|
51102 Aspiration of bladder; with insertion of suprapubic catheter
|
Professional
|
Both
|
$5,186.00
|
|
|
Service Code
|
HCPCS 51102
|
| Hospital Charge Code |
8039660
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$124.99 |
| Max. Negotiated Rate |
$4,408.10 |
| Rate for Payer: AlohaCare Medicaid |
$141.94
|
| Rate for Payer: AlohaCare Medicare |
$124.99
|
| Rate for Payer: Cash Price |
$3,370.90
|
| Rate for Payer: Cash Price |
$3,370.90
|
| Rate for Payer: Devoted Health Medicare |
$137.49
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$141.94
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$355.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$124.99
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$141.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$331.24
|
| Rate for Payer: Health Management Network Commercial |
$4,408.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$149.99
|
| Rate for Payer: Kaiser Permanente Medicaid |
$149.99
|
| Rate for Payer: Kaiser Permanente Medicare |
$149.99
|
| Rate for Payer: Ohana Health Plan Medicaid |
$141.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$124.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$141.94
|
| Rate for Payer: UnitedHealthcare Medicare |
$124.99
|
| Rate for Payer: University Health Alliance Commercial |
$189.74
|
|
|
51102 Drain Bl w Cath Insertion TechFee
|
Facility
|
OP
|
$10,424.00
|
|
|
Service Code
|
HCPCS 51102
|
| Hospital Charge Code |
8343982
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$10,111.28 |
| Rate for Payer: AlohaCare Medicaid |
$5,212.00
|
| Rate for Payer: AlohaCare Medicare |
$5,212.00
|
| Rate for Payer: Cash Price |
$6,775.60
|
| Rate for Payer: Cash Price |
$6,775.60
|
| Rate for Payer: Devoted Health Medicare |
$5,733.20
|
| 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 |
$5,212.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$9,902.80
|
| Rate for Payer: Health Management Network Commercial |
$8,860.40
|
| Rate for Payer: Humana Medicare |
$5,212.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$9,381.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$5,212.00
|
| Rate for Payer: MDX Hawaii PPO |
$10,111.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$5,212.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$5,212.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$5,212.00
|
| Rate for Payer: University Health Alliance Commercial |
$7,598.05
|
|
|
51102 Drain Bl w Cath Insertion TechFee
|
Facility
|
IP
|
$10,424.00
|
|
|
Service Code
|
HCPCS 51102
|
| Hospital Charge Code |
8343982
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$8,860.40 |
| Max. Negotiated Rate |
$10,111.28 |
| Rate for Payer: Cash Price |
$6,775.60
|
| Rate for Payer: Health Management Network Commercial |
$8,860.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$9,381.60
|
| Rate for Payer: MDX Hawaii PPO |
$10,111.28
|
|
|
51500 Excision of urachal cyst or sinus, with or without umbilical hernia repair
|
Professional
|
Both
|
$8,414.00
|
|
|
Service Code
|
HCPCS 51500
|
| Hospital Charge Code |
8039661
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$7,151.90 |
| Rate for Payer: AlohaCare Medicaid |
$649.11
|
| Rate for Payer: AlohaCare Medicare |
$584.84
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Devoted Health Medicare |
$643.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$497.38
|
| Rate for Payer: Health Management Network Commercial |
$7,151.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$701.81
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$649.11
|
| Rate for Payer: Ohana Health Plan Medicare |
$584.84
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
|
|
51525 Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure)
|
Professional
|
Both
|
$2,438.00
|
|
|
Service Code
|
HCPCS 51525
|
| Hospital Charge Code |
8039662
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,072.30 |
| Rate for Payer: AlohaCare Medicaid |
$864.50
|
| Rate for Payer: AlohaCare Medicare |
$773.11
|
| Rate for Payer: Cash Price |
$1,584.70
|
| Rate for Payer: Cash Price |
$1,584.70
|
| Rate for Payer: Cash Price |
$1,584.70
|
| Rate for Payer: Devoted Health Medicare |
$850.42
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$699.66
|
| Rate for Payer: Health Management Network Commercial |
$2,072.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$927.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$864.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$773.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
51535 Cystotomy for excision, incision, or repair of ureterocele
|
Professional
|
Both
|
$4,906.00
|
|
|
Service Code
|
HCPCS 51535
|
| Hospital Charge Code |
8039663
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$4,170.10 |
| Rate for Payer: AlohaCare Medicaid |
$788.38
|
| Rate for Payer: AlohaCare Medicare |
$706.50
|
| Rate for Payer: Cash Price |
$3,188.90
|
| Rate for Payer: Cash Price |
$3,188.90
|
| Rate for Payer: Cash Price |
$3,188.90
|
| Rate for Payer: Devoted Health Medicare |
$777.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$590.46
|
| Rate for Payer: Health Management Network Commercial |
$4,170.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$847.80
|
| 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 |
$788.38
|
| Rate for Payer: Ohana Health Plan Medicare |
$706.50
|
| 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
|
|
|
51550 Cystectomy, partial; simple
|
Professional
|
Both
|
$2,691.00
|
|
|
Service Code
|
HCPCS 51550
|
| Hospital Charge Code |
8039664
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,287.35 |
| Rate for Payer: AlohaCare Medicaid |
$967.18
|
| Rate for Payer: AlohaCare Medicare |
$867.53
|
| Rate for Payer: Cash Price |
$1,749.15
|
| Rate for Payer: Cash Price |
$1,749.15
|
| Rate for Payer: Cash Price |
$1,749.15
|
| Rate for Payer: Devoted Health Medicare |
$954.28
|
| 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 |
$750.88
|
| Rate for Payer: Health Management Network Commercial |
$2,287.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,041.04
|
| 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 |
$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 |
$967.18
|
| Rate for Payer: Ohana Health Plan Medicare |
$867.53
|
| 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
|
|
|
51555 Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location)
|
Professional
|
Both
|
$3,412.00
|
|
|
Service Code
|
HCPCS 51555
|
| Hospital Charge Code |
8039665
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,900.20 |
| Rate for Payer: AlohaCare Medicaid |
$1,260.38
|
| Rate for Payer: AlohaCare Medicare |
$1,122.62
|
| Rate for Payer: Cash Price |
$2,217.80
|
| Rate for Payer: Cash Price |
$2,217.80
|
| Rate for Payer: Cash Price |
$2,217.80
|
| Rate for Payer: Devoted Health Medicare |
$1,234.88
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$951.60
|
| Rate for Payer: Health Management Network Commercial |
$2,900.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,347.14
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,260.38
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,122.62
|
| 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
|
|
|
51570 Cystectomy, complete; (separate procedure)
|
Professional
|
Both
|
$3,922.00
|
|
|
Service Code
|
HCPCS 51570
|
| Hospital Charge Code |
8039666
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,333.70 |
| Rate for Payer: AlohaCare Medicaid |
$1,467.86
|
| Rate for Payer: AlohaCare Medicare |
$1,296.20
|
| Rate for Payer: Cash Price |
$2,549.30
|
| Rate for Payer: Cash Price |
$2,549.30
|
| Rate for Payer: Cash Price |
$2,549.30
|
| Rate for Payer: Devoted Health Medicare |
$1,425.82
|
| 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 |
$1,131.26
|
| Rate for Payer: Health Management Network Commercial |
$3,333.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,555.44
|
| 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 |
$1,467.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,296.20
|
| 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
|
|
|
51575 Cystectomy, complete; with bilateral pelvic lymphadenectomy
|
Professional
|
Both
|
$4,757.00
|
|
|
Service Code
|
HCPCS 51575
|
| Hospital Charge Code |
8039667
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$4,043.45 |
| Rate for Payer: AlohaCare Medicaid |
$1,807.32
|
| Rate for Payer: AlohaCare Medicare |
$1,597.44
|
| Rate for Payer: Cash Price |
$3,092.05
|
| Rate for Payer: Cash Price |
$3,092.05
|
| Rate for Payer: Cash Price |
$3,092.05
|
| Rate for Payer: Devoted Health Medicare |
$1,757.18
|
| 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 |
$1,501.24
|
| Rate for Payer: Health Management Network Commercial |
$4,043.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,916.93
|
| 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 |
$1,807.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,597.44
|
| 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
|
|
|
51590 Cystectomy, complete w/ ureteroileal conduit / sigmoid bladder
|
Professional
|
Both
|
$5,028.00
|
|
|
Service Code
|
HCPCS 51590
|
| Hospital Charge Code |
8039668
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$4,273.80 |
| Rate for Payer: AlohaCare Medicaid |
$1,917.34
|
| Rate for Payer: AlohaCare Medicare |
$1,696.45
|
| Rate for Payer: Cash Price |
$3,268.20
|
| Rate for Payer: Cash Price |
$3,268.20
|
| Rate for Payer: Cash Price |
$3,268.20
|
| Rate for Payer: Devoted Health Medicare |
$1,866.10
|
| 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 |
$1,610.44
|
| Rate for Payer: Health Management Network Commercial |
$4,273.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,035.74
|
| 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 |
$1,917.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,696.45
|
| 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
|
|
|
51595 Cystectomy, complete w/ ureteroileal conduit / sigmoid bladder w/ bilat pelvic lymphadenectomy
|
Professional
|
Both
|
$5,649.00
|
|
|
Service Code
|
HCPCS 51595
|
| Hospital Charge Code |
8039669
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$4,801.65 |
| Rate for Payer: AlohaCare Medicaid |
$2,170.01
|
| Rate for Payer: AlohaCare Medicare |
$1,917.04
|
| Rate for Payer: Cash Price |
$3,671.85
|
| Rate for Payer: Cash Price |
$3,671.85
|
| Rate for Payer: Cash Price |
$3,671.85
|
| Rate for Payer: Devoted Health Medicare |
$2,108.74
|
| 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 |
$1,982.50
|
| Rate for Payer: Health Management Network Commercial |
$4,801.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,300.45
|
| 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 |
$2,170.01
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,917.04
|
| 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
|
|
|
51597 Pelvic exenteration, complete, w/ removal of bladder, w/ or w/o hysterectomy
|
Professional
|
Both
|
$5,932.00
|
|
|
Service Code
|
HCPCS 51597
|
| Hospital Charge Code |
8039670
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$5,042.20 |
| Rate for Payer: AlohaCare Medicaid |
$2,284.56
|
| Rate for Payer: AlohaCare Medicare |
$2,021.60
|
| Rate for Payer: Cash Price |
$3,855.80
|
| Rate for Payer: Cash Price |
$3,855.80
|
| Rate for Payer: Cash Price |
$3,855.80
|
| Rate for Payer: Devoted Health Medicare |
$2,223.76
|
| 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 |
$2,572.70
|
| Rate for Payer: Health Management Network Commercial |
$5,042.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,425.92
|
| 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 |
$2,284.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,021.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
51600 Injection procedure for cystography or voiding urethrocystography
|
Professional
|
Both
|
$610.00
|
|
|
Service Code
|
HCPCS 51600
|
| Hospital Charge Code |
8039671
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$36.92 |
| Max. Negotiated Rate |
$518.50 |
| Rate for Payer: AlohaCare Medicaid |
$42.83
|
| Rate for Payer: AlohaCare Medicare |
$36.92
|
| Rate for Payer: Cash Price |
$396.50
|
| Rate for Payer: Cash Price |
$396.50
|
| Rate for Payer: Cash Price |
$396.50
|
| Rate for Payer: Devoted Health Medicare |
$40.61
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$67.68
|
| 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 |
$230.10
|
| Rate for Payer: Health Management Network Commercial |
$518.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$44.30
|
| 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 |
$42.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$36.92
|
| 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
|
|
|
51610 Injection procedure for retrograde urethrocystography
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 51610
|
| Hospital Charge Code |
8039672
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$287.30 |
| Rate for Payer: AlohaCare Medicaid |
$65.50
|
| Rate for Payer: AlohaCare Medicare |
$58.80
|
| Rate for Payer: Cash Price |
$219.70
|
| Rate for Payer: Cash Price |
$219.70
|
| Rate for Payer: Devoted Health Medicare |
$64.68
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$65.50
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$100.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$58.80
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$65.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.50
|
| Rate for Payer: Health Management Network Commercial |
$287.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$70.56
|
| Rate for Payer: Kaiser Permanente Medicaid |
$70.56
|
| Rate for Payer: Kaiser Permanente Medicare |
$70.56
|
| Rate for Payer: Ohana Health Plan Medicaid |
$65.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$58.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$65.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$58.80
|
| Rate for Payer: University Health Alliance Commercial |
$85.04
|
|
|
51610 Injection procedure for retrograde urethrocystography
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 51610
|
| Hospital Charge Code |
8039672
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$65.50
|
| Rate for Payer: AlohaCare Medicare |
$58.80
|
| Rate for Payer: Cash Price |
$219.70
|
| Rate for Payer: Cash Price |
$219.70
|
| Rate for Payer: Cash Price |
$219.70
|
| Rate for Payer: Devoted Health Medicare |
$64.68
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$100.44
|
| 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 |
$71.50
|
| Rate for Payer: Health Management Network Commercial |
$287.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$70.56
|
| 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 |
$65.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$58.80
|
| 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 |
$85.04
|
|
|
51610 XR INJ URETHROCYSTOGRAM RETRO
|
Facility
|
OP
|
$730.00
|
|
|
Service Code
|
HCPCS 51610
|
| Hospital Charge Code |
10073207
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$40.43 |
| Max. Negotiated Rate |
$708.10 |
| Rate for Payer: AlohaCare Medicaid |
$365.00
|
| Rate for Payer: AlohaCare Medicare |
$365.00
|
| Rate for Payer: Cash Price |
$474.50
|
| Rate for Payer: Cash Price |
$474.50
|
| Rate for Payer: Devoted Health Medicare |
$401.50
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$365.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$693.50
|
| Rate for Payer: Health Management Network Commercial |
$620.50
|
| Rate for Payer: Humana Medicare |
$365.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$657.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$372.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$365.00
|
| Rate for Payer: MDX Hawaii PPO |
$708.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$365.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$365.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$40.43
|
| Rate for Payer: UnitedHealthcare Medicare |
$365.00
|
| Rate for Payer: University Health Alliance Commercial |
$408.80
|
|
|
51610 XR INJ URETHROCYSTOGRAM RETRO
|
Facility
|
IP
|
$730.00
|
|
|
Service Code
|
HCPCS 51610
|
| Hospital Charge Code |
10073207
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$620.50 |
| Max. Negotiated Rate |
$708.10 |
| Rate for Payer: Cash Price |
$474.50
|
| Rate for Payer: Health Management Network Commercial |
$620.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$657.00
|
| Rate for Payer: MDX Hawaii PPO |
$708.10
|
|
|
51700 BLADDER IRRIGATION
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 51700
|
| Hospital Charge Code |
8051057
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$25.62 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$29.50
|
| Rate for Payer: AlohaCare Medicare |
$25.62
|
| Rate for Payer: Cash Price |
$226.20
|
| Rate for Payer: Cash Price |
$226.20
|
| Rate for Payer: Cash Price |
$226.20
|
| Rate for Payer: Devoted Health Medicare |
$28.18
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$64.88
|
| 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 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 Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$81.64
|
| Rate for Payer: Health Management Network Commercial |
$295.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$30.74
|
| 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 |
$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 |
$29.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$25.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| 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
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: University Health Alliance Commercial |
$39.85
|
|
|
51700 BLADDER IRRIGATION
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 51700
|
| Hospital Charge Code |
8051057
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$25.62 |
| Max. Negotiated Rate |
$221.85 |
| Rate for Payer: AlohaCare Medicaid |
$29.50
|
| Rate for Payer: AlohaCare Medicare |
$25.62
|
| Rate for Payer: Cash Price |
$169.65
|
| Rate for Payer: Cash Price |
$169.65
|
| Rate for Payer: Devoted Health Medicare |
$28.18
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$29.50
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$64.88
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$25.62
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$29.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$81.64
|
| Rate for Payer: Health Management Network Commercial |
$221.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$30.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$30.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$30.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$29.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$25.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$29.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$25.62
|
| Rate for Payer: University Health Alliance Commercial |
$39.85
|
|
|
51700 Bladder irrigation and/or instillation
|
Facility
|
OP
|
$1,655.00
|
|
|
Service Code
|
HCPCS 51700
|
| Hospital Charge Code |
8890098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.96 |
| Max. Negotiated Rate |
$1,605.35 |
| Rate for Payer: AlohaCare Medicaid |
$827.50
|
| Rate for Payer: AlohaCare Medicare |
$827.50
|
| Rate for Payer: Cash Price |
$1,075.75
|
| Rate for Payer: Cash Price |
$1,075.75
|
| Rate for Payer: Devoted Health Medicare |
$910.25
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$319.07
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$827.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,572.25
|
| Rate for Payer: Health Management Network Commercial |
$1,406.75
|
| Rate for Payer: Humana Medicare |
$827.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,489.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$844.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$827.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,605.35
|
| Rate for Payer: Ohana Health Plan Medicaid |
$827.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$827.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$30.96
|
| Rate for Payer: UnitedHealthcare Medicare |
$827.50
|
| Rate for Payer: University Health Alliance Commercial |
$926.80
|
|
|
51700 Bladder irrigation and/or instillation
|
Facility
|
IP
|
$1,655.00
|
|
|
Service Code
|
HCPCS 51700
|
| Hospital Charge Code |
8890098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,406.75 |
| Max. Negotiated Rate |
$1,605.35 |
| Rate for Payer: Cash Price |
$1,075.75
|
| Rate for Payer: Health Management Network Commercial |
$1,406.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,489.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,605.35
|
|
|
51700-Bladder Irrigation Simple Lavage/Instill
|
Facility
|
OP
|
$1,473.00
|
|
|
Service Code
|
HCPCS 51700
|
| Hospital Charge Code |
8080221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$736.50
|
| Rate for Payer: AlohaCare Medicare |
$736.50
|
| Rate for Payer: Cash Price |
$957.45
|
| Rate for Payer: Cash Price |
$957.45
|
| Rate for Payer: Devoted Health Medicare |
$810.15
|
| 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 |
$736.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,399.35
|
| Rate for Payer: Health Management Network Commercial |
$1,252.05
|
| Rate for Payer: Humana Medicare |
$736.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,325.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$736.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,428.81
|
| Rate for Payer: Ohana Health Plan Medicaid |
$736.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$736.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$736.50
|
| Rate for Payer: University Health Alliance Commercial |
$1,073.67
|
|
|
51700-Bladder Irrigation Simple Lavage/Instill
|
Facility
|
IP
|
$1,473.00
|
|
|
Service Code
|
HCPCS 51700
|
| Hospital Charge Code |
8080221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,252.05 |
| Max. Negotiated Rate |
$1,428.81 |
| Rate for Payer: Cash Price |
$957.45
|
| Rate for Payer: Health Management Network Commercial |
$1,252.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,325.70
|
| Rate for Payer: MDX Hawaii PPO |
$1,428.81
|
|
|
51701-Insert Bladder Cath Non-Dwelling
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
HCPCS 51701
|
| Hospital Charge Code |
8080223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$340.85 |
| Max. Negotiated Rate |
$388.97 |
| Rate for Payer: Cash Price |
$260.65
|
| Rate for Payer: Health Management Network Commercial |
$340.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$360.90
|
| Rate for Payer: MDX Hawaii PPO |
$388.97
|
|
