|
zinc sulfate 220 mg capsule [HHSC]
|
Facility
|
IP
|
$3.00
|
|
|
Service Code
|
NDC 20555004000
|
| Hospital Charge Code |
2500867
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$2.91 |
| Rate for Payer: Cash Price |
$1.95
|
| Rate for Payer: Health Management Network Commercial |
$2.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.70
|
| Rate for Payer: MDX Hawaii PPO |
$2.91
|
|
|
zinc sulfate 220 mg capsule [HHSC]
|
Facility
|
OP
|
$3.00
|
|
|
Service Code
|
NDC 68585000801
|
| Hospital Charge Code |
2500867
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$2.91 |
| Rate for Payer: AlohaCare Medicaid |
$1.50
|
| Rate for Payer: AlohaCare Medicare |
$1.50
|
| Rate for Payer: Cash Price |
$1.95
|
| Rate for Payer: Devoted Health Medicare |
$1.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2.85
|
| Rate for Payer: Health Management Network Commercial |
$2.55
|
| Rate for Payer: Humana Medicare |
$1.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.50
|
| Rate for Payer: MDX Hawaii PPO |
$2.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.50
|
| Rate for Payer: University Health Alliance Commercial |
$2.19
|
|
|
ziprasidone 20 mg vial [HHSC]
|
Facility
|
OP
|
$182.62
|
|
|
Service Code
|
HCPCS J3486
|
| Hospital Charge Code |
2500868
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$177.14 |
| Rate for Payer: AlohaCare Medicaid |
$91.31
|
| Rate for Payer: AlohaCare Medicaid |
$113.08
|
| Rate for Payer: AlohaCare Medicaid |
$59.01
|
| Rate for Payer: AlohaCare Medicare |
$113.08
|
| Rate for Payer: AlohaCare Medicare |
$59.01
|
| Rate for Payer: AlohaCare Medicare |
$91.31
|
| Rate for Payer: Cash Price |
$76.71
|
| Rate for Payer: Cash Price |
$147.01
|
| Rate for Payer: Cash Price |
$76.71
|
| Rate for Payer: Cash Price |
$147.01
|
| Rate for Payer: Cash Price |
$118.70
|
| Rate for Payer: Cash Price |
$118.70
|
| Rate for Payer: Devoted Health Medicare |
$124.39
|
| Rate for Payer: Devoted Health Medicare |
$100.44
|
| Rate for Payer: Devoted Health Medicare |
$64.91
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$3.14
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$3.14
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$3.14
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$91.31
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$113.08
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$59.01
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$3.14
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$3.14
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$3.14
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$214.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$112.12
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$173.49
|
| Rate for Payer: Health Management Network Commercial |
$100.32
|
| Rate for Payer: Health Management Network Commercial |
$155.23
|
| Rate for Payer: Health Management Network Commercial |
$192.24
|
| Rate for Payer: Humana Medicare |
$91.31
|
| Rate for Payer: Humana Medicare |
$59.01
|
| Rate for Payer: Humana Medicare |
$113.08
|
| Rate for Payer: Kaiser Permanente Commercial |
$164.36
|
| Rate for Payer: Kaiser Permanente Commercial |
$203.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$106.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$93.14
|
| Rate for Payer: Kaiser Permanente Medicaid |
$115.35
|
| Rate for Payer: Kaiser Permanente Medicaid |
$60.19
|
| Rate for Payer: Kaiser Permanente Medicare |
$91.31
|
| Rate for Payer: Kaiser Permanente Medicare |
$59.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$113.08
|
| Rate for Payer: MDX Hawaii PPO |
$219.38
|
| Rate for Payer: MDX Hawaii PPO |
$114.48
|
| Rate for Payer: MDX Hawaii PPO |
$177.14
|
| Rate for Payer: Ohana Health Plan Medicaid |
$91.31
|
| Rate for Payer: Ohana Health Plan Medicaid |
$113.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$59.01
|
| Rate for Payer: Ohana Health Plan Medicare |
$113.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$59.01
|
| Rate for Payer: Ohana Health Plan Medicare |
$91.31
|
| Rate for Payer: UnitedHealthcare Medicaid |
$70.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$109.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$135.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$59.01
|
| Rate for Payer: UnitedHealthcare Medicare |
$113.08
|
| Rate for Payer: UnitedHealthcare Medicare |
$91.31
|
| Rate for Payer: University Health Alliance Commercial |
$164.86
|
| Rate for Payer: University Health Alliance Commercial |
$133.11
|
| Rate for Payer: University Health Alliance Commercial |
$86.02
|
|
|
ziprasidone 20 mg vial [HHSC]
|
Facility
|
IP
|
$182.62
|
|
|
Service Code
|
HCPCS J3486
|
| Hospital Charge Code |
2500868
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$155.23 |
| Max. Negotiated Rate |
$177.14 |
| Rate for Payer: Cash Price |
$118.70
|
| Rate for Payer: Cash Price |
$76.71
|
| Rate for Payer: Cash Price |
$147.01
|
| Rate for Payer: Health Management Network Commercial |
$192.24
|
| Rate for Payer: Health Management Network Commercial |
$100.32
|
| Rate for Payer: Health Management Network Commercial |
$155.23
|
| Rate for Payer: Kaiser Permanente Commercial |
$203.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$106.22
|
| Rate for Payer: Kaiser Permanente Commercial |
$164.36
|
| Rate for Payer: MDX Hawaii PPO |
$177.14
|
| Rate for Payer: MDX Hawaii PPO |
$114.48
|
| Rate for Payer: MDX Hawaii PPO |
$219.38
|
|
|
zoledronic acid 4 mg/5 ml vial [HHSC]
|
Facility
|
IP
|
$413.63
|
|
|
Service Code
|
HCPCS J3489
|
| Hospital Charge Code |
2500870
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$351.59 |
| Max. Negotiated Rate |
$401.22 |
| Rate for Payer: Cash Price |
$268.86
|
| Rate for Payer: Cash Price |
$187.43
|
| Rate for Payer: Cash Price |
$450.74
|
| Rate for Payer: Cash Price |
$189.69
|
| Rate for Payer: Cash Price |
$184.71
|
| Rate for Payer: Health Management Network Commercial |
$248.06
|
| Rate for Payer: Health Management Network Commercial |
$351.59
|
| Rate for Payer: Health Management Network Commercial |
$589.42
|
| Rate for Payer: Health Management Network Commercial |
$245.10
|
| Rate for Payer: Health Management Network Commercial |
$241.54
|
| Rate for Payer: Kaiser Permanente Commercial |
$255.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$259.51
|
| Rate for Payer: Kaiser Permanente Commercial |
$262.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$372.27
|
| Rate for Payer: Kaiser Permanente Commercial |
$624.10
|
| Rate for Payer: MDX Hawaii PPO |
$401.22
|
| Rate for Payer: MDX Hawaii PPO |
$279.70
|
| Rate for Payer: MDX Hawaii PPO |
$275.64
|
| Rate for Payer: MDX Hawaii PPO |
$283.08
|
| Rate for Payer: MDX Hawaii PPO |
$672.64
|
|
|
zoledronic acid 4 mg/5 ml vial [HHSC]
|
Facility
|
OP
|
$291.83
|
|
|
Service Code
|
HCPCS J3489
|
| Hospital Charge Code |
2500870
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$283.08 |
| Rate for Payer: AlohaCare Medicaid |
$145.91
|
| Rate for Payer: AlohaCare Medicaid |
$144.18
|
| Rate for Payer: AlohaCare Medicaid |
$206.81
|
| Rate for Payer: AlohaCare Medicaid |
$346.72
|
| Rate for Payer: AlohaCare Medicaid |
$142.09
|
| Rate for Payer: AlohaCare Medicare |
$145.91
|
| Rate for Payer: AlohaCare Medicare |
$206.81
|
| Rate for Payer: AlohaCare Medicare |
$346.72
|
| Rate for Payer: AlohaCare Medicare |
$142.09
|
| Rate for Payer: AlohaCare Medicare |
$144.18
|
| Rate for Payer: Cash Price |
$187.43
|
| Rate for Payer: Cash Price |
$268.86
|
| Rate for Payer: Cash Price |
$184.71
|
| Rate for Payer: Cash Price |
$184.71
|
| Rate for Payer: Cash Price |
$187.43
|
| Rate for Payer: Cash Price |
$189.69
|
| Rate for Payer: Cash Price |
$450.74
|
| Rate for Payer: Cash Price |
$450.74
|
| Rate for Payer: Cash Price |
$268.86
|
| Rate for Payer: Cash Price |
$189.69
|
| Rate for Payer: Devoted Health Medicare |
$160.51
|
| Rate for Payer: Devoted Health Medicare |
$156.29
|
| Rate for Payer: Devoted Health Medicare |
$227.50
|
| Rate for Payer: Devoted Health Medicare |
$381.39
|
| Rate for Payer: Devoted Health Medicare |
$158.59
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$5.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$5.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$5.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$5.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$5.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$206.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$144.18
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$142.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$145.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$346.72
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$5.20
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$5.20
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$5.20
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$5.20
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$5.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$277.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$269.96
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$273.93
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$392.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$658.77
|
| Rate for Payer: Health Management Network Commercial |
$248.06
|
| Rate for Payer: Health Management Network Commercial |
$245.10
|
| Rate for Payer: Health Management Network Commercial |
$241.54
|
| Rate for Payer: Health Management Network Commercial |
$589.42
|
| Rate for Payer: Health Management Network Commercial |
$351.59
|
| Rate for Payer: Humana Medicare |
$145.91
|
| Rate for Payer: Humana Medicare |
$142.09
|
| Rate for Payer: Humana Medicare |
$144.18
|
| Rate for Payer: Humana Medicare |
$206.81
|
| Rate for Payer: Humana Medicare |
$346.72
|
| Rate for Payer: Kaiser Permanente Commercial |
$372.27
|
| Rate for Payer: Kaiser Permanente Commercial |
$624.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$262.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$255.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$259.51
|
| Rate for Payer: Kaiser Permanente Medicaid |
$148.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$210.95
|
| Rate for Payer: Kaiser Permanente Medicaid |
$144.93
|
| Rate for Payer: Kaiser Permanente Medicaid |
$147.06
|
| Rate for Payer: Kaiser Permanente Medicaid |
$353.65
|
| Rate for Payer: Kaiser Permanente Medicare |
$144.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$142.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$206.81
|
| Rate for Payer: Kaiser Permanente Medicare |
$145.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$346.72
|
| Rate for Payer: MDX Hawaii PPO |
$283.08
|
| Rate for Payer: MDX Hawaii PPO |
$401.22
|
| Rate for Payer: MDX Hawaii PPO |
$279.70
|
| Rate for Payer: MDX Hawaii PPO |
$275.64
|
| Rate for Payer: MDX Hawaii PPO |
$672.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$142.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$144.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$206.81
|
| Rate for Payer: Ohana Health Plan Medicaid |
$346.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$145.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$346.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$206.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$145.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$144.18
|
| Rate for Payer: Ohana Health Plan Medicare |
$142.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$170.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$175.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$416.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$248.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$173.01
|
| Rate for Payer: UnitedHealthcare Medicare |
$206.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$142.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$144.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$346.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$145.91
|
| Rate for Payer: University Health Alliance Commercial |
$207.13
|
| Rate for Payer: University Health Alliance Commercial |
$212.71
|
| Rate for Payer: University Health Alliance Commercial |
$301.49
|
| Rate for Payer: University Health Alliance Commercial |
$210.18
|
| Rate for Payer: University Health Alliance Commercial |
$505.45
|
|
|
zoledronic acid 5 mg/100 mL premix [HHSC]
|
Facility
|
OP
|
$1,119.80
|
|
|
Service Code
|
HCPCS J3489
|
| Hospital Charge Code |
2501147
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$1,086.21 |
| Rate for Payer: AlohaCare Medicaid |
$559.90
|
| Rate for Payer: AlohaCare Medicare |
$559.90
|
| Rate for Payer: Cash Price |
$727.87
|
| Rate for Payer: Cash Price |
$727.87
|
| Rate for Payer: Devoted Health Medicare |
$615.89
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$5.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$559.90
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$5.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,063.81
|
| Rate for Payer: Health Management Network Commercial |
$951.83
|
| Rate for Payer: Humana Medicare |
$559.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,007.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$571.10
|
| Rate for Payer: Kaiser Permanente Medicare |
$559.90
|
| Rate for Payer: MDX Hawaii PPO |
$1,086.21
|
| Rate for Payer: Ohana Health Plan Medicaid |
$559.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$559.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$671.88
|
| Rate for Payer: UnitedHealthcare Medicare |
$559.90
|
| Rate for Payer: University Health Alliance Commercial |
$816.22
|
|
|
zoledronic acid 5 mg/100 mL premix [HHSC]
|
Facility
|
IP
|
$1,119.80
|
|
|
Service Code
|
HCPCS J3489
|
| Hospital Charge Code |
2501147
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$951.83 |
| Max. Negotiated Rate |
$1,086.21 |
| Rate for Payer: Cash Price |
$727.87
|
| Rate for Payer: Health Management Network Commercial |
$951.83
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,007.82
|
| Rate for Payer: MDX Hawaii PPO |
$1,086.21
|
|
|
zolpidem 5 mg tablet [HHSC]
|
Facility
|
OP
|
$25.68
|
|
|
Service Code
|
NDC 51079072420
|
| Hospital Charge Code |
2500871
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.84 |
| Max. Negotiated Rate |
$24.91 |
| Rate for Payer: AlohaCare Medicaid |
$12.84
|
| Rate for Payer: AlohaCare Medicare |
$12.84
|
| Rate for Payer: Cash Price |
$16.69
|
| Rate for Payer: Devoted Health Medicare |
$14.12
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$12.84
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$24.40
|
| Rate for Payer: Health Management Network Commercial |
$21.83
|
| Rate for Payer: Humana Medicare |
$12.84
|
| Rate for Payer: Kaiser Permanente Commercial |
$23.11
|
| Rate for Payer: Kaiser Permanente Medicaid |
$13.10
|
| Rate for Payer: Kaiser Permanente Medicare |
$12.84
|
| Rate for Payer: MDX Hawaii PPO |
$24.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$12.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$12.84
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.41
|
| Rate for Payer: UnitedHealthcare Medicare |
$12.84
|
| Rate for Payer: University Health Alliance Commercial |
$18.72
|
|
|
zolpidem 5 mg tablet [HHSC]
|
Facility
|
IP
|
$3.00
|
|
|
Service Code
|
NDC 00904608261
|
| Hospital Charge Code |
2500871
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$2.91 |
| Rate for Payer: Cash Price |
$1.95
|
| Rate for Payer: Health Management Network Commercial |
$2.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.70
|
| Rate for Payer: MDX Hawaii PPO |
$2.91
|
|
|
zolpidem 5 mg tablet [HHSC]
|
Facility
|
IP
|
$25.68
|
|
|
Service Code
|
NDC 51079072420
|
| Hospital Charge Code |
2500871
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.83 |
| Max. Negotiated Rate |
$24.91 |
| Rate for Payer: Cash Price |
$16.69
|
| Rate for Payer: Health Management Network Commercial |
$21.83
|
| Rate for Payer: Kaiser Permanente Commercial |
$23.11
|
| Rate for Payer: MDX Hawaii PPO |
$24.91
|
|
|
zolpidem 5 mg tablet [HHSC]
|
Facility
|
OP
|
$3.00
|
|
|
Service Code
|
NDC 00904608261
|
| Hospital Charge Code |
2500871
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$2.91 |
| Rate for Payer: AlohaCare Medicaid |
$1.50
|
| Rate for Payer: AlohaCare Medicare |
$1.50
|
| Rate for Payer: Cash Price |
$1.95
|
| Rate for Payer: Devoted Health Medicare |
$1.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2.85
|
| Rate for Payer: Health Management Network Commercial |
$2.55
|
| Rate for Payer: Humana Medicare |
$1.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.50
|
| Rate for Payer: MDX Hawaii PPO |
$2.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1.80
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.50
|
| Rate for Payer: University Health Alliance Commercial |
$2.19
|
|
|
zzHHSC US Biopsy Thyroid FNA
|
Facility
|
IP
|
$1,156.00
|
|
|
Service Code
|
HCPCS 10005
|
| Hospital Charge Code |
8223490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$982.60 |
| Max. Negotiated Rate |
$1,121.32 |
| Rate for Payer: Cash Price |
$751.40
|
| Rate for Payer: Health Management Network Commercial |
$982.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,040.40
|
| Rate for Payer: MDX Hawaii PPO |
$1,121.32
|
|
|
zzHHSC US Biopsy Thyroid FNA
|
Facility
|
OP
|
$1,156.00
|
|
|
Service Code
|
HCPCS 10005
|
| Hospital Charge Code |
8223490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$2,837.00 |
| Rate for Payer: AlohaCare Medicaid |
$578.00
|
| Rate for Payer: AlohaCare Medicare |
$578.00
|
| Rate for Payer: Cash Price |
$751.40
|
| Rate for Payer: Cash Price |
$751.40
|
| Rate for Payer: Devoted Health Medicare |
$635.80
|
| 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 |
$578.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$407.95
|
| Rate for Payer: Health Management Network Commercial |
$982.60
|
| Rate for Payer: Humana Medicare |
$578.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,040.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,837.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$578.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,121.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$578.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$578.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$578.00
|
| Rate for Payer: University Health Alliance Commercial |
$842.61
|
|
