|
46257 Hemorrhoidectomy, simple w/ fissurectomy
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 46257
|
| Hospital Charge Code |
8854372
|
|
Hospital Revenue Code
|
982
|
| 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
|
|
|
46260 Hemorrhoidectomy, internal and external, 2 or more columns/groups
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
8039473
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$490.35 |
| Max. Negotiated Rate |
$3,283.55 |
| Rate for Payer: AlohaCare Medicaid |
$497.47
|
| Rate for Payer: AlohaCare Medicare |
$490.35
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Devoted Health Medicare |
$539.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$490.35
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$519.48
|
| Rate for Payer: Health Management Network Commercial |
$3,283.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$539.38
|
| Rate for Payer: Kaiser Permanente Medicaid |
$539.38
|
| Rate for Payer: Kaiser Permanente Medicare |
$539.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$497.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$490.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$497.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$490.35
|
|
|
46270 Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 46270
|
| Hospital Charge Code |
8039475
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$233.74 |
| Max. Negotiated Rate |
$3,283.55 |
| Rate for Payer: AlohaCare Medicaid |
$421.12
|
| Rate for Payer: AlohaCare Medicare |
$423.66
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Devoted Health Medicare |
$466.03
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$421.12
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$683.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$423.66
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$421.12
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$233.74
|
| Rate for Payer: Health Management Network Commercial |
$3,283.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$466.03
|
| Rate for Payer: Kaiser Permanente Medicaid |
$466.03
|
| Rate for Payer: Kaiser Permanente Medicare |
$466.03
|
| Rate for Payer: Ohana Health Plan Medicaid |
$421.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$423.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$421.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$423.66
|
| Rate for Payer: University Health Alliance Commercial |
$546.43
|
|
|
46288 Closure of fistula w/ rectal advancement flap
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 46288
|
| Hospital Charge Code |
8854379
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$375.96 |
| Max. Negotiated Rate |
$3,283.55 |
| Rate for Payer: AlohaCare Medicaid |
$580.46
|
| Rate for Payer: AlohaCare Medicare |
$566.66
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Devoted Health Medicare |
$623.33
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$566.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$375.96
|
| Rate for Payer: Health Management Network Commercial |
$3,283.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$623.33
|
| Rate for Payer: Kaiser Permanente Medicaid |
$623.33
|
| Rate for Payer: Kaiser Permanente Medicare |
$623.33
|
| Rate for Payer: Ohana Health Plan Medicaid |
$580.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$566.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$580.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$566.66
|
|
|
46320 ED REMOVAL OF HEMORRHOID CLOT TechFee
|
Facility
|
OP
|
$6,713.00
|
|
|
Service Code
|
HCPCS 46320
|
| Hospital Charge Code |
8258860
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$6,511.61 |
| Rate for Payer: AlohaCare Medicaid |
$525.09
|
| Rate for Payer: AlohaCare Medicare |
$3,356.50
|
| Rate for Payer: Cash Price |
$4,363.45
|
| Rate for Payer: Cash Price |
$4,363.45
|
| Rate for Payer: Cash Price |
$4,363.45
|
| Rate for Payer: Devoted Health Medicare |
$3,692.15
|
| 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 |
$3,356.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$520.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6,377.35
|
| Rate for Payer: Health Management Network Commercial |
$5,706.05
|
| Rate for Payer: Humana Medicare |
$3,356.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,041.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,356.50
|
| Rate for Payer: MDX Hawaii PPO |
$6,511.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3,356.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,356.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,356.50
|
| Rate for Payer: University Health Alliance Commercial |
$4,893.11
|
|
|
46320 ED REMOVAL OF HEMORRHOID CLOT TechFee
|
Facility
|
IP
|
$6,713.00
|
|
|
Service Code
|
HCPCS 46320
|
| Hospital Charge Code |
8258860
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$5,706.05 |
| Max. Negotiated Rate |
$6,511.61 |
| Rate for Payer: Cash Price |
$4,363.45
|
| Rate for Payer: Health Management Network Commercial |
$5,706.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,041.70
|
| Rate for Payer: MDX Hawaii PPO |
$6,511.61
|
|
|
46320-Excision External Thrombosed Hemorrhoid
|
Facility
|
OP
|
$1,551.00
|
|
|
Service Code
|
HCPCS 46320
|
| Hospital Charge Code |
8080215
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$1,600.00 |
| 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 |
$588.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$775.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$520.00
|
| 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
|
|
|
46320-Excision External Thrombosed Hemorrhoid
|
Facility
|
IP
|
$1,551.00
|
|
|
Service Code
|
HCPCS 46320
|
| Hospital Charge Code |
8080215
|
|
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
|
|
|
46320 Excision of thrombosed hemorrhoid, external
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 46320
|
| Hospital Charge Code |
8039479
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$108.94 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: AlohaCare Medicaid |
$117.38
|
| Rate for Payer: AlohaCare Medicare |
$110.50
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Devoted Health Medicare |
$121.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$117.38
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$194.82
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$110.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$117.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$108.94
|
| Rate for Payer: Health Management Network Commercial |
$1,415.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$121.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$121.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$121.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$117.38
|
| Rate for Payer: Ohana Health Plan Medicare |
$110.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$117.38
|
| Rate for Payer: UnitedHealthcare Medicare |
$110.50
|
| Rate for Payer: University Health Alliance Commercial |
$152.04
|
|
|
46600 ANOSCOPY DIAGNOSTIC WITH/W/O COLLECTION
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
8051052
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$33.28 |
| Max. Negotiated Rate |
$276.25 |
| Rate for Payer: AlohaCare Medicaid |
$42.94
|
| Rate for Payer: AlohaCare Medicare |
$41.99
|
| Rate for Payer: Cash Price |
$211.25
|
| Rate for Payer: Cash Price |
$211.25
|
| Rate for Payer: Devoted Health Medicare |
$46.19
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$42.94
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$68.63
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$41.99
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$42.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$33.28
|
| Rate for Payer: Health Management Network Commercial |
$276.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$46.19
|
| Rate for Payer: Kaiser Permanente Medicaid |
$46.19
|
| Rate for Payer: Kaiser Permanente Medicare |
$46.19
|
| Rate for Payer: Ohana Health Plan Medicaid |
$42.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$41.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$42.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$41.99
|
| Rate for Payer: University Health Alliance Commercial |
$55.80
|
|
|
46600 Diagnostic Anoscopy TechFee
|
Facility
|
IP
|
$274.00
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
8343980
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$232.90 |
| Max. Negotiated Rate |
$265.78 |
| Rate for Payer: Cash Price |
$178.10
|
| Rate for Payer: Health Management Network Commercial |
$232.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.60
|
| Rate for Payer: MDX Hawaii PPO |
$265.78
|
|
|
46600 Diagnostic Anoscopy TechFee
|
Facility
|
OP
|
$274.00
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
8343980
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$137.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$525.09
|
| Rate for Payer: AlohaCare Medicare |
$137.00
|
| Rate for Payer: Cash Price |
$178.10
|
| Rate for Payer: Cash Price |
$178.10
|
| Rate for Payer: Cash Price |
$178.10
|
| Rate for Payer: Devoted Health Medicare |
$150.70
|
| 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 |
$137.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$520.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$260.30
|
| Rate for Payer: Health Management Network Commercial |
$232.90
|
| Rate for Payer: Humana Medicare |
$137.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$137.00
|
| Rate for Payer: MDX Hawaii PPO |
$265.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$137.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$137.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$137.00
|
| Rate for Payer: University Health Alliance Commercial |
$199.72
|
|
|
46608 ANOSCOPY W/RMVL FOREIGN BODY TechFee
|
Facility
|
OP
|
$5,446.00
|
|
|
Service Code
|
HCPCS 46608
|
| Hospital Charge Code |
8258861
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$393.00 |
| Max. Negotiated Rate |
$5,282.62 |
| Rate for Payer: AlohaCare Medicaid |
$672.48
|
| Rate for Payer: AlohaCare Medicare |
$2,723.00
|
| Rate for Payer: Cash Price |
$3,539.90
|
| Rate for Payer: Cash Price |
$3,539.90
|
| Rate for Payer: Devoted Health Medicare |
$2,995.30
|
| 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 |
$2,723.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$407.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$5,173.70
|
| Rate for Payer: Health Management Network Commercial |
$4,629.10
|
| Rate for Payer: Humana Medicare |
$2,723.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,901.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,723.00
|
| Rate for Payer: MDX Hawaii PPO |
$5,282.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,723.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,723.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,723.00
|
| Rate for Payer: University Health Alliance Commercial |
$3,969.59
|
|
|
46608 ANOSCOPY W/RMVL FOREIGN BODY TechFee
|
Facility
|
IP
|
$5,446.00
|
|
|
Service Code
|
HCPCS 46608
|
| Hospital Charge Code |
8258861
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,629.10 |
| Max. Negotiated Rate |
$5,282.62 |
| Rate for Payer: Cash Price |
$3,539.90
|
| Rate for Payer: Health Management Network Commercial |
$4,629.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,901.40
|
| Rate for Payer: MDX Hawaii PPO |
$5,282.62
|
|
|
46922 Surgical excision, destruction of lesion (s), anus
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 46922
|
| Hospital Charge Code |
8039494
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$106.08 |
| Max. Negotiated Rate |
$3,283.55 |
| Rate for Payer: AlohaCare Medicaid |
$142.97
|
| Rate for Payer: AlohaCare Medicare |
$137.45
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Devoted Health Medicare |
$151.19
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$142.97
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$236.54
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$137.45
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$142.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$106.08
|
| Rate for Payer: Health Management Network Commercial |
$3,283.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$151.19
|
| Rate for Payer: Kaiser Permanente Medicaid |
$151.19
|
| Rate for Payer: Kaiser Permanente Medicare |
$151.19
|
| Rate for Payer: Ohana Health Plan Medicaid |
$142.97
|
| Rate for Payer: Ohana Health Plan Medicare |
$137.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$142.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$137.45
|
| Rate for Payer: University Health Alliance Commercial |
$185.97
|
|
|
46930 Destruction of internal hemorrhoid(s) by thermal energy
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 46930
|
| Hospital Charge Code |
8039496
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$162.69 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: AlohaCare Medicaid |
$162.69
|
| Rate for Payer: AlohaCare Medicare |
$167.97
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Devoted Health Medicare |
$184.77
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$162.69
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$270.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$167.97
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$162.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$193.44
|
| Rate for Payer: Health Management Network Commercial |
$1,415.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$184.77
|
| Rate for Payer: Kaiser Permanente Medicaid |
$184.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$184.77
|
| Rate for Payer: Ohana Health Plan Medicaid |
$162.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$167.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$162.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$167.97
|
| Rate for Payer: University Health Alliance Commercial |
$214.63
|
|
|
46940 Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 46940
|
| Hospital Charge Code |
8039497
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$66.82 |
| Max. Negotiated Rate |
$3,283.55 |
| Rate for Payer: AlohaCare Medicaid |
$148.45
|
| Rate for Payer: AlohaCare Medicare |
$138.32
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Devoted Health Medicare |
$152.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$148.45
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$245.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$138.32
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$148.45
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$66.82
|
| Rate for Payer: Health Management Network Commercial |
$3,283.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$152.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$152.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$152.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$148.45
|
| Rate for Payer: Ohana Health Plan Medicare |
$138.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$148.45
|
| Rate for Payer: UnitedHealthcare Medicare |
$138.32
|
| Rate for Payer: University Health Alliance Commercial |
$193.47
|
|
|
46946 HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THAN RUBBER BAND; 2 OR MORE HEMORRHOID C ProFee
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 46946
|
| Hospital Charge Code |
8020225
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$130.26 |
| Max. Negotiated Rate |
$3,283.55 |
| Rate for Payer: AlohaCare Medicaid |
$402.86
|
| Rate for Payer: AlohaCare Medicare |
$403.78
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Devoted Health Medicare |
$444.16
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$396.80
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$403.78
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$130.26
|
| Rate for Payer: Health Management Network Commercial |
$3,283.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$444.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$444.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$444.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$402.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$403.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$402.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$403.78
|
|
|
47000 Biopsy of liver, needle; percutaneous
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
8039501
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$76.43 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$87.17
|
| Rate for Payer: AlohaCare Medicare |
$76.43
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$84.07
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$87.17
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$146.74
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$76.43
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$87.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$184.86
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$84.07
|
| Rate for Payer: Kaiser Permanente Medicaid |
$84.07
|
| Rate for Payer: Kaiser Permanente Medicare |
$84.07
|
| Rate for Payer: Ohana Health Plan Medicaid |
$87.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$76.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$87.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$76.43
|
| Rate for Payer: University Health Alliance Commercial |
$115.57
|
|
|
47379 Unlisted Laparoscopic procedure liver
|
Professional
|
Both
|
$8,414.00
|
|
|
Service Code
|
HCPCS 47379
|
| Hospital Charge Code |
8729500
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$7,151.90 |
| Max. Negotiated Rate |
$7,151.90 |
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Health Management Network Commercial |
$7,151.90
|
|
|
47490 CHOLECYSTOSTOMY, PERCUTANEOUS, COMPLETE PROCEDURE, INCLUDING IMAGING GUIDANCE, CATHETE ProFee
|
Professional
|
Both
|
$4,983.00
|
|
|
Service Code
|
HCPCS 47490
|
| Hospital Charge Code |
8020265
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$308.77 |
| Max. Negotiated Rate |
$4,235.55 |
| Rate for Payer: AlohaCare Medicaid |
$341.63
|
| Rate for Payer: AlohaCare Medicare |
$308.77
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Devoted Health Medicare |
$339.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$308.77
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$336.18
|
| Rate for Payer: Health Management Network Commercial |
$4,235.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$339.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$341.63
|
| Rate for Payer: Ohana Health Plan Medicare |
$308.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$341.63
|
| Rate for Payer: UnitedHealthcare Medicare |
$308.77
|
|
|
47562 Laparoscopy, surgical; cholecystectomy
|
Professional
|
Both
|
$2,629.00
|
|
|
Service Code
|
HCPCS 47562
|
| Hospital Charge Code |
8039519
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$622.04 |
| Max. Negotiated Rate |
$2,234.65 |
| Rate for Payer: Kaiser Permanente Commercial |
$684.24
|
| Rate for Payer: AlohaCare Medicaid |
$658.28
|
| Rate for Payer: AlohaCare Medicare |
$622.04
|
| Rate for Payer: Cash Price |
$1,708.85
|
| Rate for Payer: Cash Price |
$1,708.85
|
| Rate for Payer: Devoted Health Medicare |
$684.24
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$622.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$686.66
|
| Rate for Payer: Health Management Network Commercial |
$2,234.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$684.24
|
| Rate for Payer: Kaiser Permanente Medicare |
$684.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$658.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$622.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$658.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$622.04
|
|
|
47563 Lap, cholecystectomy w/ cholangiography
|
Professional
|
Both
|
$2,656.00
|
|
|
Service Code
|
HCPCS 47563
|
| Hospital Charge Code |
8039520
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$672.19 |
| Max. Negotiated Rate |
$2,257.60 |
| Rate for Payer: AlohaCare Medicaid |
$714.60
|
| Rate for Payer: AlohaCare Medicare |
$672.19
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Devoted Health Medicare |
$739.41
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$672.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$738.92
|
| Rate for Payer: Health Management Network Commercial |
$2,257.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$739.41
|
| Rate for Payer: Kaiser Permanente Medicaid |
$739.41
|
| Rate for Payer: Kaiser Permanente Medicare |
$739.41
|
| Rate for Payer: Ohana Health Plan Medicaid |
$714.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$672.19
|
| Rate for Payer: UnitedHealthcare Medicaid |
$714.60
|
| Rate for Payer: UnitedHealthcare Medicare |
$672.19
|
|
|
47579 UNLISTED LAPAROSCOPY PROCEDURE, BILIARY TRACT ProFee
|
Professional
|
Both
|
$8,414.00
|
|
|
Service Code
|
HCPCS 47579
|
| Hospital Charge Code |
8020291
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$7,151.90 |
| Max. Negotiated Rate |
$7,151.90 |
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Health Management Network Commercial |
$7,151.90
|
|
|
47999 UNLISTED PROCEDURE, BILIARY TRACT ProFee
|
Professional
|
Both
|
$1,188.00
|
|
|
Service Code
|
HCPCS 47999
|
| Hospital Charge Code |
8020314
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,009.80 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Cash Price |
$772.20
|
| Rate for Payer: Health Management Network Commercial |
$1,009.80
|
|
