|
58554 Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g
|
Professional
|
Both
|
$14,794.00
|
|
|
Service Code
|
HCPCS 58554
|
| Hospital Charge Code |
8039951
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$12,574.90 |
| Rate for Payer: AlohaCare Medicaid |
$1,310.83
|
| Rate for Payer: AlohaCare Medicare |
$1,140.95
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Devoted Health Medicare |
$1,255.05
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,037.40
|
| Rate for Payer: Health Management Network Commercial |
$12,574.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,369.14
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,310.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,140.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
|
|
58555 Hysteroscopy, diagnostic (separate procedure)
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 58555
|
| Hospital Charge Code |
8039952
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$132.85 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$151.50
|
| Rate for Payer: AlohaCare Medicare |
$132.85
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Devoted Health Medicare |
$146.13
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$248.16
|
| 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 |
$232.44
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$159.42
|
| 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 |
$151.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$132.85
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
58558 Hysteroscopy, surgical; w/ biopsy of endometrium and/or polypectomy, with or w/o D & C
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 58558
|
| Hospital Charge Code |
8039953
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$230.09
|
| Rate for Payer: AlohaCare Medicare |
$200.38
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Devoted Health Medicare |
$220.42
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$358.40
|
| 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 |
$278.20
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$240.46
|
| 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 Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$230.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$200.38
|
| 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
|
|
|
58558 Hysteroscopy, surgical; w/ biopsy of endometrium and/or polypectomy, with or w/o D & C
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 58558
|
| Hospital Charge Code |
8039953
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$200.38 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$230.09
|
| Rate for Payer: AlohaCare Medicare |
$200.38
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Devoted Health Medicare |
$220.42
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$230.09
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$358.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$200.38
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$230.09
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$278.20
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$240.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$240.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$240.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$230.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$200.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$230.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$200.38
|
|
|
58559 Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)
|
Professional
|
Both
|
$6,962.00
|
|
|
Service Code
|
HCPCS 58559
|
| Hospital Charge Code |
8039954
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$243.52 |
| Max. Negotiated Rate |
$5,917.70 |
| Rate for Payer: AlohaCare Medicaid |
$281.70
|
| Rate for Payer: AlohaCare Medicare |
$243.52
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Devoted Health Medicare |
$267.87
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$243.52
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$321.88
|
| Rate for Payer: Health Management Network Commercial |
$5,917.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$292.22
|
| Rate for Payer: Kaiser Permanente Medicaid |
$292.22
|
| Rate for Payer: Kaiser Permanente Medicare |
$292.22
|
| Rate for Payer: Ohana Health Plan Medicaid |
$281.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$243.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$281.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$243.52
|
|
|
58559 Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)
|
Professional
|
Both
|
$6,962.00
|
|
|
Service Code
|
HCPCS 58559
|
| Hospital Charge Code |
8039954
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$5,917.70 |
| Rate for Payer: AlohaCare Medicaid |
$281.70
|
| Rate for Payer: AlohaCare Medicare |
$243.52
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Devoted Health Medicare |
$267.87
|
| 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 |
$321.88
|
| Rate for Payer: Health Management Network Commercial |
$5,917.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$292.22
|
| 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 |
$281.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$243.52
|
| 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
|
|
|
58560 Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)
|
Professional
|
Both
|
$6,962.00
|
|
|
Service Code
|
HCPCS 58560
|
| Hospital Charge Code |
8039955
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$5,917.70 |
| Rate for Payer: AlohaCare Medicaid |
$309.91
|
| Rate for Payer: AlohaCare Medicare |
$268.24
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Devoted Health Medicare |
$295.06
|
| 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 |
$375.70
|
| Rate for Payer: Health Management Network Commercial |
$5,917.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$321.89
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$309.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$268.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
|
|
58561 Hysteroscopy, surgical; with removal of leiomyomata
|
Professional
|
Both
|
$6,962.00
|
|
|
Service Code
|
HCPCS 58561
|
| Hospital Charge Code |
8039956
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$306.08 |
| Max. Negotiated Rate |
$5,917.70 |
| Rate for Payer: AlohaCare Medicaid |
$354.39
|
| Rate for Payer: AlohaCare Medicare |
$306.08
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Devoted Health Medicare |
$336.69
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$306.08
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$550.16
|
| Rate for Payer: Health Management Network Commercial |
$5,917.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$367.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$367.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$367.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$354.39
|
| Rate for Payer: Ohana Health Plan Medicare |
$306.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$354.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$306.08
|
|
|
58561 Hysteroscopy, surgical; with removal of leiomyomata
|
Professional
|
Both
|
$6,962.00
|
|
|
Service Code
|
HCPCS 58561
|
| Hospital Charge Code |
8039956
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$5,917.70 |
| Rate for Payer: AlohaCare Medicaid |
$354.39
|
| Rate for Payer: AlohaCare Medicare |
$306.08
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Devoted Health Medicare |
$336.69
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$550.16
|
| Rate for Payer: Health Management Network Commercial |
$5,917.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$367.30
|
| 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 |
$354.39
|
| Rate for Payer: Ohana Health Plan Medicare |
$306.08
|
| 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
|
|
|
58562 Hysteroscopy, surgical; with removal of impacted foreign body
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 58562
|
| Hospital Charge Code |
8039957
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$191.26 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$220.43
|
| Rate for Payer: AlohaCare Medicare |
$191.26
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Devoted Health Medicare |
$210.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$220.43
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$377.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$191.26
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$220.43
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$271.44
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$229.51
|
| Rate for Payer: Kaiser Permanente Medicaid |
$229.51
|
| Rate for Payer: Kaiser Permanente Medicare |
$229.51
|
| Rate for Payer: Ohana Health Plan Medicaid |
$220.43
|
| Rate for Payer: Ohana Health Plan Medicare |
$191.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$220.43
|
| Rate for Payer: UnitedHealthcare Medicare |
$191.26
|
|
|
58562 Hysteroscopy, surgical; with removal of impacted foreign body
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 58562
|
| Hospital Charge Code |
8039957
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$220.43
|
| Rate for Payer: AlohaCare Medicare |
$191.26
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Devoted Health Medicare |
$210.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$377.72
|
| 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 |
$271.44
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$229.51
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$220.43
|
| Rate for Payer: Ohana Health Plan Medicare |
$191.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
|
|
58563 Hysteroscopy, surgical; with endometrial ablation
|
Professional
|
Both
|
$6,962.00
|
|
|
Service Code
|
HCPCS 58563
|
| Hospital Charge Code |
8039958
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$5,917.70 |
| Rate for Payer: AlohaCare Medicaid |
$244.27
|
| Rate for Payer: AlohaCare Medicare |
$212.36
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Devoted Health Medicare |
$233.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$444.76
|
| 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 |
$355.68
|
| Rate for Payer: Health Management Network Commercial |
$5,917.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$254.83
|
| 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 |
$244.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$212.36
|
| 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
|
|
|
58563 Hysteroscopy, surgical; with endometrial ablation
|
Professional
|
Both
|
$6,962.00
|
|
|
Service Code
|
HCPCS 58563
|
| Hospital Charge Code |
8039958
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$5,917.70 |
| Rate for Payer: AlohaCare Medicaid |
$244.27
|
| Rate for Payer: AlohaCare Medicare |
$212.36
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Devoted Health Medicare |
$233.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$244.27
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$444.76
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$212.36
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$244.27
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$355.68
|
| Rate for Payer: Health Management Network Commercial |
$5,917.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$254.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$254.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$254.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$244.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$212.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$244.27
|
| Rate for Payer: UnitedHealthcare Medicare |
$212.36
|
|
|
58565 Hysteroscopy, surgical; w/ bilateral fallopian tube cannulation
|
Professional
|
Both
|
$6,962.00
|
|
|
Service Code
|
HCPCS 58565
|
| Hospital Charge Code |
8039959
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$5,917.70 |
| Rate for Payer: AlohaCare Medicaid |
$470.35
|
| Rate for Payer: AlohaCare Medicare |
$405.02
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Cash Price |
$4,525.30
|
| Rate for Payer: Devoted Health Medicare |
$445.52
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$733.50
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,091.96
|
| Rate for Payer: Health Management Network Commercial |
$5,917.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$486.02
|
| 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 |
$470.35
|
| Rate for Payer: Ohana Health Plan Medicare |
$405.02
|
| 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 |
$621.03
|
|
|
58570 Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;
|
Professional
|
Both
|
$14,794.00
|
|
|
Service Code
|
HCPCS 58570
|
| Hospital Charge Code |
8039960
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$12,574.90 |
| Rate for Payer: AlohaCare Medicaid |
$821.60
|
| Rate for Payer: AlohaCare Medicare |
$720.91
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Devoted Health Medicare |
$793.00
|
| 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 |
$873.08
|
| Rate for Payer: Health Management Network Commercial |
$12,574.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$865.09
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$821.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$720.91
|
| 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
|
|
|
58570 Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;
|
Professional
|
Both
|
$14,794.00
|
|
|
Service Code
|
HCPCS 58570
|
| Hospital Charge Code |
8039960
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$720.91 |
| Max. Negotiated Rate |
$12,574.90 |
| Rate for Payer: AlohaCare Medicaid |
$821.60
|
| Rate for Payer: AlohaCare Medicare |
$720.91
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Devoted Health Medicare |
$793.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$720.91
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$873.08
|
| Rate for Payer: Health Management Network Commercial |
$12,574.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$865.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$865.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$865.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$821.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$720.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$821.60
|
| Rate for Payer: UnitedHealthcare Medicare |
$720.91
|
|
|
58571 LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS; WITH REMOVAL ProFee
|
Professional
|
Both
|
$14,794.00
|
|
|
Service Code
|
HCPCS 58571
|
| Hospital Charge Code |
8021105
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$819.91 |
| Max. Negotiated Rate |
$12,574.90 |
| Rate for Payer: AlohaCare Medicaid |
$925.01
|
| Rate for Payer: AlohaCare Medicare |
$819.91
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Devoted Health Medicare |
$901.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$819.91
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$990.86
|
| Rate for Payer: Health Management Network Commercial |
$12,574.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$983.89
|
| Rate for Payer: Kaiser Permanente Medicaid |
$983.89
|
| Rate for Payer: Kaiser Permanente Medicare |
$983.89
|
| Rate for Payer: Ohana Health Plan Medicaid |
$925.01
|
| Rate for Payer: Ohana Health Plan Medicare |
$819.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$925.01
|
| Rate for Payer: UnitedHealthcare Medicare |
$819.91
|
|
|
58571 Laparoscopy, surgical, w/ total hysterectomy, for uterus 250 g or less; w/ remvl tubes/ovaries
|
Professional
|
Both
|
$14,794.00
|
|
|
Service Code
|
HCPCS 58571
|
| Hospital Charge Code |
8039961
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$819.91 |
| Max. Negotiated Rate |
$12,574.90 |
| Rate for Payer: AlohaCare Medicaid |
$925.01
|
| Rate for Payer: AlohaCare Medicare |
$819.91
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Devoted Health Medicare |
$901.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$819.91
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$990.86
|
| Rate for Payer: Health Management Network Commercial |
$12,574.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$983.89
|
| Rate for Payer: Kaiser Permanente Medicaid |
$983.89
|
| Rate for Payer: Kaiser Permanente Medicare |
$983.89
|
| Rate for Payer: Ohana Health Plan Medicaid |
$925.01
|
| Rate for Payer: Ohana Health Plan Medicare |
$819.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$925.01
|
| Rate for Payer: UnitedHealthcare Medicare |
$819.91
|
|
|
58571 Laparoscopy, surgical, w/ total hysterectomy, for uterus 250 g or less; w/ remvl tubes/ovaries
|
Professional
|
Both
|
$14,794.00
|
|
|
Service Code
|
HCPCS 58571
|
| Hospital Charge Code |
8039961
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$12,574.90 |
| Rate for Payer: AlohaCare Medicaid |
$925.01
|
| Rate for Payer: AlohaCare Medicare |
$819.91
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Devoted Health Medicare |
$901.90
|
| 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 |
$990.86
|
| Rate for Payer: Health Management Network Commercial |
$12,574.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$983.89
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$925.01
|
| Rate for Payer: Ohana Health Plan Medicare |
$819.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
|
|
58572 Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;
|
Professional
|
Both
|
$14,794.00
|
|
|
Service Code
|
HCPCS 58572
|
| Hospital Charge Code |
8039962
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$12,574.90 |
| Rate for Payer: AlohaCare Medicaid |
$1,022.67
|
| Rate for Payer: AlohaCare Medicare |
$931.42
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Devoted Health Medicare |
$1,024.56
|
| 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 |
$1,028.56
|
| Rate for Payer: Health Management Network Commercial |
$12,574.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,117.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,022.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$931.42
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
|
|
58573 Laparoscopy, surgical, w/ total hysterectomy, uterus > 250 g; w/ remvl tube(s) and/or ovary(s)
|
Professional
|
Both
|
$14,794.00
|
|
|
Service Code
|
HCPCS 58573
|
| Hospital Charge Code |
8039963
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$12,574.90 |
| Rate for Payer: AlohaCare Medicaid |
$1,232.23
|
| Rate for Payer: AlohaCare Medicare |
$1,088.05
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Cash Price |
$9,616.10
|
| Rate for Payer: Devoted Health Medicare |
$1,196.86
|
| 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 |
$948.48
|
| Rate for Payer: Health Management Network Commercial |
$12,574.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,305.66
|
| 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 |
$1,232.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,088.05
|
| 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
|
|
|
58600 Ligation/transection of fallopian tube(s), abdominal or vaginal approach, uni/bilateral
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 58600
|
| Hospital Charge Code |
8039965
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$380.44
|
| Rate for Payer: AlohaCare Medicare |
$332.50
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Devoted Health Medicare |
$365.75
|
| 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 |
$327.60
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$399.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$380.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$332.50
|
| 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
|
|
|
58600 Ligation/transection of fallopian tube(s), abdominal or vaginal approach, uni/bilateral
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 58600
|
| Hospital Charge Code |
8039965
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicare |
$332.50
|
| Rate for Payer: AlohaCare Medicaid |
$380.44
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Devoted Health Medicare |
$365.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$332.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$327.60
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$399.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$399.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$399.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$380.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$332.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$380.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$332.50
|
|
|
58605 Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum
|
Professional
|
Both
|
$1,086.00
|
|
|
Service Code
|
HCPCS 58605
|
| Hospital Charge Code |
8039966
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$281.84 |
| Max. Negotiated Rate |
$923.10 |
| Rate for Payer: AlohaCare Medicaid |
$346.70
|
| Rate for Payer: AlohaCare Medicare |
$303.16
|
| Rate for Payer: Cash Price |
$705.90
|
| Rate for Payer: Cash Price |
$705.90
|
| Rate for Payer: Devoted Health Medicare |
$333.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.16
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$281.84
|
| Rate for Payer: Health Management Network Commercial |
$923.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$363.79
|
| Rate for Payer: Kaiser Permanente Medicaid |
$363.79
|
| Rate for Payer: Kaiser Permanente Medicare |
$363.79
|
| Rate for Payer: Ohana Health Plan Medicaid |
$346.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$303.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$346.70
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.16
|
|
|
58605 Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum
|
Professional
|
Both
|
$1,086.00
|
|
|
Service Code
|
HCPCS 58605
|
| Hospital Charge Code |
8039966
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$923.10 |
| Rate for Payer: AlohaCare Medicaid |
$346.70
|
| Rate for Payer: AlohaCare Medicare |
$303.16
|
| Rate for Payer: Cash Price |
$705.90
|
| Rate for Payer: Cash Price |
$705.90
|
| Rate for Payer: Cash Price |
$705.90
|
| Rate for Payer: Devoted Health Medicare |
$333.48
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$281.84
|
| Rate for Payer: Health Management Network Commercial |
$923.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$363.79
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$346.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$303.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
|
