|
49592 RPR OF ANTERIOR ABD HERN(S), ANY APPR,INITIAL,MESH OR OTHR, < 3CM INCARCERATE/STRANGULATED
|
Facility
|
OP
|
$9,480.00
|
|
|
Service Code
|
HCPCS 49592
|
| Hospital Charge Code |
10602931
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$521.33 |
| Max. Negotiated Rate |
$11,119.00 |
| Rate for Payer: AlohaCare Medicaid |
$4,740.00
|
| Rate for Payer: AlohaCare Medicare |
$4,740.00
|
| Rate for Payer: Cash Price |
$6,162.00
|
| Rate for Payer: Cash Price |
$6,162.00
|
| Rate for Payer: Devoted Health Medicare |
$5,214.00
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$1,149.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$11,119.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$4,740.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$1,154.45
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$9,006.00
|
| Rate for Payer: Health Management Network Commercial |
$8,058.00
|
| Rate for Payer: Humana Medicare |
$4,740.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$8,532.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$4,834.80
|
| Rate for Payer: Kaiser Permanente Medicare |
$4,740.00
|
| Rate for Payer: MDX Hawaii PPO |
$9,195.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$4,740.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$4,740.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$521.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$4,740.00
|
| Rate for Payer: University Health Alliance Commercial |
$6,743.44
|
|
|
49593 RPR OF ANT ABDOM HERNIA(S), ANY APPR,INITIAL, INCLU IMPLNT OF MESH OR OTHR, 3-10CM, REDUCIBLE
|
Professional
|
Both
|
$910.00
|
|
|
Service Code
|
HCPCS 49593
|
| Hospital Charge Code |
10602932
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$502.59 |
| Max. Negotiated Rate |
$773.50 |
| Rate for Payer: AlohaCare Medicaid |
$554.95
|
| Rate for Payer: AlohaCare Medicare |
$502.59
|
| Rate for Payer: Cash Price |
$591.50
|
| Rate for Payer: Cash Price |
$591.50
|
| 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 |
$773.50
|
| 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
|
|
|
49593 RPR OF ANT ABDOM HERNIA(S), ANY APPR,INITIAL, INCLU IMPLNT OF MESH OR OTHR, 3-10CM, REDUCIBLE
|
Facility
|
OP
|
$7,405.00
|
|
|
Service Code
|
HCPCS 49593
|
| Hospital Charge Code |
10602932
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$10,679.55 |
| Rate for Payer: AlohaCare Medicaid |
$3,702.50
|
| Rate for Payer: AlohaCare Medicare |
$3,702.50
|
| Rate for Payer: Cash Price |
$4,813.25
|
| Rate for Payer: Cash Price |
$4,813.25
|
| Rate for Payer: Devoted Health Medicare |
$4,072.75
|
| 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 Medicare |
$3,702.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$849.21
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$7,034.75
|
| Rate for Payer: Health Management Network Commercial |
$6,294.25
|
| Rate for Payer: Humana Medicare |
$3,702.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,664.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$3,776.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,702.50
|
| Rate for Payer: MDX Hawaii PPO |
$7,182.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3,702.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,702.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,702.50
|
| Rate for Payer: University Health Alliance Commercial |
$10,679.55
|
|
|
49593 RPR OF ANT ABDOM HERNIA(S), ANY APPR,INITIAL, INCLU IMPLNT OF MESH OR OTHR, 3-10CM, REDUCIBLE
|
Facility
|
IP
|
$7,405.00
|
|
|
Service Code
|
HCPCS 49593
|
| Hospital Charge Code |
10602932
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$6,294.25 |
| Max. Negotiated Rate |
$7,182.85 |
| Rate for Payer: Cash Price |
$4,813.25
|
| Rate for Payer: Health Management Network Commercial |
$6,294.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,664.50
|
| Rate for Payer: MDX Hawaii PPO |
$7,182.85
|
|
|
49594 RPR OF ANTERIOR ABD HERN(S), ANY APPR,INITIAL,MESH OR OTHR, 3-10CM INCARCERATE/STRANGULATED
|
Professional
|
Both
|
$8,414.00
|
|
|
Service Code
|
HCPCS 49594
|
| Hospital Charge Code |
10602933
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$651.53 |
| Max. Negotiated Rate |
$7,151.90 |
| Rate for Payer: AlohaCare Medicaid |
$720.76
|
| Rate for Payer: AlohaCare Medicare |
$651.53
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Devoted Health Medicare |
$716.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$651.53
|
| Rate for Payer: Health Management Network Commercial |
$7,151.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$716.68
|
| Rate for Payer: Kaiser Permanente Medicaid |
$716.68
|
| Rate for Payer: Kaiser Permanente Medicare |
$716.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$720.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$651.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$720.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$651.53
|
|
|
49594 RPR OF ANTERIOR ABD HERN(S), ANY APPR,INITIAL,MESH OR OTHR, 3-10CM INCARCERATE/STRANGULATED
|
Facility
|
IP
|
$10,795.00
|
|
|
Service Code
|
HCPCS 49594
|
| Hospital Charge Code |
10602933
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$9,175.75 |
| Max. Negotiated Rate |
$10,471.15 |
| Rate for Payer: Cash Price |
$7,016.75
|
| Rate for Payer: Health Management Network Commercial |
$9,175.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$9,715.50
|
| Rate for Payer: MDX Hawaii PPO |
$10,471.15
|
|
|
49594 RPR OF ANTERIOR ABD HERN(S), ANY APPR,INITIAL,MESH OR OTHR, 3-10CM INCARCERATE/STRANGULATED
|
Facility
|
OP
|
$10,795.00
|
|
|
Service Code
|
HCPCS 49594
|
| Hospital Charge Code |
10602933
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$521.33 |
| Max. Negotiated Rate |
$11,157.19 |
| Rate for Payer: AlohaCare Medicaid |
$5,397.50
|
| Rate for Payer: AlohaCare Medicare |
$5,397.50
|
| Rate for Payer: Cash Price |
$7,016.75
|
| Rate for Payer: Cash Price |
$7,016.75
|
| Rate for Payer: Devoted Health Medicare |
$5,937.25
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$1,149.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$11,119.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$5,397.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$1,154.45
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$10,255.25
|
| Rate for Payer: Health Management Network Commercial |
$9,175.75
|
| Rate for Payer: Humana Medicare |
$5,397.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$9,715.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$5,505.45
|
| Rate for Payer: Kaiser Permanente Medicare |
$5,397.50
|
| Rate for Payer: MDX Hawaii PPO |
$10,471.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$5,397.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$5,397.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$521.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$5,397.50
|
| Rate for Payer: University Health Alliance Commercial |
$11,157.19
|
|
|
49595 RPR OF ANTERIOR ABD HERNIA(S), ANY APPROACH,INITIAL,IMPLANT OF MESH OR OTHR, > 3CM,REDUCIBLE
|
Facility
|
OP
|
$17,774.00
|
|
|
Service Code
|
HCPCS 49595
|
| Hospital Charge Code |
10599842
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$17,240.78 |
| Rate for Payer: AlohaCare Medicaid |
$8,887.00
|
| Rate for Payer: AlohaCare Medicare |
$8,887.00
|
| Rate for Payer: Cash Price |
$11,553.10
|
| Rate for Payer: Cash Price |
$11,553.10
|
| Rate for Payer: Devoted Health Medicare |
$9,775.70
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$1,149.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$11,119.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$8,887.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$1,154.45
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$16,885.30
|
| Rate for Payer: Health Management Network Commercial |
$15,107.90
|
| Rate for Payer: Humana Medicare |
$8,887.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$15,996.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$9,064.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$8,887.00
|
| Rate for Payer: MDX Hawaii PPO |
$17,240.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$8,887.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$8,887.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$8,887.00
|
| Rate for Payer: University Health Alliance Commercial |
$11,157.19
|
|
|
49595 RPR OF ANTERIOR ABD HERNIA(S), ANY APPROACH,INITIAL,IMPLANT OF MESH OR OTHR, > 3CM,REDUCIBLE
|
Professional
|
Both
|
$9,010.00
|
|
|
Service Code
|
HCPCS 49595
|
| Hospital Charge Code |
10599842
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$674.07 |
| Max. Negotiated Rate |
$7,658.50 |
| Rate for Payer: AlohaCare Medicaid |
$745.70
|
| Rate for Payer: AlohaCare Medicare |
$674.07
|
| Rate for Payer: Cash Price |
$5,856.50
|
| Rate for Payer: Cash Price |
$5,856.50
|
| Rate for Payer: Devoted Health Medicare |
$741.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$674.07
|
| Rate for Payer: Health Management Network Commercial |
$7,658.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$741.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$741.48
|
| Rate for Payer: Kaiser Permanente Medicare |
$741.48
|
| Rate for Payer: Ohana Health Plan Medicaid |
$745.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$674.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$745.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$674.07
|
|
|
49595 RPR OF ANTERIOR ABD HERNIA(S), ANY APPROACH,INITIAL,IMPLANT OF MESH OR OTHR, > 3CM,REDUCIBLE
|
Facility
|
IP
|
$17,774.00
|
|
|
Service Code
|
HCPCS 49595
|
| Hospital Charge Code |
10599842
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$15,107.90 |
| Max. Negotiated Rate |
$17,240.78 |
| Rate for Payer: Cash Price |
$11,553.10
|
| Rate for Payer: Health Management Network Commercial |
$15,107.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$15,996.60
|
| Rate for Payer: MDX Hawaii PPO |
$17,240.78
|
|
|
49596 RPR OF ANTERIOR ABD HERN(S), ANY APPR,INITIAL,MESH OR OTHR, > 3CM INCARCERATE/STRANGULATED
|
Professional
|
Both
|
$1,239.00
|
|
|
Service Code
|
HCPCS 49596
|
| Hospital Charge Code |
10599843
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$893.43 |
| Max. Negotiated Rate |
$1,053.15 |
| Rate for Payer: AlohaCare Medicaid |
$988.71
|
| Rate for Payer: AlohaCare Medicare |
$893.43
|
| Rate for Payer: Cash Price |
$805.35
|
| Rate for Payer: Cash Price |
$805.35
|
| 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 |
$1,053.15
|
| 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
|
|
|
49613 RPR OF ANTERIOR ABD HERNIA(S), ANY APPROACH,RECURRENT,IMPLANT OF MESH OR OTHR, < 3CM,REDUCIBLE
|
Facility
|
IP
|
$591.00
|
|
|
Service Code
|
HCPCS 49613
|
| Hospital Charge Code |
10602934
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$502.35 |
| Max. Negotiated Rate |
$573.27 |
| Rate for Payer: Cash Price |
$384.15
|
| Rate for Payer: Health Management Network Commercial |
$502.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$531.90
|
| Rate for Payer: MDX Hawaii PPO |
$573.27
|
|
|
49613 RPR OF ANTERIOR ABD HERNIA(S), ANY APPROACH,RECURRENT,IMPLANT OF MESH OR OTHR, < 3CM,REDUCIBLE
|
Professional
|
Both
|
$4,983.00
|
|
|
Service Code
|
HCPCS 49613
|
| Hospital Charge Code |
10602934
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$372.40 |
| Max. Negotiated Rate |
$4,235.55 |
| Rate for Payer: AlohaCare Medicaid |
$410.64
|
| Rate for Payer: AlohaCare Medicare |
$372.40
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Devoted Health Medicare |
$409.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$372.40
|
| Rate for Payer: Health Management Network Commercial |
$4,235.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$409.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$409.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$409.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$410.64
|
| Rate for Payer: Ohana Health Plan Medicare |
$372.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$410.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$372.40
|
|
|
49613 RPR OF ANTERIOR ABD HERNIA(S), ANY APPROACH,RECURRENT,IMPLANT OF MESH OR OTHR, < 3CM,REDUCIBLE
|
Facility
|
OP
|
$591.00
|
|
|
Service Code
|
HCPCS 49613
|
| Hospital Charge Code |
10602934
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$295.50 |
| Max. Negotiated Rate |
$11,119.00 |
| Rate for Payer: AlohaCare Medicaid |
$295.50
|
| Rate for Payer: AlohaCare Medicare |
$295.50
|
| Rate for Payer: Cash Price |
$384.15
|
| Rate for Payer: Cash Price |
$384.15
|
| Rate for Payer: Devoted Health Medicare |
$325.05
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$1,149.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$11,119.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$295.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$1,154.45
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$561.45
|
| Rate for Payer: Health Management Network Commercial |
$502.35
|
| Rate for Payer: Humana Medicare |
$295.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$531.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$301.41
|
| Rate for Payer: Kaiser Permanente Medicare |
$295.50
|
| Rate for Payer: MDX Hawaii PPO |
$573.27
|
| Rate for Payer: Ohana Health Plan Medicaid |
$295.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$295.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$295.50
|
| Rate for Payer: University Health Alliance Commercial |
$6,743.44
|
|
|
49614 RPR OF ANTERIOR ABD HERN(S), ANY APPR,RECURRENT,MESH OR OTHR, < 3CM INCARCERATE/STRANGULATED
|
Professional
|
Both
|
$2,200.00
|
|
|
Service Code
|
HCPCS 49614
|
| Hospital Charge Code |
10602935
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$501.50 |
| Max. Negotiated Rate |
$1,870.00 |
| Rate for Payer: AlohaCare Medicaid |
$553.48
|
| Rate for Payer: AlohaCare Medicare |
$501.50
|
| Rate for Payer: Cash Price |
$1,430.00
|
| Rate for Payer: Cash Price |
$1,430.00
|
| Rate for Payer: Devoted Health Medicare |
$551.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$501.50
|
| Rate for Payer: Health Management Network Commercial |
$1,870.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$551.65
|
| Rate for Payer: Kaiser Permanente Medicaid |
$551.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$551.65
|
| Rate for Payer: Ohana Health Plan Medicaid |
$553.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$501.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$553.48
|
| Rate for Payer: UnitedHealthcare Medicare |
$501.50
|
|
|
49615 RPR OF ANT ABDOM HERNIA(S), ANY APPR,RECURR, INCLU IMPLNT OF MESH OR OTHR, 3-10CM, REDUCIBLE
|
Professional
|
Both
|
$2,900.00
|
|
|
Service Code
|
HCPCS 49615
|
| Hospital Charge Code |
10602937
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$558.49 |
| Max. Negotiated Rate |
$2,465.00 |
| Rate for Payer: AlohaCare Medicaid |
$619.06
|
| Rate for Payer: AlohaCare Medicare |
$558.49
|
| Rate for Payer: Cash Price |
$1,885.00
|
| Rate for Payer: Cash Price |
$1,885.00
|
| Rate for Payer: Devoted Health Medicare |
$614.34
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$558.49
|
| Rate for Payer: Health Management Network Commercial |
$2,465.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$614.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$614.34
|
| Rate for Payer: Kaiser Permanente Medicare |
$614.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$619.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$558.49
|
| Rate for Payer: UnitedHealthcare Medicaid |
$619.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$558.49
|
|
|
49616 RPR OF ANTERIOR ABD HERN(S), ANY APPR,IRECURR,MESH OR OTHR, 3-10CM INCARCERATE/STRANGULATED
|
Facility
|
IP
|
$917.00
|
|
|
Service Code
|
HCPCS 49616
|
| Hospital Charge Code |
10602938
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$779.45 |
| Max. Negotiated Rate |
$889.49 |
| Rate for Payer: Cash Price |
$596.05
|
| Rate for Payer: Health Management Network Commercial |
$779.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$825.30
|
| Rate for Payer: MDX Hawaii PPO |
$889.49
|
|
|
49616 RPR OF ANTERIOR ABD HERN(S), ANY APPR,IRECURR,MESH OR OTHR, 3-10CM INCARCERATE/STRANGULATED
|
Facility
|
OP
|
$917.00
|
|
|
Service Code
|
HCPCS 49616
|
| Hospital Charge Code |
10602938
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$458.50 |
| Max. Negotiated Rate |
$13,058.00 |
| Rate for Payer: AlohaCare Medicaid |
$458.50
|
| Rate for Payer: AlohaCare Medicare |
$458.50
|
| Rate for Payer: Cash Price |
$596.05
|
| Rate for Payer: Cash Price |
$596.05
|
| Rate for Payer: Devoted Health Medicare |
$504.35
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$1,900.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$13,058.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$458.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$1,902.37
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$871.15
|
| Rate for Payer: Health Management Network Commercial |
$779.45
|
| Rate for Payer: Humana Medicare |
$458.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$825.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$467.67
|
| Rate for Payer: Kaiser Permanente Medicare |
$458.50
|
| Rate for Payer: MDX Hawaii PPO |
$889.49
|
| Rate for Payer: Ohana Health Plan Medicaid |
$458.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$458.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$521.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$458.50
|
| Rate for Payer: University Health Alliance Commercial |
$10,679.55
|
|
|
49616 RPR OF ANTERIOR ABD HERN(S), ANY APPR,IRECURR,MESH OR OTHR, 3-10CM INCARCERATE/STRANGULATED
|
Professional
|
Both
|
$1,039.00
|
|
|
Service Code
|
HCPCS 49616
|
| Hospital Charge Code |
10602938
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$747.57 |
| Max. Negotiated Rate |
$883.15 |
| Rate for Payer: AlohaCare Medicaid |
$829.51
|
| Rate for Payer: AlohaCare Medicare |
$747.57
|
| Rate for Payer: Cash Price |
$675.35
|
| Rate for Payer: Cash Price |
$675.35
|
| Rate for Payer: Devoted Health Medicare |
$822.33
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$747.57
|
| Rate for Payer: Health Management Network Commercial |
$883.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$822.33
|
| Rate for Payer: Kaiser Permanente Medicaid |
$822.33
|
| Rate for Payer: Kaiser Permanente Medicare |
$822.33
|
| Rate for Payer: Ohana Health Plan Medicaid |
$829.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$747.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$829.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$747.57
|
|
|
49617 RPR OF ANTERIOR ABD HERNIA(S), ANY APPROACH,RECUR,IMPLANT OF MESH OR OTHR, > 3CM,REDUCIBLE
|
Professional
|
Both
|
$1,073.00
|
|
|
Service Code
|
HCPCS 49617
|
| Hospital Charge Code |
10602939
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$772.97 |
| Max. Negotiated Rate |
$912.05 |
| Rate for Payer: AlohaCare Medicaid |
$856.76
|
| Rate for Payer: AlohaCare Medicare |
$772.97
|
| Rate for Payer: Cash Price |
$697.45
|
| Rate for Payer: Cash Price |
$697.45
|
| Rate for Payer: Devoted Health Medicare |
$850.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$772.97
|
| Rate for Payer: Health Management Network Commercial |
$912.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$850.27
|
| Rate for Payer: Kaiser Permanente Medicaid |
$850.27
|
| Rate for Payer: Kaiser Permanente Medicare |
$850.27
|
| Rate for Payer: Ohana Health Plan Medicaid |
$856.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$772.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$856.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$772.97
|
|
|
49617 RPR OF ANTERIOR ABD HERNIA(S), ANY APPROACH,RECUR,IMPLANT OF MESH OR OTHR, > 3CM,REDUCIBLE
|
Facility
|
IP
|
$946.00
|
|
|
Service Code
|
HCPCS 49617
|
| Hospital Charge Code |
10602939
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$804.10 |
| Max. Negotiated Rate |
$917.62 |
| Rate for Payer: Cash Price |
$614.90
|
| Rate for Payer: Health Management Network Commercial |
$804.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$851.40
|
| Rate for Payer: MDX Hawaii PPO |
$917.62
|
|
|
49617 RPR OF ANTERIOR ABD HERNIA(S), ANY APPROACH,RECUR,IMPLANT OF MESH OR OTHR, > 3CM,REDUCIBLE
|
Facility
|
OP
|
$946.00
|
|
|
Service Code
|
HCPCS 49617
|
| Hospital Charge Code |
10602939
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$473.00 |
| Max. Negotiated Rate |
$13,058.00 |
| Rate for Payer: AlohaCare Medicaid |
$473.00
|
| Rate for Payer: AlohaCare Medicare |
$473.00
|
| Rate for Payer: Cash Price |
$614.90
|
| Rate for Payer: Cash Price |
$614.90
|
| Rate for Payer: Devoted Health Medicare |
$520.30
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$1,900.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$13,058.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$473.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$1,902.37
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$898.70
|
| Rate for Payer: Health Management Network Commercial |
$804.10
|
| Rate for Payer: Humana Medicare |
$473.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$851.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$482.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$473.00
|
| Rate for Payer: MDX Hawaii PPO |
$917.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$473.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$473.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$521.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$473.00
|
| Rate for Payer: University Health Alliance Commercial |
$689.54
|
|
|
49618 RPR OF ANTERIOR ABD HERN(S), ANY APPR,RECUR,MESH OR OTHR, > 3CM INCARCERATE/STRANGULATED
|
Facility
|
IP
|
$1,323.00
|
|
|
Service Code
|
HCPCS 49618
|
| Hospital Charge Code |
10602940
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,124.55 |
| Max. Negotiated Rate |
$1,283.31 |
| Rate for Payer: Cash Price |
$859.95
|
| Rate for Payer: Health Management Network Commercial |
$1,124.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,190.70
|
| Rate for Payer: MDX Hawaii PPO |
$1,283.31
|
|
|
49618 RPR OF ANTERIOR ABD HERN(S), ANY APPR,RECUR,MESH OR OTHR, > 3CM INCARCERATE/STRANGULATED
|
Professional
|
Both
|
$1,500.00
|
|
|
Service Code
|
HCPCS 49618
|
| Hospital Charge Code |
10602940
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,079.48 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: AlohaCare Medicaid |
$1,197.34
|
| Rate for Payer: AlohaCare Medicare |
$1,079.48
|
| Rate for Payer: Cash Price |
$975.00
|
| Rate for Payer: Cash Price |
$975.00
|
| Rate for Payer: Devoted Health Medicare |
$1,187.43
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,079.48
|
| Rate for Payer: Health Management Network Commercial |
$1,275.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,187.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,187.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,187.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,197.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,079.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,197.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,079.48
|
|
|
49618 RPR OF ANTERIOR ABD HERN(S), ANY APPR,RECUR,MESH OR OTHR, > 3CM INCARCERATE/STRANGULATED
|
Facility
|
OP
|
$1,323.00
|
|
|
Service Code
|
HCPCS 49618
|
| Hospital Charge Code |
10602940
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$521.33 |
| Max. Negotiated Rate |
$13,058.00 |
| Rate for Payer: AlohaCare Medicaid |
$661.50
|
| Rate for Payer: AlohaCare Medicare |
$661.50
|
| Rate for Payer: Cash Price |
$859.95
|
| Rate for Payer: Cash Price |
$859.95
|
| Rate for Payer: Devoted Health Medicare |
$727.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$1,900.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$13,058.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$661.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$1,902.37
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,256.85
|
| Rate for Payer: Health Management Network Commercial |
$1,124.55
|
| Rate for Payer: Humana Medicare |
$661.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,190.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$674.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$661.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,283.31
|
| Rate for Payer: Ohana Health Plan Medicaid |
$661.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$661.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$521.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$661.50
|
| Rate for Payer: University Health Alliance Commercial |
$964.33
|
|
