|
11450 Excision of skin/subcutaneous tissue for hidradenitis, axillary; w/ simple or interm repair
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 11450
|
| Hospital Charge Code |
8037126
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$133.64 |
| Max. Negotiated Rate |
$3,436.55 |
| Rate for Payer: AlohaCare Medicaid |
$273.23
|
| Rate for Payer: AlohaCare Medicare |
$261.98
|
| Rate for Payer: Cash Price |
$2,627.95
|
| Rate for Payer: Cash Price |
$2,627.95
|
| Rate for Payer: Devoted Health Medicare |
$288.18
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$273.23
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$441.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$261.98
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$273.23
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$133.64
|
| Rate for Payer: Health Management Network Commercial |
$3,436.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$288.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$288.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$288.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$273.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$261.98
|
| Rate for Payer: UnitedHealthcare Medicaid |
$273.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$261.98
|
| Rate for Payer: University Health Alliance Commercial |
$311.65
|
|
|
11600 Excision, malignant lesion including margins, trunk, arms, or legs; < 0.5cm
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11600
|
| Hospital Charge Code |
8037131
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$108.94 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$128.36
|
| Rate for Payer: AlohaCare Medicare |
$112.24
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$123.46
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$128.36
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$210.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$112.24
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$128.36
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$108.94
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$123.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$123.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$123.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$128.36
|
| Rate for Payer: Ohana Health Plan Medicare |
$112.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$128.36
|
| Rate for Payer: UnitedHealthcare Medicare |
$112.24
|
| Rate for Payer: University Health Alliance Commercial |
$145.08
|
|
|
11601 Excision, malignant lesion including margins, trunk, arms, or legs; 0.6-1.0cm
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11601
|
| Hospital Charge Code |
8037132
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$132.11 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$155.04
|
| Rate for Payer: AlohaCare Medicare |
$132.11
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$145.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$155.04
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$254.93
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$132.11
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$155.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$134.68
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$145.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$145.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$145.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$155.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$132.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$155.04
|
| Rate for Payer: UnitedHealthcare Medicare |
$132.11
|
| Rate for Payer: University Health Alliance Commercial |
$175.48
|
|
|
11603 Excision, malignant lesion including margins, trunk, arms, or legs; 2.1-3.0cm
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 11603
|
| Hospital Charge Code |
8037134
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$166.97 |
| Max. Negotiated Rate |
$595.00 |
| Rate for Payer: AlohaCare Medicaid |
$200.05
|
| Rate for Payer: AlohaCare Medicare |
$166.97
|
| Rate for Payer: Cash Price |
$455.00
|
| Rate for Payer: Cash Price |
$455.00
|
| Rate for Payer: Devoted Health Medicare |
$183.67
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$200.05
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$329.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$166.97
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$200.05
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$178.88
|
| Rate for Payer: Health Management Network Commercial |
$595.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$183.67
|
| Rate for Payer: Kaiser Permanente Medicaid |
$183.67
|
| Rate for Payer: Kaiser Permanente Medicare |
$183.67
|
| Rate for Payer: Ohana Health Plan Medicaid |
$200.05
|
| Rate for Payer: Ohana Health Plan Medicare |
$166.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$200.05
|
| Rate for Payer: UnitedHealthcare Medicare |
$166.97
|
| Rate for Payer: University Health Alliance Commercial |
$226.85
|
|
|
11604 Excision, malignant lesion including margins, trunk, arms, or legs; 3.1-4.0cm
|
Professional
|
Both
|
$1,133.00
|
|
|
Service Code
|
HCPCS 11604
|
| Hospital Charge Code |
8037135
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$148.46 |
| Max. Negotiated Rate |
$963.05 |
| Rate for Payer: AlohaCare Medicaid |
$218.93
|
| Rate for Payer: AlohaCare Medicare |
$184.24
|
| Rate for Payer: Cash Price |
$736.45
|
| Rate for Payer: Cash Price |
$736.45
|
| Rate for Payer: Devoted Health Medicare |
$202.66
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$218.93
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$362.12
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$184.24
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$218.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$148.46
|
| Rate for Payer: Health Management Network Commercial |
$963.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$202.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$202.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$202.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$218.93
|
| Rate for Payer: Ohana Health Plan Medicare |
$184.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$218.93
|
| Rate for Payer: UnitedHealthcare Medicare |
$184.24
|
| Rate for Payer: University Health Alliance Commercial |
$249.27
|
|
|
11623 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 2.1-3.0cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11623
|
| Hospital Charge Code |
8037140
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$162.76 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$215.79
|
| Rate for Payer: AlohaCare Medicare |
$181.09
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$199.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$215.79
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$356.45
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.09
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$215.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$162.76
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$199.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$199.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$199.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$215.79
|
| Rate for Payer: Ohana Health Plan Medicare |
$181.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$215.79
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.09
|
| Rate for Payer: University Health Alliance Commercial |
$245.37
|
|
|
11640 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; < 0.5 cm
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
8037143
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$114.90 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$133.33
|
| Rate for Payer: AlohaCare Medicare |
$114.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$126.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$133.33
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$218.13
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$114.90
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$133.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$131.30
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$126.39
|
| Rate for Payer: Kaiser Permanente Medicaid |
$126.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$126.39
|
| Rate for Payer: Ohana Health Plan Medicaid |
$133.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$114.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$133.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$114.90
|
| Rate for Payer: University Health Alliance Commercial |
$150.15
|
|
|
11640 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
8016447
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$114.90 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$133.33
|
| Rate for Payer: AlohaCare Medicare |
$114.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$126.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$133.33
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$218.13
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$114.90
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$133.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$131.30
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$126.39
|
| Rate for Payer: Kaiser Permanente Medicaid |
$126.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$126.39
|
| Rate for Payer: Ohana Health Plan Medicaid |
$133.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$114.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$133.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$114.90
|
| Rate for Payer: University Health Alliance Commercial |
$150.15
|
|
|
1169771 US Upper Ext Venous Duplex Right
|
Facility
|
IP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279259
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$731.85 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
|
|
1169771 US Upper Ext Venous Duplex Right
|
Facility
|
OP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279259
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$93.10 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: AlohaCare Medicaid |
$430.50
|
| Rate for Payer: AlohaCare Medicare |
$430.50
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Devoted Health Medicare |
$473.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$93.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$430.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$109.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$817.95
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Humana Medicare |
$430.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$439.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$430.50
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$430.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$93.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$430.50
|
| Rate for Payer: University Health Alliance Commercial |
$627.58
|
|
|
1169773 US Upper Ext Venous Duplex Left
|
Facility
|
OP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279258
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$93.10 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: AlohaCare Medicaid |
$430.50
|
| Rate for Payer: AlohaCare Medicare |
$430.50
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Devoted Health Medicare |
$473.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$93.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$430.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$109.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$817.95
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Humana Medicare |
$430.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$439.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$430.50
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$430.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$93.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$430.50
|
| Rate for Payer: University Health Alliance Commercial |
$627.58
|
|
|
1169773 US Upper Ext Venous Duplex Left
|
Facility
|
IP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279258
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$731.85 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
|
|
1169861 US OB Transvaginal
|
Facility
|
OP
|
$858.00
|
|
|
Service Code
|
HCPCS 76817
|
| Hospital Charge Code |
9279260
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$46.06 |
| Max. Negotiated Rate |
$832.26 |
| Rate for Payer: AlohaCare Medicaid |
$429.00
|
| Rate for Payer: AlohaCare Medicare |
$429.00
|
| Rate for Payer: Cash Price |
$557.70
|
| Rate for Payer: Cash Price |
$557.70
|
| Rate for Payer: Devoted Health Medicare |
$471.90
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$46.06
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$429.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$53.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$106.81
|
| Rate for Payer: Health Management Network Commercial |
$729.30
|
| Rate for Payer: Humana Medicare |
$429.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$772.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$437.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$429.00
|
| Rate for Payer: MDX Hawaii PPO |
$832.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$429.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$429.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$46.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$429.00
|
| Rate for Payer: University Health Alliance Commercial |
$193.75
|
|
|
1169861 US OB Transvaginal
|
Facility
|
IP
|
$858.00
|
|
|
Service Code
|
HCPCS 76817
|
| Hospital Charge Code |
9279260
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$729.30 |
| Max. Negotiated Rate |
$832.26 |
| Rate for Payer: Cash Price |
$557.70
|
| Rate for Payer: Health Management Network Commercial |
$729.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$772.20
|
| Rate for Payer: MDX Hawaii PPO |
$832.26
|
|
|
1169903 US Lower Ext Venous Duplex Right
|
Facility
|
OP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279256
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$93.10 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: AlohaCare Medicaid |
$430.50
|
| Rate for Payer: AlohaCare Medicare |
$430.50
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Devoted Health Medicare |
$473.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$93.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$430.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$109.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$817.95
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Humana Medicare |
$430.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$439.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$430.50
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$430.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$93.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$430.50
|
| Rate for Payer: University Health Alliance Commercial |
$627.58
|
|
|
1169903 US Lower Ext Venous Duplex Right
|
Facility
|
IP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279256
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$731.85 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
|
|
1169905 US Lower Ext Venous Duplex Left
|
Facility
|
IP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279255
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$731.85 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
|
|
1169905 US Lower Ext Venous Duplex Left
|
Facility
|
OP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279255
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$93.10 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: AlohaCare Medicaid |
$430.50
|
| Rate for Payer: AlohaCare Medicare |
$430.50
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Devoted Health Medicare |
$473.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$93.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$430.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$109.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$817.95
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Humana Medicare |
$430.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$439.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$430.50
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$430.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$93.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$430.50
|
| Rate for Payer: University Health Alliance Commercial |
$627.58
|
|
|
11719-Trimming Nails Nondystrophic
|
Facility
|
OP
|
$353.00
|
|
|
Service Code
|
HCPCS 11719
|
| Hospital Charge Code |
8080196
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.50 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$525.09
|
| Rate for Payer: AlohaCare Medicare |
$176.50
|
| Rate for Payer: Cash Price |
$229.45
|
| Rate for Payer: Cash Price |
$229.45
|
| Rate for Payer: Cash Price |
$229.45
|
| Rate for Payer: Devoted Health Medicare |
$194.15
|
| 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 |
$176.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$520.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$335.35
|
| Rate for Payer: Health Management Network Commercial |
$300.05
|
| Rate for Payer: Humana Medicare |
$176.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$317.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$176.50
|
| Rate for Payer: MDX Hawaii PPO |
$342.41
|
| Rate for Payer: Ohana Health Plan Medicaid |
$176.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$176.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$176.50
|
| Rate for Payer: University Health Alliance Commercial |
$257.30
|
|
|
11719-Trimming Nails Nondystrophic
|
Facility
|
IP
|
$353.00
|
|
|
Service Code
|
HCPCS 11719
|
| Hospital Charge Code |
8080196
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$300.05 |
| Max. Negotiated Rate |
$342.41 |
| Rate for Payer: Cash Price |
$229.45
|
| Rate for Payer: Health Management Network Commercial |
$300.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$317.70
|
| Rate for Payer: MDX Hawaii PPO |
$342.41
|
|
|
11719 Trimming of nondystrophic nails, any number
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 11719
|
| Hospital Charge Code |
8037149
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: AlohaCare Medicaid |
$7.38
|
| Rate for Payer: AlohaCare Medicare |
$6.63
|
| Rate for Payer: Cash Price |
$53.30
|
| Rate for Payer: Cash Price |
$53.30
|
| Rate for Payer: Devoted Health Medicare |
$7.29
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$7.38
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$12.58
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$6.63
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$7.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$12.48
|
| Rate for Payer: Health Management Network Commercial |
$69.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$7.29
|
| Rate for Payer: Kaiser Permanente Medicaid |
$7.29
|
| Rate for Payer: Kaiser Permanente Medicare |
$7.29
|
| Rate for Payer: Ohana Health Plan Medicaid |
$7.38
|
| Rate for Payer: Ohana Health Plan Medicare |
$6.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.38
|
| Rate for Payer: UnitedHealthcare Medicare |
$6.63
|
| Rate for Payer: University Health Alliance Commercial |
$7.96
|
|
|
11720 Debridement of nail(s) by any method(s) 1 to 5
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 11720
|
| Hospital Charge Code |
8037150
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$12.45 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: AlohaCare Medicaid |
$13.89
|
| Rate for Payer: AlohaCare Medicare |
$12.45
|
| Rate for Payer: Cash Price |
$61.75
|
| Rate for Payer: Cash Price |
$61.75
|
| Rate for Payer: Devoted Health Medicare |
$13.70
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$13.89
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$24.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$12.45
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$13.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$25.74
|
| Rate for Payer: Health Management Network Commercial |
$80.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$13.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$13.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$13.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$13.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$12.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$12.45
|
| Rate for Payer: University Health Alliance Commercial |
$15.40
|
|
|
11720-Nails 1 to 5
|
Facility
|
IP
|
$404.00
|
|
|
Service Code
|
HCPCS 11720
|
| Hospital Charge Code |
8080157
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$343.40 |
| Max. Negotiated Rate |
$391.88 |
| Rate for Payer: Cash Price |
$262.60
|
| Rate for Payer: Health Management Network Commercial |
$343.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$363.60
|
| Rate for Payer: MDX Hawaii PPO |
$391.88
|
|
|
11720-Nails 1 to 5
|
Facility
|
OP
|
$404.00
|
|
|
Service Code
|
HCPCS 11720
|
| Hospital Charge Code |
8080157
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$202.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$525.09
|
| Rate for Payer: AlohaCare Medicare |
$202.00
|
| Rate for Payer: Cash Price |
$262.60
|
| Rate for Payer: Cash Price |
$262.60
|
| Rate for Payer: Cash Price |
$262.60
|
| Rate for Payer: Devoted Health Medicare |
$222.20
|
| 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 |
$202.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$520.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$383.80
|
| Rate for Payer: Health Management Network Commercial |
$343.40
|
| Rate for Payer: Humana Medicare |
$202.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$363.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$202.00
|
| Rate for Payer: MDX Hawaii PPO |
$391.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$202.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$202.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$202.00
|
| Rate for Payer: University Health Alliance Commercial |
$294.48
|
|
|
11721 Debridement of nail(s) by any method(s); 6 or more
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 11721
|
| Hospital Charge Code |
8037151
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$20.95 |
| Max. Negotiated Rate |
$108.80 |
| Rate for Payer: AlohaCare Medicaid |
$23.31
|
| Rate for Payer: AlohaCare Medicare |
$20.95
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Devoted Health Medicare |
$23.05
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$23.31
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$40.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$20.95
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$23.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$42.12
|
| Rate for Payer: Health Management Network Commercial |
$108.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$23.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$23.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$23.05
|
| Rate for Payer: Ohana Health Plan Medicaid |
$23.31
|
| Rate for Payer: Ohana Health Plan Medicare |
$20.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$23.31
|
| Rate for Payer: UnitedHealthcare Medicare |
$20.95
|
| Rate for Payer: University Health Alliance Commercial |
$25.55
|
|
