|
95874 Needle electromyography for guidance in conjunction with chemodenervation
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 95874
|
| Hospital Charge Code |
8040824
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$85.17 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$85.17
|
| Rate for Payer: AlohaCare Medicare |
$89.69
|
| Rate for Payer: Cash Price |
$131.30
|
| Rate for Payer: Cash Price |
$131.30
|
| Rate for Payer: Cash Price |
$131.30
|
| Rate for Payer: Devoted Health Medicare |
$98.66
|
| 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 |
$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 |
$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 |
$171.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$107.63
|
| 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 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 |
$85.17
|
| Rate for Payer: Ohana Health Plan Medicare |
$89.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
95885 Needle electromyography, each extremity; limited
|
Professional
|
Both
|
$160.00
|
|
|
Service Code
|
HCPCS 95885
|
| Hospital Charge Code |
8040825
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$68.53 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$68.83
|
| Rate for Payer: AlohaCare Medicare |
$71.55
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Devoted Health Medicare |
$78.70
|
| 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 |
$68.53
|
| Rate for Payer: Health Management Network Commercial |
$136.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.86
|
| 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 |
$68.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$71.55
|
| 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
|
|
|
95886 Needle electromyography, each extremity, ; complete, 5+ muscles studied
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 95886
|
| Hospital Charge Code |
8040826
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$93.62 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$105.30
|
| Rate for Payer: AlohaCare Medicare |
$109.15
|
| Rate for Payer: Cash Price |
$161.85
|
| Rate for Payer: Cash Price |
$161.85
|
| Rate for Payer: Cash Price |
$161.85
|
| Rate for Payer: Devoted Health Medicare |
$120.06
|
| 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 |
$93.62
|
| Rate for Payer: Health Management Network Commercial |
$211.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$130.98
|
| 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 |
$105.30
|
| Rate for Payer: Ohana Health Plan Medicare |
$109.15
|
| 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
|
|
|
95887 Needle electromyography, non-extremity
|
Professional
|
Both
|
$217.00
|
|
|
Service Code
|
HCPCS 95887
|
| Hospital Charge Code |
8040827
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$79.69 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$90.74
|
| Rate for Payer: AlohaCare Medicare |
$96.54
|
| Rate for Payer: Cash Price |
$141.05
|
| Rate for Payer: Cash Price |
$141.05
|
| Rate for Payer: Cash Price |
$141.05
|
| Rate for Payer: Devoted Health Medicare |
$106.19
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$79.69
|
| Rate for Payer: Health Management Network Commercial |
$184.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$115.85
|
| 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 |
$90.74
|
| Rate for Payer: Ohana Health Plan Medicare |
$96.54
|
| 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
|
|
|
95909 Nerve conduction studies; 5-6 studies
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 95909
|
| Hospital Charge Code |
8040831
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$144.94 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$144.94
|
| Rate for Payer: AlohaCare Medicare |
$153.42
|
| Rate for Payer: Cash Price |
$241.80
|
| Rate for Payer: Cash Price |
$241.80
|
| Rate for Payer: Cash Price |
$241.80
|
| Rate for Payer: Devoted Health Medicare |
$168.76
|
| 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 |
$152.12
|
| Rate for Payer: Health Management Network Commercial |
$316.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$184.10
|
| 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 |
$144.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$153.42
|
| 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
|
|
|
95910 Nerve conduction studies; 7-8 studies
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 95910
|
| Hospital Charge Code |
8040832
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$189.12
|
| Rate for Payer: AlohaCare Medicare |
$199.60
|
| Rate for Payer: Cash Price |
$318.50
|
| Rate for Payer: Cash Price |
$318.50
|
| Rate for Payer: Cash Price |
$318.50
|
| Rate for Payer: Devoted Health Medicare |
$219.56
|
| 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 |
$200.08
|
| Rate for Payer: Health Management Network Commercial |
$416.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$239.52
|
| 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 |
$189.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$199.60
|
| 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
|
|
|
95911 Nerve conduction studies; 9-10 studies
|
Professional
|
Both
|
$586.00
|
|
|
Service Code
|
HCPCS 95911
|
| Hospital Charge Code |
8040833
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$498.10 |
| Rate for Payer: AlohaCare Medicaid |
$227.55
|
| Rate for Payer: AlohaCare Medicare |
$237.24
|
| Rate for Payer: Cash Price |
$380.90
|
| Rate for Payer: Cash Price |
$380.90
|
| Rate for Payer: Cash Price |
$380.90
|
| Rate for Payer: Devoted Health Medicare |
$260.96
|
| 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 |
$241.74
|
| Rate for Payer: Health Management Network Commercial |
$498.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$284.69
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$227.55
|
| Rate for Payer: Ohana Health Plan Medicare |
$237.24
|
| 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
|
|
|
95912 Nerve conduction studies; 11-12 studies
|
Professional
|
Both
|
$671.00
|
|
|
Service Code
|
HCPCS 95912
|
| Hospital Charge Code |
8040834
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$570.35 |
| Rate for Payer: AlohaCare Medicaid |
$265.41
|
| Rate for Payer: AlohaCare Medicare |
$273.75
|
| Rate for Payer: Cash Price |
$436.15
|
| Rate for Payer: Cash Price |
$436.15
|
| Rate for Payer: Cash Price |
$436.15
|
| Rate for Payer: Devoted Health Medicare |
$301.12
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$282.63
|
| Rate for Payer: Health Management Network Commercial |
$570.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$328.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$265.41
|
| Rate for Payer: Ohana Health Plan Medicare |
$273.75
|
| 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
|
|
|
95913 Nerve conduction studies; 13 or more studies
|
Professional
|
Both
|
$776.00
|
|
|
Service Code
|
HCPCS 95913
|
| Hospital Charge Code |
8040835
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$659.60 |
| Rate for Payer: AlohaCare Medicaid |
$305.84
|
| Rate for Payer: AlohaCare Medicare |
$322.17
|
| Rate for Payer: Cash Price |
$504.40
|
| Rate for Payer: Cash Price |
$504.40
|
| Rate for Payer: Cash Price |
$504.40
|
| Rate for Payer: Devoted Health Medicare |
$354.39
|
| 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 |
$327.14
|
| Rate for Payer: Health Management Network Commercial |
$659.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$386.60
|
| 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 |
$305.84
|
| Rate for Payer: Ohana Health Plan Medicare |
$322.17
|
| 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
|
|
|
95937 Neuromuscular junction testing, each nerve, any 1 method
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 95937
|
| Hospital Charge Code |
8040842
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$41.05 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$115.32
|
| Rate for Payer: AlohaCare Medicare |
$117.52
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Devoted Health Medicare |
$129.27
|
| 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 |
$41.05
|
| Rate for Payer: Health Management Network Commercial |
$204.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$141.02
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$115.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$117.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
95992 Canalith repositioning procedure(s), per day
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 95992
|
| Hospital Charge Code |
8040857
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$30.09 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$36.24
|
| Rate for Payer: AlohaCare Medicare |
$30.09
|
| Rate for Payer: Cash Price |
$78.00
|
| Rate for Payer: Cash Price |
$78.00
|
| Rate for Payer: Cash Price |
$78.00
|
| Rate for Payer: Devoted Health Medicare |
$33.10
|
| 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 |
$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 |
$40.96
|
| Rate for Payer: Health Management Network Commercial |
$102.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$36.11
|
| 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 |
$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 |
$36.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$30.09
|
| 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 |
$44.34
|
|
|
96110 Developmental screening, with scoring and documentation, per standardized instrument
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS 96110
|
| Hospital Charge Code |
8084922
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$29.75 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: Cash Price |
$22.75
|
| Rate for Payer: Cash Price |
$22.75
|
| Rate for Payer: Cash Price |
$22.75
|
| 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 |
$84.01
|
| Rate for Payer: Health Management Network Commercial |
$29.75
|
| 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
|
|
|
96125 - Std Cognigative Performance Test
|
Facility
|
IP
|
$218.00
|
|
|
Service Code
|
HCPCS 96125 GP,CQ
|
| Hospital Charge Code |
8409224
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$185.30 |
| Max. Negotiated Rate |
$211.46 |
| Rate for Payer: Cash Price |
$141.70
|
| Rate for Payer: Health Management Network Commercial |
$185.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$196.20
|
| Rate for Payer: MDX Hawaii PPO |
$211.46
|
|
|
96125 - Std Cognigative Performance Test
|
Facility
|
OP
|
$218.00
|
|
|
Service Code
|
HCPCS 96125 GP,CQ
|
| Hospital Charge Code |
8409224
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$41.65 |
| Max. Negotiated Rate |
$211.46 |
| Rate for Payer: AlohaCare Medicaid |
$109.00
|
| Rate for Payer: AlohaCare Medicare |
$109.00
|
| Rate for Payer: Cash Price |
$141.70
|
| Rate for Payer: Cash Price |
$141.70
|
| Rate for Payer: Devoted Health Medicare |
$119.90
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$109.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$207.10
|
| Rate for Payer: Health Management Network Commercial |
$185.30
|
| Rate for Payer: Humana Medicare |
$109.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$196.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$111.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$109.00
|
| Rate for Payer: MDX Hawaii PPO |
$211.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$109.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$109.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$41.65
|
| Rate for Payer: UnitedHealthcare Medicare |
$109.00
|
| Rate for Payer: University Health Alliance Commercial |
$122.08
|
|
|
96127 Brief emotional/behavioral assessment (eg, depression invent
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 96127
|
| Hospital Charge Code |
8967269
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$5.16 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$5.16
|
| Rate for Payer: AlohaCare Medicare |
$5.51
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Devoted Health Medicare |
$6.06
|
| 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 |
$6.04
|
| Rate for Payer: Health Management Network Commercial |
$44.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$6.61
|
| 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 |
$5.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$5.51
|
| 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
|
|
|
96160 Admin and interpretation of patient-focused health risk assmt
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 96160
|
| Hospital Charge Code |
8269592
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$3.42 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$3.44
|
| Rate for Payer: AlohaCare Medicare |
$3.42
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Devoted Health Medicare |
$3.76
|
| 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 |
$5.38
|
| Rate for Payer: Health Management Network Commercial |
$44.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$4.10
|
| 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 |
$3.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$3.42
|
| 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
|
|
|
96360-59 IV Hydration Initial Addl Site w/ Modification
|
Facility
|
IP
|
$664.00
|
|
|
Service Code
|
HCPCS 96360 59
|
| Hospital Charge Code |
8079986
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$564.40 |
| Max. Negotiated Rate |
$644.08 |
| Rate for Payer: Cash Price |
$431.60
|
| Rate for Payer: Health Management Network Commercial |
$564.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$597.60
|
| Rate for Payer: MDX Hawaii PPO |
$644.08
|
|
|
96360-59 IV Hydration Initial Addl Site w/ Modification
|
Facility
|
OP
|
$664.00
|
|
|
Service Code
|
HCPCS 96360 59
|
| Hospital Charge Code |
8079986
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$332.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$332.00
|
| Rate for Payer: AlohaCare Medicare |
$332.00
|
| Rate for Payer: Cash Price |
$431.60
|
| Rate for Payer: Cash Price |
$431.60
|
| Rate for Payer: Devoted Health Medicare |
$365.20
|
| 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 |
$332.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$630.80
|
| Rate for Payer: Health Management Network Commercial |
$564.40
|
| Rate for Payer: Humana Medicare |
$332.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$597.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$332.00
|
| Rate for Payer: MDX Hawaii PPO |
$644.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$332.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$332.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$332.00
|
| Rate for Payer: University Health Alliance Commercial |
$483.99
|
|
|
96360 - ED Hydration, first hour
|
Facility
|
IP
|
$657.00
|
|
|
Service Code
|
HCPCS 96360
|
| Hospital Charge Code |
1928297
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$558.45 |
| Max. Negotiated Rate |
$637.29 |
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Health Management Network Commercial |
$558.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$591.30
|
| Rate for Payer: MDX Hawaii PPO |
$637.29
|
|
|
96360 - ED Hydration, first hour
|
Facility
|
OP
|
$657.00
|
|
|
Service Code
|
HCPCS 96360
|
| Hospital Charge Code |
1928297
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$328.50 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$328.50
|
| Rate for Payer: AlohaCare Medicare |
$328.50
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Devoted Health Medicare |
$361.35
|
| 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 |
$328.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$624.15
|
| Rate for Payer: Health Management Network Commercial |
$558.45
|
| Rate for Payer: Humana Medicare |
$328.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$591.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$328.50
|
| Rate for Payer: MDX Hawaii PPO |
$637.29
|
| Rate for Payer: Ohana Health Plan Medicaid |
$328.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$328.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$328.50
|
| Rate for Payer: University Health Alliance Commercial |
$478.89
|
|
|
96360 HYDRATION/IV FLUID INITIAL FIRST HOUR CHARGE
|
Facility
|
OP
|
$657.00
|
|
|
Service Code
|
HCPCS 96360
|
| Hospital Charge Code |
8050442
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$328.50 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$328.50
|
| Rate for Payer: AlohaCare Medicare |
$328.50
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Devoted Health Medicare |
$361.35
|
| 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 |
$328.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$624.15
|
| Rate for Payer: Health Management Network Commercial |
$558.45
|
| Rate for Payer: Humana Medicare |
$328.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$591.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$328.50
|
| Rate for Payer: MDX Hawaii PPO |
$637.29
|
| Rate for Payer: Ohana Health Plan Medicaid |
$328.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$328.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$328.50
|
| Rate for Payer: University Health Alliance Commercial |
$478.89
|
|
|
96360 HYDRATION/IV FLUID INITIAL FIRST HOUR CHARGE
|
Facility
|
IP
|
$657.00
|
|
|
Service Code
|
HCPCS 96360
|
| Hospital Charge Code |
8050442
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$558.45 |
| Max. Negotiated Rate |
$637.29 |
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Health Management Network Commercial |
$558.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$591.30
|
| Rate for Payer: MDX Hawaii PPO |
$637.29
|
|
|
96360-IV Hydration Initial 31 min - 1 hr
|
Facility
|
IP
|
$664.00
|
|
|
Service Code
|
HCPCS 96360
|
| Hospital Charge Code |
8079976
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$564.40 |
| Max. Negotiated Rate |
$644.08 |
| Rate for Payer: Cash Price |
$431.60
|
| Rate for Payer: Health Management Network Commercial |
$564.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$597.60
|
| Rate for Payer: MDX Hawaii PPO |
$644.08
|
|
|
96360-IV Hydration Initial 31 min - 1 hr
|
Facility
|
OP
|
$664.00
|
|
|
Service Code
|
HCPCS 96360
|
| Hospital Charge Code |
8079976
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$332.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$332.00
|
| Rate for Payer: AlohaCare Medicare |
$332.00
|
| Rate for Payer: Cash Price |
$431.60
|
| Rate for Payer: Cash Price |
$431.60
|
| Rate for Payer: Devoted Health Medicare |
$365.20
|
| 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 |
$332.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$630.80
|
| Rate for Payer: Health Management Network Commercial |
$564.40
|
| Rate for Payer: Humana Medicare |
$332.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$597.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$332.00
|
| Rate for Payer: MDX Hawaii PPO |
$644.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$332.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$332.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$332.00
|
| Rate for Payer: University Health Alliance Commercial |
$483.99
|
|
|
96360 IV Hydration Int 31 to 90 Min Charge
|
Facility
|
IP
|
$657.00
|
|
|
Service Code
|
HCPCS 96360
|
| Hospital Charge Code |
8220029
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$558.45 |
| Max. Negotiated Rate |
$637.29 |
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Health Management Network Commercial |
$558.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$591.30
|
| Rate for Payer: MDX Hawaii PPO |
$637.29
|
|
