|
64400-Injection Nerve Block Trigeminal
|
Facility
|
OP
|
$1,109.00
|
|
|
Service Code
|
HCPCS 64400
|
| Hospital Charge Code |
8080178
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$4,035.20 |
| Rate for Payer: AlohaCare Medicaid |
$554.50
|
| Rate for Payer: AlohaCare Medicare |
$554.50
|
| Rate for Payer: Cash Price |
$720.85
|
| Rate for Payer: Cash Price |
$720.85
|
| Rate for Payer: Devoted Health Medicare |
$609.95
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$554.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,053.55
|
| Rate for Payer: Health Management Network Commercial |
$942.65
|
| Rate for Payer: Humana Medicare |
$554.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$998.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$554.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,075.73
|
| Rate for Payer: Ohana Health Plan Medicaid |
$554.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$554.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$554.50
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
64400-Injection Nerve Block Trigeminal
|
Facility
|
IP
|
$1,109.00
|
|
|
Service Code
|
HCPCS 64400
|
| Hospital Charge Code |
8080178
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$942.65 |
| Max. Negotiated Rate |
$1,075.73 |
| Rate for Payer: Cash Price |
$720.85
|
| Rate for Payer: Health Management Network Commercial |
$942.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$998.10
|
| Rate for Payer: MDX Hawaii PPO |
$1,075.73
|
|
|
64400 INJECTION TRIGEMINAL NERVE, ER-PROCEDURE
|
Professional
|
Both
|
$425.00
|
|
|
Service Code
|
HCPCS 64400
|
| Hospital Charge Code |
8051077
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$46.67 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$51.45
|
| Rate for Payer: AlohaCare Medicare |
$46.67
|
| Rate for Payer: Cash Price |
$276.25
|
| Rate for Payer: Cash Price |
$276.25
|
| Rate for Payer: Cash Price |
$276.25
|
| Rate for Payer: Devoted Health Medicare |
$51.34
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$87.33
|
| 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 |
$53.82
|
| Rate for Payer: Health Management Network Commercial |
$361.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$56.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$51.45
|
| Rate for Payer: Ohana Health Plan Medicare |
$46.67
|
| 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 |
$64.44
|
|
|
64405 Injection, anesthetic agent; greater occipital nerve
|
Professional
|
Both
|
$427.00
|
|
|
Service Code
|
HCPCS 64405
|
| Hospital Charge Code |
8040169
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$44.28 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$51.46
|
| Rate for Payer: AlohaCare Medicare |
$44.28
|
| Rate for Payer: Cash Price |
$277.55
|
| Rate for Payer: Cash Price |
$277.55
|
| Rate for Payer: Cash Price |
$277.55
|
| Rate for Payer: Devoted Health Medicare |
$48.71
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$96.25
|
| 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 |
$83.98
|
| Rate for Payer: Health Management Network Commercial |
$362.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$53.14
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$51.46
|
| Rate for Payer: Ohana Health Plan Medicare |
$44.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: University Health Alliance Commercial |
$63.98
|
|
|
64405 INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV TechFee
|
Facility
|
OP
|
$1,992.00
|
|
|
Service Code
|
HCPCS 64405
|
| Hospital Charge Code |
8211345
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$1,932.24 |
| Rate for Payer: AlohaCare Medicaid |
$996.00
|
| Rate for Payer: AlohaCare Medicare |
$996.00
|
| Rate for Payer: Cash Price |
$1,294.80
|
| Rate for Payer: Cash Price |
$1,294.80
|
| Rate for Payer: Devoted Health Medicare |
$1,095.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$996.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,892.40
|
| Rate for Payer: Health Management Network Commercial |
$1,693.20
|
| Rate for Payer: Humana Medicare |
$996.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,792.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$996.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,932.24
|
| Rate for Payer: Ohana Health Plan Medicaid |
$996.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$996.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$996.00
|
| Rate for Payer: University Health Alliance Commercial |
$1,451.97
|
|
|
64405 INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV TechFee
|
Facility
|
IP
|
$1,992.00
|
|
|
Service Code
|
HCPCS 64405
|
| Hospital Charge Code |
8211345
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,693.20 |
| Max. Negotiated Rate |
$1,932.24 |
| Rate for Payer: Cash Price |
$1,294.80
|
| Rate for Payer: Health Management Network Commercial |
$1,693.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,792.80
|
| Rate for Payer: MDX Hawaii PPO |
$1,932.24
|
|
|
64405-Inject Nerve Block Great Occipital
|
Facility
|
IP
|
$1,714.00
|
|
|
Service Code
|
HCPCS 64405
|
| Hospital Charge Code |
8080181
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,456.90 |
| Max. Negotiated Rate |
$1,662.58 |
| Rate for Payer: Cash Price |
$1,114.10
|
| Rate for Payer: Health Management Network Commercial |
$1,456.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,542.60
|
| Rate for Payer: MDX Hawaii PPO |
$1,662.58
|
|
|
64405-Inject Nerve Block Great Occipital
|
Facility
|
OP
|
$1,714.00
|
|
|
Service Code
|
HCPCS 64405
|
| Hospital Charge Code |
8080181
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$1,662.58 |
| Rate for Payer: AlohaCare Medicaid |
$857.00
|
| Rate for Payer: AlohaCare Medicare |
$857.00
|
| Rate for Payer: Cash Price |
$1,114.10
|
| Rate for Payer: Cash Price |
$1,114.10
|
| Rate for Payer: Devoted Health Medicare |
$942.70
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$857.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,628.30
|
| Rate for Payer: Health Management Network Commercial |
$1,456.90
|
| Rate for Payer: Humana Medicare |
$857.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,542.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$857.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,662.58
|
| Rate for Payer: Ohana Health Plan Medicaid |
$857.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$857.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$857.00
|
| Rate for Payer: University Health Alliance Commercial |
$1,249.33
|
|
|
64415 Injection, anesthetic agent; brachial plexus, single
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 64415
|
| Hospital Charge Code |
8040170
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$66.66 |
| Max. Negotiated Rate |
$1,046.35 |
| Rate for Payer: AlohaCare Medicaid |
$68.81
|
| Rate for Payer: AlohaCare Medicare |
$66.66
|
| Rate for Payer: Cash Price |
$800.15
|
| Rate for Payer: Cash Price |
$800.15
|
| Rate for Payer: Cash Price |
$800.15
|
| Rate for Payer: Devoted Health Medicare |
$73.33
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$97.19
|
| 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 |
$78.78
|
| Rate for Payer: Health Management Network Commercial |
$1,046.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$79.99
|
| 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 |
$68.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$66.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: University Health Alliance Commercial |
$85.85
|
|
|
64415 NBlk Inj Brachial Plexus TechFee
|
Facility
|
OP
|
$2,128.00
|
|
|
Service Code
|
HCPCS 64415
|
| Hospital Charge Code |
8343984
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$2,064.16 |
| Rate for Payer: AlohaCare Medicaid |
$1,064.00
|
| Rate for Payer: AlohaCare Medicare |
$1,064.00
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Devoted Health Medicare |
$1,170.40
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,064.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,021.60
|
| Rate for Payer: Health Management Network Commercial |
$1,808.80
|
| Rate for Payer: Humana Medicare |
$1,064.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,915.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,064.00
|
| Rate for Payer: MDX Hawaii PPO |
$2,064.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,064.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,064.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,064.00
|
| Rate for Payer: University Health Alliance Commercial |
$1,551.10
|
|
|
64415 NBlk Inj Brachial Plexus TechFee
|
Facility
|
IP
|
$2,128.00
|
|
|
Service Code
|
HCPCS 64415
|
| Hospital Charge Code |
8343984
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,808.80 |
| Max. Negotiated Rate |
$2,064.16 |
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Health Management Network Commercial |
$1,808.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,915.20
|
| Rate for Payer: MDX Hawaii PPO |
$2,064.16
|
|
|
64418 Injection, anesthetic agent; suprascapular nerve
|
Professional
|
Both
|
$411.00
|
|
|
Service Code
|
HCPCS 64418
|
| Hospital Charge Code |
8040171
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$47.74 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$55.30
|
| Rate for Payer: AlohaCare Medicare |
$47.74
|
| Rate for Payer: Cash Price |
$267.15
|
| Rate for Payer: Cash Price |
$267.15
|
| Rate for Payer: Cash Price |
$267.15
|
| Rate for Payer: Devoted Health Medicare |
$52.51
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$102.35
|
| 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 |
$69.42
|
| Rate for Payer: Health Management Network Commercial |
$349.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$57.29
|
| 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 |
$55.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$47.74
|
| 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 |
$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 |
$68.48
|
|
|
64420 INJECTION INTERCOSTAL NERVE, SINGLE-ER P
|
Professional
|
Both
|
$982.00
|
|
|
Service Code
|
HCPCS 64420
|
| Hospital Charge Code |
8051079
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$53.14 |
| Max. Negotiated Rate |
$834.70 |
| Rate for Payer: AlohaCare Medicaid |
$58.85
|
| Rate for Payer: AlohaCare Medicare |
$53.14
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Devoted Health Medicare |
$58.45
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$92.52
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.50
|
| Rate for Payer: Health Management Network Commercial |
$834.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$63.77
|
| 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 |
$58.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$53.14
|
| 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 |
$73.56
|
|
|
64421 INJECTION INTERCOSTAL NERVE, MULTIP-ER P
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 64421
|
| Hospital Charge Code |
8051080
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$21.51 |
| Max. Negotiated Rate |
$1,046.35 |
| Rate for Payer: AlohaCare Medicaid |
$24.84
|
| Rate for Payer: AlohaCare Medicare |
$21.51
|
| Rate for Payer: Cash Price |
$800.15
|
| Rate for Payer: Cash Price |
$800.15
|
| Rate for Payer: Cash Price |
$800.15
|
| Rate for Payer: Devoted Health Medicare |
$23.66
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$122.11
|
| 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 |
$95.42
|
| Rate for Payer: Health Management Network Commercial |
$1,046.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$25.81
|
| 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 |
$24.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$21.51
|
| 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 |
$30.43
|
|
|
64425 INJECTION ANESTHETIC AGENT ILIOINGU-ER P
|
Professional
|
Both
|
$982.00
|
|
|
Service Code
|
HCPCS 64425
|
| Hospital Charge Code |
8051081
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$50.42 |
| Max. Negotiated Rate |
$834.70 |
| Rate for Payer: AlohaCare Medicaid |
$55.04
|
| Rate for Payer: AlohaCare Medicare |
$50.42
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Devoted Health Medicare |
$55.46
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$128.23
|
| 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 |
$95.94
|
| Rate for Payer: Health Management Network Commercial |
$834.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$60.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$55.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$50.42
|
| 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 |
$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 |
$68.40
|
|
|
64430 Injection, anesthetic agent; pudendal nerve
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 64430
|
| Hospital Charge Code |
8040175
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$48.91 |
| Max. Negotiated Rate |
$1,046.35 |
| Rate for Payer: AlohaCare Medicaid |
$55.03
|
| Rate for Payer: AlohaCare Medicare |
$48.91
|
| Rate for Payer: Cash Price |
$800.15
|
| Rate for Payer: Cash Price |
$800.15
|
| Rate for Payer: Cash Price |
$800.15
|
| Rate for Payer: Devoted Health Medicare |
$53.80
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$119.84
|
| 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 |
$98.02
|
| Rate for Payer: Health Management Network Commercial |
$1,046.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$58.69
|
| 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 |
$55.03
|
| Rate for Payer: Ohana Health Plan Medicare |
$48.91
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$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 |
$68.62
|
|
|
64435 Injection, anesthetic agent; paracervical (uterine) nerve
|
Professional
|
Both
|
$982.00
|
|
|
Service Code
|
HCPCS 64435
|
| Hospital Charge Code |
8040176
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$38.29 |
| Max. Negotiated Rate |
$834.70 |
| Rate for Payer: AlohaCare Medicaid |
$43.84
|
| Rate for Payer: AlohaCare Medicare |
$38.29
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Devoted Health Medicare |
$42.12
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$114.39
|
| 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 |
$92.82
|
| Rate for Payer: Health Management Network Commercial |
$834.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$45.95
|
| 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 |
$43.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$38.29
|
| 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 |
$54.10
|
|
|
64447 Injection, anesthetic agent; femoral nerve, single
|
Professional
|
Both
|
$982.00
|
|
|
Service Code
|
HCPCS 64447
|
| Hospital Charge Code |
8040177
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$60.89 |
| Max. Negotiated Rate |
$834.70 |
| Rate for Payer: AlohaCare Medicaid |
$62.72
|
| Rate for Payer: AlohaCare Medicare |
$60.89
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Devoted Health Medicare |
$66.98
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$92.91
|
| 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 |
$73.32
|
| Rate for Payer: Health Management Network Commercial |
$834.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$73.07
|
| 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 |
$62.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$60.89
|
| 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 |
$78.33
|
|
|
64449 Inj, anesthetic agent; lumbar plexus, posterior approach, continuous infusion by catheter
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 64449
|
| Hospital Charge Code |
8040178
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$60.45 |
| Max. Negotiated Rate |
$1,046.35 |
| Rate for Payer: AlohaCare Medicaid |
$63.25
|
| Rate for Payer: AlohaCare Medicare |
$60.45
|
| Rate for Payer: Cash Price |
$800.15
|
| Rate for Payer: Cash Price |
$800.15
|
| Rate for Payer: Cash Price |
$800.15
|
| Rate for Payer: Devoted Health Medicare |
$66.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| 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 |
$246.64
|
| 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 Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Health Management Network Commercial |
$1,046.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$72.54
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| 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 |
$209.49
|
| 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 |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$63.25
|
| Rate for Payer: Ohana Health Plan Medicare |
$60.45
|
| 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
|
|
|
64450 INJECTION ANES OTHER PERIPHERAL NERVE/BRANCH TechFee
|
Facility
|
OP
|
$2,203.00
|
|
|
Service Code
|
HCPCS 64450
|
| Hospital Charge Code |
8211346
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$4,035.20 |
| Rate for Payer: AlohaCare Medicaid |
$1,101.50
|
| Rate for Payer: AlohaCare Medicare |
$1,101.50
|
| Rate for Payer: Cash Price |
$1,431.95
|
| Rate for Payer: Cash Price |
$1,431.95
|
| Rate for Payer: Devoted Health Medicare |
$1,211.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,101.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,092.85
|
| Rate for Payer: Health Management Network Commercial |
$1,872.55
|
| Rate for Payer: Humana Medicare |
$1,101.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,982.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,101.50
|
| Rate for Payer: MDX Hawaii PPO |
$2,136.91
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,101.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,101.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,101.50
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
64450 INJECTION ANES OTHER PERIPHERAL NERVE/BRANCH TechFee
|
Facility
|
IP
|
$2,203.00
|
|
|
Service Code
|
HCPCS 64450
|
| Hospital Charge Code |
8211346
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,872.55 |
| Max. Negotiated Rate |
$2,136.91 |
| Rate for Payer: Cash Price |
$1,431.95
|
| Rate for Payer: Health Management Network Commercial |
$1,872.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,982.70
|
| Rate for Payer: MDX Hawaii PPO |
$2,136.91
|
|
|
64450 Injection, anesthetic agent; other peripheral nerve or branch
|
Professional
|
Both
|
$982.00
|
|
|
Service Code
|
HCPCS 64450
|
| Hospital Charge Code |
8040179
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$39.03 |
| Max. Negotiated Rate |
$834.70 |
| Rate for Payer: AlohaCare Medicaid |
$42.33
|
| Rate for Payer: AlohaCare Medicare |
$39.03
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Cash Price |
$638.30
|
| Rate for Payer: Devoted Health Medicare |
$42.93
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$95.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.50
|
| Rate for Payer: Health Management Network Commercial |
$834.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$46.84
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$42.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$39.03
|
| 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 |
$52.25
|
|
|
64450 Injection, anesthetic agent; other peripheral nerve or branch
|
Professional
|
Both
|
$1,044.00
|
|
|
Service Code
|
HCPCS 64450
|
| Hospital Charge Code |
8040179
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$39.03 |
| Max. Negotiated Rate |
$887.40 |
| Rate for Payer: AlohaCare Medicaid |
$42.33
|
| Rate for Payer: AlohaCare Medicare |
$39.03
|
| Rate for Payer: Cash Price |
$678.60
|
| Rate for Payer: Cash Price |
$678.60
|
| Rate for Payer: Devoted Health Medicare |
$42.93
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$42.33
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$95.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$39.03
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$42.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.50
|
| Rate for Payer: Health Management Network Commercial |
$887.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$46.84
|
| Rate for Payer: Kaiser Permanente Medicaid |
$46.84
|
| Rate for Payer: Kaiser Permanente Medicare |
$46.84
|
| Rate for Payer: Ohana Health Plan Medicaid |
$42.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$39.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$42.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$39.03
|
| Rate for Payer: University Health Alliance Commercial |
$52.25
|
|
|
64450-Injection Nerve Block Peripheral
|
Facility
|
IP
|
$1,883.00
|
|
|
Service Code
|
HCPCS 64450
|
| Hospital Charge Code |
8080180
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,600.55 |
| Max. Negotiated Rate |
$1,826.51 |
| Rate for Payer: Cash Price |
$1,223.95
|
| Rate for Payer: Health Management Network Commercial |
$1,600.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,694.70
|
| Rate for Payer: MDX Hawaii PPO |
$1,826.51
|
|
|
64450-Injection Nerve Block Peripheral
|
Facility
|
OP
|
$1,883.00
|
|
|
Service Code
|
HCPCS 64450
|
| Hospital Charge Code |
8080180
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$4,035.20 |
| Rate for Payer: AlohaCare Medicaid |
$941.50
|
| Rate for Payer: AlohaCare Medicare |
$941.50
|
| Rate for Payer: Cash Price |
$1,223.95
|
| Rate for Payer: Cash Price |
$1,223.95
|
| Rate for Payer: Devoted Health Medicare |
$1,035.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$941.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,788.85
|
| Rate for Payer: Health Management Network Commercial |
$1,600.55
|
| Rate for Payer: Humana Medicare |
$941.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,694.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$941.50
|
| Rate for Payer: MDX Hawaii PPO |
$1,826.51
|
| Rate for Payer: Ohana Health Plan Medicaid |
$941.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$941.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$941.50
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
