|
49082 Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance
|
Professional
|
Both
|
$2,018.00
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
8039552
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$71.63 |
| Max. Negotiated Rate |
$1,715.30 |
| Rate for Payer: AlohaCare Medicaid |
$73.51
|
| Rate for Payer: AlohaCare Medicare |
$71.63
|
| Rate for Payer: Cash Price |
$1,311.70
|
| Rate for Payer: Cash Price |
$1,311.70
|
| Rate for Payer: Devoted Health Medicare |
$78.79
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$73.51
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$123.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$71.63
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$73.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$214.76
|
| Rate for Payer: Health Management Network Commercial |
$1,715.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$78.79
|
| Rate for Payer: Kaiser Permanente Medicaid |
$78.79
|
| Rate for Payer: Kaiser Permanente Medicare |
$78.79
|
| Rate for Payer: Ohana Health Plan Medicaid |
$73.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$71.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$73.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$71.63
|
|
|
49082 Paracentesis without Imaging
|
Facility
|
IP
|
$4,535.00
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
8848445
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,854.75 |
| Max. Negotiated Rate |
$4,398.95 |
| Rate for Payer: Cash Price |
$2,947.75
|
| Rate for Payer: Health Management Network Commercial |
$3,854.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,081.50
|
| Rate for Payer: MDX Hawaii PPO |
$4,398.95
|
|
|
49082 Paracentesis without Imaging
|
Facility
|
OP
|
$4,535.00
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
8848445
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$393.00 |
| Max. Negotiated Rate |
$4,398.95 |
| Rate for Payer: AlohaCare Medicaid |
$2,267.50
|
| Rate for Payer: AlohaCare Medicare |
$2,267.50
|
| Rate for Payer: Cash Price |
$2,947.75
|
| Rate for Payer: Cash Price |
$2,947.75
|
| Rate for Payer: Devoted Health Medicare |
$2,494.25
|
| 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 |
$2,267.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$407.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4,308.25
|
| Rate for Payer: Health Management Network Commercial |
$3,854.75
|
| Rate for Payer: Humana Medicare |
$2,267.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,081.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,312.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,267.50
|
| Rate for Payer: MDX Hawaii PPO |
$4,398.95
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,267.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,267.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,267.50
|
| Rate for Payer: University Health Alliance Commercial |
$3,305.56
|
|
|
49083-Abdominal Paracentesis w/ Imaging Guide
|
Facility
|
OP
|
$2,563.00
|
|
|
Service Code
|
HCPCS 49083
|
| Hospital Charge Code |
8080219
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$393.00 |
| Max. Negotiated Rate |
$2,486.11 |
| Rate for Payer: AlohaCare Medicaid |
$525.09
|
| Rate for Payer: AlohaCare Medicare |
$1,281.50
|
| Rate for Payer: Cash Price |
$1,665.95
|
| Rate for Payer: Cash Price |
$1,665.95
|
| Rate for Payer: Cash Price |
$1,665.95
|
| Rate for Payer: Devoted Health Medicare |
$1,409.65
|
| 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 |
$1,281.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$407.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,434.85
|
| Rate for Payer: Health Management Network Commercial |
$2,178.55
|
| Rate for Payer: Humana Medicare |
$1,281.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,306.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,281.50
|
| Rate for Payer: MDX Hawaii PPO |
$2,486.11
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,281.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,281.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,281.50
|
| Rate for Payer: University Health Alliance Commercial |
$1,868.17
|
|
|
49083-Abdominal Paracentesis w/ Imaging Guide
|
Facility
|
IP
|
$1,695.00
|
|
|
Service Code
|
HCPCS 49083
|
| Hospital Charge Code |
11914097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,440.75 |
| Max. Negotiated Rate |
$1,644.15 |
| Rate for Payer: Cash Price |
$1,101.75
|
| Rate for Payer: Health Management Network Commercial |
$1,440.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,525.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,644.15
|
|
|
49083-Abdominal Paracentesis w/ Imaging Guide
|
Facility
|
OP
|
$1,695.00
|
|
|
Service Code
|
HCPCS 49083
|
| Hospital Charge Code |
11914097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$393.00 |
| Max. Negotiated Rate |
$2,837.00 |
| Rate for Payer: AlohaCare Medicaid |
$847.50
|
| Rate for Payer: AlohaCare Medicare |
$847.50
|
| Rate for Payer: Cash Price |
$1,101.75
|
| Rate for Payer: Cash Price |
$1,101.75
|
| Rate for Payer: Devoted Health Medicare |
$932.25
|
| 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 |
$847.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$407.95
|
| Rate for Payer: Health Management Network Commercial |
$1,440.75
|
| Rate for Payer: Humana Medicare |
$847.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,525.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,837.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$847.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,644.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$847.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$847.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$847.50
|
| Rate for Payer: University Health Alliance Commercial |
$1,235.49
|
|
|
49083-Abdominal Paracentesis w/ Imaging Guide
|
Facility
|
IP
|
$2,563.00
|
|
|
Service Code
|
HCPCS 49083
|
| Hospital Charge Code |
8080219
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,178.55 |
| Max. Negotiated Rate |
$2,486.11 |
| Rate for Payer: Cash Price |
$1,665.95
|
| Rate for Payer: Health Management Network Commercial |
$2,178.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,306.70
|
| Rate for Payer: MDX Hawaii PPO |
$2,486.11
|
|
|
49083 Abdominal paracentesis with imaging guidance; (diagnostic or therapeutic)
|
Professional
|
Both
|
$3,755.00
|
|
|
Service Code
|
HCPCS 49083
|
| Hospital Charge Code |
8039553
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$92.74 |
| Max. Negotiated Rate |
$3,191.75 |
| Rate for Payer: AlohaCare Medicaid |
$105.50
|
| Rate for Payer: AlohaCare Medicare |
$92.74
|
| Rate for Payer: Cash Price |
$2,440.75
|
| Rate for Payer: Cash Price |
$2,440.75
|
| Rate for Payer: Devoted Health Medicare |
$102.01
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$105.50
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$177.92
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$92.74
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$105.50
|
| Rate for Payer: Health Management Network Commercial |
$3,191.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$102.01
|
| Rate for Payer: Kaiser Permanente Medicaid |
$102.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$102.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$105.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$92.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$105.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$92.74
|
| Rate for Payer: University Health Alliance Commercial |
$140.13
|
|
|
49084 Peritoneal lavage, including imaging guidance, when performed
|
Professional
|
Both
|
$208.00
|
|
|
Service Code
|
HCPCS 49084
|
| Hospital Charge Code |
8039554
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$91.50 |
| Max. Negotiated Rate |
$176.80 |
| Rate for Payer: AlohaCare Medicaid |
$102.52
|
| Rate for Payer: AlohaCare Medicare |
$91.50
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Devoted Health Medicare |
$100.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$91.50
|
| Rate for Payer: Health Management Network Commercial |
$176.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$100.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$100.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$100.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$102.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$91.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$102.52
|
| Rate for Payer: UnitedHealthcare Medicare |
$91.50
|
|
|
49180 Biopsy, abdominal or retroperitoneal mass, percutaneous needle
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 49180
|
| Hospital Charge Code |
8039555
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$69.80 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$80.65
|
| Rate for Payer: AlohaCare Medicare |
$69.80
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$76.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$80.65
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$137.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$80.65
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$158.86
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$76.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$76.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$76.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$80.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$80.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.80
|
| Rate for Payer: University Health Alliance Commercial |
$108.08
|
|
|
49180 BIOPSY, ABDOMINAL OR RETROPERITONEAL MASS, PERCUTANEOUS NEEDLE ProFee
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 49180
|
| Hospital Charge Code |
8020358
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$69.80 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$80.65
|
| Rate for Payer: AlohaCare Medicare |
$69.80
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$76.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$80.65
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$137.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$80.65
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$158.86
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$76.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$76.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$76.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$80.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$80.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.80
|
| Rate for Payer: University Health Alliance Commercial |
$108.08
|
|
|
49255 Omentectomy, epiploectomy, resection of omentum (separate procedure)
|
Professional
|
Both
|
$9,010.00
|
|
|
Service Code
|
HCPCS 49255
|
| Hospital Charge Code |
8039562
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$613.60 |
| Max. Negotiated Rate |
$7,658.50 |
| Rate for Payer: AlohaCare Medicaid |
$797.62
|
| Rate for Payer: AlohaCare Medicare |
$745.50
|
| Rate for Payer: Cash Price |
$5,856.50
|
| Rate for Payer: Cash Price |
$5,856.50
|
| Rate for Payer: Devoted Health Medicare |
$820.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$745.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$613.60
|
| Rate for Payer: Health Management Network Commercial |
$7,658.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$820.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$820.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$820.05
|
| Rate for Payer: Ohana Health Plan Medicaid |
$797.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$745.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$797.62
|
| Rate for Payer: UnitedHealthcare Medicare |
$745.50
|
|
|
49320 Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of spec
|
Professional
|
Both
|
$8,414.00
|
|
|
Service Code
|
HCPCS 49320
|
| Hospital Charge Code |
8039563
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$313.79 |
| Max. Negotiated Rate |
$7,151.90 |
| Rate for Payer: AlohaCare Medicaid |
$330.81
|
| Rate for Payer: AlohaCare Medicare |
$313.79
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Devoted Health Medicare |
$345.17
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$313.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$343.98
|
| Rate for Payer: Health Management Network Commercial |
$7,151.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$345.17
|
| Rate for Payer: Kaiser Permanente Medicaid |
$345.17
|
| Rate for Payer: Kaiser Permanente Medicare |
$345.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$330.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$313.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$330.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$313.79
|
| Rate for Payer: University Health Alliance Commercial |
$448.00
|
|
|
49322 Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multi)
|
Professional
|
Both
|
$8,414.00
|
|
|
Service Code
|
HCPCS 49322
|
| Hospital Charge Code |
8039565
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$350.79 |
| Max. Negotiated Rate |
$7,151.90 |
| Rate for Payer: AlohaCare Medicaid |
$375.18
|
| Rate for Payer: AlohaCare Medicare |
$350.79
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Devoted Health Medicare |
$385.87
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$350.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$380.64
|
| Rate for Payer: Health Management Network Commercial |
$7,151.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$385.87
|
| Rate for Payer: Kaiser Permanente Medicaid |
$385.87
|
| Rate for Payer: Kaiser Permanente Medicare |
$385.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$375.18
|
| Rate for Payer: Ohana Health Plan Medicare |
$350.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$375.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$350.79
|
|
|
49402 Removal of peritoneal foreign body from peritoneal cavity
|
Professional
|
Both
|
$4,983.00
|
|
|
Service Code
|
HCPCS 49402
|
| Hospital Charge Code |
8039569
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$784.41 |
| Max. Negotiated Rate |
$4,235.55 |
| Rate for Payer: AlohaCare Medicaid |
$845.17
|
| Rate for Payer: AlohaCare Medicare |
$784.41
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Devoted Health Medicare |
$862.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$784.41
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$874.64
|
| Rate for Payer: Health Management Network Commercial |
$4,235.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$862.85
|
| Rate for Payer: Kaiser Permanente Medicaid |
$862.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$862.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$845.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$784.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$845.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$784.41
|
|
|
49505 Repair initial inguinal hernia, age 5 years or older; reducible
|
Professional
|
Both
|
$4,983.00
|
|
|
Service Code
|
HCPCS 49505
|
| Hospital Charge Code |
8039581
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$424.58 |
| Max. Negotiated Rate |
$4,235.55 |
| Rate for Payer: AlohaCare Medicaid |
$526.25
|
| Rate for Payer: AlohaCare Medicare |
$503.91
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Devoted Health Medicare |
$554.30
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$503.91
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$424.58
|
| Rate for Payer: Health Management Network Commercial |
$4,235.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$554.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$554.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$554.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$526.25
|
| Rate for Payer: Ohana Health Plan Medicare |
$503.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$526.25
|
| Rate for Payer: UnitedHealthcare Medicare |
$503.91
|
|
|
49507 Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated
|
Professional
|
Both
|
$4,983.00
|
|
|
Service Code
|
HCPCS 49507
|
| Hospital Charge Code |
8039582
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$518.70 |
| Max. Negotiated Rate |
$4,235.55 |
| Rate for Payer: AlohaCare Medicaid |
$589.94
|
| Rate for Payer: AlohaCare Medicare |
$562.20
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Devoted Health Medicare |
$618.42
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$562.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$518.70
|
| Rate for Payer: Health Management Network Commercial |
$4,235.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$618.42
|
| Rate for Payer: Kaiser Permanente Medicaid |
$618.42
|
| Rate for Payer: Kaiser Permanente Medicare |
$618.42
|
| Rate for Payer: Ohana Health Plan Medicaid |
$589.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$562.20
|
| Rate for Payer: UnitedHealthcare Medicaid |
$589.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$562.20
|
|
|
49520 Repair recurrent inguinal hernia, any age; reducible
|
Professional
|
Both
|
$4,983.00
|
|
|
Service Code
|
HCPCS 49520
|
| Hospital Charge Code |
8039583
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$522.34 |
| Max. Negotiated Rate |
$4,235.55 |
| Rate for Payer: AlohaCare Medicaid |
$632.99
|
| Rate for Payer: AlohaCare Medicare |
$599.28
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Devoted Health Medicare |
$659.21
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$599.28
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$522.34
|
| Rate for Payer: Health Management Network Commercial |
$4,235.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$659.21
|
| Rate for Payer: Kaiser Permanente Medicaid |
$659.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$659.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$632.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$599.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$632.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$599.28
|
|
|
49560 Repair initial incisional or ventral hernia; reducible
|
Professional
|
Both
|
$8,414.00
|
|
|
Service Code
|
HCPCS 49592
|
| Hospital Charge Code |
8039591
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$418.73 |
| Max. Negotiated Rate |
$7,151.90 |
| Rate for Payer: AlohaCare Medicaid |
$460.99
|
| Rate for Payer: AlohaCare Medicare |
$418.73
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Devoted Health Medicare |
$460.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$418.73
|
| Rate for Payer: Health Management Network Commercial |
$7,151.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$460.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$460.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$460.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$460.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$418.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$460.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$418.73
|
|
|
49565 Repair recurrent incisional or ventral hernia; reducible
|
Professional
|
Both
|
$9,010.00
|
|
|
Service Code
|
HCPCS 49593
|
| Hospital Charge Code |
8039593
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$502.59 |
| Max. Negotiated Rate |
$7,658.50 |
| Rate for Payer: AlohaCare Medicaid |
$554.95
|
| Rate for Payer: AlohaCare Medicare |
$502.59
|
| Rate for Payer: Cash Price |
$5,856.50
|
| Rate for Payer: Cash Price |
$5,856.50
|
| Rate for Payer: Devoted Health Medicare |
$552.85
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$502.59
|
| Rate for Payer: Health Management Network Commercial |
$7,658.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$552.85
|
| Rate for Payer: Kaiser Permanente Medicaid |
$552.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$552.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$554.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$502.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$554.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$502.59
|
|
|
49570 Repair epigastric hernia (eg, preperitoneal fat); reducible (separate procedure)
|
Professional
|
Both
|
$1,216.00
|
|
|
Service Code
|
HCPCS 49596
|
| Hospital Charge Code |
8039596
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$893.43 |
| Max. Negotiated Rate |
$1,033.60 |
| Rate for Payer: AlohaCare Medicaid |
$988.71
|
| Rate for Payer: AlohaCare Medicare |
$893.43
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Devoted Health Medicare |
$982.77
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$893.43
|
| Rate for Payer: Health Management Network Commercial |
$1,033.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$982.77
|
| Rate for Payer: Kaiser Permanente Medicaid |
$982.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$982.77
|
| Rate for Payer: Ohana Health Plan Medicaid |
$988.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$893.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$988.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$893.43
|
|
|
49591 RPR OF ANTERIOR ABD HERNIA(S), ANY APPROACH,INITIAL,IMPLANT OF MESH OR OTHR, < 3CM,REDUCIBLE
|
Professional
|
Both
|
$1,900.00
|
|
|
Service Code
|
HCPCS 49591
|
| Hospital Charge Code |
10602930
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$304.52 |
| Max. Negotiated Rate |
$1,615.00 |
| Rate for Payer: AlohaCare Medicaid |
$333.31
|
| Rate for Payer: AlohaCare Medicare |
$304.52
|
| Rate for Payer: Cash Price |
$1,235.00
|
| Rate for Payer: Cash Price |
$1,235.00
|
| Rate for Payer: Devoted Health Medicare |
$334.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$304.52
|
| Rate for Payer: Health Management Network Commercial |
$1,615.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$334.97
|
| Rate for Payer: Kaiser Permanente Medicaid |
$334.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$334.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$333.31
|
| Rate for Payer: Ohana Health Plan Medicare |
$304.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$333.31
|
| Rate for Payer: UnitedHealthcare Medicare |
$304.52
|
|
|
49592 RPR AA HRN 1ST < 3 NCR/STRN
|
Professional
|
Both
|
$8,414.00
|
|
|
Service Code
|
HCPCS 49592
|
| Hospital Charge Code |
10807798
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$418.73 |
| Max. Negotiated Rate |
$7,151.90 |
| Rate for Payer: AlohaCare Medicaid |
$460.99
|
| Rate for Payer: AlohaCare Medicare |
$418.73
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Devoted Health Medicare |
$460.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$418.73
|
| Rate for Payer: Health Management Network Commercial |
$7,151.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$460.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$460.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$460.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$460.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$418.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$460.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$418.73
|
|
|
49592 RPR OF ANTERIOR ABD HERN(S), ANY APPR,INITIAL,MESH OR OTHR, < 3CM INCARCERATE/STRANGULATED
|
Facility
|
IP
|
$9,480.00
|
|
|
Service Code
|
HCPCS 49592
|
| Hospital Charge Code |
10602931
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$8,058.00 |
| Max. Negotiated Rate |
$9,195.60 |
| Rate for Payer: Cash Price |
$6,162.00
|
| Rate for Payer: Health Management Network Commercial |
$8,058.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$8,532.00
|
| Rate for Payer: MDX Hawaii PPO |
$9,195.60
|
|
|
49592 RPR OF ANTERIOR ABD HERN(S), ANY APPR,INITIAL,MESH OR OTHR, < 3CM INCARCERATE/STRANGULATED
|
Professional
|
Both
|
$2,100.00
|
|
|
Service Code
|
HCPCS 49592
|
| Hospital Charge Code |
10602931
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$418.73 |
| Max. Negotiated Rate |
$1,785.00 |
| Rate for Payer: AlohaCare Medicaid |
$460.99
|
| Rate for Payer: AlohaCare Medicare |
$418.73
|
| Rate for Payer: Cash Price |
$1,365.00
|
| Rate for Payer: Cash Price |
$1,365.00
|
| Rate for Payer: Devoted Health Medicare |
$460.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$418.73
|
| Rate for Payer: Health Management Network Commercial |
$1,785.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$460.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$460.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$460.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$460.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$418.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$460.99
|
| Rate for Payer: UnitedHealthcare Medicare |
$418.73
|
|
