|
76816 US OB Biometry POC
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 76816
|
| Hospital Charge Code |
11554275
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$72.85 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$72.85
|
| Rate for Payer: AlohaCare Medicare |
$121.73
|
| Rate for Payer: Cash Price |
$100.75
|
| Rate for Payer: Cash Price |
$100.75
|
| Rate for Payer: Cash Price |
$100.75
|
| Rate for Payer: Devoted Health Medicare |
$133.90
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.34
|
| Rate for Payer: Health Management Network Commercial |
$131.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$146.08
|
| 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 |
$72.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$121.73
|
| 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
|
|
|
76816 US OB FOLLOW UP CHARGE
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
HCPCS 76816
|
| Hospital Charge Code |
8280912
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$499.80 |
| Max. Negotiated Rate |
$570.36 |
| Rate for Payer: Cash Price |
$382.20
|
| Rate for Payer: Health Management Network Commercial |
$499.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$529.20
|
| Rate for Payer: MDX Hawaii PPO |
$570.36
|
|
|
76816 US OB FOLLOW UP CHARGE
|
Professional
|
Both
|
$205.00
|
|
|
Service Code
|
HCPCS 76816
|
| Hospital Charge Code |
8280912
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$72.85 |
| Max. Negotiated Rate |
$174.25 |
| Rate for Payer: AlohaCare Medicaid |
$72.85
|
| Rate for Payer: AlohaCare Medicare |
$121.73
|
| Rate for Payer: Cash Price |
$133.25
|
| Rate for Payer: Cash Price |
$133.25
|
| Rate for Payer: Devoted Health Medicare |
$133.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$121.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.34
|
| Rate for Payer: Health Management Network Commercial |
$174.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$146.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$146.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$146.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$72.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$121.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$72.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$121.73
|
|
|
76816 US OB FOLLOW UP CHARGE
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
HCPCS 76816
|
| Hospital Charge Code |
8280912
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$36.81 |
| Max. Negotiated Rate |
$570.36 |
| Rate for Payer: AlohaCare Medicaid |
$294.00
|
| Rate for Payer: AlohaCare Medicare |
$294.00
|
| Rate for Payer: Cash Price |
$382.20
|
| Rate for Payer: Cash Price |
$382.20
|
| Rate for Payer: Devoted Health Medicare |
$323.40
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$36.81
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$294.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$39.59
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$106.81
|
| Rate for Payer: Health Management Network Commercial |
$499.80
|
| Rate for Payer: Humana Medicare |
$294.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$529.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$299.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$294.00
|
| Rate for Payer: MDX Hawaii PPO |
$570.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$294.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$294.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$36.81
|
| Rate for Payer: UnitedHealthcare Medicare |
$294.00
|
| Rate for Payer: University Health Alliance Commercial |
$203.81
|
|
|
76816 US PG UTER R-T IMG F-UP TABDL APPR PR FETUS ProFee
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 76816 26
|
| Hospital Charge Code |
8102979
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$41.79 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$72.85
|
| Rate for Payer: AlohaCare Medicare |
$41.79
|
| Rate for Payer: Cash Price |
$100.75
|
| Rate for Payer: Cash Price |
$100.75
|
| Rate for Payer: Cash Price |
$100.75
|
| Rate for Payer: Devoted Health Medicare |
$45.97
|
| 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 |
$80.34
|
| Rate for Payer: Health Management Network Commercial |
$131.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$50.15
|
| 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 |
$72.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$41.79
|
| 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
|
|
|
76816 US PG UTER R-T IMG F-UP TABDL APPR PR FETUS ProFee
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 76816 26
|
| Hospital Charge Code |
8102979
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$41.79 |
| Max. Negotiated Rate |
$131.75 |
| Rate for Payer: AlohaCare Medicaid |
$72.85
|
| Rate for Payer: AlohaCare Medicare |
$41.79
|
| Rate for Payer: Cash Price |
$100.75
|
| Rate for Payer: Cash Price |
$100.75
|
| Rate for Payer: Devoted Health Medicare |
$45.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$41.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$80.34
|
| Rate for Payer: Health Management Network Commercial |
$131.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$50.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$50.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$50.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$72.85
|
| Rate for Payer: Ohana Health Plan Medicare |
$41.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$72.85
|
| Rate for Payer: UnitedHealthcare Medicare |
$41.79
|
|
|
76817 US OB Transvaginal
|
Facility
|
OP
|
$858.00
|
|
|
Service Code
|
HCPCS 76817 26
|
| Hospital Charge Code |
9325764
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$46.06 |
| Max. Negotiated Rate |
$832.26 |
| Rate for Payer: AlohaCare Medicaid |
$429.00
|
| Rate for Payer: AlohaCare Medicare |
$429.00
|
| Rate for Payer: Cash Price |
$557.70
|
| Rate for Payer: Cash Price |
$557.70
|
| Rate for Payer: Devoted Health Medicare |
$471.90
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$46.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$429.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$53.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$815.10
|
| Rate for Payer: Health Management Network Commercial |
$729.30
|
| Rate for Payer: Humana Medicare |
$429.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$772.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$437.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$429.00
|
| Rate for Payer: MDX Hawaii PPO |
$832.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$429.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$429.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$46.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$429.00
|
| Rate for Payer: University Health Alliance Commercial |
$193.75
|
|
|
76817 US OB Transvaginal
|
Facility
|
IP
|
$858.00
|
|
|
Service Code
|
HCPCS 76817 26
|
| Hospital Charge Code |
9325764
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$729.30 |
| Max. Negotiated Rate |
$832.26 |
| Rate for Payer: Cash Price |
$557.70
|
| Rate for Payer: Health Management Network Commercial |
$729.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$772.20
|
| Rate for Payer: MDX Hawaii PPO |
$832.26
|
|
|
76817 US OB TRANSVAGINAL CHARGE
|
Facility
|
OP
|
$778.00
|
|
|
Service Code
|
HCPCS 76817
|
| Hospital Charge Code |
8280922
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$46.06 |
| Max. Negotiated Rate |
$754.66 |
| Rate for Payer: AlohaCare Medicaid |
$389.00
|
| Rate for Payer: AlohaCare Medicare |
$389.00
|
| Rate for Payer: Cash Price |
$505.70
|
| Rate for Payer: Cash Price |
$505.70
|
| Rate for Payer: Devoted Health Medicare |
$427.90
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$46.06
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$389.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$53.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$106.81
|
| Rate for Payer: Health Management Network Commercial |
$661.30
|
| Rate for Payer: Humana Medicare |
$389.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$700.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$396.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$389.00
|
| Rate for Payer: MDX Hawaii PPO |
$754.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$389.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$389.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$46.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$389.00
|
| Rate for Payer: University Health Alliance Commercial |
$193.75
|
|
|
76817 US OB TRANSVAGINAL CHARGE
|
Facility
|
IP
|
$778.00
|
|
|
Service Code
|
HCPCS 76817
|
| Hospital Charge Code |
8280922
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$661.30 |
| Max. Negotiated Rate |
$754.66 |
| Rate for Payer: Cash Price |
$505.70
|
| Rate for Payer: Health Management Network Commercial |
$661.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$700.20
|
| Rate for Payer: MDX Hawaii PPO |
$754.66
|
|
|
76817 US OB Transvaginal POC
|
Facility
|
OP
|
$758.00
|
|
|
Service Code
|
HCPCS 76817
|
| Hospital Charge Code |
8041472
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$46.06 |
| Max. Negotiated Rate |
$735.26 |
| Rate for Payer: AlohaCare Medicaid |
$379.00
|
| Rate for Payer: AlohaCare Medicare |
$379.00
|
| Rate for Payer: Cash Price |
$492.70
|
| Rate for Payer: Cash Price |
$492.70
|
| Rate for Payer: Devoted Health Medicare |
$416.90
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$46.06
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$379.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$53.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$106.81
|
| Rate for Payer: Health Management Network Commercial |
$644.30
|
| Rate for Payer: Humana Medicare |
$379.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$682.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$386.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$379.00
|
| Rate for Payer: MDX Hawaii PPO |
$735.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$379.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$379.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$46.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$379.00
|
| Rate for Payer: University Health Alliance Commercial |
$193.75
|
|
|
76817 US OB Transvaginal POC
|
Professional
|
Both
|
$758.00
|
|
|
Service Code
|
HCPCS 76817
|
| Hospital Charge Code |
8041472
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$61.09 |
| Max. Negotiated Rate |
$644.30 |
| Rate for Payer: AlohaCare Medicaid |
$61.09
|
| Rate for Payer: AlohaCare Medicare |
$101.30
|
| Rate for Payer: Cash Price |
$492.70
|
| Rate for Payer: Cash Price |
$492.70
|
| Rate for Payer: Cash Price |
$492.70
|
| Rate for Payer: Devoted Health Medicare |
$111.43
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$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 |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$97.48
|
| Rate for Payer: Health Management Network Commercial |
$644.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$121.56
|
| 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 |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$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: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$61.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$101.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
76817 US OB Transvaginal POC
|
Facility
|
IP
|
$758.00
|
|
|
Service Code
|
HCPCS 76817
|
| Hospital Charge Code |
8041472
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$644.30 |
| Max. Negotiated Rate |
$735.26 |
| Rate for Payer: Cash Price |
$492.70
|
| Rate for Payer: Health Management Network Commercial |
$644.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$682.20
|
| Rate for Payer: MDX Hawaii PPO |
$735.26
|
|
|
76817 US PG UTER R-T IMG TRVG ProFee
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 76817 26
|
| Hospital Charge Code |
8102980
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$36.17 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$61.09
|
| Rate for Payer: AlohaCare Medicare |
$36.17
|
| Rate for Payer: Cash Price |
$87.75
|
| Rate for Payer: Cash Price |
$87.75
|
| Rate for Payer: Cash Price |
$87.75
|
| Rate for Payer: Devoted Health Medicare |
$39.79
|
| 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 |
$97.48
|
| Rate for Payer: Health Management Network Commercial |
$114.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$43.40
|
| 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 |
$61.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$36.17
|
| 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
|
|
|
76817 US Preg Uterus Real Time W/Image Dcmtn Transvag
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 76817
|
| Hospital Charge Code |
9085692
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$61.09 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$61.09
|
| Rate for Payer: AlohaCare Medicare |
$101.30
|
| Rate for Payer: Cash Price |
$170.95
|
| Rate for Payer: Cash Price |
$170.95
|
| Rate for Payer: Cash Price |
$170.95
|
| Rate for Payer: Devoted Health Medicare |
$111.43
|
| 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 |
$97.48
|
| Rate for Payer: Health Management Network Commercial |
$223.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$121.56
|
| 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 |
$61.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$101.30
|
| 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
|
|
|
76817 US PREG UTRUS TRANSVAG
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 76817 26
|
| Hospital Charge Code |
8022162
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$36.17 |
| Max. Negotiated Rate |
$291.55 |
| Rate for Payer: AlohaCare Medicaid |
$61.09
|
| Rate for Payer: AlohaCare Medicare |
$36.17
|
| Rate for Payer: Cash Price |
$222.95
|
| Rate for Payer: Cash Price |
$222.95
|
| Rate for Payer: Devoted Health Medicare |
$39.79
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$36.17
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$97.48
|
| Rate for Payer: Health Management Network Commercial |
$291.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$43.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$43.40
|
| Rate for Payer: Kaiser Permanente Medicare |
$43.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$61.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$36.17
|
| Rate for Payer: UnitedHealthcare Medicaid |
$61.09
|
| Rate for Payer: UnitedHealthcare Medicare |
$36.17
|
|
|
76830 POCUS Transvaginal Non-OB Limited ProFee
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 76830
|
| Hospital Charge Code |
9280041
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$55.25 |
| Max. Negotiated Rate |
$155.39 |
| Rate for Payer: AlohaCare Medicaid |
$79.51
|
| Rate for Payer: AlohaCare Medicare |
$129.49
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Devoted Health Medicare |
$142.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$129.49
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$105.25
|
| Rate for Payer: Health Management Network Commercial |
$55.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$155.39
|
| Rate for Payer: Kaiser Permanente Medicaid |
$155.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$155.39
|
| Rate for Payer: Ohana Health Plan Medicaid |
$79.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$129.49
|
| Rate for Payer: UnitedHealthcare Medicaid |
$79.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$129.49
|
|
|
76830 US Pelvic Transvaginal POC
|
Professional
|
Both
|
$345.00
|
|
|
Service Code
|
HCPCS 76830
|
| Hospital Charge Code |
8041476
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$79.51 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$79.51
|
| Rate for Payer: AlohaCare Medicare |
$129.49
|
| Rate for Payer: Cash Price |
$224.25
|
| Rate for Payer: Cash Price |
$224.25
|
| Rate for Payer: Cash Price |
$224.25
|
| Rate for Payer: Devoted Health Medicare |
$142.44
|
| 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 |
$105.25
|
| Rate for Payer: Health Management Network Commercial |
$293.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$155.39
|
| 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 |
$79.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$129.49
|
| 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
|
|
|
76830 US Pelvic Transvaginal POC
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 76830
|
| Hospital Charge Code |
8041476
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$79.51 |
| Max. Negotiated Rate |
$155.39 |
| Rate for Payer: AlohaCare Medicaid |
$79.51
|
| Rate for Payer: AlohaCare Medicare |
$129.49
|
| Rate for Payer: Cash Price |
$94.25
|
| Rate for Payer: Cash Price |
$94.25
|
| Rate for Payer: Devoted Health Medicare |
$142.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$129.49
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$105.25
|
| Rate for Payer: Health Management Network Commercial |
$123.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$155.39
|
| Rate for Payer: Kaiser Permanente Medicaid |
$155.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$155.39
|
| Rate for Payer: Ohana Health Plan Medicaid |
$79.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$129.49
|
| Rate for Payer: UnitedHealthcare Medicaid |
$79.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$129.49
|
|
|
76830 US TRANSVAGINAL
|
Professional
|
Both
|
$276.00
|
|
|
Service Code
|
HCPCS 76830
|
| Hospital Charge Code |
9376637
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$79.51 |
| Max. Negotiated Rate |
$234.60 |
| Rate for Payer: AlohaCare Medicaid |
$79.51
|
| Rate for Payer: AlohaCare Medicare |
$129.49
|
| Rate for Payer: Cash Price |
$179.40
|
| Rate for Payer: Cash Price |
$179.40
|
| Rate for Payer: Devoted Health Medicare |
$142.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$129.49
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$105.25
|
| Rate for Payer: Health Management Network Commercial |
$234.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$155.39
|
| Rate for Payer: Kaiser Permanente Medicaid |
$155.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$155.39
|
| Rate for Payer: Ohana Health Plan Medicaid |
$79.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$129.49
|
| Rate for Payer: UnitedHealthcare Medicaid |
$79.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$129.49
|
|
|
76830 US TRANSVAGINAL
|
Professional
|
Both
|
$345.00
|
|
|
Service Code
|
HCPCS 76830
|
| Hospital Charge Code |
9376637
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$79.51 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$79.51
|
| Rate for Payer: AlohaCare Medicare |
$129.49
|
| Rate for Payer: Cash Price |
$224.25
|
| Rate for Payer: Cash Price |
$224.25
|
| Rate for Payer: Cash Price |
$224.25
|
| Rate for Payer: Devoted Health Medicare |
$142.44
|
| 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 |
$105.25
|
| Rate for Payer: Health Management Network Commercial |
$293.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$155.39
|
| 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 |
$79.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$129.49
|
| 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
|
|
|
76830 US TRANSVAGINAL ProFee
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 76830 26
|
| Hospital Charge Code |
8022165
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$33.03 |
| Max. Negotiated Rate |
$119.00 |
| Rate for Payer: AlohaCare Medicaid |
$79.51
|
| Rate for Payer: AlohaCare Medicare |
$33.03
|
| Rate for Payer: Cash Price |
$91.00
|
| Rate for Payer: Cash Price |
$91.00
|
| Rate for Payer: Devoted Health Medicare |
$36.33
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$33.03
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$105.25
|
| Rate for Payer: Health Management Network Commercial |
$119.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$39.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$39.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$39.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$79.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$33.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$79.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$33.03
|
|
|
76830 US TRVG ProFee
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 76830 26
|
| Hospital Charge Code |
8102989
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$33.03 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$79.51
|
| Rate for Payer: AlohaCare Medicare |
$33.03
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Devoted Health Medicare |
$36.33
|
| 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 |
$105.25
|
| Rate for Payer: Health Management Network Commercial |
$190.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$39.64
|
| 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 |
$79.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$33.03
|
| 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
|
|
|
76856 US PELVIC NONOB REAL-TIME IMG COMPLETE ProFee
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 76856 26
|
| Hospital Charge Code |
8102991
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$33.03 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$69.99
|
| Rate for Payer: AlohaCare Medicare |
$33.03
|
| Rate for Payer: Cash Price |
$92.95
|
| Rate for Payer: Cash Price |
$92.95
|
| Rate for Payer: Cash Price |
$92.95
|
| Rate for Payer: Devoted Health Medicare |
$36.33
|
| 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 |
$105.25
|
| Rate for Payer: Health Management Network Commercial |
$121.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$39.64
|
| 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 |
$69.99
|
| Rate for Payer: Ohana Health Plan Medicare |
$33.03
|
| 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
|
|
|
76857 US PELVIC LIMITED NONOB ProFee
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 76857 26
|
| Hospital Charge Code |
8102992
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$24.16 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$32.12
|
| Rate for Payer: AlohaCare Medicare |
$24.16
|
| Rate for Payer: Cash Price |
$94.25
|
| Rate for Payer: Cash Price |
$94.25
|
| Rate for Payer: Cash Price |
$94.25
|
| Rate for Payer: Devoted Health Medicare |
$26.58
|
| 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 |
$66.85
|
| Rate for Payer: Health Management Network Commercial |
$123.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$28.99
|
| 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 |
$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 |
$32.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$24.16
|
| 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
|
|
