|
0232T Injection(s), platelet rich plasma, including image guidance, harvesting and preparation
|
Professional
|
Both
|
$1,365.00
|
|
|
Service Code
|
HCPCS 0232T
|
| Hospital Charge Code |
8037052
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$151.32 |
| Max. Negotiated Rate |
$1,160.25 |
| Rate for Payer: Cash Price |
$887.25
|
| Rate for Payer: Cash Price |
$887.25
|
| Rate for Payer: Cash Price |
$887.25
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| 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 |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$151.32
|
| Rate for Payer: Health Management Network Commercial |
$1,160.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| 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 |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| 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 |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
10004 Fine needle aspiration biopsy, without imaging guidance; each additional lesion
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 10004
|
| Hospital Charge Code |
9696916
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$35.78 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$42.83
|
| Rate for Payer: AlohaCare Medicare |
$35.78
|
| Rate for Payer: Cash Price |
$128.05
|
| Rate for Payer: Cash Price |
$128.05
|
| Rate for Payer: Cash Price |
$128.05
|
| Rate for Payer: Devoted Health Medicare |
$39.36
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$66.57
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$55.38
|
| Rate for Payer: Health Management Network Commercial |
$167.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$42.94
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$42.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$35.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: University Health Alliance Commercial |
$49.26
|
|
|
10005 Fine needle aspiration biopsy, including ultrasound guidance; first lesion
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 10005
|
| Hospital Charge Code |
8741040
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$61.35 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$72.24
|
| Rate for Payer: AlohaCare Medicare |
$61.35
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$67.48
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$114.54
|
| 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 |
$137.80
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$73.62
|
| 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 |
$72.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$61.35
|
| 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
|
|
|
10005 Fine needle aspiration biopsy, including ultrasound guidance; first lesion
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 10005
|
| Hospital Charge Code |
8741040
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$61.35 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$72.24
|
| Rate for Payer: AlohaCare Medicare |
$61.35
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$67.48
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$72.24
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$114.54
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$61.35
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$72.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$137.80
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$73.62
|
| Rate for Payer: Kaiser Permanente Medicaid |
$73.62
|
| Rate for Payer: Kaiser Permanente Medicare |
$73.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$72.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$61.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$72.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$61.35
|
| Rate for Payer: University Health Alliance Commercial |
$78.33
|
|
|
10009 FINE NDL ASPIRATION BX W/CT GDN 1ST LSN CHARGE
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 10009
|
| Hospital Charge Code |
8668994
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$91.60 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$106.88
|
| Rate for Payer: AlohaCare Medicare |
$91.60
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$100.76
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$106.88
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$171.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$91.60
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$106.88
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$530.92
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.92
|
| Rate for Payer: Kaiser Permanente Medicaid |
$109.92
|
| Rate for Payer: Kaiser Permanente Medicare |
$109.92
|
| Rate for Payer: Ohana Health Plan Medicaid |
$106.88
|
| Rate for Payer: Ohana Health Plan Medicare |
$91.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$106.88
|
| Rate for Payer: UnitedHealthcare Medicare |
$91.60
|
| Rate for Payer: University Health Alliance Commercial |
$115.70
|
|
|
10021-Aspiration Fine Needle w/o Imaging
|
Facility
|
OP
|
$810.00
|
|
|
Service Code
|
HCPCS 10021
|
| Hospital Charge Code |
8080041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$405.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$405.00
|
| Rate for Payer: AlohaCare Medicare |
$405.00
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Devoted Health Medicare |
$445.50
|
| 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 |
$405.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$769.50
|
| Rate for Payer: Health Management Network Commercial |
$688.50
|
| Rate for Payer: Humana Medicare |
$405.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$729.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$405.00
|
| Rate for Payer: MDX Hawaii PPO |
$785.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$405.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$405.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$405.00
|
| Rate for Payer: University Health Alliance Commercial |
$590.41
|
|
|
10021-Aspiration Fine Needle w/o Imaging
|
Facility
|
IP
|
$810.00
|
|
|
Service Code
|
HCPCS 10021
|
| Hospital Charge Code |
8080041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$688.50 |
| Max. Negotiated Rate |
$785.70 |
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Health Management Network Commercial |
$688.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$729.00
|
| Rate for Payer: MDX Hawaii PPO |
$785.70
|
|
|
10021 Fine needle aspiration; without imaging guidance
|
Professional
|
Both
|
$566.00
|
|
|
Service Code
|
HCPCS 10021
|
| Hospital Charge Code |
8037061
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$45.22 |
| Max. Negotiated Rate |
$481.10 |
| Rate for Payer: AlohaCare Medicaid |
$54.49
|
| Rate for Payer: AlohaCare Medicare |
$45.22
|
| Rate for Payer: Cash Price |
$367.90
|
| Rate for Payer: Cash Price |
$367.90
|
| Rate for Payer: Cash Price |
$367.90
|
| Rate for Payer: Devoted Health Medicare |
$49.74
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$90.91
|
| 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 |
$83.72
|
| Rate for Payer: Health Management Network Commercial |
$481.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$54.26
|
| 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 |
$54.49
|
| Rate for Payer: Ohana Health Plan Medicare |
$45.22
|
| 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 |
$59.40
|
|
|
10021 FINE NEEDLE ASPIRATION W/O IMAGING GUIDANCE TechFee
|
Facility
|
IP
|
$880.00
|
|
|
Service Code
|
HCPCS 10021
|
| Hospital Charge Code |
8022536
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$748.00 |
| Max. Negotiated Rate |
$853.60 |
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Health Management Network Commercial |
$748.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$792.00
|
| Rate for Payer: MDX Hawaii PPO |
$853.60
|
|
|
10021 FINE NEEDLE ASPIRATION W/O IMAGING GUIDANCE TechFee
|
Facility
|
OP
|
$880.00
|
|
|
Service Code
|
HCPCS 10021
|
| Hospital Charge Code |
8022536
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$440.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$440.00
|
| Rate for Payer: AlohaCare Medicare |
$440.00
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Devoted Health Medicare |
$484.00
|
| 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 |
$440.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$836.00
|
| Rate for Payer: Health Management Network Commercial |
$748.00
|
| Rate for Payer: Humana Medicare |
$440.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$792.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$440.00
|
| Rate for Payer: MDX Hawaii PPO |
$853.60
|
| Rate for Payer: Ohana Health Plan Medicaid |
$440.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$440.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$440.00
|
| Rate for Payer: University Health Alliance Commercial |
$641.43
|
|
|
10022 CT GUIDED FNA
|
Facility
|
IP
|
$770.00
|
|
|
Service Code
|
HCPCS 10022
|
| Hospital Charge Code |
10060853
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$654.50 |
| Max. Negotiated Rate |
$746.90 |
| Rate for Payer: Cash Price |
$500.50
|
| Rate for Payer: Health Management Network Commercial |
$654.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$693.00
|
| Rate for Payer: MDX Hawaii PPO |
$746.90
|
|
|
10022 CT GUIDED FNA
|
Facility
|
OP
|
$770.00
|
|
|
Service Code
|
HCPCS 10022
|
| Hospital Charge Code |
10060853
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$385.00 |
| Max. Negotiated Rate |
$2,837.00 |
| Rate for Payer: AlohaCare Medicaid |
$385.00
|
| Rate for Payer: AlohaCare Medicare |
$385.00
|
| Rate for Payer: Cash Price |
$500.50
|
| Rate for Payer: Cash Price |
$500.50
|
| Rate for Payer: Devoted Health Medicare |
$423.50
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$385.00
|
| Rate for Payer: Health Management Network Commercial |
$654.50
|
| Rate for Payer: Humana Medicare |
$385.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$693.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,837.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$385.00
|
| Rate for Payer: MDX Hawaii PPO |
$746.90
|
| Rate for Payer: Ohana Health Plan Medicaid |
$385.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$385.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$385.00
|
| Rate for Payer: University Health Alliance Commercial |
$431.20
|
|
|
10022 FINE NEEDLE ASPIRATION; WITH IMAGING GUIDANCE ProFee
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 10022
|
| Hospital Charge Code |
8016361
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$86.58 |
| Max. Negotiated Rate |
$267.75 |
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Cash Price |
$204.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$86.58
|
| Rate for Payer: Health Management Network Commercial |
$267.75
|
|
|
10030 Image Guided Catheter Fluir Collection Drainage
|
Facility
|
IP
|
$2,322.00
|
|
|
Service Code
|
HCPCS 10030
|
| Hospital Charge Code |
8037063
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,973.70 |
| Max. Negotiated Rate |
$2,252.34 |
| Rate for Payer: Cash Price |
$1,509.30
|
| Rate for Payer: Health Management Network Commercial |
$1,973.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,089.80
|
| Rate for Payer: MDX Hawaii PPO |
$2,252.34
|
|
|
10030 Image Guided Catheter Fluir Collection Drainage
|
Facility
|
OP
|
$2,322.00
|
|
|
Service Code
|
HCPCS 10030
|
| Hospital Charge Code |
8037063
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$4,035.20 |
| Rate for Payer: AlohaCare Medicaid |
$1,161.00
|
| Rate for Payer: AlohaCare Medicare |
$1,161.00
|
| Rate for Payer: Cash Price |
$1,509.30
|
| Rate for Payer: Cash Price |
$1,509.30
|
| Rate for Payer: Cash Price |
$1,509.30
|
| Rate for Payer: Devoted Health Medicare |
$1,277.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$904.34
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,161.00
|
| Rate for Payer: Health Management Network Commercial |
$1,973.70
|
| Rate for Payer: Humana Medicare |
$1,161.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,089.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$2,837.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,161.00
|
| Rate for Payer: MDX Hawaii PPO |
$2,252.34
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,161.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,161.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,161.00
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
10030 IMAGE-GUIDED FLUID COLLECTION DRAINAGE BY CATHETER (EG, ABSCESS, HEMATOMA, SEROMA, LYM ProFee
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 10030
|
| Hospital Charge Code |
8016362
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$115.65 |
| Max. Negotiated Rate |
$893.88 |
| Rate for Payer: AlohaCare Medicaid |
$132.13
|
| Rate for Payer: AlohaCare Medicare |
$115.65
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$127.22
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$132.13
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$226.59
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$115.65
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$132.13
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$893.88
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$138.78
|
| Rate for Payer: Kaiser Permanente Medicaid |
$138.78
|
| Rate for Payer: Kaiser Permanente Medicare |
$138.78
|
| Rate for Payer: Ohana Health Plan Medicaid |
$132.13
|
| Rate for Payer: Ohana Health Plan Medicare |
$115.65
|
| Rate for Payer: UnitedHealthcare Medicaid |
$132.13
|
| Rate for Payer: UnitedHealthcare Medicare |
$115.65
|
| Rate for Payer: University Health Alliance Commercial |
$160.00
|
|
|
10040 Acne Surgery
|
Professional
|
Both
|
$296.00
|
|
|
Service Code
|
HCPCS 10040
|
| Hospital Charge Code |
8037064
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$35.88 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$52.81
|
| Rate for Payer: AlohaCare Medicare |
$42.67
|
| Rate for Payer: Cash Price |
$192.40
|
| Rate for Payer: Cash Price |
$192.40
|
| Rate for Payer: Cash Price |
$192.40
|
| Rate for Payer: Devoted Health Medicare |
$46.94
|
| 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 |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$35.88
|
| Rate for Payer: Health Management Network Commercial |
$251.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$51.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$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 |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$52.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$42.67
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
10060-I&D Abscess/Cyst/Hematoma Simple
|
Facility
|
OP
|
$746.00
|
|
|
Service Code
|
HCPCS 10060
|
| Hospital Charge Code |
8080043
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$373.00 |
| Max. Negotiated Rate |
$4,035.20 |
| Rate for Payer: AlohaCare Medicaid |
$373.00
|
| Rate for Payer: AlohaCare Medicare |
$373.00
|
| Rate for Payer: Cash Price |
$484.90
|
| Rate for Payer: Cash Price |
$484.90
|
| Rate for Payer: Devoted Health Medicare |
$410.30
|
| 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 |
$373.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$708.70
|
| Rate for Payer: Health Management Network Commercial |
$634.10
|
| Rate for Payer: Humana Medicare |
$373.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$671.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$373.00
|
| Rate for Payer: MDX Hawaii PPO |
$723.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$373.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$373.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$373.00
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
10060-I&D Abscess/Cyst/Hematoma Simple
|
Facility
|
IP
|
$746.00
|
|
|
Service Code
|
HCPCS 10060
|
| Hospital Charge Code |
8080043
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$634.10 |
| Max. Negotiated Rate |
$723.62 |
| Rate for Payer: Cash Price |
$484.90
|
| Rate for Payer: Health Management Network Commercial |
$634.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$671.40
|
| Rate for Payer: MDX Hawaii PPO |
$723.62
|
|
|
10060 Incision and drainage of abscess simple or single
|
Professional
|
Both
|
$469.00
|
|
|
Service Code
|
HCPCS 10060
|
| Hospital Charge Code |
8037065
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$66.56 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$114.56
|
| Rate for Payer: AlohaCare Medicare |
$106.44
|
| Rate for Payer: Cash Price |
$304.85
|
| Rate for Payer: Cash Price |
$304.85
|
| Rate for Payer: Cash Price |
$304.85
|
| Rate for Payer: Devoted Health Medicare |
$117.08
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$168.35
|
| 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 |
$66.56
|
| Rate for Payer: Health Management Network Commercial |
$398.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$127.73
|
| 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 |
$114.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$106.44
|
| 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
|
|
|
10060 Incision and drainage of abscess simple or single
|
Professional
|
Both
|
$401.00
|
|
|
Service Code
|
HCPCS 10060
|
| Hospital Charge Code |
8037065
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$66.56 |
| Max. Negotiated Rate |
$340.85 |
| Rate for Payer: AlohaCare Medicaid |
$114.56
|
| Rate for Payer: AlohaCare Medicare |
$106.44
|
| Rate for Payer: Cash Price |
$260.65
|
| Rate for Payer: Cash Price |
$260.65
|
| Rate for Payer: Devoted Health Medicare |
$117.08
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$114.56
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$168.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$106.44
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$114.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$66.56
|
| Rate for Payer: Health Management Network Commercial |
$340.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$127.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$127.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$127.73
|
| Rate for Payer: Ohana Health Plan Medicaid |
$114.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$106.44
|
| Rate for Payer: UnitedHealthcare Medicaid |
$114.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$106.44
|
|
|
10061-I&D Abscess/Cyst/Hematoma Complicated
|
Facility
|
OP
|
$810.00
|
|
|
Service Code
|
HCPCS 10061
|
| Hospital Charge Code |
8080045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$405.00 |
| Max. Negotiated Rate |
$4,035.20 |
| Rate for Payer: AlohaCare Medicaid |
$405.00
|
| Rate for Payer: AlohaCare Medicare |
$405.00
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Devoted Health Medicare |
$445.50
|
| 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 |
$405.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$769.50
|
| Rate for Payer: Health Management Network Commercial |
$688.50
|
| Rate for Payer: Humana Medicare |
$405.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$729.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$405.00
|
| Rate for Payer: MDX Hawaii PPO |
$785.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$405.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$405.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$405.00
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
10061-I&D Abscess/Cyst/Hematoma Complicated
|
Facility
|
IP
|
$810.00
|
|
|
Service Code
|
HCPCS 10061
|
| Hospital Charge Code |
8080045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$688.50 |
| Max. Negotiated Rate |
$785.70 |
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Health Management Network Commercial |
$688.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$729.00
|
| Rate for Payer: MDX Hawaii PPO |
$785.70
|
|
|
10061 Incision and drainage of abscess complicated or multiple
|
Professional
|
Both
|
$683.00
|
|
|
Service Code
|
HCPCS 10061
|
| Hospital Charge Code |
8037066
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$580.55 |
| Rate for Payer: AlohaCare Medicaid |
$194.24
|
| Rate for Payer: AlohaCare Medicare |
$180.01
|
| Rate for Payer: Cash Price |
$443.95
|
| Rate for Payer: Cash Price |
$443.95
|
| Rate for Payer: Cash Price |
$443.95
|
| Rate for Payer: Devoted Health Medicare |
$198.01
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.42
|
| Rate for Payer: Health Management Network Commercial |
$580.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$216.01
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$194.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$180.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: University Health Alliance Commercial |
$209.93
|
|
|
10061 Incision and drainage of abscess complicated or multiple
|
Professional
|
Both
|
$683.00
|
|
|
Service Code
|
HCPCS 10061
|
| Hospital Charge Code |
8037066
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$580.55 |
| Rate for Payer: AlohaCare Medicaid |
$194.24
|
| Rate for Payer: AlohaCare Medicare |
$180.01
|
| Rate for Payer: Cash Price |
$443.95
|
| Rate for Payer: Cash Price |
$443.95
|
| Rate for Payer: Devoted Health Medicare |
$198.01
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$194.24
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$180.01
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$194.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.42
|
| Rate for Payer: Health Management Network Commercial |
$580.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$216.01
|
| Rate for Payer: Kaiser Permanente Medicaid |
$216.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$216.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$194.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$180.01
|
| Rate for Payer: UnitedHealthcare Medicaid |
$194.24
|
| Rate for Payer: UnitedHealthcare Medicare |
$180.01
|
| Rate for Payer: University Health Alliance Commercial |
$209.93
|
|
