92.95
|
| Rate for Payer: Health Management Network Commercial |
$121.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$128.70
|
| Rate for Payer: MDX Hawaii PPO |
$138.71
|
|
|
Hepatitis A Antibody Total FSI
|
Facility
|
OP
|
$143.00
|
|
|
Service Code
|
HCPCS 86708
|
| Hospital Charge Code |
8117944
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.39 |
| Max. Negotiated Rate |
$138.71 |
| Rate for Payer: AlohaCare Medicaid |
$71.50
|
| Rate for Payer: AlohaCare Medicare |
$71.50
|
| Rate for Payer: Cash Price |
$92.95
|
| Rate for Payer: Cash Price |
$92.95
|
| Rate for Payer: Devoted Health Medicare |
$78.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$17.12
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$15.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$71.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$17.98
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$12.39
|
| Rate for Payer: Health Management Network Commercial |
$121.55
|
| Rate for Payer: Humana Medicare |
$71.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$128.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$72.93
|
| Rate for Payer: Kaiser Permanente Medicare |
$71.50
|
| Rate for Payer: MDX Hawaii PPO |
$138.71
|
| Rate for Payer: Ohana Health Plan Medicaid |
$71.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$71.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$71.50
|
| Rate for Payer: University Health Alliance Commercial |
$32.02
|
|
|
hepatitis B adult 20mcg/1ml vacc [HHSC]
|
Facility
|
OP
|
$390.10
|
|
|
Service Code
|
NDC 58160082152
|
| Hospital Charge Code |
2500379
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$195.05 |
| Max. Negotiated Rate |
$378.40 |
| Rate for Payer: AlohaCare Medicaid |
$195.05
|
| Rate for Payer: AlohaCare Medicare |
$195.05
|
| Rate for Payer: Cash Price |
$253.57
|
| Rate for Payer: Devoted Health Medicare |
$214.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$195.05
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$370.60
|
| Rate for Payer: Health Management Network Commercial |
$331.58
|
| Rate for Payer: Humana Medicare |
$195.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$351.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$198.95
|
| Rate for Payer: Kaiser Permanente Medicare |
$195.05
|
| Rate for Payer: MDX Hawaii PPO |
$378.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$195.05
|
| Rate for Payer: Ohana Health Plan Medicare |
$195.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$234.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$195.05
|
| Rate for Payer: University Health Alliance Commercial |
$284.34
|
|
|
hepatitis B adult 20mcg/1ml vacc [HHSC]
|
Facility
|
IP
|
$390.10
|
|
|
Service Code
|
NDC 58160082152
|
| Hospital Charge Code |
2500379
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$331.58 |
| Max. Negotiated Rate |
$378.40 |
| Rate for Payer: Cash Price |
$253.57
|
| Rate for Payer: Health Management Network Commercial |
$331.58
|
| Rate for Payer: Kaiser Permanente Commercial |
$351.09
|
| Rate for Payer: MDX Hawaii PPO |
$378.40
|
|
|
Hepatitis B Antibody Quantitative FSI
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
8117945
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.74 |
| Max. Negotiated Rate |
$123.19 |
| Rate for Payer: AlohaCare Medicaid |
$63.50
|
| Rate for Payer: AlohaCare Medicare |
$63.50
|
| Rate for Payer: Cash Price |
$82.55
|
| Rate for Payer: Cash Price |
$82.55
|
| Rate for Payer: Devoted Health Medicare |
$69.85
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$14.84
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$13.43
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$63.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$15.58
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$10.74
|
| Rate for Payer: Health Management Network Commercial |
$107.95
|
| Rate for Payer: Humana Medicare |
$63.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$114.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$64.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$63.50
|
| Rate for Payer: MDX Hawaii PPO |
$123.19
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$63.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$14.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$63.50
|
| Rate for Payer: University Health Alliance Commercial |
$27.77
|
|
|
Hepatitis B Antibody Quantitative FSI
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
8117945
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$107.95 |
| Max. Negotiated Rate |
$123.19 |
| Rate for Payer: Cash Price |
$82.55
|
| Rate for Payer: Health Management Network Commercial |
$107.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$114.30
|
| Rate for Payer: MDX Hawaii PPO |
$123.19
|
|
|
Hepatitis B Core Antibody Total FSI
|
Facility
|
IP
|
$174.00
|
|
|
Service Code
|
HCPCS 86704
|
| Hospital Charge Code |
8117946
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$147.90 |
| Max. Negotiated Rate |
$168.78 |
| Rate for Payer: Cash Price |
$113.10
|
| Rate for Payer: Health Management Network Commercial |
$147.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$156.60
|
| Rate for Payer: MDX Hawaii PPO |
$168.78
|
|
