|
43860 Revision of gastrojejunal anastomosis w/ reconst, w/ or w/o prtl gastrectomy/intestine resecti
|
Professional
|
Both
|
$4,252.00
|
|
|
Service Code
|
HCPCS 43860
|
| Hospital Charge Code |
8039326
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,614.20 |
| Rate for Payer: AlohaCare Medicaid |
$1,601.90
|
| Rate for Payer: AlohaCare Medicare |
$1,470.56
|
| Rate for Payer: Cash Price |
$2,763.80
|
| Rate for Payer: Cash Price |
$2,763.80
|
| Rate for Payer: Cash Price |
$2,763.80
|
| Rate for Payer: Devoted Health Medicare |
$1,617.62
|
| 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 |
$918.84
|
| Rate for Payer: Health Management Network Commercial |
$3,614.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,764.67
|
| 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 |
$1,601.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,470.56
|
| 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
|
|
|
43870 Closure of gastrostomy, surgical
|
Professional
|
Both
|
$5,366.00
|
|
|
Service Code
|
HCPCS 43870
|
| Hospital Charge Code |
8039327
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$4,561.10 |
| Rate for Payer: AlohaCare Medicaid |
$706.02
|
| Rate for Payer: AlohaCare Medicare |
$664.28
|
| Rate for Payer: Cash Price |
$3,487.90
|
| Rate for Payer: Cash Price |
$3,487.90
|
| Rate for Payer: Cash Price |
$3,487.90
|
| Rate for Payer: Devoted Health Medicare |
$730.71
|
| 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 |
$388.96
|
| Rate for Payer: Health Management Network Commercial |
$4,561.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$797.14
|
| 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 |
$706.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$664.28
|
| 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
|
|
|
43888 Gastric restrictive procedure, open; removal and replacement of subq port component only
|
Professional
|
Both
|
$4,932.00
|
|
|
Service Code
|
HCPCS 43888
|
| Hospital Charge Code |
8039328
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$4,192.20 |
| Rate for Payer: AlohaCare Medicaid |
$475.05
|
| Rate for Payer: AlohaCare Medicare |
$464.60
|
| Rate for Payer: Cash Price |
$3,205.80
|
| Rate for Payer: Cash Price |
$3,205.80
|
| Rate for Payer: Cash Price |
$3,205.80
|
| Rate for Payer: Devoted Health Medicare |
$511.06
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| 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 |
$246.64
|
| 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 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 |
$4,192.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$557.52
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| 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 |
$209.49
|
| 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 |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$475.05
|
| Rate for Payer: Ohana Health Plan Medicare |
$464.60
|
| 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
|
|
|
43999 UNLISTED PROCEDURE, STOMACH ProFee
|
Professional
|
Both
|
$1,702.00
|
|
|
Service Code
|
HCPCS 43999
|
| Hospital Charge Code |
8019924
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,446.70 |
| Max. Negotiated Rate |
$1,446.70 |
| Rate for Payer: Cash Price |
$1,106.30
|
| Rate for Payer: Health Management Network Commercial |
$1,446.70
|
|
|
44005 Enterolysis (freeing of intestinal adhesion) (separate procedure)
|
Professional
|
Both
|
$3,065.00
|
|
|
Service Code
|
HCPCS 44005
|
| Hospital Charge Code |
8039330
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$852.28 |
| Max. Negotiated Rate |
$2,605.25 |
| Rate for Payer: AlohaCare Medicaid |
$1,071.82
|
| Rate for Payer: AlohaCare Medicare |
$993.21
|
| Rate for Payer: Cash Price |
$1,992.25
|
| Rate for Payer: Cash Price |
$1,992.25
|
| Rate for Payer: Devoted Health Medicare |
$1,092.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$993.21
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$852.28
|
| Rate for Payer: Health Management Network Commercial |
$2,605.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,191.85
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,191.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,191.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,071.82
|
| Rate for Payer: Ohana Health Plan Medicare |
$993.21
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,071.82
|
| Rate for Payer: UnitedHealthcare Medicare |
$993.21
|
|
|
44005 Enterolysis (freeing of intestinal adhesion) (separate procedure)
|
Professional
|
Both
|
$2,948.00
|
|
|
Service Code
|
HCPCS 44005
|
| Hospital Charge Code |
8039330
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,505.80 |
| Rate for Payer: AlohaCare Medicaid |
$1,071.82
|
| Rate for Payer: AlohaCare Medicare |
$993.21
|
| Rate for Payer: Cash Price |
$1,916.20
|
| Rate for Payer: Cash Price |
$1,916.20
|
| Rate for Payer: Cash Price |
$1,916.20
|
| Rate for Payer: Devoted Health Medicare |
$1,092.53
|
| 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 |
$852.28
|
| Rate for Payer: Health Management Network Commercial |
$2,505.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,191.85
|
| 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 |
$1,071.82
|
| Rate for Payer: Ohana Health Plan Medicare |
$993.21
|
| 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
|
|
|
44010 Duodenotomy, for exploration, biopsy(s), or foreign body removal
|
Professional
|
Both
|
$2,336.00
|
|
|
Service Code
|
HCPCS 44010
|
| Hospital Charge Code |
8039331
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,985.60 |
| Rate for Payer: AlohaCare Medicaid |
$852.94
|
| Rate for Payer: AlohaCare Medicare |
$776.99
|
| Rate for Payer: Cash Price |
$1,518.40
|
| Rate for Payer: Cash Price |
$1,518.40
|
| Rate for Payer: Cash Price |
$1,518.40
|
| Rate for Payer: Devoted Health Medicare |
$854.69
|
| 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 |
$521.04
|
| Rate for Payer: Health Management Network Commercial |
$1,985.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$932.39
|
| 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 |
$852.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$776.99
|
| 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
|
|
|
44015 Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method
|
Professional
|
Both
|
$386.00
|
|
|
Service Code
|
HCPCS 44015
|
| Hospital Charge Code |
8039332
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$120.71 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$134.73
|
| Rate for Payer: AlohaCare Medicare |
$120.71
|
| Rate for Payer: Cash Price |
$250.90
|
| Rate for Payer: Cash Price |
$250.90
|
| Rate for Payer: Cash Price |
$250.90
|
| Rate for Payer: Devoted Health Medicare |
$132.78
|
| 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 |
$204.62
|
| Rate for Payer: Health Management Network Commercial |
$328.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$144.85
|
| 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 |
$134.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$120.71
|
| 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
|
|
|
44020 Enterotomy, small intestine, other than duodenum; for exploration/biopsy/foreign body removal
|
Professional
|
Both
|
$2,620.00
|
|
|
Service Code
|
HCPCS 44020
|
| Hospital Charge Code |
8039333
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,227.00 |
| Rate for Payer: AlohaCare Medicaid |
$958.67
|
| Rate for Payer: AlohaCare Medicare |
$893.11
|
| Rate for Payer: Cash Price |
$1,703.00
|
| Rate for Payer: Cash Price |
$1,703.00
|
| Rate for Payer: Cash Price |
$1,703.00
|
| Rate for Payer: Devoted Health Medicare |
$982.42
|
| 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 |
$580.58
|
| Rate for Payer: Health Management Network Commercial |
$2,227.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,071.73
|
| 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 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 |
$958.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$893.11
|
| 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
|
|
|
44021 Enterotomy, small intestine, other than duodenum; for decompression
|
Professional
|
Both
|
$2,662.00
|
|
|
Service Code
|
HCPCS 44021
|
| Hospital Charge Code |
8039334
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$562.12 |
| Max. Negotiated Rate |
$2,262.70 |
| Rate for Payer: AlohaCare Medicaid |
$955.36
|
| Rate for Payer: AlohaCare Medicare |
$886.79
|
| Rate for Payer: Cash Price |
$1,730.30
|
| Rate for Payer: Cash Price |
$1,730.30
|
| Rate for Payer: Devoted Health Medicare |
$975.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$886.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$562.12
|
| Rate for Payer: Health Management Network Commercial |
$2,262.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,064.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,064.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,064.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$955.36
|
| Rate for Payer: Ohana Health Plan Medicare |
$886.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$955.36
|
| Rate for Payer: UnitedHealthcare Medicare |
$886.79
|
|
|
44021 Enterotomy, small intestine, other than duodenum; for decompression
|
Professional
|
Both
|
$2,662.00
|
|
|
Service Code
|
HCPCS 44021
|
| Hospital Charge Code |
8039334
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,262.70 |
| Rate for Payer: AlohaCare Medicaid |
$955.36
|
| Rate for Payer: AlohaCare Medicare |
$886.79
|
| Rate for Payer: Cash Price |
$1,730.30
|
| Rate for Payer: Cash Price |
$1,730.30
|
| Rate for Payer: Cash Price |
$1,730.30
|
| Rate for Payer: Devoted Health Medicare |
$975.47
|
| 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 |
$562.12
|
| Rate for Payer: Health Management Network Commercial |
$2,262.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,064.15
|
| 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 |
$955.36
|
| Rate for Payer: Ohana Health Plan Medicare |
$886.79
|
| 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
|
|
|
44025 Colotomy, for exploration, biopsy(s), or foreign body removal
|
Professional
|
Both
|
$2,661.00
|
|
|
Service Code
|
HCPCS 44025
|
| Hospital Charge Code |
8039335
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,261.85 |
| Rate for Payer: AlohaCare Medicaid |
$967.19
|
| Rate for Payer: AlohaCare Medicare |
$898.58
|
| Rate for Payer: Cash Price |
$1,729.65
|
| Rate for Payer: Cash Price |
$1,729.65
|
| Rate for Payer: Cash Price |
$1,729.65
|
| Rate for Payer: Devoted Health Medicare |
$988.44
|
| 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 |
$584.22
|
| Rate for Payer: Health Management Network Commercial |
$2,261.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,078.30
|
| 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 |
$967.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$898.58
|
| 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
|
|
|
44050 Reduction of volvulus, intussusception, internal hernia, by laparotomy
|
Professional
|
Both
|
$2,519.00
|
|
|
Service Code
|
HCPCS 44050
|
| Hospital Charge Code |
8039336
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,141.15 |
| Rate for Payer: AlohaCare Medicaid |
$923.77
|
| Rate for Payer: AlohaCare Medicare |
$860.85
|
| Rate for Payer: Cash Price |
$1,637.35
|
| Rate for Payer: Cash Price |
$1,637.35
|
| Rate for Payer: Cash Price |
$1,637.35
|
| Rate for Payer: Devoted Health Medicare |
$946.93
|
| 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 |
$563.94
|
| Rate for Payer: Health Management Network Commercial |
$2,141.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,033.02
|
| 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 |
$923.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$860.85
|
| 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
|
|
|
44055 Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus
|
Professional
|
Both
|
$3,888.00
|
|
|
Service Code
|
HCPCS 44055
|
| Hospital Charge Code |
8039337
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,304.80 |
| Rate for Payer: Cash Price |
$2,527.20
|
| Rate for Payer: AlohaCare Medicaid |
$1,453.85
|
| Rate for Payer: AlohaCare Medicare |
$1,334.03
|
| Rate for Payer: Cash Price |
$2,527.20
|
| Rate for Payer: Cash Price |
$2,527.20
|
| Rate for Payer: Devoted Health Medicare |
$1,467.43
|
| 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 |
$611.00
|
| Rate for Payer: Health Management Network Commercial |
$3,304.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,600.84
|
| 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 |
$1,453.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,334.03
|
| 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
|
|
|
44055 Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus
|
Professional
|
Both
|
$3,888.00
|
|
|
Service Code
|
HCPCS 44055
|
| Hospital Charge Code |
8039337
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$611.00 |
| Max. Negotiated Rate |
$3,304.80 |
| Rate for Payer: AlohaCare Medicaid |
$1,453.85
|
| Rate for Payer: AlohaCare Medicare |
$1,334.03
|
| Rate for Payer: Cash Price |
$2,527.20
|
| Rate for Payer: Cash Price |
$2,527.20
|
| Rate for Payer: Devoted Health Medicare |
$1,467.43
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,334.03
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$611.00
|
| Rate for Payer: Health Management Network Commercial |
$3,304.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,600.84
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,600.84
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,600.84
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,453.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,334.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,453.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,334.03
|
|
|
44110 Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriori
|
Professional
|
Both
|
$2,291.00
|
|
|
Service Code
|
HCPCS 44110
|
| Hospital Charge Code |
8039338
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,947.35 |
| Rate for Payer: AlohaCare Medicaid |
$847.12
|
| Rate for Payer: AlohaCare Medicare |
$784.59
|
| Rate for Payer: Cash Price |
$1,489.15
|
| Rate for Payer: Cash Price |
$1,489.15
|
| Rate for Payer: Cash Price |
$1,489.15
|
| Rate for Payer: Devoted Health Medicare |
$863.05
|
| 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 |
$523.38
|
| Rate for Payer: Health Management Network Commercial |
$1,947.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$941.51
|
| 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 |
$847.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$784.59
|
| 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
|
|
|
44120 Enterectomy, resection of small intestine; single resection and anastomosis
|
Professional
|
Both
|
$3,257.00
|
|
|
Service Code
|
HCPCS 44120
|
| Hospital Charge Code |
8039339
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,768.45 |
| Rate for Payer: AlohaCare Medicaid |
$1,197.17
|
| Rate for Payer: AlohaCare Medicare |
$1,104.03
|
| Rate for Payer: Cash Price |
$2,117.05
|
| Rate for Payer: Cash Price |
$2,117.05
|
| Rate for Payer: Cash Price |
$2,117.05
|
| Rate for Payer: Devoted Health Medicare |
$1,214.43
|
| 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 |
$703.04
|
| Rate for Payer: Health Management Network Commercial |
$2,768.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,324.84
|
| 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 |
$1,197.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,104.03
|
| 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
|
|
|
44121 Enterectomy, resection of small intestine; each additional resection and anastomosis
|
Professional
|
Both
|
$651.00
|
|
|
Service Code
|
HCPCS 44121
|
| Hospital Charge Code |
8039340
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$553.35 |
| Rate for Payer: AlohaCare Medicaid |
$230.50
|
| Rate for Payer: AlohaCare Medicare |
$206.33
|
| Rate for Payer: Cash Price |
$423.15
|
| Rate for Payer: Cash Price |
$423.15
|
| Rate for Payer: Cash Price |
$423.15
|
| Rate for Payer: Devoted Health Medicare |
$226.96
|
| 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 |
$197.60
|
| Rate for Payer: Health Management Network Commercial |
$553.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$247.60
|
| 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 |
$230.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$206.33
|
| 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
|
|
|
44125 Enterectomy, resection of small intestine; with enterostomy
|
Professional
|
Both
|
$3,158.00
|
|
|
Service Code
|
HCPCS 44125
|
| Hospital Charge Code |
8039341
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,684.30 |
| Rate for Payer: AlohaCare Medicaid |
$1,157.12
|
| Rate for Payer: AlohaCare Medicare |
$1,070.95
|
| Rate for Payer: Cash Price |
$2,052.70
|
| Rate for Payer: Cash Price |
$2,052.70
|
| Rate for Payer: Cash Price |
$2,052.70
|
| Rate for Payer: Devoted Health Medicare |
$1,178.05
|
| 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 |
$802.36
|
| Rate for Payer: Health Management Network Commercial |
$2,684.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,285.14
|
| 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 |
$1,157.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,070.95
|
| 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
|
|
|
44130 Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy
|
Professional
|
Both
|
$3,497.00
|
|
|
Service Code
|
HCPCS 44130
|
| Hospital Charge Code |
8039342
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,972.45 |
| Rate for Payer: AlohaCare Medicaid |
$1,294.90
|
| Rate for Payer: AlohaCare Medicare |
$1,201.26
|
| Rate for Payer: Cash Price |
$2,273.05
|
| Rate for Payer: Cash Price |
$2,273.05
|
| Rate for Payer: Cash Price |
$2,273.05
|
| Rate for Payer: Devoted Health Medicare |
$1,321.39
|
| 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 |
$619.32
|
| Rate for Payer: Health Management Network Commercial |
$2,972.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,441.51
|
| 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 |
$1,294.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,201.26
|
| 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
|
|
|
44130 Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy
|
Professional
|
Both
|
$3,497.00
|
|
|
Service Code
|
HCPCS 44130
|
| Hospital Charge Code |
8039342
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$619.32 |
| Max. Negotiated Rate |
$2,972.45 |
| Rate for Payer: AlohaCare Medicaid |
$1,294.90
|
| Rate for Payer: AlohaCare Medicare |
$1,201.26
|
| Rate for Payer: Cash Price |
$2,273.05
|
| Rate for Payer: Cash Price |
$2,273.05
|
| Rate for Payer: Devoted Health Medicare |
$1,321.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,201.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$619.32
|
| Rate for Payer: Health Management Network Commercial |
$2,972.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,441.51
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,441.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,441.51
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,294.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,201.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,294.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,201.26
|
|
|
44139 Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 44139
|
| Hospital Charge Code |
8039343
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$102.46 |
| Max. Negotiated Rate |
$277.10 |
| Rate for Payer: AlohaCare Medicaid |
$115.31
|
| Rate for Payer: AlohaCare Medicare |
$102.46
|
| Rate for Payer: Cash Price |
$211.90
|
| Rate for Payer: Cash Price |
$211.90
|
| Rate for Payer: Devoted Health Medicare |
$112.71
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$102.46
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$130.00
|
| Rate for Payer: Health Management Network Commercial |
$277.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$122.95
|
| Rate for Payer: Kaiser Permanente Medicaid |
$122.95
|
| Rate for Payer: Kaiser Permanente Medicare |
$122.95
|
| Rate for Payer: Ohana Health Plan Medicaid |
$115.31
|
| Rate for Payer: Ohana Health Plan Medicare |
$102.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$115.31
|
| Rate for Payer: UnitedHealthcare Medicare |
$102.46
|
|
|
44139 Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 44139
|
| Hospital Charge Code |
8039343
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$102.46 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$115.31
|
| Rate for Payer: AlohaCare Medicare |
$102.46
|
| Rate for Payer: Cash Price |
$211.90
|
| Rate for Payer: Cash Price |
$211.90
|
| Rate for Payer: Cash Price |
$211.90
|
| Rate for Payer: Devoted Health Medicare |
$112.71
|
| 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 |
$130.00
|
| Rate for Payer: Health Management Network Commercial |
$277.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$122.95
|
| 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 |
$115.31
|
| Rate for Payer: Ohana Health Plan Medicare |
$102.46
|
| 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
|
|
|
44140 Colectomy, partial; with anastomosis
|
Professional
|
Both
|
$3,559.00
|
|
|
Service Code
|
HCPCS 44140
|
| Hospital Charge Code |
8039344
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,025.15 |
| Rate for Payer: AlohaCare Medicaid |
$1,320.02
|
| Rate for Payer: AlohaCare Medicare |
$1,220.02
|
| Rate for Payer: Cash Price |
$2,313.35
|
| Rate for Payer: Cash Price |
$2,313.35
|
| Rate for Payer: Cash Price |
$2,313.35
|
| Rate for Payer: Devoted Health Medicare |
$1,342.02
|
| 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 |
$1,142.18
|
| Rate for Payer: Health Management Network Commercial |
$3,025.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,464.02
|
| 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 |
$1,320.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,220.02
|
| 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
|
|
|
44141 Colectomy, partial; with skin level cecostomy or colostomy
|
Professional
|
Both
|
$4,702.00
|
|
|
Service Code
|
HCPCS 44141
|
| Hospital Charge Code |
8039345
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$939.38 |
| Max. Negotiated Rate |
$3,996.70 |
| Rate for Payer: AlohaCare Medicaid |
$1,784.74
|
| Rate for Payer: AlohaCare Medicare |
$1,655.89
|
| Rate for Payer: Cash Price |
$3,056.30
|
| Rate for Payer: Cash Price |
$3,056.30
|
| Rate for Payer: Devoted Health Medicare |
$1,821.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,655.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$939.38
|
| Rate for Payer: Health Management Network Commercial |
$3,996.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,987.07
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,987.07
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,987.07
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,784.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,655.89
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,784.74
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,655.89
|
|
