|
99222 Initial Hospital Care, Level 2
|
Professional
|
Both
|
$449.00
|
|
|
Service Code
|
HCPCS 99222
|
| Hospital Charge Code |
8041027
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$113.39 |
| Max. Negotiated Rate |
$381.65 |
| Rate for Payer: AlohaCare Medicaid |
$131.00
|
| Rate for Payer: AlohaCare Medicare |
$116.73
|
| Rate for Payer: Cash Price |
$291.85
|
| Rate for Payer: Cash Price |
$291.85
|
| Rate for Payer: Devoted Health Medicare |
$128.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$116.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$113.39
|
| Rate for Payer: Health Management Network Commercial |
$381.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$140.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$140.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$140.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$131.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$116.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$131.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$116.73
|
|
|
99222 Initial Hospital Care, Level 2
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 99222
|
| Hospital Charge Code |
8041027
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$113.39 |
| Max. Negotiated Rate |
$325.55 |
| Rate for Payer: AlohaCare Medicaid |
$131.00
|
| Rate for Payer: AlohaCare Medicare |
$116.73
|
| Rate for Payer: Cash Price |
$248.95
|
| Rate for Payer: Cash Price |
$248.95
|
| Rate for Payer: Devoted Health Medicare |
$128.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$116.73
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$113.39
|
| Rate for Payer: Health Management Network Commercial |
$325.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$140.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$140.08
|
| Rate for Payer: Kaiser Permanente Medicare |
$140.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$131.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$116.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$131.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$116.73
|
|
|
99223 Initial Hospital Care, Level 3
|
Professional
|
Both
|
$576.00
|
|
|
Service Code
|
HCPCS 99223
|
| Hospital Charge Code |
8041028
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$149.55 |
| Max. Negotiated Rate |
$489.60 |
| Rate for Payer: AlohaCare Medicaid |
$174.14
|
| Rate for Payer: AlohaCare Medicare |
$156.50
|
| Rate for Payer: Cash Price |
$374.40
|
| Rate for Payer: Cash Price |
$374.40
|
| Rate for Payer: Devoted Health Medicare |
$172.15
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$156.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$149.55
|
| Rate for Payer: Health Management Network Commercial |
$489.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$187.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$187.80
|
| Rate for Payer: Kaiser Permanente Medicare |
$187.80
|
| Rate for Payer: Ohana Health Plan Medicaid |
$174.14
|
| Rate for Payer: Ohana Health Plan Medicare |
$156.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$174.14
|
| Rate for Payer: UnitedHealthcare Medicare |
$156.50
|
|
|
99224 Subsequent Observation Visit, Low
|
Professional
|
Both
|
$101.00
|
|
| Hospital Charge Code |
8041029
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$85.85 |
| Max. Negotiated Rate |
$85.85 |
| Rate for Payer: Cash Price |
$65.65
|
| Rate for Payer: Health Management Network Commercial |
$85.85
|
|
|
99225 Subsequent Observation Visit, Moderate
|
Professional
|
Both
|
$181.00
|
|
| Hospital Charge Code |
8041030
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$153.85 |
| Max. Negotiated Rate |
$153.85 |
| Rate for Payer: Cash Price |
$117.65
|
| Rate for Payer: Health Management Network Commercial |
$153.85
|
|
|
99226 Subsequent Observation Visit, High
|
Professional
|
Both
|
$269.00
|
|
| Hospital Charge Code |
8041031
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$228.65 |
| Max. Negotiated Rate |
$228.65 |
| Rate for Payer: Cash Price |
$174.85
|
| Rate for Payer: Health Management Network Commercial |
$228.65
|
|
|
99231 Subsequent Hospital Care, Level 1
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 99231
|
| Hospital Charge Code |
8041032
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$36.28 |
| Max. Negotiated Rate |
$119.00 |
| Rate for Payer: AlohaCare Medicaid |
$49.50
|
| Rate for Payer: AlohaCare Medicare |
$44.06
|
| Rate for Payer: Cash Price |
$91.00
|
| Rate for Payer: Cash Price |
$91.00
|
| Rate for Payer: Devoted Health Medicare |
$48.47
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$44.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$36.28
|
| Rate for Payer: Health Management Network Commercial |
$119.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$52.87
|
| Rate for Payer: Kaiser Permanente Medicaid |
$52.87
|
| Rate for Payer: Kaiser Permanente Medicare |
$52.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$49.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$44.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$49.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$44.06
|
|
|
99232 Subsequent Hospital Care, Level 2
|
Professional
|
Both
|
$253.00
|
|
|
Service Code
|
HCPCS 99232
|
| Hospital Charge Code |
8041033
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$54.57 |
| Max. Negotiated Rate |
$215.05 |
| Rate for Payer: AlohaCare Medicaid |
$79.26
|
| Rate for Payer: AlohaCare Medicare |
$70.62
|
| Rate for Payer: Cash Price |
$164.45
|
| Rate for Payer: Cash Price |
$164.45
|
| Rate for Payer: Devoted Health Medicare |
$77.68
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$70.62
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$54.57
|
| Rate for Payer: Health Management Network Commercial |
$215.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$84.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$84.74
|
| Rate for Payer: Kaiser Permanente Medicare |
$84.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$79.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$70.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$79.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$70.62
|
|
|
99233 Subsequent Hospital Care, Level 3
|
Professional
|
Both
|
$361.00
|
|
|
Service Code
|
HCPCS 99233
|
| Hospital Charge Code |
8041034
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$76.28 |
| Max. Negotiated Rate |
$306.85 |
| Rate for Payer: AlohaCare Medicaid |
$119.20
|
| Rate for Payer: AlohaCare Medicare |
$107.19
|
| Rate for Payer: Cash Price |
$234.65
|
| Rate for Payer: Cash Price |
$234.65
|
| Rate for Payer: Devoted Health Medicare |
$117.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$107.19
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$76.28
|
| Rate for Payer: Health Management Network Commercial |
$306.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$128.63
|
| Rate for Payer: Kaiser Permanente Medicaid |
$128.63
|
| Rate for Payer: Kaiser Permanente Medicare |
$128.63
|
| Rate for Payer: Ohana Health Plan Medicaid |
$119.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$107.19
|
| Rate for Payer: UnitedHealthcare Medicaid |
$119.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$107.19
|
|
|
99234 Same Day Admit/Discharge, Low
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 99234
|
| Hospital Charge Code |
8041035
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$323.85 |
| Rate for Payer: AlohaCare Medicaid |
$97.67
|
| Rate for Payer: AlohaCare Medicare |
$87.75
|
| Rate for Payer: Cash Price |
$247.65
|
| Rate for Payer: Cash Price |
$247.65
|
| Rate for Payer: Devoted Health Medicare |
$96.53
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$87.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$70.50
|
| Rate for Payer: Health Management Network Commercial |
$323.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$105.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$105.30
|
| Rate for Payer: Kaiser Permanente Medicare |
$105.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$97.67
|
| Rate for Payer: Ohana Health Plan Medicare |
$87.75
|
| Rate for Payer: UnitedHealthcare Medicaid |
$97.67
|
| Rate for Payer: UnitedHealthcare Medicare |
$87.75
|
|
|
99235 Same Day Admit/Discharge, Moderate
|
Professional
|
Both
|
$535.00
|
|
|
Service Code
|
HCPCS 99235
|
| Hospital Charge Code |
8041036
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$117.50 |
| Max. Negotiated Rate |
$454.75 |
| Rate for Payer: AlohaCare Medicaid |
$160.14
|
| Rate for Payer: AlohaCare Medicare |
$143.06
|
| Rate for Payer: Cash Price |
$347.75
|
| Rate for Payer: Cash Price |
$347.75
|
| Rate for Payer: Devoted Health Medicare |
$157.37
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$143.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$117.50
|
| Rate for Payer: Health Management Network Commercial |
$454.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$171.67
|
| Rate for Payer: Kaiser Permanente Medicaid |
$171.67
|
| Rate for Payer: Kaiser Permanente Medicare |
$171.67
|
| Rate for Payer: Ohana Health Plan Medicaid |
$160.14
|
| Rate for Payer: Ohana Health Plan Medicare |
$143.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$160.14
|
| Rate for Payer: UnitedHealthcare Medicare |
$143.06
|
|
|
99236 Same Day Admit/Discharge, High
|
Professional
|
Both
|
$679.00
|
|
|
Service Code
|
HCPCS 99236
|
| Hospital Charge Code |
8041037
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$164.50 |
| Max. Negotiated Rate |
$577.15 |
| Rate for Payer: AlohaCare Medicaid |
$208.78
|
| Rate for Payer: AlohaCare Medicare |
$189.32
|
| Rate for Payer: Cash Price |
$441.35
|
| Rate for Payer: Cash Price |
$441.35
|
| Rate for Payer: Devoted Health Medicare |
$208.25
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$189.32
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$164.50
|
| Rate for Payer: Health Management Network Commercial |
$577.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$227.18
|
| Rate for Payer: Kaiser Permanente Medicaid |
$227.18
|
| Rate for Payer: Kaiser Permanente Medicare |
$227.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$208.78
|
| Rate for Payer: Ohana Health Plan Medicare |
$189.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$208.78
|
| Rate for Payer: UnitedHealthcare Medicare |
$189.32
|
|
|
99238 Hospital Discharge Day, <30 Minutes
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 99238
|
| Hospital Charge Code |
8041038
|
|
Hospital Revenue Code
|
987
|
| Min. Negotiated Rate |
$64.63 |
| Max. Negotiated Rate |
$172.55 |
| Rate for Payer: AlohaCare Medicaid |
$82.58
|
| Rate for Payer: AlohaCare Medicare |
$75.97
|
| Rate for Payer: Cash Price |
$131.95
|
| Rate for Payer: Cash Price |
$131.95
|
| Rate for Payer: Devoted Health Medicare |
$83.57
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$75.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$64.63
|
| Rate for Payer: Health Management Network Commercial |
$172.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$91.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$91.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$91.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$82.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$75.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$75.97
|
|
|
99238 Hospital Discharge Day, <30 Minutes
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 99238
|
| Hospital Charge Code |
8041038
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$64.63 |
| Max. Negotiated Rate |
$215.90 |
| Rate for Payer: AlohaCare Medicaid |
$82.58
|
| Rate for Payer: AlohaCare Medicare |
$75.97
|
| Rate for Payer: Cash Price |
$165.10
|
| Rate for Payer: Cash Price |
$165.10
|
| Rate for Payer: Devoted Health Medicare |
$83.57
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$75.97
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$64.63
|
| Rate for Payer: Health Management Network Commercial |
$215.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$91.16
|
| Rate for Payer: Kaiser Permanente Medicaid |
$91.16
|
| Rate for Payer: Kaiser Permanente Medicare |
$91.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$82.58
|
| Rate for Payer: Ohana Health Plan Medicare |
$75.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.58
|
| Rate for Payer: UnitedHealthcare Medicare |
$75.97
|
|
|
99239 Hospital Discharge Day, > 30 Min
|
Professional
|
Both
|
$373.00
|
|
|
Service Code
|
HCPCS 99239
|
| Hospital Charge Code |
8041039
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$78.33 |
| Max. Negotiated Rate |
$317.05 |
| Rate for Payer: AlohaCare Medicaid |
$116.44
|
| Rate for Payer: AlohaCare Medicare |
$108.33
|
| Rate for Payer: Cash Price |
$242.45
|
| Rate for Payer: Cash Price |
$242.45
|
| Rate for Payer: Devoted Health Medicare |
$119.16
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$108.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$78.33
|
| Rate for Payer: Health Management Network Commercial |
$317.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$130.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$130.00
|
| Rate for Payer: Kaiser Permanente Medicare |
$130.00
|
| Rate for Payer: Ohana Health Plan Medicaid |
$116.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$108.33
|
| Rate for Payer: UnitedHealthcare Medicaid |
$116.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$108.33
|
|
|
99241 Office Consultation, Level 1
|
Professional
|
Both
|
$53.00
|
|
| Hospital Charge Code |
8041041
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$45.05 |
| Max. Negotiated Rate |
$45.05 |
| Rate for Payer: Cash Price |
$34.45
|
| Rate for Payer: Health Management Network Commercial |
$45.05
|
|
|
99241 Office Consultation, Level 1
|
Professional
|
Both
|
$175.00
|
|
| Hospital Charge Code |
8041041
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$148.75 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: Cash Price |
$113.75
|
| Rate for Payer: Cash Price |
$113.75
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$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 |
$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: Health Management Network Commercial |
$148.75
|
| 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 |
$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 |
$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
|
|
|
99242 Office Consultation, Level 2
|
Professional
|
Both
|
$296.00
|
|
|
Service Code
|
HCPCS 99242
|
| Hospital Charge Code |
8041042
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$82.11 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: Cash Price |
$192.40
|
| Rate for Payer: Cash Price |
$192.40
|
| Rate for Payer: Cash Price |
$192.40
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association 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 Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$82.11
|
| Rate for Payer: Health Management Network Commercial |
$251.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| 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 |
$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 |
$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
|
|
|
99242 Office Consultation, Level 2
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 99242
|
| Hospital Charge Code |
8041042
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$56.76 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$56.76
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$56.76
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$82.11
|
| Rate for Payer: Health Management Network Commercial |
$107.10
|
|
|
99243 Office Consultation, Level 3
|
Professional
|
Both
|
$423.00
|
|
|
Service Code
|
HCPCS 99243
|
| Hospital Charge Code |
8041043
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$89.13 |
| Max. Negotiated Rate |
$359.55 |
| Rate for Payer: Cash Price |
$274.95
|
| Rate for Payer: Cash Price |
$274.95
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$89.13
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$89.13
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$105.54
|
| Rate for Payer: Health Management Network Commercial |
$359.55
|
|
|
99243 Office Consultation, Level 3
|
Professional
|
Both
|
$423.00
|
|
|
Service Code
|
HCPCS 99243
|
| Hospital Charge Code |
8041043
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$105.54 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: Cash Price |
$274.95
|
| Rate for Payer: Cash Price |
$274.95
|
| Rate for Payer: Cash Price |
$274.95
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| 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 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 Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$105.54
|
| Rate for Payer: Health Management Network Commercial |
$359.55
|
| 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 Commercial |
$303.73
|
| 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
|
|
|
99244 Office Consultation, Level 4
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 99244
|
| Hospital Charge Code |
8041044
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$136.13 |
| Max. Negotiated Rate |
$144.50 |
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$136.13
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$136.13
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$139.47
|
| Rate for Payer: Health Management Network Commercial |
$144.50
|
|
|
99244 Office Consultation, Level 4
|
Professional
|
Both
|
$496.00
|
|
|
Service Code
|
HCPCS 99244
|
| Hospital Charge Code |
8041044
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$139.47 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| 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 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 Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$139.47
|
| Rate for Payer: Health Management Network Commercial |
$421.60
|
| 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 Commercial |
$303.73
|
| 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
|
|
|
99245 Office Consultation, Level 5
|
Professional
|
Both
|
$799.00
|
|
|
Service Code
|
HCPCS 99245
|
| Hospital Charge Code |
8041045
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$679.15 |
| Rate for Payer: Cash Price |
$519.35
|
| Rate for Payer: Cash Price |
$519.35
|
| Rate for Payer: Cash Price |
$519.35
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| 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 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 Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$150.80
|
| Rate for Payer: Health Management Network Commercial |
$679.15
|
| 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 Commercial |
$303.73
|
| 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
|
|
|
99245 Office Consultation, Level 5
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 99245
|
| Hospital Charge Code |
8041045
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$348.50 |
| Rate for Payer: Cash Price |
$266.50
|
| Rate for Payer: Cash Price |
$266.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$181.90
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$181.90
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$150.80
|
| Rate for Payer: Health Management Network Commercial |
$348.50
|
|
