|
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing
|
Professional
|
Both
|
$1,226.00
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
8039436
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$1,042.10 |
| Rate for Payer: AlohaCare Medicaid |
$184.06
|
| Rate for Payer: AlohaCare Medicare |
$165.03
|
| Rate for Payer: Cash Price |
$796.90
|
| Rate for Payer: Cash Price |
$796.90
|
| Rate for Payer: Devoted Health Medicare |
$181.53
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$184.06
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$374.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$165.03
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$184.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$319.54
|
| Rate for Payer: Health Management Network Commercial |
$1,042.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.53
|
| Rate for Payer: Kaiser Permanente Medicaid |
$181.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.53
|
| Rate for Payer: Ohana Health Plan Medicaid |
$184.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$165.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$184.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$165.03
|
| Rate for Payer: University Health Alliance Commercial |
$124.82
|
|
|
45380 Colonoscopy, flexible; with biopsy, single or multiple
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
8039438
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$178.33 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: AlohaCare Medicaid |
$200.16
|
| Rate for Payer: AlohaCare Medicare |
$178.33
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Devoted Health Medicare |
$196.16
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$200.16
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$443.45
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$178.33
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$200.16
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$351.52
|
| Rate for Payer: Health Management Network Commercial |
$1,415.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$196.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$196.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$196.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$200.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$178.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$200.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$178.33
|
| Rate for Payer: University Health Alliance Commercial |
$400.00
|
|
|
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare techniq
|
Professional
|
Both
|
$1,644.00
|
|
|
Service Code
|
HCPCS 45385
|
| Hospital Charge Code |
8039442
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$224.15 |
| Max. Negotiated Rate |
$1,397.40 |
| Rate for Payer: AlohaCare Medicaid |
$252.85
|
| Rate for Payer: AlohaCare Medicare |
$224.15
|
| Rate for Payer: Cash Price |
$1,068.60
|
| Rate for Payer: Cash Price |
$1,068.60
|
| Rate for Payer: Devoted Health Medicare |
$246.56
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$252.85
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$525.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$224.15
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$252.85
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$466.18
|
| Rate for Payer: Health Management Network Commercial |
$1,397.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.56
|
| Rate for Payer: Kaiser Permanente Medicaid |
$246.56
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.56
|
| Rate for Payer: Ohana Health Plan Medicaid |
$252.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$224.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$252.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$224.15
|
| Rate for Payer: University Health Alliance Commercial |
$420.00
|
|
|
45390 COLONOSCOPY, FLEXIBLE; WITH ENDOSCOPIC MUCOSAL RESECTION ProFee
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 45390
|
| Hospital Charge Code |
8020123
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$290.95 |
| Max. Negotiated Rate |
$3,283.55 |
| Rate for Payer: AlohaCare Medicare |
$290.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Devoted Health Medicare |
$320.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$290.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$359.84
|
| Rate for Payer: Health Management Network Commercial |
$3,283.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$320.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$320.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$320.05
|
| Rate for Payer: Ohana Health Plan Medicare |
$290.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$290.95
|
|
|
45393 COLONOSCOPY, FLEXIBLE; WITH DECOMPRESSION (FOR PATHOLOGIC DISTENTION) (EG, VOLVULUS, M ProFee
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 45393
|
| Hospital Charge Code |
8020126
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$217.07 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: AlohaCare Medicare |
$217.07
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Devoted Health Medicare |
$238.78
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$217.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$274.82
|
| Rate for Payer: Health Management Network Commercial |
$1,415.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$238.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$238.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$238.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$217.07
|
| Rate for Payer: UnitedHealthcare Medicare |
$217.07
|
|
|
45900 Reduction of procidentia (separate procedure) under anesthesia
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 45900
|
| Hospital Charge Code |
8039452
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$71.76 |
| Max. Negotiated Rate |
$1,099.90 |
| Rate for Payer: AlohaCare Medicaid |
$215.84
|
| Rate for Payer: AlohaCare Medicare |
$212.31
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Devoted Health Medicare |
$233.54
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$212.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.76
|
| Rate for Payer: Health Management Network Commercial |
$1,099.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$233.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$233.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$233.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$215.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$212.31
|
| Rate for Payer: UnitedHealthcare Medicaid |
$215.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$212.31
|
|
|
45915-Fecal Impaction w/ Anesthesia
|
Facility
|
OP
|
$1,551.00
|
|
|
Service Code
|
HCPCS 45915
|
| Hospital Charge Code |
8080149
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$393.00 |
| Max. Negotiated Rate |
$2,389.00 |
| Rate for Payer: AlohaCare Medicaid |
$525.09
|
| Rate for Payer: AlohaCare Medicare |
$775.50
|
| Rate for Payer: Cash Price |
$1,008.15
|
| Rate for Payer: Cash Price |
$1,008.15
|
| Rate for Payer: Cash Price |
$1,008.15
|
| Rate for Payer: Devoted Health Medicare |
$853.05
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$393.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$2,389.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$775.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$407.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,473.45
|
| Rate for Payer: Health Management Network Commercial |
$1,318.35
|
| Rate for Payer: Humana Medicare |
$775.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,395.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$775.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,504.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$775.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$775.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$775.50
|
| Rate for Payer: University Health Alliance Commercial |
$1,130.52
|
|
|
45915-Fecal Impaction w/ Anesthesia
|
Facility
|
IP
|
$1,551.00
|
|
|
Service Code
|
HCPCS 45915
|
| Hospital Charge Code |
8080149
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,318.35 |
| Max. Negotiated Rate |
$1,504.47 |
| Rate for Payer: Cash Price |
$1,008.15
|
| Rate for Payer: Health Management Network Commercial |
$1,318.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,395.90
|
| Rate for Payer: MDX Hawaii PPO |
$1,504.47
|
|
|
46040 I & D ISCHIORECTAL ABSCESS - ER SERV PR
|
Professional
|
Both
|
$1,766.00
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
8051048
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$238.42 |
| Max. Negotiated Rate |
$1,501.10 |
| Rate for Payer: AlohaCare Medicaid |
$443.86
|
| Rate for Payer: AlohaCare Medicare |
$448.12
|
| Rate for Payer: Cash Price |
$1,147.90
|
| Rate for Payer: Cash Price |
$1,147.90
|
| Rate for Payer: Devoted Health Medicare |
$492.93
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$443.86
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$734.71
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$448.12
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$443.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$238.42
|
| Rate for Payer: Health Management Network Commercial |
$1,501.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$492.93
|
| Rate for Payer: Kaiser Permanente Medicaid |
$492.93
|
| Rate for Payer: Kaiser Permanente Medicare |
$492.93
|
| Rate for Payer: Ohana Health Plan Medicaid |
$443.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$448.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$443.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$448.12
|
| Rate for Payer: University Health Alliance Commercial |
$555.80
|
|
|
46040-I&D Ischiorectal/Perirectal Abscess
|
Facility
|
IP
|
$5,679.00
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
8080052
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,827.15 |
| Max. Negotiated Rate |
$5,508.63 |
| Rate for Payer: Cash Price |
$3,691.35
|
| Rate for Payer: Health Management Network Commercial |
$4,827.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$5,111.10
|
| Rate for Payer: MDX Hawaii PPO |
$5,508.63
|
|
|
46040-I&D Ischiorectal/Perirectal Abscess
|
Facility
|
OP
|
$5,679.00
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
8080052
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$6,743.44 |
| Rate for Payer: AlohaCare Medicaid |
$1,030.55
|
| Rate for Payer: AlohaCare Medicare |
$2,839.50
|
| Rate for Payer: Cash Price |
$3,691.35
|
| Rate for Payer: Cash Price |
$3,691.35
|
| Rate for Payer: Devoted Health Medicare |
$3,123.45
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$695.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$5,655.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2,839.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$700.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$5,395.05
|
| Rate for Payer: Health Management Network Commercial |
$4,827.15
|
| Rate for Payer: Humana Medicare |
$2,839.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$5,111.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,839.50
|
| Rate for Payer: MDX Hawaii PPO |
$5,508.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,839.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,839.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,839.50
|
| Rate for Payer: University Health Alliance Commercial |
$6,743.44
|
|
|
46040 I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX TechFee
|
Facility
|
OP
|
$6,998.00
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
8211329
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$6,788.06 |
| Rate for Payer: AlohaCare Medicaid |
$1,030.55
|
| Rate for Payer: AlohaCare Medicare |
$3,499.00
|
| Rate for Payer: Cash Price |
$4,548.70
|
| Rate for Payer: Cash Price |
$4,548.70
|
| Rate for Payer: Devoted Health Medicare |
$3,848.90
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$695.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$5,655.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3,499.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$700.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6,648.10
|
| Rate for Payer: Health Management Network Commercial |
$5,948.30
|
| Rate for Payer: Humana Medicare |
$3,499.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,298.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,499.00
|
| Rate for Payer: MDX Hawaii PPO |
$6,788.06
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3,499.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,499.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,499.00
|
| Rate for Payer: University Health Alliance Commercial |
$6,743.44
|
|
|
46040 I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX TechFee
|
Facility
|
IP
|
$6,998.00
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
8211329
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$5,948.30 |
| Max. Negotiated Rate |
$6,788.06 |
| Rate for Payer: Cash Price |
$4,548.70
|
| Rate for Payer: Health Management Network Commercial |
$5,948.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,298.20
|
| Rate for Payer: MDX Hawaii PPO |
$6,788.06
|
|
|
46040 INCISION AND DRAINAGE OF ISCHIORECTAL AND/OR PERIRECTAL ABSCESS (SEPARATE PROCEDURE) ProFee
|
Professional
|
Both
|
$1,766.00
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
8020155
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$238.42 |
| Max. Negotiated Rate |
$1,501.10 |
| Rate for Payer: AlohaCare Medicaid |
$443.86
|
| Rate for Payer: AlohaCare Medicare |
$448.12
|
| Rate for Payer: Cash Price |
$1,147.90
|
| Rate for Payer: Cash Price |
$1,147.90
|
| Rate for Payer: Devoted Health Medicare |
$492.93
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$443.86
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$734.71
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$448.12
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$443.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$238.42
|
| Rate for Payer: Health Management Network Commercial |
$1,501.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$492.93
|
| Rate for Payer: Kaiser Permanente Medicaid |
$492.93
|
| Rate for Payer: Kaiser Permanente Medicare |
$492.93
|
| Rate for Payer: Ohana Health Plan Medicaid |
$443.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$448.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$443.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$448.12
|
| Rate for Payer: University Health Alliance Commercial |
$555.80
|
|
|
46050 I & D PERIANAL ABSCESS - ER SERV PROC
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 46050
|
| Hospital Charge Code |
8051049
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$87.88 |
| Max. Negotiated Rate |
$1,099.90 |
| Rate for Payer: AlohaCare Medicaid |
$106.57
|
| Rate for Payer: AlohaCare Medicare |
$107.72
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Devoted Health Medicare |
$118.49
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$106.57
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$174.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$107.72
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$106.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$87.88
|
| Rate for Payer: Health Management Network Commercial |
$1,099.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$118.49
|
| Rate for Payer: Kaiser Permanente Medicaid |
$118.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$118.49
|
| Rate for Payer: Ohana Health Plan Medicaid |
$106.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$107.72
|
| Rate for Payer: UnitedHealthcare Medicaid |
$106.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$107.72
|
| Rate for Payer: University Health Alliance Commercial |
$150.00
|
|
|
46050-I&D Perianal Abscess Superficial
|
Facility
|
OP
|
$1,644.00
|
|
|
Service Code
|
HCPCS 46050
|
| Hospital Charge Code |
8080054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$525.09
|
| Rate for Payer: AlohaCare Medicare |
$822.00
|
| Rate for Payer: Cash Price |
$1,068.60
|
| Rate for Payer: Cash Price |
$1,068.60
|
| Rate for Payer: Cash Price |
$1,068.60
|
| Rate for Payer: Devoted Health Medicare |
$904.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$588.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$822.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$520.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,561.80
|
| Rate for Payer: Health Management Network Commercial |
$1,397.40
|
| Rate for Payer: Humana Medicare |
$822.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,479.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$822.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,594.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$822.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$822.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$822.00
|
| Rate for Payer: University Health Alliance Commercial |
$1,198.31
|
|
|
46050-I&D Perianal Abscess Superficial
|
Facility
|
IP
|
$1,644.00
|
|
|
Service Code
|
HCPCS 46050
|
| Hospital Charge Code |
8080054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,397.40 |
| Max. Negotiated Rate |
$1,594.68 |
| Rate for Payer: Cash Price |
$1,068.60
|
| Rate for Payer: Health Management Network Commercial |
$1,397.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,479.60
|
| Rate for Payer: MDX Hawaii PPO |
$1,594.68
|
|
|
46050 I&D PERIANAL ABSCESS SUPERFICIAL TechFee
|
Facility
|
OP
|
$1,995.00
|
|
|
Service Code
|
HCPCS 46050
|
| Hospital Charge Code |
8211330
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$1,935.15 |
| Rate for Payer: AlohaCare Medicaid |
$525.09
|
| Rate for Payer: AlohaCare Medicare |
$997.50
|
| Rate for Payer: Cash Price |
$1,296.75
|
| Rate for Payer: Cash Price |
$1,296.75
|
| Rate for Payer: Cash Price |
$1,296.75
|
| Rate for Payer: Devoted Health Medicare |
$1,097.25
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$588.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$997.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$520.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,895.25
|
| Rate for Payer: Health Management Network Commercial |
$1,695.75
|
| Rate for Payer: Humana Medicare |
$997.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,795.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$997.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,935.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$997.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$997.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$997.50
|
| Rate for Payer: University Health Alliance Commercial |
$1,454.16
|
|
|
46050 I&D PERIANAL ABSCESS SUPERFICIAL TechFee
|
Facility
|
IP
|
$1,995.00
|
|
|
Service Code
|
HCPCS 46050
|
| Hospital Charge Code |
8211330
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,695.75 |
| Max. Negotiated Rate |
$1,935.15 |
| Rate for Payer: Cash Price |
$1,296.75
|
| Rate for Payer: Health Management Network Commercial |
$1,695.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,795.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,935.15
|
|
|
46083-Incision Hemorrhoid Thrombosed External
|
Facility
|
IP
|
$1,498.00
|
|
|
Service Code
|
HCPCS 46083
|
| Hospital Charge Code |
8080056
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,273.30 |
| Max. Negotiated Rate |
$1,453.06 |
| Rate for Payer: Cash Price |
$973.70
|
| Rate for Payer: Health Management Network Commercial |
$1,273.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,348.20
|
| Rate for Payer: MDX Hawaii PPO |
$1,453.06
|
|
|
46083-Incision Hemorrhoid Thrombosed External
|
Facility
|
OP
|
$1,498.00
|
|
|
Service Code
|
HCPCS 46083
|
| Hospital Charge Code |
8080056
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$393.00 |
| Max. Negotiated Rate |
$2,389.00 |
| Rate for Payer: AlohaCare Medicaid |
$525.09
|
| Rate for Payer: AlohaCare Medicare |
$749.00
|
| Rate for Payer: Cash Price |
$973.70
|
| Rate for Payer: Cash Price |
$973.70
|
| Rate for Payer: Cash Price |
$973.70
|
| Rate for Payer: Devoted Health Medicare |
$823.90
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$393.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$2,389.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$749.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$407.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,423.10
|
| Rate for Payer: Health Management Network Commercial |
$1,273.30
|
| Rate for Payer: Humana Medicare |
$749.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,348.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$749.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,453.06
|
| Rate for Payer: Ohana Health Plan Medicaid |
$749.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$749.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$749.00
|
| Rate for Payer: University Health Alliance Commercial |
$1,091.89
|
|
|
46220 Excision of single external papilla or tag, anus
|
Professional
|
Both
|
$575.00
|
|
|
Service Code
|
HCPCS 46220
|
| Hospital Charge Code |
8039467
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$47.58 |
| Max. Negotiated Rate |
$488.75 |
| Rate for Payer: AlohaCare Medicaid |
$126.89
|
| Rate for Payer: AlohaCare Medicare |
$123.37
|
| Rate for Payer: Cash Price |
$373.75
|
| Rate for Payer: Cash Price |
$373.75
|
| Rate for Payer: Devoted Health Medicare |
$135.71
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$126.89
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$209.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$123.37
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$126.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$47.58
|
| Rate for Payer: Health Management Network Commercial |
$488.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$135.71
|
| Rate for Payer: Kaiser Permanente Medicaid |
$135.71
|
| Rate for Payer: Kaiser Permanente Medicare |
$135.71
|
| Rate for Payer: Ohana Health Plan Medicaid |
$126.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$123.37
|
| Rate for Payer: UnitedHealthcare Medicaid |
$126.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$123.37
|
| Rate for Payer: University Health Alliance Commercial |
$163.25
|
|
|
46221 Hemorrhoidectomy, internal, by rubber band ligation(s)
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 46221
|
| Hospital Charge Code |
8039468
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$94.64 |
| Max. Negotiated Rate |
$1,099.90 |
| Rate for Payer: AlohaCare Medicaid |
$203.28
|
| Rate for Payer: AlohaCare Medicare |
$206.83
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Devoted Health Medicare |
$227.51
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$203.28
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$341.67
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$206.83
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$203.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$94.64
|
| Rate for Payer: Health Management Network Commercial |
$1,099.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$227.51
|
| Rate for Payer: Kaiser Permanente Medicaid |
$227.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$227.51
|
| Rate for Payer: Ohana Health Plan Medicaid |
$203.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$206.83
|
| Rate for Payer: UnitedHealthcare Medicaid |
$203.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$206.83
|
|
|
46250 Hemorrhoidectomy, external, 2 or more columns/groups
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
8039470
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$301.34 |
| Max. Negotiated Rate |
$3,283.55 |
| Rate for Payer: AlohaCare Medicaid |
$331.19
|
| Rate for Payer: AlohaCare Medicare |
$327.70
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Devoted Health Medicare |
$360.47
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$331.19
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$555.93
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$327.70
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$331.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$301.34
|
| Rate for Payer: Health Management Network Commercial |
$3,283.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$360.47
|
| Rate for Payer: Kaiser Permanente Medicaid |
$360.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$360.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$331.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$327.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$331.19
|
| Rate for Payer: UnitedHealthcare Medicare |
$327.70
|
| Rate for Payer: University Health Alliance Commercial |
$438.56
|
|
|
46257 Hemorrhoidectomy, internal and external, single column/group; with fissurectomy
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 46257
|
| Hospital Charge Code |
8961821
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$337.22 |
| Max. Negotiated Rate |
$3,283.55 |
| Rate for Payer: AlohaCare Medicaid |
$437.32
|
| Rate for Payer: AlohaCare Medicare |
$432.00
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Devoted Health Medicare |
$475.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$432.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$337.22
|
| Rate for Payer: Health Management Network Commercial |
$3,283.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$475.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$475.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$475.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$437.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$432.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$437.32
|
| Rate for Payer: UnitedHealthcare Medicare |
$432.00
|
|
