|
99203 Office/Outpatient Visit - New Patient, Level 3 (30-44 min)
|
Professional
|
Both
|
$416.00
|
|
|
Service Code
|
HCPCS 99203
|
| Hospital Charge Code |
8041014
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$70.97 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$82.26
|
| Rate for Payer: AlohaCare Medicare |
$70.97
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Devoted Health Medicare |
$78.07
|
| 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 |
$77.24
|
| Rate for Payer: Health Management Network Commercial |
$353.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.16
|
| 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 |
$82.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$70.97
|
| 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
|
|
|
99203 Office/Outpatient Visit - New Patient, Level 3 (30-44 min)
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 99203
|
| Hospital Charge Code |
8041014
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$70.97 |
| Max. Negotiated Rate |
$99.45 |
| Rate for Payer: AlohaCare Medicaid |
$82.26
|
| Rate for Payer: AlohaCare Medicare |
$70.97
|
| Rate for Payer: Cash Price |
$76.05
|
| Rate for Payer: Cash Price |
$76.05
|
| Rate for Payer: Devoted Health Medicare |
$78.07
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$82.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$70.97
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$82.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$77.24
|
| Rate for Payer: Health Management Network Commercial |
$99.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$85.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$85.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$85.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$82.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$70.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$70.97
|
|
|
99204 Office/Outpatient Visit - New Patient, Level 4 (45-59 min)
|
Professional
|
Both
|
$577.00
|
|
|
Service Code
|
HCPCS 99204
|
| Hospital Charge Code |
8041015
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$112.99 |
| Max. Negotiated Rate |
$490.45 |
| Rate for Payer: AlohaCare Medicaid |
$134.25
|
| Rate for Payer: AlohaCare Medicare |
$116.55
|
| Rate for Payer: Cash Price |
$375.05
|
| Rate for Payer: Cash Price |
$375.05
|
| Rate for Payer: Cash Price |
$375.05
|
| Rate for Payer: Devoted Health Medicare |
$128.21
|
| 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 |
$112.99
|
| Rate for Payer: Health Management Network Commercial |
$490.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$139.86
|
| 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 |
$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 |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$134.25
|
| Rate for Payer: Ohana Health Plan Medicare |
$116.55
|
| 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
|
|
|
99205 Office/Outpatient New High MDM 60-74 Min
|
Facility
|
OP
|
$346.00
|
|
|
Service Code
|
HCPCS 99205
|
| Hospital Charge Code |
11404760
|
|
Hospital Revenue Code
|
961
|
| Min. Negotiated Rate |
$122.28 |
| Max. Negotiated Rate |
$335.62 |
| Rate for Payer: AlohaCare Medicaid |
$173.00
|
| Rate for Payer: AlohaCare Medicare |
$173.00
|
| Rate for Payer: Cash Price |
$224.90
|
| Rate for Payer: Cash Price |
$224.90
|
| Rate for Payer: Devoted Health Medicare |
$190.30
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$173.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$328.70
|
| Rate for Payer: Health Management Network Commercial |
$294.10
|
| Rate for Payer: Humana Medicare |
$173.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$311.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$176.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$173.00
|
| Rate for Payer: MDX Hawaii PPO |
$335.62
|
| Rate for Payer: Ohana Health Plan Medicaid |
$173.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$173.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$122.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$173.00
|
| Rate for Payer: University Health Alliance Commercial |
$193.76
|
|
|
99205 Office/Outpatient New High MDM 60-74 Min
|
Facility
|
IP
|
$346.00
|
|
|
Service Code
|
HCPCS 99205
|
| Hospital Charge Code |
11404760
|
|
Hospital Revenue Code
|
961
|
| Min. Negotiated Rate |
$294.10 |
| Max. Negotiated Rate |
$335.62 |
| Rate for Payer: Cash Price |
$224.90
|
| Rate for Payer: Health Management Network Commercial |
$294.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$311.40
|
| Rate for Payer: MDX Hawaii PPO |
$335.62
|
|
|
99205 Office/Outpatient New High MDM 60-74 Min
|
Professional
|
Both
|
$433.00
|
|
|
Service Code
|
HCPCS 99205
|
| Hospital Charge Code |
11404760
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$135.52 |
| Max. Negotiated Rate |
$368.05 |
| Rate for Payer: AlohaCare Medicaid |
$182.72
|
| Rate for Payer: AlohaCare Medicare |
$159.56
|
| Rate for Payer: Cash Price |
$281.45
|
| Rate for Payer: Cash Price |
$281.45
|
| Rate for Payer: Devoted Health Medicare |
$175.52
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$182.72
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$159.56
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$182.72
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$135.52
|
| Rate for Payer: Health Management Network Commercial |
$368.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$191.47
|
| Rate for Payer: Kaiser Permanente Medicaid |
$191.47
|
| Rate for Payer: Kaiser Permanente Medicare |
$191.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$182.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$159.56
|
| Rate for Payer: UnitedHealthcare Medicaid |
$182.72
|
| Rate for Payer: UnitedHealthcare Medicare |
$159.56
|
|
|
99205 Office/Outpatient Visit - New Patient, Level 5 (60 Min)
|
Professional
|
Both
|
$739.00
|
|
|
Service Code
|
HCPCS 99205
|
| Hospital Charge Code |
8041016
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$135.52 |
| Max. Negotiated Rate |
$628.15 |
| Rate for Payer: AlohaCare Medicaid |
$182.72
|
| Rate for Payer: AlohaCare Medicare |
$159.56
|
| Rate for Payer: Cash Price |
$480.35
|
| Rate for Payer: Cash Price |
$480.35
|
| Rate for Payer: Cash Price |
$480.35
|
| Rate for Payer: Devoted Health Medicare |
$175.52
|
| 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 |
$135.52
|
| Rate for Payer: Health Management Network Commercial |
$628.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$191.47
|
| 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 |
$182.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$159.56
|
| 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
|
|
|
99211 Nurse Office/Outpatient Visit - Established Patient, Level 1
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 99211
|
| Hospital Charge Code |
8041017
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$8.86
|
| Rate for Payer: AlohaCare Medicare |
$7.72
|
| Rate for Payer: Cash Price |
$55.25
|
| Rate for Payer: Cash Price |
$55.25
|
| Rate for Payer: Cash Price |
$55.25
|
| Rate for Payer: Devoted Health Medicare |
$8.49
|
| 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 |
$72.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$9.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$8.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$7.72
|
| 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
|
|
|
99211 Nurse Office/Outpatient Visit - Established Patient, Level 1
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 99211
|
| Hospital Charge Code |
8041017
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$72.25 |
| Rate for Payer: AlohaCare Medicaid |
$8.86
|
| Rate for Payer: AlohaCare Medicare |
$7.72
|
| Rate for Payer: Cash Price |
$55.25
|
| Rate for Payer: Cash Price |
$55.25
|
| Rate for Payer: Devoted Health Medicare |
$8.49
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$8.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$7.72
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$8.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$17.23
|
| Rate for Payer: Health Management Network Commercial |
$72.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$9.26
|
| Rate for Payer: Kaiser Permanente Medicaid |
$9.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$9.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$8.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$7.72
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.86
|
| Rate for Payer: UnitedHealthcare Medicare |
$7.72
|
|
|
99212 Office/Outpatient Visit - Established Patient, Level 2
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 99212
|
| Hospital Charge Code |
8041018
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$29.59 |
| Max. Negotiated Rate |
$62.90 |
| Rate for Payer: AlohaCare Medicaid |
$35.51
|
| Rate for Payer: AlohaCare Medicare |
$31.00
|
| Rate for Payer: Cash Price |
$48.10
|
| Rate for Payer: Cash Price |
$48.10
|
| Rate for Payer: Devoted Health Medicare |
$34.10
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$35.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$31.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$35.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$29.59
|
| Rate for Payer: Health Management Network Commercial |
$62.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$37.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$37.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$37.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$35.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$31.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$35.51
|
| Rate for Payer: UnitedHealthcare Medicare |
$31.00
|
|
|
99212 Office/Outpatient Visit - Established Patient, Level 2
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 99212
|
| Hospital Charge Code |
8041018
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$29.59 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$35.51
|
| Rate for Payer: AlohaCare Medicare |
$31.00
|
| Rate for Payer: Cash Price |
$113.75
|
| Rate for Payer: Cash Price |
$113.75
|
| Rate for Payer: Cash Price |
$113.75
|
| Rate for Payer: Devoted Health Medicare |
$34.10
|
| 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 |
$29.59
|
| Rate for Payer: Health Management Network Commercial |
$148.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$37.20
|
| 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 |
$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 |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$35.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$31.00
|
| 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
|
|
|
99213 Office/Outpatient Visit - Established Patient, Level 3
|
Professional
|
Both
|
$286.00
|
|
|
Service Code
|
HCPCS 99213
|
| Hospital Charge Code |
8041019
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$42.37 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$66.56
|
| Rate for Payer: AlohaCare Medicare |
$57.69
|
| Rate for Payer: Cash Price |
$185.90
|
| Rate for Payer: Cash Price |
$185.90
|
| Rate for Payer: Cash Price |
$185.90
|
| Rate for Payer: Devoted Health Medicare |
$63.46
|
| 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 |
$42.37
|
| Rate for Payer: Health Management Network Commercial |
$243.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$69.23
|
| 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 |
$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 |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$66.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$57.69
|
| 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
|
|
|
99214 Office/Outpatient Visit - Established Patient, Level 4
|
Professional
|
Both
|
$421.00
|
|
|
Service Code
|
HCPCS 99214
|
| Hospital Charge Code |
8041020
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$63.45 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$98.27
|
| Rate for Payer: AlohaCare Medicare |
$84.69
|
| Rate for Payer: Cash Price |
$273.65
|
| Rate for Payer: Cash Price |
$273.65
|
| Rate for Payer: Cash Price |
$273.65
|
| Rate for Payer: Devoted Health Medicare |
$93.16
|
| 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 |
$63.45
|
| Rate for Payer: Health Management Network Commercial |
$357.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$101.63
|
| 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 |
$98.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$84.69
|
| 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
|
|
|
99215 Office/Outpatient Established High MDM 40-54 Min
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
HCPCS 99215
|
| Hospital Charge Code |
11404761
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$83.80 |
| Max. Negotiated Rate |
$301.75 |
| Rate for Payer: AlohaCare Medicaid |
$145.89
|
| Rate for Payer: AlohaCare Medicare |
$126.07
|
| Rate for Payer: Cash Price |
$230.75
|
| Rate for Payer: Cash Price |
$230.75
|
| Rate for Payer: Devoted Health Medicare |
$138.68
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$145.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$126.07
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$145.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$83.80
|
| Rate for Payer: Health Management Network Commercial |
$301.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$151.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$151.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$151.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$145.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$126.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$145.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$126.07
|
|
|
99215 Office/Outpatient Established High MDM 40-54 Min
|
Facility
|
IP
|
$284.00
|
|
|
Service Code
|
HCPCS 99215
|
| Hospital Charge Code |
11404761
|
|
Hospital Revenue Code
|
961
|
| Min. Negotiated Rate |
$241.40 |
| Max. Negotiated Rate |
$275.48 |
| Rate for Payer: Cash Price |
$184.60
|
| Rate for Payer: Health Management Network Commercial |
$241.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$255.60
|
| Rate for Payer: MDX Hawaii PPO |
$275.48
|
|
|
99215 Office/Outpatient Established High MDM 40-54 Min
|
Facility
|
OP
|
$284.00
|
|
|
Service Code
|
HCPCS 99215
|
| Hospital Charge Code |
11404761
|
|
Hospital Revenue Code
|
961
|
| Min. Negotiated Rate |
$83.57 |
| Max. Negotiated Rate |
$275.48 |
| Rate for Payer: AlohaCare Medicaid |
$142.00
|
| Rate for Payer: AlohaCare Medicare |
$142.00
|
| Rate for Payer: Cash Price |
$184.60
|
| Rate for Payer: Cash Price |
$184.60
|
| Rate for Payer: Devoted Health Medicare |
$156.20
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$142.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$269.80
|
| Rate for Payer: Health Management Network Commercial |
$241.40
|
| Rate for Payer: Humana Medicare |
$142.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$255.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$144.84
|
| Rate for Payer: Kaiser Permanente Medicare |
$142.00
|
| Rate for Payer: MDX Hawaii PPO |
$275.48
|
| Rate for Payer: Ohana Health Plan Medicaid |
$142.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$142.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$83.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$142.00
|
| Rate for Payer: University Health Alliance Commercial |
$159.04
|
|
|
99215 Office/Outpatient Visit - Established Patient, Level 5 (40-54 min).
|
Professional
|
Both
|
$470.00
|
|
|
Service Code
|
HCPCS 99215
|
| Hospital Charge Code |
8041021
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$83.80 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$145.89
|
| Rate for Payer: AlohaCare Medicare |
$126.07
|
| Rate for Payer: Cash Price |
$305.50
|
| Rate for Payer: Cash Price |
$305.50
|
| Rate for Payer: Cash Price |
$305.50
|
| Rate for Payer: Devoted Health Medicare |
$138.68
|
| 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 |
$83.80
|
| Rate for Payer: Health Management Network Commercial |
$399.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$151.28
|
| 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 |
$145.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$126.07
|
| 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
|
|
|
99215 Office/Outpatient Visit - Established Patient, Level 5 (40-54 min).
|
Professional
|
Both
|
$565.00
|
|
|
Service Code
|
HCPCS 99215
|
| Hospital Charge Code |
8041021
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$83.80 |
| Max. Negotiated Rate |
$480.25 |
| Rate for Payer: AlohaCare Medicaid |
$145.89
|
| Rate for Payer: AlohaCare Medicare |
$126.07
|
| Rate for Payer: Cash Price |
$367.25
|
| Rate for Payer: Cash Price |
$367.25
|
| Rate for Payer: Devoted Health Medicare |
$138.68
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$145.89
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$126.07
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$145.89
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$83.80
|
| Rate for Payer: Health Management Network Commercial |
$480.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$151.28
|
| Rate for Payer: Kaiser Permanente Medicaid |
$151.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$151.28
|
| Rate for Payer: Ohana Health Plan Medicaid |
$145.89
|
| Rate for Payer: Ohana Health Plan Medicare |
$126.07
|
| Rate for Payer: UnitedHealthcare Medicaid |
$145.89
|
| Rate for Payer: UnitedHealthcare Medicare |
$126.07
|
|
|
99217 Observation Discharge Day Management
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 99217
|
| Hospital Charge Code |
8041022
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$65.40 |
| Max. Negotiated Rate |
$217.60 |
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$65.40
|
| Rate for Payer: Health Management Network Commercial |
$217.60
|
|
|
99217 Observation Discharge Day Management
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 99217
|
| Hospital Charge Code |
8041022
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$65.40 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cash Price |
$166.40
|
| 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 |
$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 |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$65.40
|
| Rate for Payer: Health Management Network Commercial |
$217.60
|
| 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 Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| 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 |
$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: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
99218 Initial Observation Visit, Low
|
Professional
|
Both
|
$233.00
|
|
|
Service Code
|
HCPCS 99218
|
| Hospital Charge Code |
8041023
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$198.05 |
| Rate for Payer: Cash Price |
$151.45
|
| Rate for Payer: Cash Price |
$151.45
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$72.12
|
| Rate for Payer: Health Management Network Commercial |
$198.05
|
|
|
99219 Initial Observation Visit, Moderate
|
Professional
|
Both
|
$389.00
|
|
| Hospital Charge Code |
8041024
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$330.65 |
| Max. Negotiated Rate |
$330.65 |
| Rate for Payer: Cash Price |
$252.85
|
| Rate for Payer: Health Management Network Commercial |
$330.65
|
|
|
99220 Initial Observation Visit, High
|
Professional
|
Both
|
$545.00
|
|
| Hospital Charge Code |
8041025
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$463.25 |
| Max. Negotiated Rate |
$463.25 |
| Rate for Payer: Cash Price |
$354.25
|
| Rate for Payer: Health Management Network Commercial |
$463.25
|
|
|
99221 Initial Hospital Care, Level 1
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
HCPCS 99221
|
| Hospital Charge Code |
8041026
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$68.50 |
| Max. Negotiated Rate |
$238.85 |
| Rate for Payer: AlohaCare Medicaid |
$82.48
|
| Rate for Payer: AlohaCare Medicare |
$73.69
|
| Rate for Payer: Cash Price |
$182.65
|
| Rate for Payer: Cash Price |
$182.65
|
| Rate for Payer: Devoted Health Medicare |
$81.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$73.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$68.50
|
| Rate for Payer: Health Management Network Commercial |
$238.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$88.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$88.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$88.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$82.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$73.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.48
|
| Rate for Payer: UnitedHealthcare Medicare |
$73.69
|
|
|
99221 Initial Hospital Care, Level 1
|
Professional
|
Both
|
$296.00
|
|
|
Service Code
|
HCPCS 99221
|
| Hospital Charge Code |
8041026
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$68.50 |
| Max. Negotiated Rate |
$251.60 |
| Rate for Payer: AlohaCare Medicaid |
$82.48
|
| Rate for Payer: AlohaCare Medicare |
$73.69
|
| Rate for Payer: Cash Price |
$192.40
|
| Rate for Payer: Cash Price |
$192.40
|
| Rate for Payer: Devoted Health Medicare |
$81.06
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$73.69
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$68.50
|
| Rate for Payer: Health Management Network Commercial |
$251.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$88.43
|
| Rate for Payer: Kaiser Permanente Medicaid |
$88.43
|
| Rate for Payer: Kaiser Permanente Medicare |
$88.43
|
| Rate for Payer: Ohana Health Plan Medicaid |
$82.48
|
| Rate for Payer: Ohana Health Plan Medicare |
$73.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.48
|
| Rate for Payer: UnitedHealthcare Medicare |
$73.69
|
|
