|
94016 Patient-initiated spirometric recording per 30-day period of time; review and interpretation
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 94016
|
| Hospital Charge Code |
8040749
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$24.57 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$24.57
|
| Rate for Payer: AlohaCare Medicare |
$25.40
|
| Rate for Payer: Cash Price |
$44.85
|
| Rate for Payer: Cash Price |
$44.85
|
| Rate for Payer: Cash Price |
$44.85
|
| Rate for Payer: Devoted Health Medicare |
$27.94
|
| 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 |
$25.73
|
| Rate for Payer: Health Management Network Commercial |
$58.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$30.48
|
| 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 |
$24.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$25.40
|
| 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
|
|
|
94060 Bronchodilation responsiveness, spirometry pre and post interp
|
Professional
|
Both
|
$519.00
|
|
|
Service Code
|
HCPCS 94060
|
| Hospital Charge Code |
8040750
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$43.27 |
| Max. Negotiated Rate |
$441.15 |
| Rate for Payer: AlohaCare Medicaid |
$43.27
|
| Rate for Payer: AlohaCare Medicare |
$48.04
|
| Rate for Payer: Cash Price |
$337.35
|
| Rate for Payer: Cash Price |
$337.35
|
| Rate for Payer: Cash Price |
$337.35
|
| Rate for Payer: Devoted Health Medicare |
$52.84
|
| 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 |
$62.42
|
| Rate for Payer: Health Management Network Commercial |
$441.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$57.65
|
| 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 |
$43.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$48.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
94617 EXERCISE TEST FOR BRONCHOSPASM CHARGE
|
Facility
|
OP
|
$679.00
|
|
|
Service Code
|
HCPCS 94617
|
| Hospital Charge Code |
8243389
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$43.09 |
| Max. Negotiated Rate |
$658.63 |
| Rate for Payer: AlohaCare Medicaid |
$339.50
|
| Rate for Payer: AlohaCare Medicare |
$339.50
|
| Rate for Payer: Cash Price |
$441.35
|
| Rate for Payer: Cash Price |
$441.35
|
| Rate for Payer: Devoted Health Medicare |
$373.45
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$43.09
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$169.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$61.98
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$645.05
|
| Rate for Payer: Health Management Network Commercial |
$577.15
|
| Rate for Payer: Humana Medicare |
$339.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$611.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$346.29
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.50
|
| Rate for Payer: MDX Hawaii PPO |
$658.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$339.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$339.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$97.87
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.50
|
| Rate for Payer: University Health Alliance Commercial |
$380.24
|
|
|
94617 EXERCISE TEST FOR BRONCHOSPASM CHARGE
|
Facility
|
IP
|
$679.00
|
|
|
Service Code
|
HCPCS 94617
|
| Hospital Charge Code |
8243389
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$577.15 |
| Max. Negotiated Rate |
$658.63 |
| Rate for Payer: Cash Price |
$441.35
|
| Rate for Payer: Health Management Network Commercial |
$577.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$611.10
|
| Rate for Payer: MDX Hawaii PPO |
$658.63
|
|
|
94621 PULMONARY REHAB - PERFORMANCE TEST (15 M ) CHARGE
|
Professional
|
Both
|
$519.00
|
|
|
Service Code
|
HCPCS 94621
|
| Hospital Charge Code |
8542829
|
|
Hospital Revenue Code
|
976
|
| Min. Negotiated Rate |
$130.82 |
| Max. Negotiated Rate |
$441.15 |
| Rate for Payer: AlohaCare Medicaid |
$168.27
|
| Rate for Payer: AlohaCare Medicare |
$180.37
|
| Rate for Payer: Cash Price |
$337.35
|
| Rate for Payer: Cash Price |
$337.35
|
| Rate for Payer: Devoted Health Medicare |
$198.41
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$180.37
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$130.82
|
| Rate for Payer: Health Management Network Commercial |
$441.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$216.44
|
| Rate for Payer: Kaiser Permanente Medicaid |
$216.44
|
| Rate for Payer: Kaiser Permanente Medicare |
$216.44
|
| Rate for Payer: Ohana Health Plan Medicaid |
$168.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$180.37
|
| Rate for Payer: UnitedHealthcare Medicaid |
$168.27
|
| Rate for Payer: UnitedHealthcare Medicare |
$180.37
|
|
|
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 94640
|
| Hospital Charge Code |
8040758
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$53.55 |
| Rate for Payer: AlohaCare Medicaid |
$8.98
|
| Rate for Payer: AlohaCare Medicare |
$9.69
|
| Rate for Payer: Cash Price |
$40.95
|
| Rate for Payer: Cash Price |
$40.95
|
| Rate for Payer: Devoted Health Medicare |
$10.66
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$9.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$17.23
|
| Rate for Payer: Health Management Network Commercial |
$53.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$11.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$11.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$8.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.98
|
| Rate for Payer: UnitedHealthcare Medicare |
$9.69
|
|
|
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 94640
|
| Hospital Charge Code |
8040758
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$8.98
|
| Rate for Payer: AlohaCare Medicare |
$9.69
|
| Rate for Payer: Cash Price |
$198.25
|
| Rate for Payer: Cash Price |
$198.25
|
| Rate for Payer: Cash Price |
$198.25
|
| Rate for Payer: Devoted Health Medicare |
$10.66
|
| 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 |
$17.23
|
| Rate for Payer: Health Management Network Commercial |
$259.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$11.63
|
| 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 |
$8.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$9.69
|
| 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
|
|
|
94664 Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 94664
|
| Hospital Charge Code |
8040760
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$20.26 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: AlohaCare Medicaid |
$20.26
|
| Rate for Payer: AlohaCare Medicare |
$22.41
|
| Rate for Payer: Cash Price |
$198.25
|
| Rate for Payer: Cash Price |
$198.25
|
| Rate for Payer: Cash Price |
$198.25
|
| Rate for Payer: Devoted Health Medicare |
$24.65
|
| 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 |
$22.25
|
| Rate for Payer: Health Management Network Commercial |
$259.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$26.89
|
| 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 |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$20.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$22.41
|
| 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
|
|
|
94729 Diffusing capacity pulmonary interp
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 94729
|
| Hospital Charge Code |
8040763
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$60.47 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$63.69
|
| Rate for Payer: AlohaCare Medicare |
$70.91
|
| Rate for Payer: Cash Price |
$201.50
|
| Rate for Payer: Cash Price |
$201.50
|
| Rate for Payer: Cash Price |
$201.50
|
| Rate for Payer: Devoted Health Medicare |
$78.00
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$60.47
|
| Rate for Payer: Health Management Network Commercial |
$263.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.09
|
| 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 |
$63.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$70.91
|
| 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
|
|
|
94760 Pulse Pximetry POC
|
Professional
|
Both
|
$9.00
|
|
|
Service Code
|
HCPCS 94760
|
| Hospital Charge Code |
8040764
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$2.86
|
| Rate for Payer: AlohaCare Medicare |
$4.37
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Devoted Health Medicare |
$4.81
|
| 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 |
$11.26
|
| Rate for Payer: Health Management Network Commercial |
$7.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$5.24
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$4.37
|
| 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
|
|
|
94761 Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 94761
|
| Hospital Charge Code |
8040765
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$28.79 |
| Rate for Payer: AlohaCare Medicaid |
$4.39
|
| Rate for Payer: AlohaCare Medicare |
$4.75
|
| Rate for Payer: Cash Price |
$7.15
|
| Rate for Payer: Cash Price |
$7.15
|
| Rate for Payer: Devoted Health Medicare |
$5.22
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$4.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$28.79
|
| Rate for Payer: Health Management Network Commercial |
$9.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$5.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$5.70
|
| Rate for Payer: Kaiser Permanente Medicare |
$5.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$4.39
|
| Rate for Payer: Ohana Health Plan Medicare |
$4.75
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$4.75
|
|
|
94761 Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 94761
|
| Hospital Charge Code |
8040765
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$4.39
|
| Rate for Payer: AlohaCare Medicare |
$4.75
|
| Rate for Payer: Cash Price |
$7.15
|
| Rate for Payer: Cash Price |
$7.15
|
| Rate for Payer: Cash Price |
$7.15
|
| Rate for Payer: Devoted Health Medicare |
$5.22
|
| 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 |
$28.79
|
| Rate for Payer: Health Management Network Commercial |
$9.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$5.70
|
| 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 |
$4.39
|
| Rate for Payer: Ohana Health Plan Medicare |
$4.75
|
| 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
|
|
|
94780 Car Seat/Bed Testing for Airway Integrity Infant - 12 MO
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 94780
|
| Hospital Charge Code |
10314818
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$20.41 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: AlohaCare Medicaid |
$23.42
|
| Rate for Payer: AlohaCare Medicare |
$20.41
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Devoted Health Medicare |
$22.45
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$23.42
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$20.41
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$23.42
|
| Rate for Payer: Health Management Network Commercial |
$76.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$24.49
|
| Rate for Payer: Kaiser Permanente Medicaid |
$24.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$24.49
|
| Rate for Payer: Ohana Health Plan Medicaid |
$23.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$20.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$23.42
|
| Rate for Payer: UnitedHealthcare Medicare |
$20.41
|
| Rate for Payer: University Health Alliance Commercial |
$28.80
|
|
|
95115 Professional Services for allergen immunotherapy single injection
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 95115
|
| Hospital Charge Code |
8238796
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$11.59 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$11.66
|
| Rate for Payer: AlohaCare Medicare |
$11.59
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Devoted Health Medicare |
$12.75
|
| 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 |
$16.36
|
| Rate for Payer: Health Management Network Commercial |
$55.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$13.91
|
| 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 |
$11.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$11.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
95115 Professional Services for allergen immunotherapy single injection HHSC
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 95115
|
| Hospital Charge Code |
12816334
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$11.59 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$11.66
|
| Rate for Payer: AlohaCare Medicare |
$11.59
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Devoted Health Medicare |
$12.75
|
| 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 |
$16.36
|
| Rate for Payer: Health Management Network Commercial |
$55.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$13.91
|
| 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 |
$11.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$11.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
95117 Professional Services for allergen immunotherapy 2 or more injections
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 95117
|
| Hospital Charge Code |
8238797
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$13.96
|
| Rate for Payer: AlohaCare Medicare |
$13.87
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Devoted Health Medicare |
$15.26
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$17.23
|
| Rate for Payer: Health Management Network Commercial |
$55.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$16.64
|
| 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 |
$13.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$13.87
|
| 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
|
|
|
95117 Professional Services for allergen immunotherapy 2 or more injections HHSC
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 95117
|
| Hospital Charge Code |
12816335
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$13.96
|
| Rate for Payer: AlohaCare Medicare |
$13.87
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Devoted Health Medicare |
$15.26
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$17.23
|
| Rate for Payer: Health Management Network Commercial |
$55.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$16.64
|
| 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 |
$13.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$13.87
|
| 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
|
|
|
95117 PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX Clinic Charge
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 95117
|
| Hospital Charge Code |
11289229
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$13.96
|
| Rate for Payer: AlohaCare Medicare |
$13.87
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Devoted Health Medicare |
$15.26
|
| 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 |
$17.23
|
| Rate for Payer: Health Management Network Commercial |
$81.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$16.64
|
| 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 |
$13.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$13.87
|
| 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
|
|
|
95117 Prof Svs Inj of incremental dosages of allergen, 2 or more injections
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 95117
|
| Hospital Charge Code |
8898408
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$55.25 |
| Rate for Payer: AlohaCare Medicaid |
$13.96
|
| Rate for Payer: AlohaCare Medicare |
$13.87
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Cash Price |
$42.25
|
| Rate for Payer: Devoted Health Medicare |
$15.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$13.87
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$17.23
|
| Rate for Payer: Health Management Network Commercial |
$55.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$16.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$16.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$16.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$13.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$13.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.96
|
| Rate for Payer: UnitedHealthcare Medicare |
$13.87
|
|
|
95250 Ambulatory continuous glucose monitoring of interstitial tissue fluid for minimum of 72 hours
|
Professional
|
Both
|
$560.00
|
|
|
Service Code
|
HCPCS 95250
|
| Hospital Charge Code |
8040798
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$168.65 |
| Max. Negotiated Rate |
$476.00 |
| Rate for Payer: AlohaCare Medicaid |
$168.65
|
| Rate for Payer: AlohaCare Medicare |
$172.62
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Devoted Health Medicare |
$189.88
|
| 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 |
$177.31
|
| Rate for Payer: Health Management Network Commercial |
$476.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$207.14
|
| 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 |
$168.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$172.62
|
| 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
|
|
|
95251 Ambulatory continuous glucose monitoring for minimum of 72 hours; interpretation and report
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 95251
|
| Hospital Charge Code |
8040799
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$35.14 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$35.14
|
| Rate for Payer: AlohaCare Medicare |
$35.83
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Devoted Health Medicare |
$39.41
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$43.36
|
| Rate for Payer: Health Management Network Commercial |
$100.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$43.00
|
| 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 |
$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 |
$35.14
|
| Rate for Payer: Ohana Health Plan Medicare |
$35.83
|
| 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
|
|
|
95816 EEG INCL REC AWAKE/DROWSY ProFee
|
Professional
|
Both
|
$939.00
|
|
|
Service Code
|
HCPCS 95816
|
| Hospital Charge Code |
8022316
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$105.68 |
| Max. Negotiated Rate |
$798.15 |
| Rate for Payer: AlohaCare Medicaid |
$445.92
|
| Rate for Payer: AlohaCare Medicare |
$463.48
|
| Rate for Payer: Cash Price |
$610.35
|
| Rate for Payer: Cash Price |
$610.35
|
| Rate for Payer: Devoted Health Medicare |
$509.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$463.48
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$105.68
|
| Rate for Payer: Health Management Network Commercial |
$798.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$556.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$556.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$556.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$445.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$463.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$445.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$463.48
|
|
|
95816 Electroencephalogram (EEG); including Wake & Sleep 20 - 40 Min
|
Facility
|
OP
|
$1,330.00
|
|
|
Service Code
|
HCPCS 95816
|
| Hospital Charge Code |
8040806
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$84.17 |
| Max. Negotiated Rate |
$1,290.10 |
| Rate for Payer: AlohaCare Medicaid |
$665.00
|
| Rate for Payer: AlohaCare Medicare |
$665.00
|
| Rate for Payer: Cash Price |
$864.50
|
| Rate for Payer: Cash Price |
$864.50
|
| Rate for Payer: Devoted Health Medicare |
$731.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$84.17
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$275.75
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$665.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$145.63
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,263.50
|
| Rate for Payer: Health Management Network Commercial |
$1,130.50
|
| Rate for Payer: Humana Medicare |
$665.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,197.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$678.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$665.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,290.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$665.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$665.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$84.17
|
| Rate for Payer: UnitedHealthcare Medicare |
$665.00
|
| Rate for Payer: University Health Alliance Commercial |
$744.80
|
|
|
95816 Electroencephalogram (EEG); including Wake & Sleep 20 - 40 Min
|
Facility
|
IP
|
$1,330.00
|
|
|
Service Code
|
HCPCS 95816
|
| Hospital Charge Code |
8040806
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,130.50 |
| Max. Negotiated Rate |
$1,290.10 |
| Rate for Payer: Cash Price |
$864.50
|
| Rate for Payer: Health Management Network Commercial |
$1,130.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,197.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,290.10
|
|
|
95873 ELECT STIM GUID W/CHEMODE
|
Professional
|
Both
|
$196.00
|
|
|
Service Code
|
HCPCS 95873
|
| Hospital Charge Code |
10429202
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$78.67 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$78.67
|
| Rate for Payer: AlohaCare Medicare |
$84.75
|
| Rate for Payer: Cash Price |
$127.40
|
| Rate for Payer: Cash Price |
$127.40
|
| Rate for Payer: Cash Price |
$127.40
|
| Rate for Payer: Devoted Health Medicare |
$93.22
|
| 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 |
$166.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$101.70
|
| 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 |
$78.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$84.75
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
|
