|
43215 Esophagoscopy, flexible, transoral; with removal of foreign body
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 43215
|
| Hospital Charge Code |
8039246
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$127.47 |
| Max. Negotiated Rate |
$2,270.35 |
| Rate for Payer: AlohaCare Medicaid |
$140.72
|
| Rate for Payer: AlohaCare Medicare |
$127.47
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Devoted Health Medicare |
$140.22
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$140.72
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$247.88
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$127.47
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$140.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$155.48
|
| Rate for Payer: Health Management Network Commercial |
$2,270.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$152.96
|
| Rate for Payer: Kaiser Permanente Medicaid |
$152.96
|
| Rate for Payer: Kaiser Permanente Medicare |
$152.96
|
| Rate for Payer: Ohana Health Plan Medicaid |
$140.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$127.47
|
| Rate for Payer: UnitedHealthcare Medicaid |
$140.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$127.47
|
| Rate for Payer: University Health Alliance Commercial |
$190.47
|
|
|
43215 Esophagoscopy, flexible, transoral; with removal of foreign body
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 43215
|
| Hospital Charge Code |
8039246
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$127.47 |
| Max. Negotiated Rate |
$2,270.35 |
| Rate for Payer: AlohaCare Medicaid |
$140.72
|
| Rate for Payer: AlohaCare Medicare |
$127.47
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Devoted Health Medicare |
$140.22
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$247.88
|
| 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 |
$155.48
|
| Rate for Payer: Health Management Network Commercial |
$2,270.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$152.96
|
| 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 |
$140.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$127.47
|
| 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 |
$190.47
|
|
|
43217 Esophagoscopy, flexible, transoral; with removal of foreign body(s)
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 43217
|
| Hospital Charge Code |
8039247
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$143.70 |
| Max. Negotiated Rate |
$2,270.35 |
| Rate for Payer: AlohaCare Medicaid |
$160.56
|
| Rate for Payer: AlohaCare Medicare |
$143.70
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Devoted Health Medicare |
$158.07
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$272.72
|
| 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 |
$169.78
|
| Rate for Payer: Health Management Network Commercial |
$2,270.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$172.44
|
| 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 |
$160.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$143.70
|
| 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 |
$212.36
|
|
|
43220 Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 43220
|
| Hospital Charge Code |
8039248
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$106.62 |
| Max. Negotiated Rate |
$2,270.35 |
| Rate for Payer: AlohaCare Medicaid |
$118.66
|
| Rate for Payer: AlohaCare Medicare |
$106.62
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Devoted Health Medicare |
$117.28
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$206.56
|
| 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 |
$162.50
|
| Rate for Payer: Health Management Network Commercial |
$2,270.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$127.94
|
| 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 |
$118.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$106.62
|
| 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 |
$156.48
|
|
|
43226 Esophagoscopy, flexible, transoral; insertion of guide wire w/ passage of dilator(s)
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 43226
|
| Hospital Charge Code |
8039249
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$116.61 |
| Max. Negotiated Rate |
$2,270.35 |
| Rate for Payer: AlohaCare Medicaid |
$129.86
|
| Rate for Payer: AlohaCare Medicare |
$116.61
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Devoted Health Medicare |
$128.27
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$225.72
|
| 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 |
$136.24
|
| Rate for Payer: Health Management Network Commercial |
$2,270.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$139.93
|
| 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 |
$129.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$116.61
|
| 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 |
$172.02
|
|
|
43227 Esophagoscopy, flexible, transoral; with control of bleeding, any method
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 43227
|
| Hospital Charge Code |
8039250
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$147.48 |
| Max. Negotiated Rate |
$2,270.35 |
| Rate for Payer: AlohaCare Medicaid |
$165.07
|
| Rate for Payer: AlohaCare Medicare |
$147.48
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Devoted Health Medicare |
$162.23
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$333.49
|
| 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 |
$208.26
|
| Rate for Payer: Health Management Network Commercial |
$2,270.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$176.98
|
| 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 |
$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 |
$165.07
|
| Rate for Payer: Ohana Health Plan Medicare |
$147.48
|
| 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 |
$218.25
|
|
|
43235 Esophagogastroduodenoscopy, flexible, transoral; diagnostic, collection of specimen brsh/floss
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 43235
|
| Hospital Charge Code |
8039254
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$111.90 |
| Max. Negotiated Rate |
$1,072.70 |
| Rate for Payer: AlohaCare Medicaid |
$123.38
|
| Rate for Payer: AlohaCare Medicare |
$111.90
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Devoted Health Medicare |
$123.09
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$221.81
|
| 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 |
$232.96
|
| Rate for Payer: Health Management Network Commercial |
$1,072.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$134.28
|
| 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 |
$123.38
|
| Rate for Payer: Ohana Health Plan Medicare |
$111.90
|
| 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
|
|
|
43235 Esophagogastroduodenoscopy, flexible, transoral; diagnostic, collection of specimen brsh/floss
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 43235
|
| Hospital Charge Code |
8039254
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$111.90 |
| Max. Negotiated Rate |
$1,072.70 |
| Rate for Payer: AlohaCare Medicaid |
$123.38
|
| Rate for Payer: AlohaCare Medicare |
$111.90
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Devoted Health Medicare |
$123.09
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$123.38
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$221.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$111.90
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$123.38
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$232.96
|
| Rate for Payer: Health Management Network Commercial |
$1,072.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$134.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$134.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$134.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$123.38
|
| Rate for Payer: Ohana Health Plan Medicare |
$111.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$123.38
|
| Rate for Payer: UnitedHealthcare Medicare |
$111.90
|
|
|
43236 Esophagogastroduodenoscopy, flexible,transoral; w/ directed submucosal injection(s), any subst
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 43236
|
| Hospital Charge Code |
8039255
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$1,072.70 |
| Rate for Payer: AlohaCare Medicaid |
$139.09
|
| Rate for Payer: AlohaCare Medicare |
$124.82
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Devoted Health Medicare |
$137.30
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$267.61
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| 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 |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$352.30
|
| Rate for Payer: Health Management Network Commercial |
$1,072.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$149.78
|
| 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 |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| 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 |
$139.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$124.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| 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
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
|
|
43237 Endoscopic US Exam Esoph TechFee
|
Facility
|
OP
|
$5,660.00
|
|
|
Service Code
|
HCPCS 43237
|
| Hospital Charge Code |
8343978
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$5,490.20 |
| Rate for Payer: AlohaCare Medicaid |
$2,830.00
|
| Rate for Payer: AlohaCare Medicare |
$2,830.00
|
| Rate for Payer: Cash Price |
$3,679.00
|
| Rate for Payer: Cash Price |
$3,679.00
|
| Rate for Payer: Devoted Health Medicare |
$3,113.00
|
| 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 |
$2,830.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$5,377.00
|
| Rate for Payer: Health Management Network Commercial |
$4,811.00
|
| Rate for Payer: Humana Medicare |
$2,830.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$5,094.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,830.00
|
| Rate for Payer: MDX Hawaii PPO |
$5,490.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,830.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,830.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,830.00
|
| Rate for Payer: University Health Alliance Commercial |
$5,160.40
|
|
|
43237 Endoscopic US Exam Esoph TechFee
|
Facility
|
IP
|
$5,660.00
|
|
|
Service Code
|
HCPCS 43237
|
| Hospital Charge Code |
8343978
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,811.00 |
| Max. Negotiated Rate |
$5,490.20 |
| Rate for Payer: Cash Price |
$3,679.00
|
| Rate for Payer: Health Management Network Commercial |
$4,811.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$5,094.00
|
| Rate for Payer: MDX Hawaii PPO |
$5,490.20
|
|
|
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 43239
|
| Hospital Charge Code |
8039256
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$1,072.70 |
| Rate for Payer: AlohaCare Medicaid |
$139.09
|
| Rate for Payer: AlohaCare Medicare |
$124.82
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Devoted Health Medicare |
$137.30
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$139.09
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$262.58
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$124.82
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$139.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$256.36
|
| Rate for Payer: Health Management Network Commercial |
$1,072.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$149.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$149.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$149.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$139.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$124.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$139.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$124.82
|
|
|
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple
|
Professional
|
Both
|
$1,330.00
|
|
|
Service Code
|
HCPCS 43239
|
| Hospital Charge Code |
8039256
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$1,130.50 |
| Rate for Payer: AlohaCare Medicaid |
$139.09
|
| Rate for Payer: AlohaCare Medicare |
$124.82
|
| Rate for Payer: Cash Price |
$864.50
|
| Rate for Payer: Cash Price |
$864.50
|
| Rate for Payer: Cash Price |
$864.50
|
| Rate for Payer: Devoted Health Medicare |
$137.30
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$262.58
|
| 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 |
$256.36
|
| Rate for Payer: Health Management Network Commercial |
$1,130.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$149.78
|
| 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 |
$139.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$124.82
|
| 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
|
|
|
43241 Esophagogastroduodenoscopy, flexible, transoral; w/ insertion of intraluminal tube or catheter
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 43241
|
| Hospital Charge Code |
8039257
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$127.60 |
| Max. Negotiated Rate |
$2,270.35 |
| Rate for Payer: AlohaCare Medicaid |
$142.21
|
| Rate for Payer: AlohaCare Medicare |
$127.60
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Devoted Health Medicare |
$140.36
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| 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 |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$200.46
|
| Rate for Payer: Health Management Network Commercial |
$2,270.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$153.12
|
| 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 |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| 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 |
$142.21
|
| Rate for Payer: Ohana Health Plan Medicare |
$127.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| 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
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
|
|
43241 Esophagogastroduodenoscopy, flexible, transoral; w/ insertion of intraluminal tube or catheter
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 43241
|
| Hospital Charge Code |
8039257
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$127.60 |
| Max. Negotiated Rate |
$2,270.35 |
| Rate for Payer: AlohaCare Medicaid |
$142.21
|
| Rate for Payer: AlohaCare Medicare |
$127.60
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Devoted Health Medicare |
$140.36
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$127.60
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$200.46
|
| Rate for Payer: Health Management Network Commercial |
$2,270.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$153.12
|
| Rate for Payer: Kaiser Permanente Medicaid |
$153.12
|
| Rate for Payer: Kaiser Permanente Medicare |
$153.12
|
| Rate for Payer: Ohana Health Plan Medicaid |
$142.21
|
| Rate for Payer: Ohana Health Plan Medicare |
$127.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$142.21
|
| Rate for Payer: UnitedHealthcare Medicare |
$127.60
|
|
|
43243 Esophagogastroduodenoscopy, flexible, transoral; w/ inject sclerosis of esoph/gastric varices
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 43243
|
| Hospital Charge Code |
8039258
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,270.35 |
| Rate for Payer: AlohaCare Medicaid |
$235.78
|
| Rate for Payer: AlohaCare Medicare |
$208.82
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Devoted Health Medicare |
$229.70
|
| 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 |
$345.54
|
| Rate for Payer: Health Management Network Commercial |
$2,270.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$250.58
|
| 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 |
$235.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$208.82
|
| 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 |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
|
|
43244 Esophagogastroduodenoscopy, flexible, transoral; w/ band ligation of esoph/gastric varices
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 43244
|
| Hospital Charge Code |
8039259
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,270.35 |
| Rate for Payer: AlohaCare Medicaid |
$244.34
|
| Rate for Payer: AlohaCare Medicare |
$216.56
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Devoted Health Medicare |
$238.22
|
| 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 |
$295.88
|
| Rate for Payer: Health Management Network Commercial |
$2,270.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$259.87
|
| 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 |
$244.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$216.56
|
| 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
|
|
|
43245 Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 43245
|
| Hospital Charge Code |
8039260
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$156.94 |
| Max. Negotiated Rate |
$2,270.35 |
| Rate for Payer: AlohaCare Medicaid |
$174.62
|
| Rate for Payer: AlohaCare Medicare |
$156.94
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Devoted Health Medicare |
$172.63
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$290.64
|
| 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 |
$259.48
|
| Rate for Payer: Health Management Network Commercial |
$2,270.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$188.33
|
| 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 |
$174.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$156.94
|
| 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
|
|
|
43245 Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 43245
|
| Hospital Charge Code |
8039260
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$156.94 |
| Max. Negotiated Rate |
$2,270.35 |
| Rate for Payer: AlohaCare Medicaid |
$174.62
|
| Rate for Payer: AlohaCare Medicare |
$156.94
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Devoted Health Medicare |
$172.63
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$174.62
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$290.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$156.94
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$174.62
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$259.48
|
| Rate for Payer: Health Management Network Commercial |
$2,270.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$188.33
|
| Rate for Payer: Kaiser Permanente Medicaid |
$188.33
|
| Rate for Payer: Kaiser Permanente Medicare |
$188.33
|
| Rate for Payer: Ohana Health Plan Medicaid |
$174.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$156.94
|
| Rate for Payer: UnitedHealthcare Medicaid |
$174.62
|
| Rate for Payer: UnitedHealthcare Medicare |
$156.94
|
|
|
43246 Esophagogastroduodenoscopy, flxble, transoral; w/ directed placemt of percutaneous gastro tube
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 43246
|
| Hospital Charge Code |
8039261
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$177.04 |
| Max. Negotiated Rate |
$2,270.35 |
| Rate for Payer: AlohaCare Medicaid |
$198.00
|
| Rate for Payer: AlohaCare Medicare |
$177.04
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Cash Price |
$1,736.15
|
| Rate for Payer: Devoted Health Medicare |
$194.74
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| 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 |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$330.72
|
| Rate for Payer: Health Management Network Commercial |
$2,270.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$212.45
|
| 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 |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| 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 |
$198.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$177.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| 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
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
|
|
43246 Esophagogastroduodenoscopy, flxble, transoral; w/ directed placemt of percutaneous gastro tube
|
Professional
|
Both
|
$715.00
|
|
|
Service Code
|
HCPCS 43246
|
| Hospital Charge Code |
8039261
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$177.04 |
| Max. Negotiated Rate |
$607.75 |
| Rate for Payer: AlohaCare Medicaid |
$198.00
|
| Rate for Payer: AlohaCare Medicare |
$177.04
|
| Rate for Payer: Cash Price |
$464.75
|
| Rate for Payer: Cash Price |
$464.75
|
| Rate for Payer: Devoted Health Medicare |
$194.74
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$177.04
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$330.72
|
| Rate for Payer: Health Management Network Commercial |
$607.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$212.45
|
| Rate for Payer: Kaiser Permanente Medicaid |
$212.45
|
| Rate for Payer: Kaiser Permanente Medicare |
$212.45
|
| Rate for Payer: Ohana Health Plan Medicaid |
$198.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$177.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$198.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$177.04
|
|
|
43247-EGD w/ Removal Foreign Body
|
Facility
|
OP
|
$4,535.00
|
|
|
Service Code
|
HCPCS 43247
|
| Hospital Charge Code |
8080207
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$5,160.40 |
| Rate for Payer: AlohaCare Medicaid |
$2,267.50
|
| Rate for Payer: AlohaCare Medicare |
$2,267.50
|
| Rate for Payer: Cash Price |
$2,947.75
|
| Rate for Payer: Cash Price |
$2,947.75
|
| Rate for Payer: Devoted Health Medicare |
$2,494.25
|
| 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 |
$2,267.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4,308.25
|
| Rate for Payer: Health Management Network Commercial |
$3,854.75
|
| Rate for Payer: Humana Medicare |
$2,267.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,081.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,267.50
|
| Rate for Payer: MDX Hawaii PPO |
$4,398.95
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,267.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,267.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,267.50
|
| Rate for Payer: University Health Alliance Commercial |
$5,160.40
|
|
|
43247-EGD w/ Removal Foreign Body
|
Facility
|
IP
|
$4,535.00
|
|
|
Service Code
|
HCPCS 43247
|
| Hospital Charge Code |
8080207
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,854.75 |
| Max. Negotiated Rate |
$4,398.95 |
| Rate for Payer: Cash Price |
$2,947.75
|
| Rate for Payer: Health Management Network Commercial |
$3,854.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,081.50
|
| Rate for Payer: MDX Hawaii PPO |
$4,398.95
|
|
|
43247 Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 43247
|
| Hospital Charge Code |
8039262
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$157.92 |
| Max. Negotiated Rate |
$1,072.70 |
| Rate for Payer: AlohaCare Medicaid |
$176.40
|
| Rate for Payer: AlohaCare Medicare |
$157.92
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Devoted Health Medicare |
$173.71
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$308.20
|
| 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 |
$258.96
|
| Rate for Payer: Health Management Network Commercial |
$1,072.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$189.50
|
| 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 Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| 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 |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$176.40
|
| Rate for Payer: Ohana Health Plan Medicare |
$157.92
|
| 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
|
|
|
43247 Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 43247
|
| Hospital Charge Code |
8039262
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$157.92 |
| Max. Negotiated Rate |
$1,072.70 |
| Rate for Payer: AlohaCare Medicaid |
$176.40
|
| Rate for Payer: AlohaCare Medicare |
$157.92
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Devoted Health Medicare |
$173.71
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$176.40
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$308.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$157.92
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$176.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$258.96
|
| Rate for Payer: Health Management Network Commercial |
$1,072.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$189.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$189.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$189.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$176.40
|
| Rate for Payer: Ohana Health Plan Medicare |
$157.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$176.40
|
| Rate for Payer: UnitedHealthcare Medicare |
$157.92
|
|
