|
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing
|
Professional
|
Both
|
$1,211.00
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
8039436
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$1,029.35 |
| Rate for Payer: AlohaCare Medicaid |
$184.06
|
| Rate for Payer: AlohaCare Medicare |
$165.03
|
| Rate for Payer: Cash Price |
$787.15
|
| Rate for Payer: Cash Price |
$787.15
|
| Rate for Payer: Cash Price |
$787.15
|
| Rate for Payer: Devoted Health Medicare |
$181.53
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$348.60
|
| 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 |
$319.54
|
| Rate for Payer: Health Management Network Commercial |
$1,029.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$198.04
|
| 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 |
$184.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$165.03
|
| 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 |
$124.82
|
|
|
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing
|
Professional
|
Both
|
$1,226.00
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
8039436
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$1,042.10 |
| Rate for Payer: AlohaCare Medicaid |
$184.06
|
| Rate for Payer: AlohaCare Medicare |
$165.03
|
| Rate for Payer: Cash Price |
$796.90
|
| Rate for Payer: Cash Price |
$796.90
|
| Rate for Payer: Devoted Health Medicare |
$181.53
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$184.06
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$348.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$165.03
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$184.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$319.54
|
| Rate for Payer: Health Management Network Commercial |
$1,042.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$198.04
|
| Rate for Payer: Kaiser Permanente Medicaid |
$198.04
|
| Rate for Payer: Kaiser Permanente Medicare |
$198.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$184.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$165.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$184.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$165.03
|
| Rate for Payer: University Health Alliance Commercial |
$124.82
|
|
|
45379 Colonoscopy, flexible; with removal of foreign body(s)
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 45379
|
| Hospital Charge Code |
8039437
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: AlohaCare Medicaid |
$237.47
|
| Rate for Payer: AlohaCare Medicare |
$210.66
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Devoted Health Medicare |
$231.73
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$434.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$303.42
|
| Rate for Payer: Health Management Network Commercial |
$1,415.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$252.79
|
| 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 |
$237.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$210.66
|
| 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 |
$323.56
|
|
|
45380 Colonoscopy, flexible; with biopsy, single or multiple
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
8039438
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$178.33 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: AlohaCare Medicaid |
$200.16
|
| Rate for Payer: AlohaCare Medicare |
$178.33
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Devoted Health Medicare |
$196.16
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$412.51
|
| 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 |
$351.52
|
| Rate for Payer: Health Management Network Commercial |
$1,415.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$214.00
|
| 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 |
$200.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$178.33
|
| 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 |
$400.00
|
|
|
45380 Colonoscopy, flexible; with biopsy, single or multiple
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
8039438
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$178.33 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: AlohaCare Medicaid |
$200.16
|
| Rate for Payer: AlohaCare Medicare |
$178.33
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Devoted Health Medicare |
$196.16
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$200.16
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$412.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$178.33
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$200.16
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$351.52
|
| Rate for Payer: Health Management Network Commercial |
$1,415.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$214.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$214.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$214.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$200.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$178.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$200.16
|
| Rate for Payer: UnitedHealthcare Medicare |
$178.33
|
| Rate for Payer: University Health Alliance Commercial |
$400.00
|
|
|
45381 Colonoscopy, flexible; with directed submucosal injection(s), any substance
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 45381
|
| Hospital Charge Code |
8039439
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$178.33 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: AlohaCare Medicaid |
$199.77
|
| Rate for Payer: AlohaCare Medicare |
$178.33
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Devoted Health Medicare |
$196.16
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$377.77
|
| 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 |
$436.28
|
| Rate for Payer: Health Management Network Commercial |
$1,415.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$214.00
|
| 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 |
$199.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$178.33
|
| 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 |
$271.68
|
|
|
45382 Colonoscopy, flexible; with control of bleeding, any method
|
Professional
|
Both
|
$1,848.00
|
|
|
Service Code
|
HCPCS 45382
|
| Hospital Charge Code |
8039440
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,570.80 |
| Rate for Payer: AlohaCare Medicaid |
$257.57
|
| Rate for Payer: AlohaCare Medicare |
$227.77
|
| Rate for Payer: Cash Price |
$1,201.20
|
| Rate for Payer: Cash Price |
$1,201.20
|
| Rate for Payer: Cash Price |
$1,201.20
|
| Rate for Payer: Devoted Health Medicare |
$250.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$506.13
|
| 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 |
$453.18
|
| Rate for Payer: Health Management Network Commercial |
$1,570.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$273.32
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$257.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$227.77
|
| 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 |
$342.94
|
|
|
45384 Colonoscopy, flexible; w/ removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forc
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 45384
|
| Hospital Charge Code |
8039441
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: AlohaCare Medicaid |
$225.47
|
| Rate for Payer: AlohaCare Medicare |
$201.74
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Devoted Health Medicare |
$221.91
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$435.69
|
| 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 |
$395.20
|
| Rate for Payer: Health Management Network Commercial |
$1,415.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$242.09
|
| 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 |
$225.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$201.74
|
| 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 |
$495.00
|
|
|
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare techniq
|
Professional
|
Both
|
$1,644.00
|
|
|
Service Code
|
HCPCS 45385
|
| Hospital Charge Code |
8039442
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$224.15 |
| Max. Negotiated Rate |
$1,397.40 |
| Rate for Payer: AlohaCare Medicaid |
$252.85
|
| Rate for Payer: AlohaCare Medicare |
$224.15
|
| Rate for Payer: Cash Price |
$1,068.60
|
| Rate for Payer: Cash Price |
$1,068.60
|
| Rate for Payer: Devoted Health Medicare |
$246.56
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$252.85
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$489.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$224.15
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$252.85
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$466.18
|
| Rate for Payer: Health Management Network Commercial |
$1,397.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$268.98
|
| Rate for Payer: Kaiser Permanente Medicaid |
$268.98
|
| Rate for Payer: Kaiser Permanente Medicare |
$268.98
|
| Rate for Payer: Ohana Health Plan Medicaid |
$252.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$224.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$252.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$224.15
|
| Rate for Payer: University Health Alliance Commercial |
$420.00
|
|
|
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare techniq
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 45385
|
| Hospital Charge Code |
8039442
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: AlohaCare Medicaid |
$252.85
|
| Rate for Payer: AlohaCare Medicare |
$224.15
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Devoted Health Medicare |
$246.56
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$489.22
|
| 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 |
$466.18
|
| Rate for Payer: Health Management Network Commercial |
$1,415.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$268.98
|
| 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 |
$252.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$224.15
|
| 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 |
$420.00
|
|
|
45386 Colonoscopy, flexible; with transendoscopic balloon dilation
|
Professional
|
Both
|
$1,955.00
|
|
|
Service Code
|
HCPCS 45386
|
| Hospital Charge Code |
8039443
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,661.75 |
| Rate for Payer: AlohaCare Medicaid |
$210.95
|
| Rate for Payer: AlohaCare Medicare |
$188.01
|
| Rate for Payer: Cash Price |
$1,270.75
|
| Rate for Payer: Cash Price |
$1,270.75
|
| Rate for Payer: Cash Price |
$1,270.75
|
| Rate for Payer: Devoted Health Medicare |
$206.81
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$410.07
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| 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 Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$640.64
|
| Rate for Payer: Health Management Network Commercial |
$1,661.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$225.61
|
| 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 |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$210.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$188.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| 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 |
$246.64
|
|
|
45390 COLONOSCOPY, FLEXIBLE; WITH ENDOSCOPIC MUCOSAL RESECTION ProFee
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 45390
|
| Hospital Charge Code |
8020123
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$290.95 |
| Max. Negotiated Rate |
$3,283.55 |
| Rate for Payer: AlohaCare Medicare |
$290.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Devoted Health Medicare |
$320.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$290.95
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$359.84
|
| Rate for Payer: Health Management Network Commercial |
$3,283.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$349.14
|
| Rate for Payer: Kaiser Permanente Medicaid |
$349.14
|
| Rate for Payer: Kaiser Permanente Medicare |
$349.14
|
| Rate for Payer: Ohana Health Plan Medicare |
$290.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$290.95
|
|
|
45393 COLONOSCOPY, FLEXIBLE; WITH DECOMPRESSION (FOR PATHOLOGIC DISTENTION) (EG, VOLVULUS, M ProFee
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 45393
|
| Hospital Charge Code |
8020126
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$217.07 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: AlohaCare Medicare |
$217.07
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Devoted Health Medicare |
$238.78
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$217.07
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$274.82
|
| Rate for Payer: Health Management Network Commercial |
$1,415.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$260.48
|
| Rate for Payer: Kaiser Permanente Medicaid |
$260.48
|
| Rate for Payer: Kaiser Permanente Medicare |
$260.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$217.07
|
| Rate for Payer: UnitedHealthcare Medicare |
$217.07
|
|
|
45399 Unlisted procedure, colon
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 45399
|
| Hospital Charge Code |
8039446
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,099.90 |
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| 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 |
$265.97
|
| 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 |
$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: Health Management Network Commercial |
$1,099.90
|
| 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 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 |
$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: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
45540 Proctopexy (eg, for prolapse); abdominal approach
|
Professional
|
Both
|
$2,864.00
|
|
|
Service Code
|
HCPCS 45540
|
| Hospital Charge Code |
8039447
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,434.40 |
| Rate for Payer: AlohaCare Medicaid |
$1,049.70
|
| Rate for Payer: AlohaCare Medicare |
$967.66
|
| Rate for Payer: Cash Price |
$1,861.60
|
| Rate for Payer: Cash Price |
$1,861.60
|
| Rate for Payer: Cash Price |
$1,861.60
|
| Rate for Payer: Devoted Health Medicare |
$1,064.43
|
| 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 |
$671.58
|
| Rate for Payer: Health Management Network Commercial |
$2,434.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,161.19
|
| 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 |
$1,049.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$967.66
|
| 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
|
|
|
45541 Proctopexy (eg, for prolapse); perineal approach
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 45541
|
| Hospital Charge Code |
8039448
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,283.55 |
| Rate for Payer: AlohaCare Medicaid |
$946.09
|
| Rate for Payer: AlohaCare Medicare |
$891.97
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Devoted Health Medicare |
$981.17
|
| 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 |
$609.96
|
| Rate for Payer: Health Management Network Commercial |
$3,283.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,070.36
|
| 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 |
$946.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$891.97
|
| 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
|
|
|
45560 Repair of rectocele (separate procedure)
|
Professional
|
Both
|
$3,863.00
|
|
|
Service Code
|
HCPCS 45560
|
| Hospital Charge Code |
8039449
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,283.55 |
| Rate for Payer: AlohaCare Medicaid |
$701.15
|
| Rate for Payer: AlohaCare Medicare |
$633.34
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Cash Price |
$2,510.95
|
| Rate for Payer: Devoted Health Medicare |
$696.67
|
| 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 |
$391.56
|
| Rate for Payer: Health Management Network Commercial |
$3,283.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$760.01
|
| 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 |
$701.15
|
| Rate for Payer: Ohana Health Plan Medicare |
$633.34
|
| 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
|
|
|
45562 Exploration, repair, and presacral drainage for rectal injury;
|
Professional
|
Both
|
$3,035.00
|
|
|
Service Code
|
HCPCS 45562
|
| Hospital Charge Code |
8039450
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,579.75 |
| Rate for Payer: AlohaCare Medicaid |
$1,163.64
|
| Rate for Payer: AlohaCare Medicare |
$1,109.53
|
| Rate for Payer: Cash Price |
$1,972.75
|
| Rate for Payer: Cash Price |
$1,972.75
|
| Rate for Payer: Cash Price |
$1,972.75
|
| Rate for Payer: Devoted Health Medicare |
$1,220.48
|
| 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 |
$593.06
|
| Rate for Payer: Health Management Network Commercial |
$2,579.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,331.44
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,163.64
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,109.53
|
| 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
|
|
|
45563 Exploration, repair, and presacral drainage for rectal injury; with colostomy
|
Professional
|
Both
|
$4,337.00
|
|
|
Service Code
|
HCPCS 45563
|
| Hospital Charge Code |
8039451
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,686.45 |
| Rate for Payer: AlohaCare Medicaid |
$1,636.39
|
| Rate for Payer: AlohaCare Medicare |
$1,539.36
|
| Rate for Payer: Cash Price |
$2,819.05
|
| Rate for Payer: Cash Price |
$2,819.05
|
| Rate for Payer: Cash Price |
$2,819.05
|
| Rate for Payer: Devoted Health Medicare |
$1,693.30
|
| 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 |
$762.84
|
| Rate for Payer: Health Management Network Commercial |
$3,686.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,847.23
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,636.39
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,539.36
|
| 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
|
|
|
45900 Reduction of procidentia (separate procedure) under anesthesia
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 45900
|
| Hospital Charge Code |
8039452
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$71.76 |
| Max. Negotiated Rate |
$1,099.90 |
| Rate for Payer: AlohaCare Medicaid |
$215.84
|
| Rate for Payer: AlohaCare Medicare |
$212.31
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Devoted Health Medicare |
$233.54
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$212.31
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.76
|
| Rate for Payer: Health Management Network Commercial |
$1,099.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$254.77
|
| Rate for Payer: Kaiser Permanente Medicaid |
$254.77
|
| Rate for Payer: Kaiser Permanente Medicare |
$254.77
|
| Rate for Payer: Ohana Health Plan Medicaid |
$215.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$212.31
|
| Rate for Payer: UnitedHealthcare Medicaid |
$215.84
|
| Rate for Payer: UnitedHealthcare Medicare |
$212.31
|
|
|
45900 Reduction of procidentia (separate procedure) under anesthesia
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 45900
|
| Hospital Charge Code |
8039452
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$71.76 |
| Max. Negotiated Rate |
$1,099.90 |
| Rate for Payer: AlohaCare Medicaid |
$215.84
|
| Rate for Payer: AlohaCare Medicare |
$212.31
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Devoted Health Medicare |
$233.54
|
| 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 |
$71.76
|
| Rate for Payer: Health Management Network Commercial |
$1,099.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$254.77
|
| 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 |
$215.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$212.31
|
| 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
|
|
|
45905 Dilation of anal sphincter (separate procedure) under anesthesia other than local
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 45905
|
| Hospital Charge Code |
8039453
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: AlohaCare Medicaid |
$176.72
|
| Rate for Payer: AlohaCare Medicare |
$173.86
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Devoted Health Medicare |
$191.25
|
| 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 |
$78.00
|
| Rate for Payer: Health Management Network Commercial |
$1,415.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$208.63
|
| 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 |
$176.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$173.86
|
| 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
|
|
|
45910 Dilation of rectal stricture (separate procedure) under anesthesia other than local
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 45910
|
| Hospital Charge Code |
8039454
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$1,415.25 |
| Rate for Payer: AlohaCare Medicaid |
$199.07
|
| Rate for Payer: AlohaCare Medicare |
$192.14
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,082.25
|
| Rate for Payer: Devoted Health Medicare |
$211.35
|
| 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 |
$95.42
|
| Rate for Payer: Health Management Network Commercial |
$1,415.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$230.57
|
| 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 |
$199.07
|
| Rate for Payer: Ohana Health Plan Medicare |
$192.14
|
| 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
|
|
|
45915-Fecal Impaction w/ Anesthesia
|
Facility
|
IP
|
$1,551.00
|
|
|
Service Code
|
HCPCS 45915
|
| Hospital Charge Code |
8080149
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,318.35 |
| Max. Negotiated Rate |
$1,504.47 |
| Rate for Payer: Cash Price |
$1,008.15
|
| Rate for Payer: Health Management Network Commercial |
$1,318.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,395.90
|
| Rate for Payer: MDX Hawaii PPO |
$1,504.47
|
|
|
45915-Fecal Impaction w/ Anesthesia
|
Facility
|
OP
|
$1,551.00
|
|
|
Service Code
|
HCPCS 45915
|
| Hospital Charge Code |
8080149
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$775.50
|
| Rate for Payer: AlohaCare Medicare |
$775.50
|
| Rate for Payer: Cash Price |
$1,008.15
|
| Rate for Payer: Cash Price |
$1,008.15
|
| Rate for Payer: Devoted Health Medicare |
$853.05
|
| 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 |
$775.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,473.45
|
| Rate for Payer: Health Management Network Commercial |
$1,318.35
|
| Rate for Payer: Humana Medicare |
$775.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,395.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$775.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,504.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$775.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$775.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$775.50
|
| Rate for Payer: University Health Alliance Commercial |
$1,130.52
|
|
