|
POVIDONE-IODINE 10 % TOP SOLN
|
Facility
|
IP
|
$11.73
|
|
|
Service Code
|
HCPCS A9270
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.97 |
| Max. Negotiated Rate |
$11.38 |
| Rate for Payer: Cash Price |
$7.62
|
| Rate for Payer: Health Management Network Commercial |
$9.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$10.56
|
| Rate for Payer: MDX Hawaii PPO |
$11.38
|
|
|
PRAMIPEXOLE 0.25 MG PO TABLET
|
Facility
|
OP
|
$1.99
|
|
|
Service Code
|
HCPCS A9270
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$1.97 |
| Rate for Payer: AlohaCare Medicaid |
$1.00
|
| Rate for Payer: AlohaCare Medicare |
$1.79
|
| Rate for Payer: Cash Price |
$1.29
|
| Rate for Payer: Devoted Health Medicare |
$1.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1.89
|
| Rate for Payer: Health Management Network Commercial |
$1.69
|
| Rate for Payer: Humana Medicare |
$1.79
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.79
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.79
|
| Rate for Payer: MDX Hawaii PPO |
$1.93
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.79
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.79
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.79
|
| Rate for Payer: University Health Alliance Commercial |
$1.45
|
|
|
PRAMIPEXOLE 0.25 MG PO TABLET
|
Facility
|
IP
|
$1.99
|
|
|
Service Code
|
HCPCS A9270
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$1.93 |
| Rate for Payer: Cash Price |
$1.29
|
| Rate for Payer: Health Management Network Commercial |
$1.69
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.79
|
| Rate for Payer: MDX Hawaii PPO |
$1.93
|
|
|
PRAVASTATIN 40 MG PO TABLET
|
Facility
|
OP
|
$23.71
|
|
|
Service Code
|
HCPCS A9270
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.86 |
| Max. Negotiated Rate |
$23.47 |
| Rate for Payer: AlohaCare Medicaid |
$11.86
|
| Rate for Payer: AlohaCare Medicare |
$21.34
|
| Rate for Payer: Cash Price |
$15.41
|
| Rate for Payer: Devoted Health Medicare |
$23.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$21.34
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$22.52
|
| Rate for Payer: Health Management Network Commercial |
$20.15
|
| Rate for Payer: Humana Medicare |
$21.34
|
| Rate for Payer: Kaiser Permanente Commercial |
$21.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$12.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$21.34
|
| Rate for Payer: MDX Hawaii PPO |
$23.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$21.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$21.34
|
| Rate for Payer: UnitedHealthcare Medicare |
$21.34
|
| Rate for Payer: University Health Alliance Commercial |
$17.28
|
|
|
PRAVASTATIN 40 MG PO TABLET
|
Facility
|
IP
|
$23.71
|
|
|
Service Code
|
HCPCS A9270
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.15 |
| Max. Negotiated Rate |
$23.00 |
| Rate for Payer: Cash Price |
$15.41
|
| Rate for Payer: Health Management Network Commercial |
$20.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$21.34
|
| Rate for Payer: MDX Hawaii PPO |
$23.00
|
|
|
PRAZIQUANTEL 600 MG PO TABLET
|
Facility
|
OP
|
$409.53
|
|
|
Service Code
|
HCPCS A9270
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$204.76 |
| Max. Negotiated Rate |
$405.43 |
| Rate for Payer: AlohaCare Medicaid |
$204.76
|
| Rate for Payer: AlohaCare Medicare |
$368.58
|
| Rate for Payer: Cash Price |
$266.19
|
| Rate for Payer: Devoted Health Medicare |
$405.43
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$368.58
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$389.05
|
| Rate for Payer: Health Management Network Commercial |
$348.10
|
| Rate for Payer: Humana Medicare |
$368.58
|
| Rate for Payer: Kaiser Permanente Commercial |
$368.58
|
| Rate for Payer: Kaiser Permanente Medicaid |
$208.86
|
| Rate for Payer: Kaiser Permanente Medicare |
$368.58
|
| Rate for Payer: MDX Hawaii PPO |
$397.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$368.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$368.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$368.58
|
| Rate for Payer: University Health Alliance Commercial |
$298.51
|
|
|
PRAZIQUANTEL 600 MG PO TABLET
|
Facility
|
IP
|
$409.53
|
|
|
Service Code
|
HCPCS A9270
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$348.10 |
| Max. Negotiated Rate |
$397.24 |
| Rate for Payer: Cash Price |
$266.19
|
| Rate for Payer: Health Management Network Commercial |
$348.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$368.58
|
| Rate for Payer: MDX Hawaii PPO |
$397.24
|
|
|
PRAZOSIN 1 MG PO CAP
|
Facility
|
IP
|
$10.01
|
|
|
Service Code
|
HCPCS A9270
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$9.71 |
| Rate for Payer: Cash Price |
$6.51
|
| Rate for Payer: Health Management Network Commercial |
$8.51
|
| Rate for Payer: Kaiser Permanente Commercial |
$9.01
|
| Rate for Payer: MDX Hawaii PPO |
$9.71
|
|
|
PRAZOSIN 1 MG PO CAP
|
Facility
|
OP
|
$10.01
|
|
|
Service Code
|
HCPCS A9270
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$9.91 |
| Rate for Payer: AlohaCare Medicaid |
$5.00
|
| Rate for Payer: AlohaCare Medicare |
$9.01
|
| Rate for Payer: Cash Price |
$6.51
|
| Rate for Payer: Devoted Health Medicare |
$9.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$9.51
|
| Rate for Payer: Health Management Network Commercial |
$8.51
|
| Rate for Payer: Humana Medicare |
$9.01
|
| Rate for Payer: Kaiser Permanente Commercial |
$9.01
|
| Rate for Payer: Kaiser Permanente Medicaid |
$5.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$9.01
|
| Rate for Payer: MDX Hawaii PPO |
$9.71
|
| Rate for Payer: Ohana Health Plan Medicaid |
$9.01
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.01
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.01
|
| Rate for Payer: University Health Alliance Commercial |
$7.30
|
|
|
PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC
|
Facility
|
IP
|
$20,407.42
|
|
|
Service Code
|
MSDRG 067
|
| Min. Negotiated Rate |
$20,407.42 |
| Max. Negotiated Rate |
$20,407.42 |
| Rate for Payer: Hawaii Medical Service Association Commercial |
$20,407.42
|
|
|
PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC
|
Facility
|
IP
|
$20,407.42
|
|
|
Service Code
|
MSDRG 068
|
| Min. Negotiated Rate |
$20,407.42 |
| Max. Negotiated Rate |
$20,407.42 |
| Rate for Payer: Hawaii Medical Service Association Commercial |
$20,407.42
|
|
|
PREDNISOLONE ACETATE 1 % OPHT DRPS
|
Facility
|
IP
|
$290.79
|
|
|
Service Code
|
HCPCS A9270
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$247.17 |
| Max. Negotiated Rate |
$282.07 |
| Rate for Payer: Cash Price |
$189.01
|
| Rate for Payer: Cash Price |
$183.35
|
| Rate for Payer: Health Management Network Commercial |
$239.77
|
| Rate for Payer: Health Management Network Commercial |
$247.17
|
| Rate for Payer: Kaiser Permanente Commercial |
$253.87
|
| Rate for Payer: Kaiser Permanente Commercial |
$261.71
|
| Rate for Payer: MDX Hawaii PPO |
$282.07
|
| Rate for Payer: MDX Hawaii PPO |
$273.62
|
|
|
PREDNISOLONE ACETATE 1 % OPHT DRPS
|
Facility
|
OP
|
$290.79
|
|
|
Service Code
|
HCPCS A9270
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$145.40 |
| Max. Negotiated Rate |
$287.88 |
| Rate for Payer: AlohaCare Medicaid |
$145.40
|
| Rate for Payer: AlohaCare Medicaid |
$141.04
|
| Rate for Payer: AlohaCare Medicare |
$253.87
|
| Rate for Payer: AlohaCare Medicare |
$261.71
|
| Rate for Payer: Cash Price |
$183.35
|
| Rate for Payer: Cash Price |
$189.01
|
| Rate for Payer: Devoted Health Medicare |
$279.26
|
| Rate for Payer: Devoted Health Medicare |
$287.88
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$261.71
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$253.87
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$276.25
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$267.98
|
| Rate for Payer: Health Management Network Commercial |
$239.77
|
| Rate for Payer: Health Management Network Commercial |
$247.17
|
| Rate for Payer: Humana Medicare |
$253.87
|
| Rate for Payer: Humana Medicare |
$261.71
|
| Rate for Payer: Kaiser Permanente Commercial |
$253.87
|
| Rate for Payer: Kaiser Permanente Commercial |
$261.71
|
| Rate for Payer: Kaiser Permanente Medicaid |
$143.86
|
| Rate for Payer: Kaiser Permanente Medicaid |
$148.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$261.71
|
| Rate for Payer: Kaiser Permanente Medicare |
$253.87
|
| Rate for Payer: MDX Hawaii PPO |
$282.07
|
| Rate for Payer: MDX Hawaii PPO |
$273.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$253.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$261.71
|
| Rate for Payer: Ohana Health Plan Medicare |
$253.87
|
| Rate for Payer: Ohana Health Plan Medicare |
$261.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$253.87
|
| Rate for Payer: UnitedHealthcare Medicare |
$261.71
|
| Rate for Payer: University Health Alliance Commercial |
$205.61
|
| Rate for Payer: University Health Alliance Commercial |
$211.96
|
|
|
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) PO SOLN
|
Facility
|
IP
|
$39.15
|
|
|
Service Code
|
HCPCS J7510
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$33.28 |
| Max. Negotiated Rate |
$37.98 |
| Rate for Payer: Cash Price |
$25.45
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Health Management Network Commercial |
$33.28
|
| Rate for Payer: Health Management Network Commercial |
$35.56
|
| Rate for Payer: Kaiser Permanente Commercial |
$35.23
|
| Rate for Payer: Kaiser Permanente Commercial |
$37.66
|
| Rate for Payer: MDX Hawaii PPO |
$40.58
|
| Rate for Payer: MDX Hawaii PPO |
$37.98
|
|
|
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) PO SOLN
|
Facility
|
OP
|
$39.15
|
|
|
Service Code
|
HCPCS J7510
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.27 |
| Max. Negotiated Rate |
$38.76 |
| Rate for Payer: AlohaCare Medicaid |
$19.57
|
| Rate for Payer: AlohaCare Medicaid |
$20.92
|
| Rate for Payer: AlohaCare Medicare |
$37.66
|
| Rate for Payer: AlohaCare Medicare |
$35.23
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$25.45
|
| Rate for Payer: Cash Price |
$25.45
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Devoted Health Medicare |
$38.76
|
| Rate for Payer: Devoted Health Medicare |
$41.42
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.27
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$37.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$35.23
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.27
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.27
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$37.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$39.75
|
| Rate for Payer: Health Management Network Commercial |
$35.56
|
| Rate for Payer: Health Management Network Commercial |
$33.28
|
| Rate for Payer: Humana Medicare |
$35.23
|
| Rate for Payer: Humana Medicare |
$37.66
|
| Rate for Payer: Kaiser Permanente Commercial |
$35.23
|
| Rate for Payer: Kaiser Permanente Commercial |
$37.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$21.34
|
| Rate for Payer: Kaiser Permanente Medicaid |
$19.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$35.23
|
| Rate for Payer: Kaiser Permanente Medicare |
$37.66
|
| Rate for Payer: MDX Hawaii PPO |
$37.98
|
| Rate for Payer: MDX Hawaii PPO |
$40.58
|
| Rate for Payer: Ohana Health Plan Medicaid |
$37.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$35.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$35.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$37.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$25.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$23.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$35.23
|
| Rate for Payer: UnitedHealthcare Medicare |
$37.66
|
| Rate for Payer: University Health Alliance Commercial |
$28.54
|
| Rate for Payer: University Health Alliance Commercial |
$30.50
|
|
|
PREDNISONE 10 MG PO TABLET
|
Facility
|
OP
|
$1.20
|
|
|
Service Code
|
HCPCS J7512
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1.19 |
| Rate for Payer: AlohaCare Medicaid |
$0.60
|
| Rate for Payer: AlohaCare Medicare |
$1.08
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Devoted Health Medicare |
$1.19
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.08
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1.14
|
| Rate for Payer: Health Management Network Commercial |
$1.02
|
| Rate for Payer: Humana Medicare |
$1.08
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$0.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.08
|
| Rate for Payer: MDX Hawaii PPO |
$1.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$0.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.08
|
| Rate for Payer: University Health Alliance Commercial |
$0.87
|
|
|
PREDNISONE 10 MG PO TABLET
|
Facility
|
IP
|
$1.20
|
|
|
Service Code
|
HCPCS J7512
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$1.16 |
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Health Management Network Commercial |
$1.02
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.08
|
| Rate for Payer: MDX Hawaii PPO |
$1.16
|
|
|
PREDNISONE 1 MG PO TABLET
|
Facility
|
OP
|
$1.40
|
|
|
Service Code
|
HCPCS J7512
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1.39 |
| Rate for Payer: AlohaCare Medicaid |
$0.70
|
| Rate for Payer: AlohaCare Medicare |
$1.26
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: Devoted Health Medicare |
$1.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.26
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1.33
|
| Rate for Payer: Health Management Network Commercial |
$1.19
|
| Rate for Payer: Humana Medicare |
$1.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$0.71
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.26
|
| Rate for Payer: MDX Hawaii PPO |
$1.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$0.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.26
|
| Rate for Payer: University Health Alliance Commercial |
$1.02
|
|
|
PREDNISONE 1 MG PO TABLET
|
Facility
|
IP
|
$1.40
|
|
|
Service Code
|
HCPCS J7512
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$1.36 |
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: Health Management Network Commercial |
$1.19
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.26
|
| Rate for Payer: MDX Hawaii PPO |
$1.36
|
|
|
PREDNISONE 20 MG PO TABLET
|
Facility
|
IP
|
$1.43
|
|
|
Service Code
|
HCPCS J7512
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.22 |
| Max. Negotiated Rate |
$1.39 |
| Rate for Payer: Cash Price |
$0.93
|
| Rate for Payer: Health Management Network Commercial |
$1.22
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.29
|
| Rate for Payer: MDX Hawaii PPO |
$1.39
|
|
|
PREDNISONE 20 MG PO TABLET
|
Facility
|
OP
|
$1.43
|
|
|
Service Code
|
HCPCS J7512
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1.42 |
| Rate for Payer: AlohaCare Medicaid |
$0.72
|
| Rate for Payer: AlohaCare Medicare |
$1.29
|
| Rate for Payer: Cash Price |
$0.93
|
| Rate for Payer: Cash Price |
$0.93
|
| Rate for Payer: Devoted Health Medicare |
$1.42
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.29
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1.36
|
| Rate for Payer: Health Management Network Commercial |
$1.22
|
| Rate for Payer: Humana Medicare |
$1.29
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.29
|
| Rate for Payer: Kaiser Permanente Medicaid |
$0.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.29
|
| Rate for Payer: MDX Hawaii PPO |
$1.39
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.29
|
| Rate for Payer: UnitedHealthcare Medicaid |
$0.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.29
|
| Rate for Payer: University Health Alliance Commercial |
$1.04
|
|
|
PREDNISONE 50 MG PO TABLET
|
Facility
|
OP
|
$2.97
|
|
|
Service Code
|
HCPCS J7512
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$2.94 |
| Rate for Payer: AlohaCare Medicaid |
$1.49
|
| Rate for Payer: AlohaCare Medicaid |
$1.12
|
| Rate for Payer: AlohaCare Medicare |
$2.02
|
| Rate for Payer: AlohaCare Medicare |
$2.67
|
| Rate for Payer: Cash Price |
$1.46
|
| Rate for Payer: Cash Price |
$1.46
|
| Rate for Payer: Cash Price |
$1.93
|
| Rate for Payer: Cash Price |
$1.93
|
| Rate for Payer: Devoted Health Medicare |
$2.23
|
| Rate for Payer: Devoted Health Medicare |
$2.94
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.01
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2.02
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2.67
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.01
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2.14
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2.82
|
| Rate for Payer: Health Management Network Commercial |
$1.91
|
| Rate for Payer: Health Management Network Commercial |
$2.52
|
| Rate for Payer: Humana Medicare |
$2.02
|
| Rate for Payer: Humana Medicare |
$2.67
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.67
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$2.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$2.67
|
| Rate for Payer: MDX Hawaii PPO |
$2.18
|
| Rate for Payer: MDX Hawaii PPO |
$2.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2.67
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$2.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$2.67
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$2.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$2.02
|
| Rate for Payer: University Health Alliance Commercial |
$1.64
|
| Rate for Payer: University Health Alliance Commercial |
$2.16
|
|
|
PREDNISONE 50 MG PO TABLET
|
Facility
|
IP
|
$2.25
|
|
|
Service Code
|
HCPCS J7512
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.91 |
| Max. Negotiated Rate |
$2.18 |
| Rate for Payer: Cash Price |
$1.46
|
| Rate for Payer: Cash Price |
$1.93
|
| Rate for Payer: Health Management Network Commercial |
$2.52
|
| Rate for Payer: Health Management Network Commercial |
$1.91
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.02
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.67
|
| Rate for Payer: MDX Hawaii PPO |
$2.18
|
| Rate for Payer: MDX Hawaii PPO |
$2.88
|
|
|
PREDNISONE 5 MG PO TABLET
|
Facility
|
OP
|
$1.20
|
|
|
Service Code
|
HCPCS J7512
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1.19 |
| Rate for Payer: AlohaCare Medicaid |
$0.60
|
| Rate for Payer: AlohaCare Medicaid |
$0.69
|
| Rate for Payer: AlohaCare Medicare |
$1.24
|
| Rate for Payer: AlohaCare Medicare |
$1.08
|
| Rate for Payer: Cash Price |
$0.90
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Cash Price |
$0.90
|
| Rate for Payer: Devoted Health Medicare |
$1.19
|
| Rate for Payer: Devoted Health Medicare |
$1.37
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.01
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$0.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.24
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1.08
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.01
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$0.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1.14
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1.31
|
| Rate for Payer: Health Management Network Commercial |
$1.17
|
| Rate for Payer: Health Management Network Commercial |
$1.02
|
| Rate for Payer: Humana Medicare |
$1.08
|
| Rate for Payer: Humana Medicare |
$1.24
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.08
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.24
|
| Rate for Payer: Kaiser Permanente Medicaid |
$0.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$0.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$1.24
|
| Rate for Payer: MDX Hawaii PPO |
$1.16
|
| Rate for Payer: MDX Hawaii PPO |
$1.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$0.83
|
| Rate for Payer: UnitedHealthcare Medicaid |
$0.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.08
|
| Rate for Payer: UnitedHealthcare Medicare |
$1.24
|
| Rate for Payer: University Health Alliance Commercial |
$0.87
|
| Rate for Payer: University Health Alliance Commercial |
$1.01
|
|
|
PREDNISONE 5 MG PO TABLET
|
Facility
|
IP
|
$1.20
|
|
|
Service Code
|
HCPCS J7512
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$1.16 |
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Cash Price |
$0.90
|
| Rate for Payer: Health Management Network Commercial |
$1.02
|
| Rate for Payer: Health Management Network Commercial |
$1.17
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.08
|
| Rate for Payer: Kaiser Permanente Commercial |
$1.24
|
| Rate for Payer: MDX Hawaii PPO |
$1.34
|
| Rate for Payer: MDX Hawaii PPO |
$1.16
|
|
