|
48510 External drainage, pseudocyst of pancreas, open
|
Professional
|
Both
|
$2,934.00
|
|
|
Service Code
|
HCPCS 48510
|
| Hospital Charge Code |
8039542
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,493.90 |
| Rate for Payer: AlohaCare Medicaid |
$1,089.82
|
| Rate for Payer: AlohaCare Medicare |
$1,026.59
|
| Rate for Payer: Cash Price |
$1,907.10
|
| Rate for Payer: Cash Price |
$1,907.10
|
| Rate for Payer: Cash Price |
$1,907.10
|
| Rate for Payer: Devoted Health Medicare |
$1,129.25
|
| 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 |
$606.58
|
| Rate for Payer: Health Management Network Commercial |
$2,493.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,231.91
|
| 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 |
$1,089.82
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,026.59
|
| 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
|
|
|
48520 Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct
|
Professional
|
Both
|
$2,945.00
|
|
|
Service Code
|
HCPCS 48520
|
| Hospital Charge Code |
8039543
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,503.25 |
| Rate for Payer: AlohaCare Medicaid |
$1,082.08
|
| Rate for Payer: AlohaCare Medicare |
$1,006.81
|
| Rate for Payer: Cash Price |
$1,914.25
|
| Rate for Payer: Cash Price |
$1,914.25
|
| Rate for Payer: Cash Price |
$1,914.25
|
| Rate for Payer: Devoted Health Medicare |
$1,107.49
|
| 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 |
$748.54
|
| Rate for Payer: Health Management Network Commercial |
$2,503.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,208.17
|
| 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 |
$1,082.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,006.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
48547 Duodenal exclusion with gastrojejunostomy for pancreatic injury
|
Professional
|
Both
|
$4,613.00
|
|
|
Service Code
|
HCPCS 48547
|
| Hospital Charge Code |
8039544
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,921.05 |
| Rate for Payer: AlohaCare Medicaid |
$1,748.61
|
| Rate for Payer: AlohaCare Medicare |
$1,609.81
|
| Rate for Payer: Cash Price |
$2,998.45
|
| Rate for Payer: Cash Price |
$2,998.45
|
| Rate for Payer: Cash Price |
$2,998.45
|
| Rate for Payer: Devoted Health Medicare |
$1,770.79
|
| 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 |
$1,015.30
|
| Rate for Payer: Health Management Network Commercial |
$3,921.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,931.77
|
| 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 |
$1,748.61
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,609.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
49000 Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)
|
Professional
|
Both
|
$2,091.00
|
|
|
Service Code
|
HCPCS 49000
|
| Hospital Charge Code |
8039545
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,777.35 |
| Rate for Payer: AlohaCare Medicaid |
$763.58
|
| Rate for Payer: AlohaCare Medicare |
$716.59
|
| Rate for Payer: Cash Price |
$1,359.15
|
| Rate for Payer: Cash Price |
$1,359.15
|
| Rate for Payer: Cash Price |
$1,359.15
|
| Rate for Payer: Devoted Health Medicare |
$788.25
|
| 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 |
$711.88
|
| Rate for Payer: Health Management Network Commercial |
$1,777.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$859.91
|
| 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 |
$763.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$716.59
|
| 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
|
|
|
49002 Reopening of recent laparotomy
|
Professional
|
Both
|
$2,796.00
|
|
|
Service Code
|
HCPCS 49002
|
| Hospital Charge Code |
8039546
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,376.60 |
| Rate for Payer: AlohaCare Medicaid |
$1,024.42
|
| Rate for Payer: AlohaCare Medicare |
$949.54
|
| Rate for Payer: Cash Price |
$1,817.40
|
| Rate for Payer: Cash Price |
$1,817.40
|
| Rate for Payer: Cash Price |
$1,817.40
|
| Rate for Payer: Devoted Health Medicare |
$1,044.49
|
| 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 |
$490.62
|
| Rate for Payer: Health Management Network Commercial |
$2,376.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,139.45
|
| 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 |
$1,024.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$949.54
|
| 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
|
|
|
49010 Exploration, retroperitoneal area with or without biopsy(s) (separate procedure)
|
Professional
|
Both
|
$9,010.00
|
|
|
Service Code
|
HCPCS 49010
|
| Hospital Charge Code |
8039547
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$7,658.50 |
| Rate for Payer: AlohaCare Medicaid |
$902.96
|
| Rate for Payer: AlohaCare Medicare |
$838.87
|
| Rate for Payer: Cash Price |
$5,856.50
|
| Rate for Payer: Cash Price |
$5,856.50
|
| Rate for Payer: Cash Price |
$5,856.50
|
| Rate for Payer: Devoted Health Medicare |
$922.76
|
| 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 |
$741.26
|
| Rate for Payer: Health Management Network Commercial |
$7,658.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,006.64
|
| 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 |
$902.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$838.87
|
| 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
|
|
|
49020 Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, ope
|
Professional
|
Both
|
$4,179.00
|
|
|
Service Code
|
HCPCS 49020
|
| Hospital Charge Code |
8039548
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,552.15 |
| Rate for Payer: AlohaCare Medicaid |
$1,572.25
|
| Rate for Payer: AlohaCare Medicare |
$1,454.73
|
| Rate for Payer: Cash Price |
$2,716.35
|
| Rate for Payer: Cash Price |
$2,716.35
|
| Rate for Payer: Cash Price |
$2,716.35
|
| Rate for Payer: Devoted Health Medicare |
$1,600.20
|
| 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 |
$842.92
|
| Rate for Payer: Health Management Network Commercial |
$3,552.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,745.68
|
| 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 |
$1,572.25
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,454.73
|
| 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
|
|
|
49040 Drainage of subdiaphragmatic or subphrenic abscess, open
|
Professional
|
Both
|
$2,708.00
|
|
|
Service Code
|
HCPCS 49040
|
| Hospital Charge Code |
8039550
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,301.80 |
| Rate for Payer: AlohaCare Medicaid |
$992.18
|
| Rate for Payer: AlohaCare Medicare |
$939.25
|
| Rate for Payer: Cash Price |
$1,760.20
|
| Rate for Payer: Cash Price |
$1,760.20
|
| Rate for Payer: Cash Price |
$1,760.20
|
| Rate for Payer: Devoted Health Medicare |
$1,033.17
|
| 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 |
$499.20
|
| Rate for Payer: Health Management Network Commercial |
$2,301.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,127.10
|
| 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 |
$992.18
|
| Rate for Payer: Ohana Health Plan Medicare |
$939.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
49060 Drainage of retroperitoneal abscess, open
|
Professional
|
Both
|
$2,971.00
|
|
|
Service Code
|
HCPCS 49060
|
| Hospital Charge Code |
8039551
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,525.35 |
| Rate for Payer: AlohaCare Medicaid |
$1,080.98
|
| Rate for Payer: AlohaCare Medicare |
$1,004.94
|
| Rate for Payer: Cash Price |
$1,931.15
|
| Rate for Payer: Cash Price |
$1,931.15
|
| Rate for Payer: Cash Price |
$1,931.15
|
| Rate for Payer: Devoted Health Medicare |
$1,105.43
|
| 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 |
$517.40
|
| Rate for Payer: Health Management Network Commercial |
$2,525.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,205.93
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$1,080.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,004.94
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
49082 Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance
|
Professional
|
Both
|
$2,018.00
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
8039552
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$71.63 |
| Max. Negotiated Rate |
$1,715.30 |
| Rate for Payer: AlohaCare Medicaid |
$73.51
|
| Rate for Payer: AlohaCare Medicare |
$71.63
|
| Rate for Payer: Cash Price |
$1,311.70
|
| Rate for Payer: Cash Price |
$1,311.70
|
| Rate for Payer: Devoted Health Medicare |
$78.79
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$73.51
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$114.98
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$71.63
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$73.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$214.76
|
| Rate for Payer: Health Management Network Commercial |
$1,715.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.96
|
| Rate for Payer: Kaiser Permanente Medicaid |
$85.96
|
| Rate for Payer: Kaiser Permanente Medicare |
$85.96
|
| Rate for Payer: Ohana Health Plan Medicaid |
$73.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$71.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$73.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$71.63
|
|
|
49082 Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
8039552
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$71.63 |
| Max. Negotiated Rate |
$1,072.70 |
| Rate for Payer: AlohaCare Medicaid |
$73.51
|
| Rate for Payer: AlohaCare Medicare |
$71.63
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Devoted Health Medicare |
$78.79
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$114.98
|
| 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 |
$214.76
|
| Rate for Payer: Health Management Network Commercial |
$1,072.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.96
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$73.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$71.63
|
| 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
|
|
|
49082 Paracentesis without Imaging
|
Facility
|
OP
|
$4,535.00
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
8848445
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$4,398.95 |
| Rate for Payer: AlohaCare Medicaid |
$2,267.50
|
| Rate for Payer: AlohaCare Medicare |
$2,267.50
|
| Rate for Payer: Cash Price |
$2,947.75
|
| Rate for Payer: Cash Price |
$2,947.75
|
| Rate for Payer: Cash Price |
$2,947.75
|
| Rate for Payer: Devoted Health Medicare |
$2,494.25
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,158.29
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2,267.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4,308.25
|
| Rate for Payer: Health Management Network Commercial |
$3,854.75
|
| Rate for Payer: Humana Medicare |
$2,267.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,081.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,312.85
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,267.50
|
| Rate for Payer: MDX Hawaii PPO |
$4,398.95
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,267.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,267.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,267.50
|
| Rate for Payer: University Health Alliance Commercial |
$2,539.60
|
|
|
49082 Paracentesis without Imaging
|
Facility
|
IP
|
$4,535.00
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
8848445
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,854.75 |
| Max. Negotiated Rate |
$4,398.95 |
| Rate for Payer: Cash Price |
$2,947.75
|
| Rate for Payer: Health Management Network Commercial |
$3,854.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,081.50
|
| Rate for Payer: MDX Hawaii PPO |
$4,398.95
|
|
|
49083-Abdominal Paracentesis w/ Imaging Guide
|
Facility
|
OP
|
$2,563.00
|
|
|
Service Code
|
HCPCS 49083
|
| Hospital Charge Code |
8080219
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$2,486.11 |
| Rate for Payer: AlohaCare Medicaid |
$1,281.50
|
| Rate for Payer: AlohaCare Medicare |
$1,281.50
|
| Rate for Payer: Cash Price |
$1,665.95
|
| Rate for Payer: Cash Price |
$1,665.95
|
| Rate for Payer: Devoted Health Medicare |
$1,409.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,281.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,434.85
|
| Rate for Payer: Health Management Network Commercial |
$2,178.55
|
| Rate for Payer: Humana Medicare |
$1,281.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,306.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,281.50
|
| Rate for Payer: MDX Hawaii PPO |
$2,486.11
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,281.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,281.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,281.50
|
| Rate for Payer: University Health Alliance Commercial |
$1,868.17
|
|
|
49083-Abdominal Paracentesis w/ Imaging Guide
|
Facility
|
IP
|
$2,563.00
|
|
|
Service Code
|
HCPCS 49083
|
| Hospital Charge Code |
8080219
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,178.55 |
| Max. Negotiated Rate |
$2,486.11 |
| Rate for Payer: Cash Price |
$1,665.95
|
| Rate for Payer: Health Management Network Commercial |
$2,178.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,306.70
|
| Rate for Payer: MDX Hawaii PPO |
$2,486.11
|
|
|
49083-Abdominal Paracentesis w/ Imaging Guide
|
Facility
|
OP
|
$1,695.00
|
|
|
Service Code
|
HCPCS 49083
|
| Hospital Charge Code |
11914097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$2,837.00 |
| Rate for Payer: AlohaCare Medicaid |
$847.50
|
| Rate for Payer: AlohaCare Medicare |
$847.50
|
| Rate for Payer: Cash Price |
$1,101.75
|
| Rate for Payer: Cash Price |
$1,101.75
|
| Rate for Payer: Cash Price |
$1,101.75
|
| Rate for Payer: Devoted Health Medicare |
$932.25
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,158.29
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$847.50
|
| Rate for Payer: Health Management Network Commercial |
$1,440.75
|
| Rate for Payer: Humana Medicare |
$847.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,525.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,837.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$847.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,644.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$847.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$847.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$847.50
|
| Rate for Payer: University Health Alliance Commercial |
$949.20
|
|
|
49083-Abdominal Paracentesis w/ Imaging Guide
|
Facility
|
IP
|
$1,695.00
|
|
|
Service Code
|
HCPCS 49083
|
| Hospital Charge Code |
11914097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,440.75 |
| Max. Negotiated Rate |
$1,644.15 |
| Rate for Payer: Cash Price |
$1,101.75
|
| Rate for Payer: Health Management Network Commercial |
$1,440.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,525.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,644.15
|
|
|
49083 Abdominal paracentesis with imaging guidance; (diagnostic or therapeutic)
|
Professional
|
Both
|
$3,755.00
|
|
|
Service Code
|
HCPCS 49083
|
| Hospital Charge Code |
8039553
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$92.74 |
| Max. Negotiated Rate |
$3,191.75 |
| Rate for Payer: AlohaCare Medicaid |
$105.50
|
| Rate for Payer: AlohaCare Medicare |
$92.74
|
| Rate for Payer: Cash Price |
$2,440.75
|
| Rate for Payer: Cash Price |
$2,440.75
|
| Rate for Payer: Devoted Health Medicare |
$102.01
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$105.50
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$165.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$92.74
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$105.50
|
| Rate for Payer: Health Management Network Commercial |
$3,191.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$111.29
|
| Rate for Payer: Kaiser Permanente Medicaid |
$111.29
|
| Rate for Payer: Kaiser Permanente Medicare |
$111.29
|
| Rate for Payer: Ohana Health Plan Medicaid |
$105.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$92.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$105.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$92.74
|
| Rate for Payer: University Health Alliance Commercial |
$140.13
|
|
|
49083 Abdominal paracentesis with imaging guidance; (diagnostic or therapeutic)
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 49083
|
| Hospital Charge Code |
8039553
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$92.74 |
| Max. Negotiated Rate |
$1,072.70 |
| Rate for Payer: AlohaCare Medicaid |
$105.50
|
| Rate for Payer: AlohaCare Medicare |
$92.74
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Devoted Health Medicare |
$102.01
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$165.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Health Management Network Commercial |
$1,072.70
|
| 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 Commercial |
$111.29
|
| 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 |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$105.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$92.74
|
| 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 |
$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 |
$237.64
|
| Rate for Payer: University Health Alliance Commercial |
$140.13
|
|
|
49084 Peritoneal lavage, including imaging guidance, when performed
|
Professional
|
Both
|
$208.00
|
|
|
Service Code
|
HCPCS 49084
|
| Hospital Charge Code |
8039554
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$91.50 |
| Max. Negotiated Rate |
$176.80 |
| Rate for Payer: AlohaCare Medicaid |
$102.52
|
| Rate for Payer: AlohaCare Medicare |
$91.50
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Devoted Health Medicare |
$100.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$91.50
|
| Rate for Payer: Health Management Network Commercial |
$176.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$109.80
|
| Rate for Payer: Kaiser Permanente Medicare |
$109.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$102.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$91.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$102.52
|
| Rate for Payer: UnitedHealthcare Medicare |
$91.50
|
|
|
49084 Peritoneal lavage, including imaging guidance, when performed
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 49084
|
| Hospital Charge Code |
8039554
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$91.50 |
| Max. Negotiated Rate |
$1,072.70 |
| Rate for Payer: AlohaCare Medicaid |
$102.52
|
| Rate for Payer: AlohaCare Medicare |
$91.50
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Cash Price |
$820.30
|
| Rate for Payer: Devoted Health Medicare |
$100.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Health Management Network Commercial |
$1,072.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$102.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$91.50
|
| 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
|
|
|
49180 Biopsy, abdominal or retroperitoneal mass, percutaneous needle
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 49180
|
| Hospital Charge Code |
8039555
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$69.80 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$80.65
|
| Rate for Payer: AlohaCare Medicare |
$69.80
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$76.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$80.65
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$127.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$80.65
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$158.86
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$83.76
|
| Rate for Payer: Kaiser Permanente Medicaid |
$83.76
|
| Rate for Payer: Kaiser Permanente Medicare |
$83.76
|
| Rate for Payer: Ohana Health Plan Medicaid |
$80.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$80.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.80
|
| Rate for Payer: University Health Alliance Commercial |
$108.08
|
|
|
49180 Biopsy, abdominal or retroperitoneal mass, percutaneous needle
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 49180
|
| Hospital Charge Code |
8039555
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$69.80 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$80.65
|
| Rate for Payer: AlohaCare Medicare |
$69.80
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$76.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$127.65
|
| 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 |
$158.86
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$83.76
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$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 |
$80.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| 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 |
$181.39
|
| 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 |
$108.08
|
|
|
49180 BIOPSY, ABDOMINAL OR RETROPERITONEAL MASS, PERCUTANEOUS NEEDLE ProFee
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 49180
|
| Hospital Charge Code |
8020358
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$69.80 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$80.65
|
| Rate for Payer: AlohaCare Medicare |
$69.80
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$76.78
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$80.65
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$127.65
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$69.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$80.65
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$158.86
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$83.76
|
| Rate for Payer: Kaiser Permanente Medicaid |
$83.76
|
| Rate for Payer: Kaiser Permanente Medicare |
$83.76
|
| Rate for Payer: Ohana Health Plan Medicaid |
$80.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$69.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$80.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$69.80
|
| Rate for Payer: University Health Alliance Commercial |
$108.08
|
|
|
49186 OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5 CM OR LESS
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 49186
|
| Hospital Charge Code |
12548206
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$1.27 |
| Max. Negotiated Rate |
$1,440.54 |
| Rate for Payer: AlohaCare Medicaid |
$1.27
|
| Rate for Payer: AlohaCare Medicare |
$1,200.45
|
| Rate for Payer: Cash Price |
$84.50
|
| Rate for Payer: Cash Price |
$84.50
|
| Rate for Payer: Cash Price |
$84.50
|
| Rate for Payer: Devoted Health Medicare |
$1,320.49
|
| 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 |
$110.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,440.54
|
| 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 |
$1.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,200.45
|
| 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
|
|
