|
38221 Bone Marrow Biopsy Bilat TechFee
|
Facility
|
OP
|
$3,863.00
|
|
|
Service Code
|
HCPCS 38221
|
| Hospital Charge Code |
8343976
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$3,747.11 |
| Rate for Payer: AlohaCare Medicaid |
$1,931.50
|
| Rate for Payer: AlohaCare Medicare |
$1,931.50
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Devoted Health Medicare |
$2,124.65
|
| 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 |
$1,931.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3,669.85
|
| Rate for Payer: Health Management Network Commercial |
$3,283.55
|
| Rate for Payer: Humana Medicare |
$1,931.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,476.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,931.50
|
| Rate for Payer: MDX Hawaii PPO |
$3,747.11
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,931.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,931.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,931.50
|
| Rate for Payer: University Health Alliance Commercial |
$2,815.74
|
|
|
38221 Bone marrow; biopsy, needle or trocar
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 38221
|
| Hospital Charge Code |
8039054
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$57.93 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$71.25
|
| Rate for Payer: AlohaCare Medicare |
$57.93
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$63.72
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$111.80
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$225.94
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$69.52
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$71.25
|
| Rate for Payer: Ohana Health Plan Medicare |
$57.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: University Health Alliance Commercial |
$94.65
|
|
|
38300 Drainage of lymph node abscess or lymphadenitis; simple
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 38300
|
| Hospital Charge Code |
8039055
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$80.34 |
| Max. Negotiated Rate |
$3,436.55 |
| Rate for Payer: AlohaCare Medicaid |
$219.80
|
| Rate for Payer: AlohaCare Medicare |
$223.82
|
| Rate for Payer: Cash Price |
$2,627.95
|
| Rate for Payer: Cash Price |
$2,627.95
|
| Rate for Payer: Cash Price |
$2,627.95
|
| Rate for Payer: Devoted Health Medicare |
$246.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$296.33
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.34
|
| Rate for Payer: Health Management Network Commercial |
$3,436.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$268.58
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$219.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$223.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: University Health Alliance Commercial |
$288.33
|
|
|
38305 Drainage of lymph node abscess or lymphadenitis; extensive
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 38305
|
| Hospital Charge Code |
8039056
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,436.55 |
| Rate for Payer: AlohaCare Medicaid |
$506.91
|
| Rate for Payer: AlohaCare Medicare |
$496.42
|
| Rate for Payer: Cash Price |
$2,627.95
|
| Rate for Payer: Cash Price |
$2,627.95
|
| Rate for Payer: Cash Price |
$2,627.95
|
| Rate for Payer: Devoted Health Medicare |
$546.06
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$200.72
|
| Rate for Payer: Health Management Network Commercial |
$3,436.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$595.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$506.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$496.42
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
38380 Suture and/or ligation of thoracic duct; cervical approach
|
Professional
|
Both
|
$1,631.00
|
|
|
Service Code
|
HCPCS 38380
|
| Hospital Charge Code |
8039057
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,386.35 |
| Rate for Payer: Devoted Health Medicare |
$579.55
|
| Rate for Payer: AlohaCare Medicaid |
$596.88
|
| Rate for Payer: AlohaCare Medicare |
$526.86
|
| Rate for Payer: Cash Price |
$1,060.15
|
| Rate for Payer: Cash Price |
$1,060.15
|
| Rate for Payer: Cash Price |
$1,060.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$364.00
|
| Rate for Payer: Health Management Network Commercial |
$1,386.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$632.23
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$596.88
|
| Rate for Payer: Ohana Health Plan Medicare |
$526.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
38500 Biopsy or excision of lymph node(s); open, superficial
|
Professional
|
Both
|
$5,449.00
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
8039058
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$179.40 |
| Max. Negotiated Rate |
$4,631.65 |
| Rate for Payer: AlohaCare Medicaid |
$258.09
|
| Rate for Payer: AlohaCare Medicare |
$245.42
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Devoted Health Medicare |
$269.96
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$403.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network Commercial |
$4,631.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$294.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$258.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$245.42
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: University Health Alliance Commercial |
$341.82
|
|
|
38500 Biopsy or excision of lymph node(s); open, superficial
|
Professional
|
Both
|
$5,449.00
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
8039058
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$179.40 |
| Max. Negotiated Rate |
$4,631.65 |
| Rate for Payer: AlohaCare Medicaid |
$258.09
|
| Rate for Payer: AlohaCare Medicare |
$245.42
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Devoted Health Medicare |
$269.96
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$258.09
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$403.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$245.42
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$258.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network Commercial |
$4,631.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$294.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$294.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$294.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$258.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$245.42
|
| Rate for Payer: UnitedHealthcare Medicaid |
$258.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$245.42
|
| Rate for Payer: University Health Alliance Commercial |
$341.82
|
|
|
38505 BIOPSY OR EXCISION OF LYMPH NODE(S); BY NEEDLE, SUPERFICIAL (EG, CERVICAL, INGUINAL, A ProFee
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 38505
|
| Hospital Charge Code |
8019497
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$74.81 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$85.75
|
| Rate for Payer: AlohaCare Medicare |
$74.81
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$82.29
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$85.75
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$130.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$74.81
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$85.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$105.30
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$89.77
|
| Rate for Payer: Kaiser Permanente Medicaid |
$89.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$89.77
|
| Rate for Payer: Ohana Health Plan Medicaid |
$85.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$74.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$85.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$74.81
|
| Rate for Payer: University Health Alliance Commercial |
$106.77
|
|
|
38505 Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 38505
|
| Hospital Charge Code |
8039059
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$74.81 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$85.75
|
| Rate for Payer: AlohaCare Medicare |
$74.81
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$82.29
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$85.75
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$130.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$74.81
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$85.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$105.30
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$89.77
|
| Rate for Payer: Kaiser Permanente Medicaid |
$89.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$89.77
|
| Rate for Payer: Ohana Health Plan Medicaid |
$85.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$74.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$85.75
|
| Rate for Payer: UnitedHealthcare Medicare |
$74.81
|
| Rate for Payer: University Health Alliance Commercial |
$106.77
|
|
|
38505 Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 38505
|
| Hospital Charge Code |
8039059
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$74.81 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$85.75
|
| Rate for Payer: AlohaCare Medicare |
$74.81
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$82.29
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$130.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$105.30
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$89.77
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$85.75
|
| Rate for Payer: Ohana Health Plan Medicare |
$74.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: University Health Alliance Commercial |
$106.77
|
|
|
38505 CT Biopsy Lymph Node
|
Facility
|
OP
|
$3,181.00
|
|
|
Service Code
|
HCPCS 38505
|
| Hospital Charge Code |
9882955
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$3,085.57 |
| Rate for Payer: AlohaCare Medicaid |
$1,590.50
|
| Rate for Payer: AlohaCare Medicare |
$1,590.50
|
| Rate for Payer: Cash Price |
$2,067.65
|
| Rate for Payer: Cash Price |
$2,067.65
|
| Rate for Payer: Cash Price |
$2,067.65
|
| Rate for Payer: Devoted Health Medicare |
$1,749.55
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$2,109.21
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,590.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3,021.95
|
| Rate for Payer: Health Management Network Commercial |
$2,703.85
|
| Rate for Payer: Humana Medicare |
$1,590.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,862.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,622.31
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,590.50
|
| Rate for Payer: MDX Hawaii PPO |
$3,085.57
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,590.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,590.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,590.50
|
| Rate for Payer: University Health Alliance Commercial |
$1,781.36
|
|
|
38505 CT Biopsy Lymph Node
|
Facility
|
IP
|
$3,181.00
|
|
|
Service Code
|
HCPCS 38505
|
| Hospital Charge Code |
9882955
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,703.85 |
| Max. Negotiated Rate |
$3,085.57 |
| Rate for Payer: Cash Price |
$2,067.65
|
| Rate for Payer: Health Management Network Commercial |
$2,703.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,862.90
|
| Rate for Payer: MDX Hawaii PPO |
$3,085.57
|
|
|
38505 US Biopsy Lymph Node Superficial
|
Facility
|
IP
|
$3,181.00
|
|
|
Service Code
|
HCPCS 38505
|
| Hospital Charge Code |
9887434
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$2,703.85 |
| Max. Negotiated Rate |
$3,085.57 |
| Rate for Payer: Cash Price |
$2,067.65
|
| Rate for Payer: Health Management Network Commercial |
$2,703.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,862.90
|
| Rate for Payer: MDX Hawaii PPO |
$3,085.57
|
|
|
38505 US Biopsy Lymph Node Superficial
|
Facility
|
OP
|
$3,181.00
|
|
|
Service Code
|
HCPCS 38505
|
| Hospital Charge Code |
9887434
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$3,085.57 |
| Rate for Payer: AlohaCare Medicaid |
$1,590.50
|
| Rate for Payer: AlohaCare Medicare |
$1,590.50
|
| Rate for Payer: Cash Price |
$2,067.65
|
| Rate for Payer: Cash Price |
$2,067.65
|
| Rate for Payer: Cash Price |
$2,067.65
|
| Rate for Payer: Devoted Health Medicare |
$1,749.55
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$2,109.21
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,590.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3,021.95
|
| Rate for Payer: Health Management Network Commercial |
$2,703.85
|
| Rate for Payer: Humana Medicare |
$1,590.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,862.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,622.31
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,590.50
|
| Rate for Payer: MDX Hawaii PPO |
$3,085.57
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,590.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,590.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,590.50
|
| Rate for Payer: University Health Alliance Commercial |
$1,781.36
|
|
|
38510 Biopsy or excision of lymph node(s); open, deep cervical node(s)
|
Professional
|
Both
|
$5,449.00
|
|
|
Service Code
|
HCPCS 38510
|
| Hospital Charge Code |
8039060
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$4,631.65 |
| Rate for Payer: AlohaCare Medicaid |
$422.47
|
| Rate for Payer: AlohaCare Medicare |
$376.16
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Devoted Health Medicare |
$413.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$659.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$271.70
|
| Rate for Payer: Health Management Network Commercial |
$4,631.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$451.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$422.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$376.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: University Health Alliance Commercial |
$557.99
|
|
|
38520 Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad
|
Professional
|
Both
|
$5,449.00
|
|
|
Service Code
|
HCPCS 38520
|
| Hospital Charge Code |
8039061
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$4,631.65 |
| Rate for Payer: AlohaCare Medicaid |
$475.83
|
| Rate for Payer: AlohaCare Medicare |
$442.18
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Devoted Health Medicare |
$486.40
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$246.22
|
| Rate for Payer: Health Management Network Commercial |
$4,631.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$530.62
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$475.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$442.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
38525 Biopsy or excision of lymph node(s); open, deep axillary node(s)
|
Professional
|
Both
|
$5,449.00
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
8039062
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$4,631.65 |
| Rate for Payer: AlohaCare Medicaid |
$446.82
|
| Rate for Payer: AlohaCare Medicare |
$430.82
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Devoted Health Medicare |
$473.90
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$286.78
|
| Rate for Payer: Health Management Network Commercial |
$4,631.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$516.98
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$446.82
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
38525 Biopsy or excision of lymph node(s); open, deep axillary node(s)
|
Professional
|
Both
|
$5,449.00
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
8039062
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$286.78 |
| Max. Negotiated Rate |
$4,631.65 |
| Rate for Payer: AlohaCare Medicaid |
$446.82
|
| Rate for Payer: AlohaCare Medicare |
$430.82
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Devoted Health Medicare |
$473.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$430.82
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$286.78
|
| Rate for Payer: Health Management Network Commercial |
$4,631.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$516.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$516.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$516.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$446.82
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$446.82
|
| Rate for Payer: UnitedHealthcare Medicare |
$430.82
|
|
|
38530 Biopsy or excision of lymph node(s); open, internal mammary node(s)
|
Professional
|
Both
|
$5,449.00
|
|
|
Service Code
|
HCPCS 38530
|
| Hospital Charge Code |
8039063
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$4,631.65 |
| Rate for Payer: AlohaCare Medicaid |
$577.46
|
| Rate for Payer: AlohaCare Medicare |
$534.19
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Devoted Health Medicare |
$587.61
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$283.92
|
| Rate for Payer: Health Management Network Commercial |
$4,631.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$641.03
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$577.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$534.19
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
|
|
38531 - Biopsy or Excision of lymph node(s); open , inguinofemoral.
|
Professional
|
Both
|
$5,449.00
|
|
|
Service Code
|
HCPCS 38531
|
| Hospital Charge Code |
9208305
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$4,631.65 |
| Rate for Payer: AlohaCare Medicaid |
$451.97
|
| Rate for Payer: AlohaCare Medicare |
$431.36
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Cash Price |
$3,541.85
|
| Rate for Payer: Devoted Health Medicare |
$474.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Health Management Network Commercial |
$4,631.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$517.63
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$451.97
|
| Rate for Payer: Ohana Health Plan Medicare |
$431.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
38542 Dissection, deep jugular node(s)
|
Professional
|
Both
|
$8,414.00
|
|
|
Service Code
|
HCPCS 38542
|
| Hospital Charge Code |
8039064
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$7,151.90 |
| Rate for Payer: AlohaCare Medicaid |
$538.05
|
| Rate for Payer: AlohaCare Medicare |
$473.70
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Devoted Health Medicare |
$521.07
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$311.74
|
| Rate for Payer: Health Management Network Commercial |
$7,151.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$568.44
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$538.05
|
| Rate for Payer: Ohana Health Plan Medicare |
$473.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
38555 Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection
|
Professional
|
Both
|
$9,241.00
|
|
|
Service Code
|
HCPCS 38555
|
| Hospital Charge Code |
8039065
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$7,854.85 |
| Rate for Payer: AlohaCare Medicaid |
$1,026.41
|
| Rate for Payer: AlohaCare Medicare |
$972.81
|
| Rate for Payer: Cash Price |
$6,006.65
|
| Rate for Payer: Cash Price |
$6,006.65
|
| Rate for Payer: Cash Price |
$6,006.65
|
| Rate for Payer: Devoted Health Medicare |
$1,070.09
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$846.82
|
| Rate for Payer: Health Management Network Commercial |
$7,854.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,167.37
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,026.41
|
| Rate for Payer: Ohana Health Plan Medicare |
$972.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
38562 Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic
|
Professional
|
Both
|
$11,375.00
|
|
|
Service Code
|
HCPCS 38562
|
| Hospital Charge Code |
8039066
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$9,668.75 |
| Rate for Payer: AlohaCare Medicaid |
$720.29
|
| Rate for Payer: AlohaCare Medicare |
$670.17
|
| Rate for Payer: Cash Price |
$7,393.75
|
| Rate for Payer: Cash Price |
$7,393.75
|
| Rate for Payer: Cash Price |
$7,393.75
|
| Rate for Payer: Devoted Health Medicare |
$737.19
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$515.84
|
| Rate for Payer: Health Management Network Commercial |
$9,668.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$804.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$720.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$670.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
38564 Limited lymphadenectomy for staging; retroperitoneal (aortic and/or splenic)
|
Professional
|
Both
|
$1,933.00
|
|
|
Service Code
|
HCPCS 38564
|
| Hospital Charge Code |
8039067
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,643.05 |
| Rate for Payer: AlohaCare Medicaid |
$700.90
|
| Rate for Payer: AlohaCare Medicare |
$656.25
|
| Rate for Payer: Cash Price |
$1,256.45
|
| Rate for Payer: Cash Price |
$1,256.45
|
| Rate for Payer: Cash Price |
$1,256.45
|
| Rate for Payer: Devoted Health Medicare |
$721.88
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$540.02
|
| Rate for Payer: Health Management Network Commercial |
$1,643.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$787.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$700.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$656.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
38571 Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy
|
Professional
|
Both
|
$14,794.00
|
|
|
Service Code
|
HCPCS 38571
|
| Hospital Charge Code |
8039068
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$12,574.90 |
| Rate for Payer: AlohaCare Medicaid |
$666.10
|
| Rate for Payer: AlohaCare Medicare |
$593.60
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Devoted Health Medicare |
$652.96
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$753.74
|
| Rate for Payer: Health Management Network Commercial |
$12,574.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$712.32
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$666.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$593.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
