|
59121 Surgical treatment of ectopic pregnancy; tubal or ovarian, w/o salpingectomy/oophorectomy
|
Professional
|
Both
|
$2,200.00
|
|
|
Service Code
|
HCPCS 59121
|
| Hospital Charge Code |
8040006
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,870.00 |
| Rate for Payer: AlohaCare Medicaid |
$807.86
|
| Rate for Payer: AlohaCare Medicare |
$704.86
|
| Rate for Payer: Cash Price |
$1,430.00
|
| Rate for Payer: Cash Price |
$1,430.00
|
| Rate for Payer: Cash Price |
$1,430.00
|
| Rate for Payer: Devoted Health Medicare |
$775.35
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$568.36
|
| Rate for Payer: Health Management Network Commercial |
$1,870.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$845.83
|
| 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 |
$807.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$704.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
|
|
59121 Surgical treatment of ectopic pregnancy; tubal or ovarian, w/o salpingectomy/oophorectomy
|
Professional
|
Both
|
$2,200.00
|
|
|
Service Code
|
HCPCS 59121
|
| Hospital Charge Code |
8040006
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$568.36 |
| Max. Negotiated Rate |
$1,870.00 |
| Rate for Payer: AlohaCare Medicaid |
$807.86
|
| Rate for Payer: AlohaCare Medicare |
$704.86
|
| Rate for Payer: Cash Price |
$1,430.00
|
| Rate for Payer: Cash Price |
$1,430.00
|
| Rate for Payer: Devoted Health Medicare |
$775.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$704.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$568.36
|
| Rate for Payer: Health Management Network Commercial |
$1,870.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$845.83
|
| Rate for Payer: Kaiser Permanente Medicaid |
$845.83
|
| Rate for Payer: Kaiser Permanente Medicare |
$845.83
|
| Rate for Payer: Ohana Health Plan Medicaid |
$807.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$704.86
|
| Rate for Payer: UnitedHealthcare Medicaid |
$807.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$704.86
|
|
|
59150 Laparoscopic treatment of ectopic pregnancy; w/o salpingectomy and/or oophorectomy
|
Professional
|
Both
|
$8,414.00
|
|
|
Service Code
|
HCPCS 59150
|
| Hospital Charge Code |
8040007
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$452.14 |
| Max. Negotiated Rate |
$7,151.90 |
| Rate for Payer: AlohaCare Medicaid |
$784.15
|
| Rate for Payer: AlohaCare Medicare |
$684.42
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Devoted Health Medicare |
$752.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$684.42
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$452.14
|
| Rate for Payer: Health Management Network Commercial |
$7,151.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$821.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$821.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$821.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$784.15
|
| Rate for Payer: Ohana Health Plan Medicare |
$684.42
|
| Rate for Payer: UnitedHealthcare Medicaid |
$784.15
|
| Rate for Payer: UnitedHealthcare Medicare |
$684.42
|
|
|
59150 Laparoscopic treatment of ectopic pregnancy; w/o salpingectomy and/or oophorectomy
|
Professional
|
Both
|
$8,414.00
|
|
|
Service Code
|
HCPCS 59150
|
| Hospital Charge Code |
8040007
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$7,151.90 |
| Rate for Payer: AlohaCare Medicaid |
$784.15
|
| Rate for Payer: AlohaCare Medicare |
$684.42
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Devoted Health Medicare |
$752.86
|
| 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 |
$452.14
|
| Rate for Payer: Health Management Network Commercial |
$7,151.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$821.30
|
| 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 |
$784.15
|
| Rate for Payer: Ohana Health Plan Medicare |
$684.42
|
| 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
|
|
|
59151 Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy
|
Professional
|
Both
|
$8,414.00
|
|
|
Service Code
|
HCPCS 59151
|
| Hospital Charge Code |
8040008
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$7,151.90 |
| Rate for Payer: AlohaCare Medicaid |
$766.13
|
| Rate for Payer: AlohaCare Medicare |
$665.05
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Devoted Health Medicare |
$731.55
|
| 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 |
$602.68
|
| Rate for Payer: Health Management Network Commercial |
$7,151.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$798.06
|
| 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 |
$766.13
|
| Rate for Payer: Ohana Health Plan Medicare |
$665.05
|
| 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
|
|
|
59151 Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy
|
Professional
|
Both
|
$8,414.00
|
|
|
Service Code
|
HCPCS 59151
|
| Hospital Charge Code |
8040008
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$602.68 |
| Max. Negotiated Rate |
$7,151.90 |
| Rate for Payer: AlohaCare Medicaid |
$766.13
|
| Rate for Payer: AlohaCare Medicare |
$665.05
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Cash Price |
$5,469.10
|
| Rate for Payer: Devoted Health Medicare |
$731.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$665.05
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$602.68
|
| Rate for Payer: Health Management Network Commercial |
$7,151.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$798.06
|
| Rate for Payer: Kaiser Permanente Medicaid |
$798.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$798.06
|
| Rate for Payer: Ohana Health Plan Medicaid |
$766.13
|
| Rate for Payer: Ohana Health Plan Medicare |
$665.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$766.13
|
| Rate for Payer: UnitedHealthcare Medicare |
$665.05
|
|
|
59160 Curettage, postpartum
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 59160
|
| Hospital Charge Code |
8040009
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$162.12 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$188.45
|
| Rate for Payer: AlohaCare Medicare |
$162.12
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Devoted Health Medicare |
$178.33
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$188.45
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$252.56
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$162.12
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$188.45
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$231.40
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$194.54
|
| Rate for Payer: Kaiser Permanente Medicaid |
$194.54
|
| Rate for Payer: Kaiser Permanente Medicare |
$194.54
|
| Rate for Payer: Ohana Health Plan Medicaid |
$188.45
|
| Rate for Payer: Ohana Health Plan Medicare |
$162.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$188.45
|
| Rate for Payer: UnitedHealthcare Medicare |
$162.12
|
| Rate for Payer: University Health Alliance Commercial |
$250.65
|
|
|
59160 Curettage, postpartum
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 59160
|
| Hospital Charge Code |
8040009
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$162.12 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$188.45
|
| Rate for Payer: AlohaCare Medicare |
$162.12
|
| 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 |
$178.33
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$252.56
|
| 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 |
$231.40
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$194.54
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$188.45
|
| Rate for Payer: Ohana Health Plan Medicare |
$162.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: University Health Alliance Commercial |
$250.65
|
|
|
59200 INSERTION OF CERVICAL DILATOR CHARGE
|
Facility
|
OP
|
$903.00
|
|
|
Service Code
|
HCPCS 59200
|
| Hospital Charge Code |
8021176
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$29.09 |
| Max. Negotiated Rate |
$875.91 |
| Rate for Payer: AlohaCare Medicaid |
$451.50
|
| Rate for Payer: AlohaCare Medicare |
$451.50
|
| Rate for Payer: Cash Price |
$586.95
|
| Rate for Payer: Cash Price |
$586.95
|
| Rate for Payer: Devoted Health Medicare |
$496.65
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$389.16
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$451.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$857.85
|
| Rate for Payer: Health Management Network Commercial |
$767.55
|
| Rate for Payer: Humana Medicare |
$451.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$812.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$460.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$451.50
|
| Rate for Payer: MDX Hawaii PPO |
$875.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$451.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$451.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$29.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$451.50
|
| Rate for Payer: University Health Alliance Commercial |
$505.68
|
|
|
59200 INSERTION OF CERVICAL DILATOR CHARGE
|
Facility
|
IP
|
$903.00
|
|
|
Service Code
|
HCPCS 59200
|
| Hospital Charge Code |
8021176
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$767.55 |
| Max. Negotiated Rate |
$875.91 |
| Rate for Payer: Cash Price |
$586.95
|
| Rate for Payer: Health Management Network Commercial |
$767.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$812.70
|
| Rate for Payer: MDX Hawaii PPO |
$875.91
|
|
|
59200 Insertion of cervical dilator (eg, laminaria, prostaglandin)
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 59200
|
| Hospital Charge Code |
8040010
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$42.45 |
| Max. Negotiated Rate |
$360.40 |
| Rate for Payer: AlohaCare Medicaid |
$42.45
|
| Rate for Payer: AlohaCare Medicare |
$55.92
|
| Rate for Payer: Cash Price |
$275.60
|
| Rate for Payer: Cash Price |
$275.60
|
| Rate for Payer: Devoted Health Medicare |
$61.51
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$42.45
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$65.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$55.92
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$42.45
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$59.02
|
| Rate for Payer: Health Management Network Commercial |
$360.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$67.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$67.10
|
| Rate for Payer: Kaiser Permanente Medicare |
$67.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$42.45
|
| Rate for Payer: Ohana Health Plan Medicare |
$55.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$42.45
|
| Rate for Payer: UnitedHealthcare Medicare |
$55.92
|
| Rate for Payer: University Health Alliance Commercial |
$79.55
|
|
|
59200 Insertion of cervical dilator (eg, laminaria, prostaglandin)
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 59200
|
| Hospital Charge Code |
8040010
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$42.45 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$42.45
|
| Rate for Payer: AlohaCare Medicare |
$55.92
|
| Rate for Payer: Cash Price |
$275.60
|
| Rate for Payer: Cash Price |
$275.60
|
| Rate for Payer: Cash Price |
$275.60
|
| Rate for Payer: Devoted Health Medicare |
$61.51
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$65.25
|
| 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 |
$59.02
|
| Rate for Payer: Health Management Network Commercial |
$360.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$67.10
|
| 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 |
$42.45
|
| Rate for Payer: Ohana Health Plan Medicare |
$55.92
|
| 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 |
$79.55
|
|
|
59300 Episiotomy or vaginal repair, by other than attending
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 59300
|
| Hospital Charge Code |
8040011
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$126.99 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$143.76
|
| Rate for Payer: AlohaCare Medicare |
$126.99
|
| 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 |
$139.69
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$221.72
|
| 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 |
$132.86
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$152.39
|
| 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 |
$143.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$126.99
|
| 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 |
$189.45
|
|
|
59300 Episiotomy or vaginal repair, by other than attending
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 59300
|
| Hospital Charge Code |
8040011
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$126.99 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$143.76
|
| Rate for Payer: AlohaCare Medicare |
$126.99
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Devoted Health Medicare |
$139.69
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$143.76
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$221.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$126.99
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$143.76
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$132.86
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$152.39
|
| Rate for Payer: Kaiser Permanente Medicaid |
$152.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$152.39
|
| Rate for Payer: Ohana Health Plan Medicaid |
$143.76
|
| Rate for Payer: Ohana Health Plan Medicare |
$126.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$143.76
|
| Rate for Payer: UnitedHealthcare Medicare |
$126.99
|
| Rate for Payer: University Health Alliance Commercial |
$189.45
|
|
|
59320 Cerclage of cervix, during pregnancy; vaginal
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 59320
|
| Hospital Charge Code |
8040012
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$130.29 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$147.43
|
| Rate for Payer: AlohaCare Medicare |
$130.29
|
| 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 |
$143.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$143.26
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$156.35
|
| 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 |
$147.43
|
| Rate for Payer: Ohana Health Plan Medicare |
$130.29
|
| 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
|
|
|
59350 Hysterorrhaphy of ruptured uterus
|
Professional
|
Both
|
$763.00
|
|
|
Service Code
|
HCPCS 59350
|
| Hospital Charge Code |
8040013
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$648.55 |
| Rate for Payer: AlohaCare Medicaid |
$265.50
|
| Rate for Payer: AlohaCare Medicare |
$229.32
|
| Rate for Payer: Cash Price |
$495.95
|
| Rate for Payer: Cash Price |
$495.95
|
| Rate for Payer: Cash Price |
$495.95
|
| Rate for Payer: Devoted Health Medicare |
$252.25
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$245.18
|
| Rate for Payer: Health Management Network Commercial |
$648.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$275.18
|
| 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 |
$265.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$229.32
|
| 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
|
|
|
59400 Routine obstetric care including antepartum care, vaginal delivery, postpartum care
|
Professional
|
Both
|
$6,236.00
|
|
|
Service Code
|
HCPCS 59400
|
| Hospital Charge Code |
8040014
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,053.78 |
| Max. Negotiated Rate |
$5,300.60 |
| Rate for Payer: AlohaCare Medicaid |
$2,408.90
|
| Rate for Payer: AlohaCare Medicare |
$2,152.11
|
| Rate for Payer: Cash Price |
$4,053.40
|
| Rate for Payer: Cash Price |
$4,053.40
|
| Rate for Payer: Devoted Health Medicare |
$2,367.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2,152.11
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,053.78
|
| Rate for Payer: Health Management Network Commercial |
$5,300.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,582.53
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,582.53
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,582.53
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,408.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,152.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$2,408.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,152.11
|
|
|
59400 Routine obstetric care including antepartum care, vaginal delivery, postpartum care
|
Professional
|
Both
|
$6,236.00
|
|
|
Service Code
|
HCPCS 59400
|
| Hospital Charge Code |
8040014
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$5,300.60 |
| Rate for Payer: AlohaCare Medicaid |
$2,408.90
|
| Rate for Payer: AlohaCare Medicare |
$2,152.11
|
| Rate for Payer: Cash Price |
$4,053.40
|
| Rate for Payer: Cash Price |
$4,053.40
|
| Rate for Payer: Cash Price |
$4,053.40
|
| Rate for Payer: Devoted Health Medicare |
$2,367.32
|
| 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 |
$1,053.78
|
| Rate for Payer: Health Management Network Commercial |
$5,300.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,582.53
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,408.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,152.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
59409 Vaginal delivery only, with or without episiotomy and/or forceps
|
Professional
|
Both
|
$2,207.00
|
|
|
Service Code
|
HCPCS 59409
|
| Hospital Charge Code |
8040015
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$553.28 |
| Max. Negotiated Rate |
$1,875.95 |
| Rate for Payer: AlohaCare Medicaid |
$770.52
|
| Rate for Payer: AlohaCare Medicare |
$680.00
|
| Rate for Payer: Cash Price |
$1,434.55
|
| Rate for Payer: Cash Price |
$1,434.55
|
| Rate for Payer: Devoted Health Medicare |
$748.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$680.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$553.28
|
| Rate for Payer: Health Management Network Commercial |
$1,875.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$816.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$816.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$816.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$770.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$680.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$770.52
|
| Rate for Payer: UnitedHealthcare Medicare |
$680.00
|
|
|
59409 Vaginal delivery only, with or without episiotomy and/or forceps
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 59409
|
| Hospital Charge Code |
8040015
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$770.52
|
| Rate for Payer: AlohaCare Medicare |
$680.00
|
| 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 |
$748.00
|
| 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 |
$553.28
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$816.00
|
| 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 |
$770.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$680.00
|
| 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
|
|
|
59410 Vaginal delivery only; including postpartum care
|
Professional
|
Both
|
$2,894.00
|
|
|
Service Code
|
HCPCS 59410
|
| Hospital Charge Code |
8040016
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,459.90 |
| Rate for Payer: AlohaCare Medicaid |
$1,049.57
|
| Rate for Payer: AlohaCare Medicare |
$924.69
|
| Rate for Payer: Cash Price |
$1,881.10
|
| Rate for Payer: Cash Price |
$1,881.10
|
| Rate for Payer: Cash Price |
$1,881.10
|
| Rate for Payer: Devoted Health Medicare |
$1,017.16
|
| 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 |
$514.02
|
| Rate for Payer: Health Management Network Commercial |
$2,459.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,109.63
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,049.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$924.69
|
| 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
|
|
|
59410 Vaginal delivery only; including postpartum care
|
Professional
|
Both
|
$2,894.00
|
|
|
Service Code
|
HCPCS 59410
|
| Hospital Charge Code |
8040016
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$514.02 |
| Max. Negotiated Rate |
$2,459.90 |
| Rate for Payer: AlohaCare Medicaid |
$1,049.57
|
| Rate for Payer: AlohaCare Medicare |
$924.69
|
| Rate for Payer: Cash Price |
$1,881.10
|
| Rate for Payer: Cash Price |
$1,881.10
|
| Rate for Payer: Devoted Health Medicare |
$1,017.16
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$924.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$514.02
|
| Rate for Payer: Health Management Network Commercial |
$2,459.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,109.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,109.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,109.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,049.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$924.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,049.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$924.69
|
|
|
59410 VAGINAL DELIVERY ONLY WITH OR WITHOUT EPISIOTOMY AND/OR FORCEPS INCLUDING POSTPARTU ProFee
|
Professional
|
Both
|
$2,309.00
|
|
|
Service Code
|
HCPCS 59410
|
| Hospital Charge Code |
8021183
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$514.02 |
| Max. Negotiated Rate |
$1,962.65 |
| Rate for Payer: AlohaCare Medicaid |
$1,049.57
|
| Rate for Payer: AlohaCare Medicare |
$924.69
|
| Rate for Payer: Cash Price |
$1,500.85
|
| Rate for Payer: Cash Price |
$1,500.85
|
| Rate for Payer: Devoted Health Medicare |
$1,017.16
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$924.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$514.02
|
| Rate for Payer: Health Management Network Commercial |
$1,962.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,109.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,109.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,109.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,049.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$924.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,049.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$924.69
|
|
|
59412 EXTERNAL CEPHALIC VERSION CHARGE
|
Facility
|
OP
|
$6,802.00
|
|
|
Service Code
|
HCPCS 59412
|
| Hospital Charge Code |
8021184
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$456.03 |
| Max. Negotiated Rate |
$6,597.94 |
| Rate for Payer: AlohaCare Medicaid |
$3,401.00
|
| Rate for Payer: AlohaCare Medicare |
$3,401.00
|
| Rate for Payer: Cash Price |
$4,421.30
|
| Rate for Payer: Cash Price |
$4,421.30
|
| Rate for Payer: Cash Price |
$4,421.30
|
| Rate for Payer: Devoted Health Medicare |
$3,741.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$4,134.05
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3,401.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6,461.90
|
| Rate for Payer: Health Management Network Commercial |
$5,781.70
|
| Rate for Payer: Humana Medicare |
$3,401.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,121.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$3,469.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,401.00
|
| Rate for Payer: MDX Hawaii PPO |
$6,597.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3,401.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,401.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,401.00
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
59412 EXTERNAL CEPHALIC VERSION CHARGE
|
Facility
|
IP
|
$6,802.00
|
|
|
Service Code
|
HCPCS 59412
|
| Hospital Charge Code |
8021184
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$5,781.70 |
| Max. Negotiated Rate |
$6,597.94 |
| Rate for Payer: Cash Price |
$4,421.30
|
| Rate for Payer: Health Management Network Commercial |
$5,781.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,121.80
|
| Rate for Payer: MDX Hawaii PPO |
$6,597.94
|
|
