|
59412 External cephalic version, with or without tocolysis
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 59412
|
| Hospital Charge Code |
8040017
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$89.21 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$99.52
|
| Rate for Payer: AlohaCare Medicare |
$89.21
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Devoted Health Medicare |
$98.13
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$118.04
|
| Rate for Payer: Health Management Network Commercial |
$382.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$107.05
|
| 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 |
$99.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$89.21
|
| 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
|
|
|
59412 External cephalic version, with or without tocolysis
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 59412
|
| Hospital Charge Code |
8040017
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$89.21 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$99.52
|
| Rate for Payer: AlohaCare Medicare |
$89.21
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Devoted Health Medicare |
$98.13
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$89.21
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$118.04
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$107.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$107.05
|
| Rate for Payer: Kaiser Permanente Medicare |
$107.05
|
| Rate for Payer: Ohana Health Plan Medicaid |
$99.52
|
| Rate for Payer: Ohana Health Plan Medicare |
$89.21
|
| Rate for Payer: UnitedHealthcare Medicaid |
$99.52
|
| Rate for Payer: UnitedHealthcare Medicare |
$89.21
|
|
|
59414 Delivery of placenta (separate procedure)
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 59414
|
| Hospital Charge Code |
8040018
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$76.74 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$86.46
|
| Rate for Payer: AlohaCare Medicare |
$76.74
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Devoted Health Medicare |
$84.41
|
| 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 |
$109.72
|
| Rate for Payer: Health Management Network Commercial |
$382.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$92.09
|
| 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 |
$86.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$76.74
|
| 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
|
|
|
59414 Delivery of placenta (separate procedure)
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 59414
|
| Hospital Charge Code |
8040018
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$76.74 |
| Max. Negotiated Rate |
$276.25 |
| Rate for Payer: AlohaCare Medicaid |
$86.46
|
| Rate for Payer: AlohaCare Medicare |
$76.74
|
| Rate for Payer: Cash Price |
$211.25
|
| Rate for Payer: Cash Price |
$211.25
|
| Rate for Payer: Devoted Health Medicare |
$84.41
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$76.74
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$109.72
|
| Rate for Payer: Health Management Network Commercial |
$276.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$92.09
|
| Rate for Payer: Kaiser Permanente Medicaid |
$92.09
|
| Rate for Payer: Kaiser Permanente Medicare |
$92.09
|
| Rate for Payer: Ohana Health Plan Medicaid |
$86.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$76.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$86.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$76.74
|
|
|
59425 Antepartum care only; 4-6 visits
|
Professional
|
Both
|
$1,593.00
|
|
|
Service Code
|
HCPCS 59425
|
| Hospital Charge Code |
8040019
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,354.05 |
| Rate for Payer: AlohaCare Medicaid |
$417.21
|
| Rate for Payer: AlohaCare Medicare |
$368.21
|
| Rate for Payer: Cash Price |
$1,035.45
|
| Rate for Payer: Cash Price |
$1,035.45
|
| Rate for Payer: Cash Price |
$1,035.45
|
| Rate for Payer: Devoted Health Medicare |
$405.03
|
| 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 |
$197.60
|
| Rate for Payer: Health Management Network Commercial |
$1,354.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$441.85
|
| 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 |
$417.21
|
| Rate for Payer: Ohana Health Plan Medicare |
$368.21
|
| 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
|
|
|
59426 Antepartum care only; 7 or more visits
|
Professional
|
Both
|
$2,848.00
|
|
|
Service Code
|
HCPCS 59426
|
| Hospital Charge Code |
8040020
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$395.20 |
| Max. Negotiated Rate |
$2,420.80 |
| Rate for Payer: AlohaCare Medicaid |
$765.67
|
| Rate for Payer: AlohaCare Medicare |
$675.03
|
| Rate for Payer: Cash Price |
$1,851.20
|
| Rate for Payer: Cash Price |
$1,851.20
|
| Rate for Payer: Devoted Health Medicare |
$742.53
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$765.67
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$675.03
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$765.67
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$395.20
|
| Rate for Payer: Health Management Network Commercial |
$2,420.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$810.04
|
| Rate for Payer: Kaiser Permanente Medicaid |
$810.04
|
| Rate for Payer: Kaiser Permanente Medicare |
$810.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$765.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$675.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$765.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$675.03
|
|
|
59426 Antepartum care only; 7 or more visits
|
Professional
|
Both
|
$2,848.00
|
|
|
Service Code
|
HCPCS 59426
|
| Hospital Charge Code |
8040020
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,420.80 |
| Rate for Payer: AlohaCare Medicaid |
$765.67
|
| Rate for Payer: AlohaCare Medicare |
$675.03
|
| Rate for Payer: Cash Price |
$1,851.20
|
| Rate for Payer: Cash Price |
$1,851.20
|
| Rate for Payer: Cash Price |
$1,851.20
|
| Rate for Payer: Devoted Health Medicare |
$742.53
|
| 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 |
$395.20
|
| Rate for Payer: Health Management Network Commercial |
$2,420.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$810.04
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$765.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$675.03
|
| 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
|
|
|
59430 Postpartum care only (separate procedure)
|
Professional
|
Both
|
$571.00
|
|
|
Service Code
|
HCPCS 59430
|
| Hospital Charge Code |
8040021
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$79.04 |
| Max. Negotiated Rate |
$485.35 |
| Rate for Payer: AlohaCare Medicaid |
$172.57
|
| Rate for Payer: AlohaCare Medicare |
$151.93
|
| Rate for Payer: Cash Price |
$371.15
|
| Rate for Payer: Cash Price |
$371.15
|
| Rate for Payer: Devoted Health Medicare |
$167.12
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$172.57
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$151.93
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$172.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$79.04
|
| Rate for Payer: Health Management Network Commercial |
$485.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$182.32
|
| Rate for Payer: Kaiser Permanente Medicaid |
$182.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$182.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$172.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$151.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$172.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$151.93
|
|
|
59430 Postpartum care only (separate procedure)
|
Professional
|
Both
|
$571.00
|
|
|
Service Code
|
HCPCS 59430
|
| Hospital Charge Code |
8040021
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$79.04 |
| Max. Negotiated Rate |
$485.35 |
| Rate for Payer: AlohaCare Medicaid |
$172.57
|
| Rate for Payer: AlohaCare Medicare |
$151.93
|
| Rate for Payer: Cash Price |
$371.15
|
| Rate for Payer: Cash Price |
$371.15
|
| Rate for Payer: Cash Price |
$371.15
|
| Rate for Payer: Devoted Health Medicare |
$167.12
|
| 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 |
$79.04
|
| Rate for Payer: Health Management Network Commercial |
$485.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$182.32
|
| 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 |
$172.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$151.93
|
| 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
|
|
|
59510 Routine obstetric care including antepartum care, cesarean delivery, and postpartum care
|
Professional
|
Both
|
$6,845.00
|
|
|
Service Code
|
HCPCS 59510
|
| Hospital Charge Code |
8040022
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$5,818.25 |
| Rate for Payer: AlohaCare Medicaid |
$2,656.47
|
| Rate for Payer: AlohaCare Medicare |
$2,382.05
|
| Rate for Payer: Cash Price |
$4,449.25
|
| Rate for Payer: Cash Price |
$4,449.25
|
| Rate for Payer: Cash Price |
$4,449.25
|
| Rate for Payer: Devoted Health Medicare |
$2,620.26
|
| 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 |
$1,448.98
|
| Rate for Payer: Health Management Network Commercial |
$5,818.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,858.46
|
| 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 |
$2,656.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,382.05
|
| 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
|
|
|
59510 Routine obstetric care including antepartum care, cesarean delivery, and postpartum care
|
Professional
|
Both
|
$6,845.00
|
|
|
Service Code
|
HCPCS 59510
|
| Hospital Charge Code |
8040022
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,448.98 |
| Max. Negotiated Rate |
$5,818.25 |
| Rate for Payer: AlohaCare Medicaid |
$2,656.47
|
| Rate for Payer: AlohaCare Medicare |
$2,382.05
|
| Rate for Payer: Cash Price |
$4,449.25
|
| Rate for Payer: Cash Price |
$4,449.25
|
| Rate for Payer: Devoted Health Medicare |
$2,620.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2,382.05
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,448.98
|
| Rate for Payer: Health Management Network Commercial |
$5,818.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,858.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,858.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,858.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,656.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,382.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$2,656.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,382.05
|
|
|
59514 Cesarean delivery only
|
Professional
|
Both
|
$2,447.00
|
|
|
Service Code
|
HCPCS 59514
|
| Hospital Charge Code |
8040023
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,079.95 |
| Rate for Payer: AlohaCare Medicaid |
$867.91
|
| Rate for Payer: AlohaCare Medicare |
$769.32
|
| Rate for Payer: Cash Price |
$1,590.55
|
| Rate for Payer: Cash Price |
$1,590.55
|
| Rate for Payer: Cash Price |
$1,590.55
|
| Rate for Payer: Devoted Health Medicare |
$846.25
|
| 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 |
$422.76
|
| Rate for Payer: Health Management Network Commercial |
$2,079.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$923.18
|
| 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 |
$867.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$769.32
|
| 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
|
|
|
59514 Cesarean delivery only
|
Professional
|
Both
|
$2,457.00
|
|
|
Service Code
|
HCPCS 59514
|
| Hospital Charge Code |
8040023
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$422.76 |
| Max. Negotiated Rate |
$2,088.45 |
| Rate for Payer: AlohaCare Medicaid |
$867.91
|
| Rate for Payer: AlohaCare Medicare |
$769.32
|
| Rate for Payer: Cash Price |
$1,597.05
|
| Rate for Payer: Cash Price |
$1,597.05
|
| Rate for Payer: Devoted Health Medicare |
$846.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$769.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$422.76
|
| Rate for Payer: Health Management Network Commercial |
$2,088.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$923.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$923.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$923.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$867.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$769.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$867.91
|
| Rate for Payer: UnitedHealthcare Medicare |
$769.32
|
|
|
59515 Cesarean delivery only; including postpartum care
|
Professional
|
Both
|
$3,500.00
|
|
|
Service Code
|
HCPCS 59515
|
| Hospital Charge Code |
8040024
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$841.62 |
| Max. Negotiated Rate |
$2,975.00 |
| Rate for Payer: AlohaCare Medicaid |
$1,296.15
|
| Rate for Payer: AlohaCare Medicare |
$1,153.02
|
| Rate for Payer: Cash Price |
$2,275.00
|
| Rate for Payer: Cash Price |
$2,275.00
|
| Rate for Payer: Devoted Health Medicare |
$1,268.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,153.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$841.62
|
| Rate for Payer: Health Management Network Commercial |
$2,975.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,383.62
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,383.62
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,383.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,296.15
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,153.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,296.15
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,153.02
|
|
|
59515 Cesarean delivery only; including postpartum care
|
Professional
|
Both
|
$3,500.00
|
|
|
Service Code
|
HCPCS 59515
|
| Hospital Charge Code |
8040024
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,975.00 |
| Rate for Payer: AlohaCare Medicaid |
$1,296.15
|
| Rate for Payer: AlohaCare Medicare |
$1,153.02
|
| Rate for Payer: Cash Price |
$2,275.00
|
| Rate for Payer: Cash Price |
$2,275.00
|
| Rate for Payer: Cash Price |
$2,275.00
|
| Rate for Payer: Devoted Health Medicare |
$1,268.32
|
| 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 |
$841.62
|
| Rate for Payer: Health Management Network Commercial |
$2,975.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,383.62
|
| 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 |
$1,296.15
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,153.02
|
| 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
|
|
|
59515 CESAREAN DELIVERY ONLY INCLUDING POSTPARTUM CARE ProFee
|
Professional
|
Both
|
$1,716.00
|
|
|
Service Code
|
HCPCS 59515
|
| Hospital Charge Code |
8021191
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$841.62 |
| Max. Negotiated Rate |
$1,458.60 |
| Rate for Payer: AlohaCare Medicaid |
$1,296.15
|
| Rate for Payer: AlohaCare Medicare |
$1,153.02
|
| Rate for Payer: Cash Price |
$1,115.40
|
| Rate for Payer: Cash Price |
$1,115.40
|
| Rate for Payer: Devoted Health Medicare |
$1,268.32
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,153.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$841.62
|
| Rate for Payer: Health Management Network Commercial |
$1,458.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,383.62
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,383.62
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,383.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,296.15
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,153.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,296.15
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,153.02
|
|
|
59525 Subtotal/total hysterectomy after cesarean delivery
|
Professional
|
Both
|
$1,416.00
|
|
|
Service Code
|
HCPCS 59525
|
| Hospital Charge Code |
8040025
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,203.60 |
| Rate for Payer: AlohaCare Medicaid |
$458.70
|
| Rate for Payer: AlohaCare Medicare |
$396.75
|
| Rate for Payer: Cash Price |
$920.40
|
| Rate for Payer: Cash Price |
$920.40
|
| Rate for Payer: Cash Price |
$920.40
|
| Rate for Payer: Devoted Health Medicare |
$436.43
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$468.78
|
| Rate for Payer: Health Management Network Commercial |
$1,203.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$476.10
|
| 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 |
$458.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$396.75
|
| 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
|
|
|
59610 Routine obstetric care including antepartum care, vaginal delivery and postpartum care, vbac
|
Professional
|
Both
|
$5,489.00
|
|
|
Service Code
|
HCPCS 59610
|
| Hospital Charge Code |
8040026
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$4,665.65 |
| Rate for Payer: AlohaCare Medicaid |
$2,502.15
|
| Rate for Payer: AlohaCare Medicare |
$2,241.04
|
| Rate for Payer: Cash Price |
$3,567.85
|
| Rate for Payer: Cash Price |
$3,567.85
|
| Rate for Payer: Cash Price |
$3,567.85
|
| Rate for Payer: Devoted Health Medicare |
$2,465.14
|
| 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 |
$1,548.56
|
| Rate for Payer: Health Management Network Commercial |
$4,665.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,689.25
|
| 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 |
$2,502.15
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,241.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
59612 Vaginal delivery only, vbac (with or w/o episiotomy and/or forceps)
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 59612
|
| Hospital Charge Code |
8040027
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$864.61
|
| Rate for Payer: AlohaCare Medicare |
$766.52
|
| 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 |
$843.17
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$709.02
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$919.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$864.61
|
| Rate for Payer: Ohana Health Plan Medicare |
$766.52
|
| 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
|
|
|
59614 Vaginal delivery only, vbac (with or w/o episiotomy and/or forceps); including postpartum care
|
Professional
|
Both
|
$2,779.00
|
|
|
Service Code
|
HCPCS 59614
|
| Hospital Charge Code |
8040028
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,362.15 |
| Rate for Payer: AlohaCare Medicaid |
$1,120.09
|
| Rate for Payer: AlohaCare Medicare |
$996.44
|
| Rate for Payer: Cash Price |
$1,806.35
|
| Rate for Payer: Cash Price |
$1,806.35
|
| Rate for Payer: Cash Price |
$1,806.35
|
| Rate for Payer: Devoted Health Medicare |
$1,096.08
|
| 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 |
$769.60
|
| Rate for Payer: Health Management Network Commercial |
$2,362.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,195.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,120.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$996.44
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
59618 Assisted C-section w/ ante and postpartum care, post vaginal delivery attempt, previous c-sect
|
Professional
|
Both
|
$5,916.00
|
|
|
Service Code
|
HCPCS 59618
|
| Hospital Charge Code |
8040029
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$5,028.60 |
| Rate for Payer: AlohaCare Medicaid |
$2,681.49
|
| Rate for Payer: AlohaCare Medicare |
$2,403.72
|
| Rate for Payer: Cash Price |
$3,845.40
|
| Rate for Payer: Cash Price |
$3,845.40
|
| Rate for Payer: Cash Price |
$3,845.40
|
| Rate for Payer: Devoted Health Medicare |
$2,644.09
|
| 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 |
$1,694.94
|
| Rate for Payer: Health Management Network Commercial |
$5,028.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,884.46
|
| 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 |
$2,681.49
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,403.72
|
| 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
|
|
|
59620 Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;
|
Professional
|
Both
|
$2,371.00
|
|
|
Service Code
|
HCPCS 59620
|
| Hospital Charge Code |
8040030
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,015.35 |
| Rate for Payer: AlohaCare Medicaid |
$895.54
|
| Rate for Payer: AlohaCare Medicare |
$793.59
|
| Rate for Payer: Cash Price |
$1,541.15
|
| Rate for Payer: Cash Price |
$1,541.15
|
| Rate for Payer: Cash Price |
$1,541.15
|
| Rate for Payer: Devoted Health Medicare |
$872.95
|
| 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 |
$823.68
|
| Rate for Payer: Health Management Network Commercial |
$2,015.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$952.31
|
| 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 |
$895.54
|
| Rate for Payer: Ohana Health Plan Medicare |
$793.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
59622 Cesarean delivery only, vbac; including postpartum care
|
Professional
|
Both
|
$3,205.00
|
|
|
Service Code
|
HCPCS 59622
|
| Hospital Charge Code |
8040031
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,724.25 |
| Rate for Payer: AlohaCare Medicaid |
$1,344.65
|
| Rate for Payer: AlohaCare Medicare |
$1,190.35
|
| Rate for Payer: Cash Price |
$2,083.25
|
| Rate for Payer: Cash Price |
$2,083.25
|
| Rate for Payer: Cash Price |
$2,083.25
|
| Rate for Payer: Devoted Health Medicare |
$1,309.38
|
| 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 |
$888.94
|
| Rate for Payer: Health Management Network Commercial |
$2,724.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,428.42
|
| 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 |
$1,344.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,190.35
|
| 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
|
|
|
59812 Treatment of incomplete abortion, any trimester, completed surgically
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 59812
|
| Hospital Charge Code |
8040032
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$272.52 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$309.17
|
| Rate for Payer: AlohaCare Medicare |
$272.52
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Cash Price |
$2,928.25
|
| Rate for Payer: Devoted Health Medicare |
$299.77
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$309.17
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$299.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$272.52
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$309.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$288.34
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$327.02
|
| Rate for Payer: Kaiser Permanente Medicaid |
$327.02
|
| Rate for Payer: Kaiser Permanente Medicare |
$327.02
|
| Rate for Payer: Ohana Health Plan Medicaid |
$309.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$272.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$309.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$272.52
|
| Rate for Payer: University Health Alliance Commercial |
$409.08
|
|
|
59812 Treatment of incomplete abortion, any trimester, completed surgically
|
Professional
|
Both
|
$4,505.00
|
|
|
Service Code
|
HCPCS 59812
|
| Hospital Charge Code |
8040032
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,829.25 |
| Rate for Payer: AlohaCare Medicaid |
$309.17
|
| Rate for Payer: AlohaCare Medicare |
$272.52
|
| 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 |
$299.77
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$299.64
|
| 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 |
$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 |
$288.34
|
| Rate for Payer: Health Management Network Commercial |
$3,829.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$327.02
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$309.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$272.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: University Health Alliance Commercial |
$409.08
|
|
