|
HCHG IDENT ANAEROBIC ISOL 1
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
HCPCS 87076
|
| Hospital Charge Code |
H3060274
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$103.70 |
| Max. Negotiated Rate |
$118.34 |
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
|
|
HCHG IDENT ANAEROBIC ISOL 1
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
HCPCS 87076
|
| Hospital Charge Code |
H3060272
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$120.78 |
| Rate for Payer: AlohaCare Medicaid |
$61.00
|
| Rate for Payer: AlohaCare Medicare |
$109.80
|
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Devoted Health Medicare |
$120.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$11.16
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$10.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$109.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$13.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$8.08
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Humana Medicare |
$109.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$62.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$109.80
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$109.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$109.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$109.80
|
| Rate for Payer: University Health Alliance Commercial |
$20.89
|
|
|
HCHG IDENT ANAEROBIC ISOL 1
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
HCPCS 87076
|
| Hospital Charge Code |
H3060272
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$103.70 |
| Max. Negotiated Rate |
$118.34 |
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
|
|
HCHG IDENT ANAEROBIC ISOL 1
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
HCPCS 87076
|
| Hospital Charge Code |
H3060270
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$120.78 |
| Rate for Payer: AlohaCare Medicaid |
$61.00
|
| Rate for Payer: AlohaCare Medicare |
$109.80
|
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Devoted Health Medicare |
$120.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$11.16
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$10.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$109.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$13.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$8.08
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Humana Medicare |
$109.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$62.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$109.80
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$109.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$109.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$109.80
|
| Rate for Payer: University Health Alliance Commercial |
$20.89
|
|
|
HCHG IDENT ANAEROBIC ISOL 1
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
HCPCS 87076
|
| Hospital Charge Code |
H3060270
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$103.70 |
| Max. Negotiated Rate |
$118.34 |
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
|
|
HCHG IDENT ANAEROBIC ISOL 1
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
HCPCS 87076
|
| Hospital Charge Code |
H3060268
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$120.78 |
| Rate for Payer: AlohaCare Medicaid |
$61.00
|
| Rate for Payer: AlohaCare Medicare |
$109.80
|
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Devoted Health Medicare |
$120.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$11.16
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$10.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$109.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$13.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$8.08
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Humana Medicare |
$109.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$62.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$109.80
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$109.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$109.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$109.80
|
| Rate for Payer: University Health Alliance Commercial |
$20.89
|
|
|
HCHG IDENT ANAEROBIC ISOL 1
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
HCPCS 87076
|
| Hospital Charge Code |
H3060268
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$103.70 |
| Max. Negotiated Rate |
$118.34 |
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
|
|
HCHG IDENT ANAEROBIC ISOL 1
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
HCPCS 87076
|
| Hospital Charge Code |
H3060266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$120.78 |
| Rate for Payer: AlohaCare Medicaid |
$61.00
|
| Rate for Payer: AlohaCare Medicare |
$109.80
|
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Devoted Health Medicare |
$120.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$11.16
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$10.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$109.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$13.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$8.08
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Humana Medicare |
$109.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$62.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$109.80
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$109.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$109.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$109.80
|
| Rate for Payer: University Health Alliance Commercial |
$20.89
|
|
|
HCHG IDENT ANAEROBIC ISOL 1
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
HCPCS 87076
|
| Hospital Charge Code |
H3060266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$103.70 |
| Max. Negotiated Rate |
$118.34 |
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
|
|
HCHG IDENT ANAEROBIC ISOL 1
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
HCPCS 87076
|
| Hospital Charge Code |
H3060264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$120.78 |
| Rate for Payer: AlohaCare Medicaid |
$61.00
|
| Rate for Payer: AlohaCare Medicare |
$109.80
|
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Devoted Health Medicare |
$120.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$11.16
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$10.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$109.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$13.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$8.08
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Humana Medicare |
$109.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$62.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$109.80
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$109.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$109.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$109.80
|
| Rate for Payer: University Health Alliance Commercial |
$20.89
|
|
|
HCHG IDENT ANAEROBIC ISOL 1
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
HCPCS 87076
|
| Hospital Charge Code |
H3060264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$103.70 |
| Max. Negotiated Rate |
$118.34 |
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
|
|
HCHG IDENT ANAEROBIC ISOL 1
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
HCPCS 87076
|
| Hospital Charge Code |
H3060274
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$120.78 |
| Rate for Payer: AlohaCare Medicaid |
$61.00
|
| Rate for Payer: AlohaCare Medicare |
$109.80
|
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Cash Price |
$79.30
|
| Rate for Payer: Devoted Health Medicare |
$120.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$11.16
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$10.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$109.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$13.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$8.08
|
| Rate for Payer: Health Management Network Commercial |
$103.70
|
| Rate for Payer: Humana Medicare |
$109.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$62.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$109.80
|
| Rate for Payer: MDX Hawaii PPO |
$118.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$109.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$109.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$109.80
|
| Rate for Payer: University Health Alliance Commercial |
$20.89
|
|
|
HCHG IDENT FUNGUS ISOLATES 1
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
HCPCS 87107
|
| Hospital Charge Code |
H3060278
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.32 |
| Max. Negotiated Rate |
$78.21 |
| Rate for Payer: AlohaCare Medicaid |
$39.50
|
| Rate for Payer: AlohaCare Medicare |
$71.10
|
| Rate for Payer: Cash Price |
$51.35
|
| Rate for Payer: Cash Price |
$51.35
|
| Rate for Payer: Devoted Health Medicare |
$78.21
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$14.42
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$12.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$71.10
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$15.14
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$10.32
|
| Rate for Payer: Health Management Network Commercial |
$67.15
|
| Rate for Payer: Humana Medicare |
$71.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$71.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$40.29
|
| Rate for Payer: Kaiser Permanente Medicare |
$71.10
|
| Rate for Payer: MDX Hawaii PPO |
$76.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$71.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$71.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$14.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$71.10
|
| Rate for Payer: University Health Alliance Commercial |
$26.68
|
|
|
HCHG IDENT FUNGUS ISOLATES 1
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
HCPCS 87107
|
| Hospital Charge Code |
H3060278
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$67.15 |
| Max. Negotiated Rate |
$76.63 |
| Rate for Payer: Cash Price |
$51.35
|
| Rate for Payer: Health Management Network Commercial |
$67.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$71.10
|
| Rate for Payer: MDX Hawaii PPO |
$76.63
|
|
|
HCHG I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE
|
Facility
|
IP
|
$5,754.00
|
|
|
Service Code
|
HCPCS 54700
|
| Hospital Charge Code |
H4501070
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,890.90 |
| Max. Negotiated Rate |
$5,581.38 |
| Rate for Payer: Cash Price |
$3,740.10
|
| Rate for Payer: Health Management Network Commercial |
$4,890.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$5,178.60
|
| Rate for Payer: MDX Hawaii PPO |
$5,581.38
|
|
|
HCHG I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE
|
Facility
|
OP
|
$5,754.00
|
|
|
Service Code
|
HCPCS 54700
|
| Hospital Charge Code |
H4501070
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$5,696.46 |
| Rate for Payer: AlohaCare Medicaid |
$2,877.00
|
| Rate for Payer: AlohaCare Medicare |
$5,178.60
|
| Rate for Payer: Cash Price |
$3,740.10
|
| Rate for Payer: Cash Price |
$3,740.10
|
| Rate for Payer: Devoted Health Medicare |
$5,696.46
|
| 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 |
$5,178.60
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$5,466.30
|
| Rate for Payer: Health Management Network Commercial |
$4,890.90
|
| Rate for Payer: Humana Medicare |
$5,178.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$5,178.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$5,178.60
|
| Rate for Payer: MDX Hawaii PPO |
$5,581.38
|
| Rate for Payer: Ohana Health Plan Medicaid |
$5,178.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$5,178.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$5,178.60
|
| Rate for Payer: University Health Alliance Commercial |
$5,160.40
|
|
|
HCHG ID FROM ISOLATE USING 16S RRNA SEQ
|
Facility
|
OP
|
$653.00
|
|
|
Service Code
|
HCPCS 87153
|
| Hospital Charge Code |
H3060673
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$115.36 |
| Max. Negotiated Rate |
$646.47 |
| Rate for Payer: AlohaCare Medicaid |
$326.50
|
| Rate for Payer: AlohaCare Medicare |
$587.70
|
| Rate for Payer: Cash Price |
$424.45
|
| Rate for Payer: Cash Price |
$424.45
|
| Rate for Payer: Devoted Health Medicare |
$646.47
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$165.22
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$144.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$587.70
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$150.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$115.36
|
| Rate for Payer: Health Management Network Commercial |
$555.05
|
| Rate for Payer: Humana Medicare |
$587.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$587.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$333.03
|
| Rate for Payer: Kaiser Permanente Medicare |
$587.70
|
| Rate for Payer: MDX Hawaii PPO |
$633.41
|
| Rate for Payer: Ohana Health Plan Medicaid |
$587.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$587.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$165.22
|
| Rate for Payer: UnitedHealthcare Medicare |
$587.70
|
| Rate for Payer: University Health Alliance Commercial |
$300.31
|
|
|
HCHG ID FROM ISOLATE USING 16S RRNA SEQ
|
Facility
|
IP
|
$653.00
|
|
|
Service Code
|
HCPCS 87153
|
| Hospital Charge Code |
H3060673
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$555.05 |
| Max. Negotiated Rate |
$633.41 |
| Rate for Payer: Cash Price |
$424.45
|
| Rate for Payer: Health Management Network Commercial |
$555.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$587.70
|
| Rate for Payer: MDX Hawaii PPO |
$633.41
|
|
|
HCHG I&D HEMATOMA/SEROMA/FLUID
|
Facility
|
IP
|
$4,919.00
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
H4500476
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,181.15 |
| Max. Negotiated Rate |
$4,771.43 |
| Rate for Payer: Cash Price |
$3,197.35
|
| Rate for Payer: Health Management Network Commercial |
$4,181.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,427.10
|
| Rate for Payer: MDX Hawaii PPO |
$4,771.43
|
|
|
HCHG I&D HEMATOMA/SEROMA/FLUID
|
Facility
|
OP
|
$4,919.00
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
H4500476
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$5,160.40 |
| Rate for Payer: AlohaCare Medicaid |
$2,459.50
|
| Rate for Payer: AlohaCare Medicare |
$4,427.10
|
| Rate for Payer: Cash Price |
$3,197.35
|
| Rate for Payer: Cash Price |
$3,197.35
|
| Rate for Payer: Devoted Health Medicare |
$4,869.81
|
| 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 |
$4,427.10
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4,673.05
|
| Rate for Payer: Health Management Network Commercial |
$4,181.15
|
| Rate for Payer: Humana Medicare |
$4,427.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,427.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$4,427.10
|
| Rate for Payer: MDX Hawaii PPO |
$4,771.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$4,427.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$4,427.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$4,427.10
|
| Rate for Payer: University Health Alliance Commercial |
$5,160.40
|
|
|
HCHG I&D LEG/ANKLE DEEP ABSCESS/HEMATOMA
|
Facility
|
IP
|
$9,564.00
|
|
|
Service Code
|
HCPCS 27603
|
| Hospital Charge Code |
H4501144
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$8,129.40 |
| Max. Negotiated Rate |
$9,277.08 |
| Rate for Payer: Cash Price |
$6,216.60
|
| Rate for Payer: Health Management Network Commercial |
$8,129.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$8,607.60
|
| Rate for Payer: MDX Hawaii PPO |
$9,277.08
|
|
|
HCHG I&D LEG/ANKLE DEEP ABSCESS/HEMATOMA
|
Facility
|
OP
|
$9,564.00
|
|
|
Service Code
|
HCPCS 27603
|
| Hospital Charge Code |
H4501144
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$9,468.36 |
| Rate for Payer: AlohaCare Medicaid |
$4,782.00
|
| Rate for Payer: AlohaCare Medicare |
$8,607.60
|
| Rate for Payer: Cash Price |
$6,216.60
|
| Rate for Payer: Cash Price |
$6,216.60
|
| Rate for Payer: Devoted Health Medicare |
$9,468.36
|
| 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 |
$8,607.60
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$9,085.80
|
| Rate for Payer: Health Management Network Commercial |
$8,129.40
|
| Rate for Payer: Humana Medicare |
$8,607.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$8,607.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$8,607.60
|
| Rate for Payer: MDX Hawaii PPO |
$9,277.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$8,607.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$8,607.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$8,607.60
|
| Rate for Payer: University Health Alliance Commercial |
$5,160.40
|
|
|
HCHG I&D PERIANAL ABSCESS SUPERFIC
|
Facility
|
IP
|
$4,437.00
|
|
|
Service Code
|
HCPCS 46050
|
| Hospital Charge Code |
H4500478
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,771.45 |
| Max. Negotiated Rate |
$4,303.89 |
| Rate for Payer: Cash Price |
$2,884.05
|
| Rate for Payer: Health Management Network Commercial |
$3,771.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,993.30
|
| Rate for Payer: MDX Hawaii PPO |
$4,303.89
|
|
|
HCHG I&D PERIANAL ABSCESS SUPERFIC
|
Facility
|
OP
|
$4,437.00
|
|
|
Service Code
|
HCPCS 46050
|
| Hospital Charge Code |
H4500478
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$4,392.63 |
| Rate for Payer: AlohaCare Medicaid |
$2,218.50
|
| Rate for Payer: AlohaCare Medicare |
$3,993.30
|
| Rate for Payer: Cash Price |
$2,884.05
|
| Rate for Payer: Cash Price |
$2,884.05
|
| Rate for Payer: Devoted Health Medicare |
$4,392.63
|
| 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 |
$3,993.30
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4,215.15
|
| Rate for Payer: Health Management Network Commercial |
$3,771.45
|
| Rate for Payer: Humana Medicare |
$3,993.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,993.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,993.30
|
| Rate for Payer: MDX Hawaii PPO |
$4,303.89
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3,993.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,993.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,993.30
|
| Rate for Payer: University Health Alliance Commercial |
$3,234.13
|
|
|
HCHG I&D PILONIDA CYST SIMP
|
Facility
|
OP
|
$3,592.00
|
|
|
Service Code
|
HCPCS 10080
|
| Hospital Charge Code |
H4500480
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$4,035.20 |
| Rate for Payer: AlohaCare Medicaid |
$1,796.00
|
| Rate for Payer: AlohaCare Medicare |
$3,232.80
|
| Rate for Payer: Cash Price |
$2,334.80
|
| Rate for Payer: Cash Price |
$2,334.80
|
| Rate for Payer: Devoted Health Medicare |
$3,556.08
|
| 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 |
$3,232.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3,412.40
|
| Rate for Payer: Health Management Network Commercial |
$3,053.20
|
| Rate for Payer: Humana Medicare |
$3,232.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,232.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,232.80
|
| Rate for Payer: MDX Hawaii PPO |
$3,484.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3,232.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,232.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,232.80
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
