|
51701-Insert Bladder Cath Non-Dwelling
|
Facility
|
OP
|
$401.00
|
|
|
Service Code
|
HCPCS 51701
|
| Hospital Charge Code |
8080223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.82 |
| Max. Negotiated Rate |
$388.97 |
| Rate for Payer: AlohaCare Medicaid |
$200.50
|
| Rate for Payer: AlohaCare Medicare |
$200.50
|
| Rate for Payer: Cash Price |
$260.65
|
| Rate for Payer: Cash Price |
$260.65
|
| Rate for Payer: Devoted Health Medicare |
$220.55
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$169.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$200.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$380.95
|
| Rate for Payer: Health Management Network Commercial |
$340.85
|
| Rate for Payer: Humana Medicare |
$200.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$360.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$204.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$200.50
|
| Rate for Payer: MDX Hawaii PPO |
$388.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$200.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$200.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$19.82
|
| Rate for Payer: UnitedHealthcare Medicare |
$200.50
|
| Rate for Payer: University Health Alliance Commercial |
$224.56
|
|
|
51701 INSERT NON DWELLING BLADDER CATH-ER SERV
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 51701
|
| Hospital Charge Code |
8051060
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$25.22
|
| Rate for Payer: AlohaCare Medicare |
$21.52
|
| Rate for Payer: Cash Price |
$131.30
|
| Rate for Payer: Cash Price |
$131.30
|
| Rate for Payer: Cash Price |
$131.30
|
| Rate for Payer: Devoted Health Medicare |
$23.67
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$40.13
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$54.86
|
| Rate for Payer: Health Management Network Commercial |
$171.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$25.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$25.22
|
| Rate for Payer: Ohana Health Plan Medicare |
$21.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: University Health Alliance Commercial |
$30.89
|
|
|
51702 Insert Foley Catheter Charges
|
Facility
|
OP
|
$451.00
|
|
|
Service Code
|
HCPCS 51702
|
| Hospital Charge Code |
8221527
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.90 |
| Max. Negotiated Rate |
$437.47 |
| Rate for Payer: AlohaCare Medicaid |
$225.50
|
| Rate for Payer: AlohaCare Medicare |
$225.50
|
| Rate for Payer: Cash Price |
$293.15
|
| Rate for Payer: Cash Price |
$293.15
|
| Rate for Payer: Devoted Health Medicare |
$248.05
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$169.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$225.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$428.45
|
| Rate for Payer: Health Management Network Commercial |
$383.35
|
| Rate for Payer: Humana Medicare |
$225.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$405.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$230.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$225.50
|
| Rate for Payer: MDX Hawaii PPO |
$437.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$225.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$225.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$21.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$225.50
|
| Rate for Payer: University Health Alliance Commercial |
$252.56
|
|
|
51702 Insert Foley Catheter Charges
|
Facility
|
IP
|
$451.00
|
|
|
Service Code
|
HCPCS 51702
|
| Hospital Charge Code |
8221527
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$383.35 |
| Max. Negotiated Rate |
$437.47 |
| Rate for Payer: Cash Price |
$293.15
|
| Rate for Payer: Health Management Network Commercial |
$383.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$405.90
|
| Rate for Payer: MDX Hawaii PPO |
$437.47
|
|
|
51702-Insertion Indwelling Catheter
|
Facility
|
OP
|
$397.00
|
|
|
Service Code
|
HCPCS 51702
|
| Hospital Charge Code |
8080225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.90 |
| Max. Negotiated Rate |
$385.09 |
| Rate for Payer: AlohaCare Medicaid |
$198.50
|
| Rate for Payer: AlohaCare Medicare |
$198.50
|
| Rate for Payer: Cash Price |
$258.05
|
| Rate for Payer: Cash Price |
$258.05
|
| Rate for Payer: Devoted Health Medicare |
$218.35
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$169.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$198.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$377.15
|
| Rate for Payer: Health Management Network Commercial |
$337.45
|
| Rate for Payer: Humana Medicare |
$198.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$357.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$202.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$198.50
|
| Rate for Payer: MDX Hawaii PPO |
$385.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$198.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$198.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$21.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$198.50
|
| Rate for Payer: University Health Alliance Commercial |
$222.32
|
|
|
51702-Insertion Indwelling Catheter
|
Facility
|
IP
|
$397.00
|
|
|
Service Code
|
HCPCS 51702
|
| Hospital Charge Code |
8080225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$337.45 |
| Max. Negotiated Rate |
$385.09 |
| Rate for Payer: Cash Price |
$258.05
|
| Rate for Payer: Health Management Network Commercial |
$337.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$357.30
|
| Rate for Payer: MDX Hawaii PPO |
$385.09
|
|
|
51702 INSERT TEMP INDWELLING BLADDER C ER SERV
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 51702
|
| Hospital Charge Code |
8051062
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$22.28 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$25.03
|
| Rate for Payer: AlohaCare Medicare |
$22.28
|
| Rate for Payer: Cash Price |
$170.95
|
| Rate for Payer: Cash Price |
$170.95
|
| Rate for Payer: Cash Price |
$170.95
|
| Rate for Payer: Devoted Health Medicare |
$24.51
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$45.38
|
| 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 |
$93.34
|
| Rate for Payer: Health Management Network Commercial |
$223.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$26.74
|
| 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 |
$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 |
$25.03
|
| Rate for Payer: Ohana Health Plan Medicare |
$22.28
|
| 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 |
$80.00
|
|
|
51703-Insert Indwelling Cath Complicated
|
Facility
|
IP
|
$536.00
|
|
|
Service Code
|
HCPCS 51703
|
| Hospital Charge Code |
8080226
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$455.60 |
| Max. Negotiated Rate |
$519.92 |
| Rate for Payer: Cash Price |
$348.40
|
| Rate for Payer: Health Management Network Commercial |
$455.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$482.40
|
| Rate for Payer: MDX Hawaii PPO |
$519.92
|
|
|
51703-Insert Indwelling Cath Complicated
|
Facility
|
OP
|
$536.00
|
|
|
Service Code
|
HCPCS 51703
|
| Hospital Charge Code |
8080226
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$268.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$268.00
|
| Rate for Payer: AlohaCare Medicare |
$268.00
|
| Rate for Payer: Cash Price |
$348.40
|
| Rate for Payer: Cash Price |
$348.40
|
| Rate for Payer: Devoted Health Medicare |
$294.80
|
| 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 |
$268.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$509.20
|
| Rate for Payer: Health Management Network Commercial |
$455.60
|
| Rate for Payer: Humana Medicare |
$268.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$482.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$268.00
|
| Rate for Payer: MDX Hawaii PPO |
$519.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$268.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$268.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$268.00
|
| Rate for Payer: University Health Alliance Commercial |
$390.69
|
|
|
51703 INSERT TEMP INDWELLING BLADDER C-ER SERV
|
Professional
|
Both
|
$416.00
|
|
|
Service Code
|
HCPCS 51703
|
| Hospital Charge Code |
8051063
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$66.63 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$75.62
|
| Rate for Payer: AlohaCare Medicare |
$66.63
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Devoted Health Medicare |
$73.29
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$122.10
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$162.24
|
| Rate for Payer: Health Management Network Commercial |
$353.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$79.96
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$75.62
|
| Rate for Payer: Ohana Health Plan Medicare |
$66.63
|
| 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 |
$103.51
|
|
|
51703 INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED TechFee
|
Facility
|
OP
|
$631.00
|
|
|
Service Code
|
HCPCS 51703
|
| Hospital Charge Code |
8211336
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$315.50 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$315.50
|
| Rate for Payer: AlohaCare Medicare |
$315.50
|
| Rate for Payer: Cash Price |
$410.15
|
| Rate for Payer: Cash Price |
$410.15
|
| Rate for Payer: Devoted Health Medicare |
$347.05
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$315.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$599.45
|
| Rate for Payer: Health Management Network Commercial |
$536.35
|
| Rate for Payer: Humana Medicare |
$315.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$567.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$315.50
|
| Rate for Payer: MDX Hawaii PPO |
$612.07
|
| Rate for Payer: Ohana Health Plan Medicaid |
$315.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$315.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$315.50
|
| Rate for Payer: University Health Alliance Commercial |
$459.94
|
|
|
51703 INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED TechFee
|
Facility
|
IP
|
$631.00
|
|
|
Service Code
|
HCPCS 51703
|
| Hospital Charge Code |
8211336
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$536.35 |
| Max. Negotiated Rate |
$612.07 |
| Rate for Payer: Cash Price |
$410.15
|
| Rate for Payer: Health Management Network Commercial |
$536.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$567.90
|
| Rate for Payer: MDX Hawaii PPO |
$612.07
|
|
|
51705-Change Cystostomy Tube Simple
|
Facility
|
IP
|
$998.00
|
|
|
Service Code
|
HCPCS 51705
|
| Hospital Charge Code |
8080228
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$848.30 |
| Max. Negotiated Rate |
$968.06 |
| Rate for Payer: Cash Price |
$648.70
|
| Rate for Payer: Health Management Network Commercial |
$848.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$898.20
|
| Rate for Payer: MDX Hawaii PPO |
$968.06
|
|
|
51705-Change Cystostomy Tube Simple
|
Facility
|
OP
|
$998.00
|
|
|
Service Code
|
HCPCS 51705
|
| Hospital Charge Code |
8080228
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$499.00
|
| Rate for Payer: AlohaCare Medicare |
$499.00
|
| Rate for Payer: Cash Price |
$648.70
|
| Rate for Payer: Cash Price |
$648.70
|
| Rate for Payer: Devoted Health Medicare |
$548.90
|
| 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 |
$499.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$948.10
|
| Rate for Payer: Health Management Network Commercial |
$848.30
|
| Rate for Payer: Humana Medicare |
$499.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$898.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$499.00
|
| Rate for Payer: MDX Hawaii PPO |
$968.06
|
| Rate for Payer: Ohana Health Plan Medicaid |
$499.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$499.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$499.00
|
| Rate for Payer: University Health Alliance Commercial |
$727.44
|
|
|
51705 CHANGE OF CYSTOSTOMY TUBE, SIMPLE
|
Professional
|
Both
|
$341.00
|
|
|
Service Code
|
HCPCS 51705
|
| Hospital Charge Code |
8051064
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$47.28 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$52.28
|
| Rate for Payer: AlohaCare Medicare |
$47.28
|
| Rate for Payer: Cash Price |
$221.65
|
| Rate for Payer: Cash Price |
$221.65
|
| Rate for Payer: Cash Price |
$221.65
|
| Rate for Payer: Devoted Health Medicare |
$52.01
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$102.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$47.84
|
| Rate for Payer: Health Management Network Commercial |
$289.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$56.74
|
| 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 |
$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 |
$52.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$47.28
|
| 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 |
$67.83
|
|
|
51710 Change of cystostomy tube; complicated
|
Professional
|
Both
|
$970.00
|
|
|
Service Code
|
HCPCS 51710
|
| Hospital Charge Code |
8039678
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$73.96 |
| Max. Negotiated Rate |
$824.50 |
| Rate for Payer: AlohaCare Medicaid |
$81.39
|
| Rate for Payer: AlohaCare Medicare |
$73.96
|
| Rate for Payer: Cash Price |
$630.50
|
| Rate for Payer: Cash Price |
$630.50
|
| Rate for Payer: Cash Price |
$630.50
|
| Rate for Payer: Devoted Health Medicare |
$81.36
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$146.38
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$85.80
|
| Rate for Payer: Health Management Network Commercial |
$824.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$88.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$81.39
|
| Rate for Payer: Ohana Health Plan Medicare |
$73.96
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: University Health Alliance Commercial |
$105.16
|
|
|
51715 Endoscopic inj of implant material into the submucosal tissues of the urethra/bladder neck
|
Professional
|
Both
|
$4,906.00
|
|
|
Service Code
|
HCPCS 51715
|
| Hospital Charge Code |
8039679
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$173.98 |
| Max. Negotiated Rate |
$4,170.10 |
| Rate for Payer: AlohaCare Medicaid |
$197.94
|
| Rate for Payer: AlohaCare Medicare |
$173.98
|
| 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 |
$191.38
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$307.41
|
| 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 |
$255.84
|
| Rate for Payer: Health Management Network Commercial |
$4,170.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$208.78
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$197.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$173.98
|
| 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 |
$260.27
|
|
|
51720 Bladder instillation of anticarcinogenic agent (including retention time)
|
Professional
|
Both
|
$970.00
|
|
|
Service Code
|
HCPCS 51720
|
| Hospital Charge Code |
8039680
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$37.35 |
| Max. Negotiated Rate |
$824.50 |
| Rate for Payer: AlohaCare Medicaid |
$42.87
|
| Rate for Payer: AlohaCare Medicare |
$37.35
|
| Rate for Payer: Cash Price |
$630.50
|
| Rate for Payer: Cash Price |
$630.50
|
| Rate for Payer: Cash Price |
$630.50
|
| Rate for Payer: Devoted Health Medicare |
$41.09
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$121.87
|
| 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 |
$117.00
|
| Rate for Payer: Health Management Network Commercial |
$824.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$44.82
|
| 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 |
$42.87
|
| Rate for Payer: Ohana Health Plan Medicare |
$37.35
|
| 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 |
$56.65
|
|
|
51725 Simple cystometrogram (CMG) (eg, spinal manometer)
|
Professional
|
Both
|
$645.00
|
|
|
Service Code
|
HCPCS 51725
|
| Hospital Charge Code |
8039681
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$95.68 |
| Max. Negotiated Rate |
$548.25 |
| Rate for Payer: AlohaCare Medicaid |
$250.22
|
| Rate for Payer: AlohaCare Medicare |
$215.13
|
| Rate for Payer: Cash Price |
$419.25
|
| Rate for Payer: Cash Price |
$419.25
|
| Rate for Payer: Cash Price |
$419.25
|
| Rate for Payer: Devoted Health Medicare |
$236.64
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.68
|
| Rate for Payer: Health Management Network Commercial |
$548.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$258.16
|
| 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 |
$250.22
|
| Rate for Payer: Ohana Health Plan Medicare |
$215.13
|
| 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
|
|
|
51726 Complex cystometrogram (ie, calibrated electronic equipment);
|
Professional
|
Both
|
$951.00
|
|
|
Service Code
|
HCPCS 51726
|
| Hospital Charge Code |
8039682
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$114.14 |
| Max. Negotiated Rate |
$808.35 |
| Rate for Payer: AlohaCare Medicaid |
$332.80
|
| Rate for Payer: AlohaCare Medicare |
$297.18
|
| Rate for Payer: Cash Price |
$618.15
|
| Rate for Payer: Cash Price |
$618.15
|
| Rate for Payer: Cash Price |
$618.15
|
| Rate for Payer: Devoted Health Medicare |
$326.90
|
| 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 |
$114.14
|
| Rate for Payer: Health Management Network Commercial |
$808.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$356.62
|
| 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 |
$332.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$297.18
|
| 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
|
|
|
51727 Complex cystometrogram; with urethral pressure profile studies, any technique
|
Professional
|
Both
|
$936.00
|
|
|
Service Code
|
HCPCS 51727
|
| Hospital Charge Code |
8039683
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$795.60 |
| Rate for Payer: AlohaCare Medicaid |
$404.60
|
| Rate for Payer: AlohaCare Medicare |
$362.08
|
| Rate for Payer: Cash Price |
$608.40
|
| Rate for Payer: Cash Price |
$608.40
|
| Rate for Payer: Cash Price |
$608.40
|
| Rate for Payer: Devoted Health Medicare |
$398.29
|
| 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 |
$236.08
|
| Rate for Payer: Health Management Network Commercial |
$795.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$434.50
|
| 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 |
$404.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$362.08
|
| 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
|
|
|
51728 Complex cystometrogram; with voiding pressure studies, any technique
|
Professional
|
Both
|
$928.00
|
|
|
Service Code
|
HCPCS 51728
|
| Hospital Charge Code |
8039684
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$788.80 |
| Rate for Payer: AlohaCare Medicaid |
$402.70
|
| Rate for Payer: AlohaCare Medicare |
$369.28
|
| Rate for Payer: Cash Price |
$603.20
|
| Rate for Payer: Cash Price |
$603.20
|
| Rate for Payer: Cash Price |
$603.20
|
| Rate for Payer: Devoted Health Medicare |
$406.21
|
| 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 |
$236.08
|
| Rate for Payer: Health Management Network Commercial |
$788.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$443.14
|
| 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 |
$402.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$369.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
51729 Complex cystometrogram w/ voiding & urethral pressure profile studies, any technique
|
Professional
|
Both
|
$1,011.00
|
|
|
Service Code
|
HCPCS 51729
|
| Hospital Charge Code |
8039685
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$859.35 |
| Rate for Payer: AlohaCare Medicaid |
$422.10
|
| Rate for Payer: AlohaCare Medicare |
$385.57
|
| Rate for Payer: Cash Price |
$657.15
|
| Rate for Payer: Cash Price |
$657.15
|
| Rate for Payer: Cash Price |
$657.15
|
| Rate for Payer: Devoted Health Medicare |
$424.13
|
| 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 |
$252.98
|
| Rate for Payer: Health Management Network Commercial |
$859.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$462.68
|
| 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 |
$422.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$385.57
|
| 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
|
|
|
51741 Complex uroflowmetry (eg, calibrated electronic equipment)
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 51741
|
| Hospital Charge Code |
8039686
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$15.02
|
| Rate for Payer: AlohaCare Medicare |
$16.13
|
| Rate for Payer: Cash Price |
$195.65
|
| Rate for Payer: Cash Price |
$195.65
|
| Rate for Payer: Cash Price |
$195.65
|
| Rate for Payer: Devoted Health Medicare |
$17.74
|
| 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 |
$59.80
|
| Rate for Payer: Health Management Network Commercial |
$255.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$19.36
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$15.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$16.13
|
| 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
|
|
|
51784 Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 51784
|
| Hospital Charge Code |
8039687
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$68.53 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$68.53
|
| Rate for Payer: AlohaCare Medicare |
$70.74
|
| Rate for Payer: Cash Price |
$245.05
|
| Rate for Payer: Cash Price |
$245.05
|
| Rate for Payer: Cash Price |
$245.05
|
| Rate for Payer: Devoted Health Medicare |
$77.81
|
| 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 |
$92.82
|
| Rate for Payer: Health Management Network Commercial |
$320.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$84.89
|
| 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 |
$68.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$70.74
|
| 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
|
|
