|
HCHG CALCULUS SPECTROSCOPY
|
Facility
|
OP
|
$99.00
|
|
|
Service Code
|
HCPCS 82365
|
| Hospital Charge Code |
H3011675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$98.01 |
| Rate for Payer: AlohaCare Medicaid |
$49.50
|
| Rate for Payer: AlohaCare Medicare |
$89.10
|
| Rate for Payer: Cash Price |
$64.35
|
| Rate for Payer: Cash Price |
$64.35
|
| Rate for Payer: Devoted Health Medicare |
$98.01
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$11.44
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$16.12
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$89.10
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$12.01
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$12.90
|
| Rate for Payer: Health Management Network Commercial |
$84.15
|
| Rate for Payer: Humana Medicare |
$89.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$89.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$50.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$89.10
|
| Rate for Payer: MDX Hawaii PPO |
$96.03
|
| Rate for Payer: Ohana Health Plan Medicaid |
$89.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$89.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$89.10
|
| Rate for Payer: University Health Alliance Commercial |
$21.40
|
|
|
HCHG CALCULUS SPECTROSCOPY
|
Facility
|
IP
|
$99.00
|
|
|
Service Code
|
HCPCS 82365
|
| Hospital Charge Code |
H3011675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$84.15 |
| Max. Negotiated Rate |
$96.03 |
| Rate for Payer: Cash Price |
$64.35
|
| Rate for Payer: Health Management Network Commercial |
$84.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$89.10
|
| Rate for Payer: MDX Hawaii PPO |
$96.03
|
|
|
HCHG CALPROTECTIN, STOOL-90
|
Facility
|
OP
|
$133.00
|
|
|
Service Code
|
HCPCS 83993
|
| Hospital Charge Code |
H3011635
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.63 |
| Max. Negotiated Rate |
$131.67 |
| Rate for Payer: AlohaCare Medicaid |
$66.50
|
| Rate for Payer: AlohaCare Medicare |
$119.70
|
| Rate for Payer: Cash Price |
$86.45
|
| Rate for Payer: Cash Price |
$86.45
|
| Rate for Payer: Devoted Health Medicare |
$131.67
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$27.42
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$24.54
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$119.70
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$27.11
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$19.63
|
| Rate for Payer: Health Management Network Commercial |
$113.05
|
| Rate for Payer: Humana Medicare |
$119.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$119.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$67.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$119.70
|
| Rate for Payer: MDX Hawaii PPO |
$129.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$119.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$119.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$27.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$119.70
|
| Rate for Payer: University Health Alliance Commercial |
$50.73
|
|
|
HCHG CALPROTECTIN, STOOL-90
|
Facility
|
IP
|
$133.00
|
|
|
Service Code
|
HCPCS 83993
|
| Hospital Charge Code |
H3011635
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$113.05 |
| Max. Negotiated Rate |
$129.01 |
| Rate for Payer: Cash Price |
$86.45
|
| Rate for Payer: Health Management Network Commercial |
$113.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$119.70
|
| Rate for Payer: MDX Hawaii PPO |
$129.01
|
|
|
HCHG CALR EXON 9 ANALYSIS SO
|
Facility
|
IP
|
$518.00
|
|
|
Service Code
|
HCPCS 81219
|
| Hospital Charge Code |
K3100001
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$440.30 |
| Max. Negotiated Rate |
$502.46 |
| Rate for Payer: Cash Price |
$336.70
|
| Rate for Payer: Health Management Network Commercial |
$440.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$466.20
|
| Rate for Payer: MDX Hawaii PPO |
$502.46
|
|
|
HCHG CALR EXON 9 ANALYSIS SO
|
Facility
|
OP
|
$518.00
|
|
|
Service Code
|
HCPCS 81219
|
| Hospital Charge Code |
K3100001
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$99.41 |
| Max. Negotiated Rate |
$512.82 |
| Rate for Payer: AlohaCare Medicaid |
$259.00
|
| Rate for Payer: AlohaCare Medicare |
$466.20
|
| Rate for Payer: Cash Price |
$336.70
|
| Rate for Payer: Cash Price |
$336.70
|
| Rate for Payer: Devoted Health Medicare |
$512.82
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$122.60
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$152.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$466.20
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$122.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$121.63
|
| Rate for Payer: Health Management Network Commercial |
$440.30
|
| Rate for Payer: Humana Medicare |
$466.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$466.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$264.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$466.20
|
| Rate for Payer: MDX Hawaii PPO |
$502.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$466.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$466.20
|
| Rate for Payer: UnitedHealthcare Medicaid |
$99.41
|
| Rate for Payer: UnitedHealthcare Medicare |
$466.20
|
| Rate for Payer: University Health Alliance Commercial |
$377.57
|
|
|
HCHG CAMPY ANTIGEN DIRECT
|
Facility
|
OP
|
$144.00
|
|
|
Service Code
|
HCPCS 87899
|
| Hospital Charge Code |
K3060048
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.07 |
| Max. Negotiated Rate |
$142.56 |
| Rate for Payer: AlohaCare Medicaid |
$72.00
|
| Rate for Payer: AlohaCare Medicare |
$129.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Devoted Health Medicare |
$142.56
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$16.58
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$20.09
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$129.60
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$17.41
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$16.07
|
| Rate for Payer: Health Management Network Commercial |
$122.40
|
| Rate for Payer: Humana Medicare |
$129.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$129.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$73.44
|
| Rate for Payer: Kaiser Permanente Medicare |
$129.60
|
| Rate for Payer: MDX Hawaii PPO |
$139.68
|
| Rate for Payer: Ohana Health Plan Medicaid |
$129.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$129.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$129.60
|
| Rate for Payer: University Health Alliance Commercial |
$31.01
|
|
|
HCHG CAMPY ANTIGEN DIRECT
|
Facility
|
IP
|
$144.00
|
|
|
Service Code
|
HCPCS 87899
|
| Hospital Charge Code |
K3060048
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$122.40 |
| Max. Negotiated Rate |
$139.68 |
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Health Management Network Commercial |
$122.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$129.60
|
| Rate for Payer: MDX Hawaii PPO |
$139.68
|
|
|
HCHG CANALITH REPOSITIONING PROCEDURE
|
Facility
|
IP
|
$206.00
|
|
|
Service Code
|
HCPCS 95992
|
| Hospital Charge Code |
H4501139
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$175.10 |
| Max. Negotiated Rate |
$199.82 |
| Rate for Payer: Cash Price |
$133.90
|
| Rate for Payer: Health Management Network Commercial |
$175.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$185.40
|
| Rate for Payer: MDX Hawaii PPO |
$199.82
|
|
|
HCHG CANALITH REPOSITIONING PROCEDURE
|
Facility
|
OP
|
$206.00
|
|
|
Service Code
|
HCPCS 95992
|
| Hospital Charge Code |
H4501139
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$103.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$103.00
|
| Rate for Payer: AlohaCare Medicare |
$185.40
|
| Rate for Payer: Cash Price |
$133.90
|
| Rate for Payer: Cash Price |
$133.90
|
| Rate for Payer: Devoted Health Medicare |
$203.94
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$185.40
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$195.70
|
| Rate for Payer: Health Management Network Commercial |
$175.10
|
| Rate for Payer: Humana Medicare |
$185.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$185.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$185.40
|
| Rate for Payer: MDX Hawaii PPO |
$199.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$185.40
|
| Rate for Payer: Ohana Health Plan Medicare |
$185.40
|
| Rate for Payer: UnitedHealthcare Medicare |
$185.40
|
| Rate for Payer: University Health Alliance Commercial |
$150.15
|
|
|
HCHG CANDIDA AB ID
|
Facility
|
IP
|
$91.00
|
|
|
Service Code
|
HCPCS 86628
|
| Hospital Charge Code |
H3020366
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$77.35 |
| Max. Negotiated Rate |
$88.27 |
| Rate for Payer: Cash Price |
$59.15
|
| Rate for Payer: Health Management Network Commercial |
$77.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$81.90
|
| Rate for Payer: MDX Hawaii PPO |
$88.27
|
|
|
HCHG CANDIDA AB ID
|
Facility
|
OP
|
$91.00
|
|
|
Service Code
|
HCPCS 86628
|
| Hospital Charge Code |
H3020366
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.01 |
| Max. Negotiated Rate |
$90.09 |
| Rate for Payer: AlohaCare Medicaid |
$45.50
|
| Rate for Payer: AlohaCare Medicare |
$81.90
|
| Rate for Payer: Cash Price |
$59.15
|
| Rate for Payer: Cash Price |
$59.15
|
| Rate for Payer: Devoted Health Medicare |
$90.09
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$16.60
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$15.01
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$81.90
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$17.43
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$12.01
|
| Rate for Payer: Health Management Network Commercial |
$77.35
|
| Rate for Payer: Humana Medicare |
$81.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$81.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$46.41
|
| Rate for Payer: Kaiser Permanente Medicare |
$81.90
|
| Rate for Payer: MDX Hawaii PPO |
$88.27
|
| Rate for Payer: Ohana Health Plan Medicaid |
$81.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$81.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.60
|
| Rate for Payer: UnitedHealthcare Medicare |
$81.90
|
| Rate for Payer: University Health Alliance Commercial |
$31.04
|
|
|
HCHG CANDIDA SPECIES, DIRECT PROBE
|
Facility
|
OP
|
$297.00
|
|
|
Service Code
|
HCPCS 87480
|
| Hospital Charge Code |
H3060676
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.05 |
| Max. Negotiated Rate |
$294.03 |
| Rate for Payer: AlohaCare Medicaid |
$148.50
|
| Rate for Payer: AlohaCare Medicare |
$267.30
|
| Rate for Payer: Cash Price |
$193.05
|
| Rate for Payer: Cash Price |
$193.05
|
| Rate for Payer: Devoted Health Medicare |
$294.03
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$27.71
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$25.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$267.30
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$29.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$20.05
|
| Rate for Payer: Health Management Network Commercial |
$252.45
|
| Rate for Payer: Humana Medicare |
$267.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$267.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$151.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$267.30
|
| Rate for Payer: MDX Hawaii PPO |
$288.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$267.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$267.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$27.71
|
| Rate for Payer: UnitedHealthcare Medicare |
$267.30
|
| Rate for Payer: University Health Alliance Commercial |
$51.84
|
|
|
HCHG CANDIDA SPECIES, DIRECT PROBE
|
Facility
|
IP
|
$297.00
|
|
|
Service Code
|
HCPCS 87480
|
| Hospital Charge Code |
H3060676
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$252.45 |
| Max. Negotiated Rate |
$288.09 |
| Rate for Payer: Cash Price |
$193.05
|
| Rate for Payer: Health Management Network Commercial |
$252.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$267.30
|
| Rate for Payer: MDX Hawaii PPO |
$288.09
|
|
|
HCHG CANTHOTOMY
|
Facility
|
IP
|
$6,935.00
|
|
|
Service Code
|
HCPCS 67715
|
| Hospital Charge Code |
H4500882
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$5,894.75 |
| Max. Negotiated Rate |
$6,726.95 |
| Rate for Payer: Cash Price |
$4,507.75
|
| Rate for Payer: Health Management Network Commercial |
$5,894.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,241.50
|
| Rate for Payer: MDX Hawaii PPO |
$6,726.95
|
|
|
HCHG CANTHOTOMY
|
Facility
|
OP
|
$6,935.00
|
|
|
Service Code
|
HCPCS 67715
|
| Hospital Charge Code |
H4500882
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$6,865.65 |
| Rate for Payer: AlohaCare Medicaid |
$3,467.50
|
| Rate for Payer: AlohaCare Medicare |
$6,241.50
|
| Rate for Payer: Cash Price |
$4,507.75
|
| Rate for Payer: Cash Price |
$4,507.75
|
| Rate for Payer: Devoted Health Medicare |
$6,865.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$6,241.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6,588.25
|
| Rate for Payer: Health Management Network Commercial |
$5,894.75
|
| Rate for Payer: Humana Medicare |
$6,241.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,241.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$6,241.50
|
| Rate for Payer: MDX Hawaii PPO |
$6,726.95
|
| Rate for Payer: Ohana Health Plan Medicaid |
$6,241.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$6,241.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$6,241.50
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
HCHG CARBAMAZEPINE (TEGRETOL) TOTAL
|
Facility
|
IP
|
$111.00
|
|
|
Service Code
|
HCPCS 80156
|
| Hospital Charge Code |
H3010316
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$94.35 |
| Max. Negotiated Rate |
$107.67 |
| Rate for Payer: Cash Price |
$72.15
|
| Rate for Payer: Health Management Network Commercial |
$94.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$99.90
|
| Rate for Payer: MDX Hawaii PPO |
$107.67
|
|
|
HCHG CARBAMAZEPINE (TEGRETOL) TOTAL
|
Facility
|
OP
|
$111.00
|
|
|
Service Code
|
HCPCS 80156
|
| Hospital Charge Code |
H3010316
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.57 |
| Max. Negotiated Rate |
$109.89 |
| Rate for Payer: AlohaCare Medicaid |
$55.50
|
| Rate for Payer: AlohaCare Medicare |
$99.90
|
| Rate for Payer: Cash Price |
$72.15
|
| Rate for Payer: Cash Price |
$72.15
|
| Rate for Payer: Devoted Health Medicare |
$109.89
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$20.12
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$18.21
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$99.90
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$21.13
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$14.57
|
| Rate for Payer: Health Management Network Commercial |
$94.35
|
| Rate for Payer: Humana Medicare |
$99.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$99.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$56.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$99.90
|
| Rate for Payer: MDX Hawaii PPO |
$107.67
|
| Rate for Payer: Ohana Health Plan Medicaid |
$99.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$99.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$20.12
|
| Rate for Payer: UnitedHealthcare Medicare |
$99.90
|
| Rate for Payer: University Health Alliance Commercial |
$37.63
|
|
|
HCHG CARBOXYHEMOGLOBIN QUANT
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
HCPCS 82375
|
| Hospital Charge Code |
H3010318
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$80.75 |
| Max. Negotiated Rate |
$92.15 |
| Rate for Payer: Cash Price |
$61.75
|
| Rate for Payer: Health Management Network Commercial |
$80.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.50
|
| Rate for Payer: MDX Hawaii PPO |
$92.15
|
|
|
HCHG CARBOXYHEMOGLOBIN QUANT
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
HCPCS 82375
|
| Hospital Charge Code |
H3010318
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.32 |
| Max. Negotiated Rate |
$94.05 |
| Rate for Payer: AlohaCare Medicaid |
$47.50
|
| Rate for Payer: AlohaCare Medicare |
$85.50
|
| Rate for Payer: Cash Price |
$61.75
|
| Rate for Payer: Cash Price |
$61.75
|
| Rate for Payer: Devoted Health Medicare |
$94.05
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$15.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$85.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$17.88
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$12.32
|
| Rate for Payer: Health Management Network Commercial |
$80.75
|
| Rate for Payer: Humana Medicare |
$85.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$48.45
|
| Rate for Payer: Kaiser Permanente Medicare |
$85.50
|
| Rate for Payer: MDX Hawaii PPO |
$92.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$85.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$85.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$85.50
|
| Rate for Payer: University Health Alliance Commercial |
$31.86
|
|
|
HCHG CARCINOEMBRYONIC AG, BODY FLUID
|
Facility
|
OP
|
$140.00
|
|
|
Service Code
|
HCPCS 82378
|
| Hospital Charge Code |
H3011554
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$138.60 |
| Rate for Payer: AlohaCare Medicaid |
$70.00
|
| Rate for Payer: AlohaCare Medicare |
$126.00
|
| Rate for Payer: Cash Price |
$91.00
|
| Rate for Payer: Cash Price |
$91.00
|
| Rate for Payer: Devoted Health Medicare |
$138.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$26.22
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$23.70
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$126.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$27.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$18.96
|
| Rate for Payer: Health Management Network Commercial |
$119.00
|
| Rate for Payer: Humana Medicare |
$126.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$126.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$71.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$126.00
|
| Rate for Payer: MDX Hawaii PPO |
$135.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$126.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$126.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$26.22
|
| Rate for Payer: UnitedHealthcare Medicare |
$126.00
|
| Rate for Payer: University Health Alliance Commercial |
$49.04
|
|
|
HCHG CARCINOEMBRYONIC AG, BODY FLUID
|
Facility
|
IP
|
$140.00
|
|
|
Service Code
|
HCPCS 82378
|
| Hospital Charge Code |
H3011554
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$119.00 |
| Max. Negotiated Rate |
$135.80 |
| Rate for Payer: Cash Price |
$91.00
|
| Rate for Payer: Health Management Network Commercial |
$119.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$126.00
|
| Rate for Payer: MDX Hawaii PPO |
$135.80
|
|
|
HCHG CARDIAC RISK/LIPID PROFILE
|
Facility
|
OP
|
$197.00
|
|
|
Service Code
|
HCPCS 80061
|
| Hospital Charge Code |
H3010320
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$195.03 |
| Rate for Payer: AlohaCare Medicaid |
$98.50
|
| Rate for Payer: AlohaCare Medicare |
$177.30
|
| Rate for Payer: Cash Price |
$128.05
|
| Rate for Payer: Cash Price |
$128.05
|
| Rate for Payer: Devoted Health Medicare |
$195.03
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$18.51
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$16.74
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$177.30
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$19.44
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$13.39
|
| Rate for Payer: Health Management Network Commercial |
$167.45
|
| Rate for Payer: Humana Medicare |
$177.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$177.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$100.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$177.30
|
| Rate for Payer: MDX Hawaii PPO |
$191.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$177.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$177.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$18.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$177.30
|
| Rate for Payer: University Health Alliance Commercial |
$34.63
|
|
|
HCHG CARDIAC RISK/LIPID PROFILE
|
Facility
|
IP
|
$197.00
|
|
|
Service Code
|
HCPCS 80061
|
| Hospital Charge Code |
H3010320
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$167.45 |
| Max. Negotiated Rate |
$191.09 |
| Rate for Payer: Cash Price |
$128.05
|
| Rate for Payer: Health Management Network Commercial |
$167.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$177.30
|
| Rate for Payer: MDX Hawaii PPO |
$191.09
|
|
|
HCHG CARDIOLIPIN IGA AB
|
Facility
|
IP
|
$182.00
|
|
|
Service Code
|
HCPCS 86147
|
| Hospital Charge Code |
H3020380
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$154.70 |
| Max. Negotiated Rate |
$176.54 |
| Rate for Payer: Cash Price |
$118.30
|
| Rate for Payer: Health Management Network Commercial |
$154.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$163.80
|
| Rate for Payer: MDX Hawaii PPO |
$176.54
|
|
