|
16000 INITIAL TX 1ST DEGREE BURN LOCAL TX TechFee
|
Facility
|
OP
|
$495.00
|
|
|
Service Code
|
HCPCS 16000
|
| Hospital Charge Code |
8022702
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$247.50 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$247.50
|
| Rate for Payer: AlohaCare Medicare |
$247.50
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Devoted Health Medicare |
$272.25
|
| 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 |
$247.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$470.25
|
| Rate for Payer: Health Management Network Commercial |
$420.75
|
| Rate for Payer: Humana Medicare |
$247.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$445.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$247.50
|
| Rate for Payer: MDX Hawaii PPO |
$480.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$247.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$247.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$247.50
|
| Rate for Payer: University Health Alliance Commercial |
$360.81
|
|
|
16000 INITIAL TX 1ST DEGREE BURN LOCAL TX TechFee
|
Facility
|
IP
|
$495.00
|
|
|
Service Code
|
HCPCS 16000
|
| Hospital Charge Code |
8022702
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$420.75 |
| Max. Negotiated Rate |
$480.15 |
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Health Management Network Commercial |
$420.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$445.50
|
| Rate for Payer: MDX Hawaii PPO |
$480.15
|
|
|
16020-Burn Dressings/Debridement Small
|
Facility
|
OP
|
$510.00
|
|
|
Service Code
|
HCPCS 16020
|
| Hospital Charge Code |
8080212
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$255.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$255.00
|
| Rate for Payer: AlohaCare Medicare |
$255.00
|
| Rate for Payer: Cash Price |
$331.50
|
| Rate for Payer: Cash Price |
$331.50
|
| Rate for Payer: Devoted Health Medicare |
$280.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$255.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$484.50
|
| Rate for Payer: Health Management Network Commercial |
$433.50
|
| Rate for Payer: Humana Medicare |
$255.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$459.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$255.00
|
| Rate for Payer: MDX Hawaii PPO |
$494.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$255.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$255.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$255.00
|
| Rate for Payer: University Health Alliance Commercial |
$371.74
|
|
|
16020-Burn Dressings/Debridement Small
|
Facility
|
IP
|
$510.00
|
|
|
Service Code
|
HCPCS 16020
|
| Hospital Charge Code |
8080212
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$433.50 |
| Max. Negotiated Rate |
$494.70 |
| Rate for Payer: Cash Price |
$331.50
|
| Rate for Payer: Health Management Network Commercial |
$433.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$459.00
|
| Rate for Payer: MDX Hawaii PPO |
$494.70
|
|
|
16020 Dressings and/or debridement of partial-thickness burns, initial or subsequent; small
|
Professional
|
Both
|
$279.00
|
|
|
Service Code
|
HCPCS 16020
|
| Hospital Charge Code |
8037312
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$47.58 |
| Max. Negotiated Rate |
$237.15 |
| Rate for Payer: AlohaCare Medicaid |
$58.39
|
| Rate for Payer: AlohaCare Medicare |
$56.51
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Devoted Health Medicare |
$62.16
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$58.39
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$87.36
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$56.51
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$58.39
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$47.58
|
| Rate for Payer: Health Management Network Commercial |
$237.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$67.81
|
| Rate for Payer: Kaiser Permanente Medicaid |
$67.81
|
| Rate for Payer: Kaiser Permanente Medicare |
$67.81
|
| Rate for Payer: Ohana Health Plan Medicaid |
$58.39
|
| Rate for Payer: Ohana Health Plan Medicare |
$56.51
|
| Rate for Payer: UnitedHealthcare Medicaid |
$58.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$56.51
|
| Rate for Payer: University Health Alliance Commercial |
$100.00
|
|
|
16020 Dressings and/or debridement of partial-thickness burns, initial or subsequent; small
|
Professional
|
Both
|
$313.00
|
|
|
Service Code
|
HCPCS 16020
|
| Hospital Charge Code |
8037312
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$47.58 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$58.39
|
| Rate for Payer: AlohaCare Medicare |
$56.51
|
| Rate for Payer: Cash Price |
$203.45
|
| Rate for Payer: Cash Price |
$203.45
|
| Rate for Payer: Cash Price |
$203.45
|
| Rate for Payer: Devoted Health Medicare |
$62.16
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$87.36
|
| 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 |
$47.58
|
| Rate for Payer: Health Management Network Commercial |
$266.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$67.81
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$58.39
|
| Rate for Payer: Ohana Health Plan Medicare |
$56.51
|
| 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 |
$100.00
|
|
|
16020 DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL TechFee
|
Facility
|
OP
|
$605.00
|
|
|
Service Code
|
HCPCS 16020
|
| Hospital Charge Code |
8022703
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$302.50 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$302.50
|
| Rate for Payer: AlohaCare Medicare |
$302.50
|
| Rate for Payer: Cash Price |
$393.25
|
| Rate for Payer: Cash Price |
$393.25
|
| Rate for Payer: Devoted Health Medicare |
$332.75
|
| 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 |
$302.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$574.75
|
| Rate for Payer: Health Management Network Commercial |
$514.25
|
| Rate for Payer: Humana Medicare |
$302.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$544.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$302.50
|
| Rate for Payer: MDX Hawaii PPO |
$586.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$302.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$302.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$302.50
|
| Rate for Payer: University Health Alliance Commercial |
$440.98
|
|
|
16020 DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL TechFee
|
Facility
|
IP
|
$605.00
|
|
|
Service Code
|
HCPCS 16020
|
| Hospital Charge Code |
8022703
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$514.25 |
| Max. Negotiated Rate |
$586.85 |
| Rate for Payer: Cash Price |
$393.25
|
| Rate for Payer: Health Management Network Commercial |
$514.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$544.50
|
| Rate for Payer: MDX Hawaii PPO |
$586.85
|
|
|
16025-Burn Dressings/Debridement Medium
|
Facility
|
OP
|
$510.00
|
|
|
Service Code
|
HCPCS 16025
|
| Hospital Charge Code |
8080214
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$255.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$255.00
|
| Rate for Payer: AlohaCare Medicare |
$255.00
|
| Rate for Payer: Cash Price |
$331.50
|
| Rate for Payer: Cash Price |
$331.50
|
| Rate for Payer: Devoted Health Medicare |
$280.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$255.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$484.50
|
| Rate for Payer: Health Management Network Commercial |
$433.50
|
| Rate for Payer: Humana Medicare |
$255.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$459.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$255.00
|
| Rate for Payer: MDX Hawaii PPO |
$494.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$255.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$255.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$255.00
|
| Rate for Payer: University Health Alliance Commercial |
$371.74
|
|
|
16025-Burn Dressings/Debridement Medium
|
Facility
|
IP
|
$510.00
|
|
|
Service Code
|
HCPCS 16025
|
| Hospital Charge Code |
8080214
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$433.50 |
| Max. Negotiated Rate |
$494.70 |
| Rate for Payer: Cash Price |
$331.50
|
| Rate for Payer: Health Management Network Commercial |
$433.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$459.00
|
| Rate for Payer: MDX Hawaii PPO |
$494.70
|
|
|
16025 Dressings and/or debridement of partial-thickness burns, initial or subsequent; mediumâ€
|
Professional
|
Both
|
$421.00
|
|
|
Service Code
|
HCPCS 16025
|
| Hospital Charge Code |
8037313
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$71.50 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$113.44
|
| Rate for Payer: AlohaCare Medicare |
$103.02
|
| 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 |
$113.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$175.44
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$71.50
|
| Rate for Payer: Health Management Network Commercial |
$357.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$123.62
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$113.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$103.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: University Health Alliance Commercial |
$129.83
|
|
|
16025 DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM TechFee
|
Facility
|
IP
|
$605.00
|
|
|
Service Code
|
HCPCS 16025
|
| Hospital Charge Code |
8022704
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$514.25 |
| Max. Negotiated Rate |
$586.85 |
| Rate for Payer: Cash Price |
$393.25
|
| Rate for Payer: Health Management Network Commercial |
$514.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$544.50
|
| Rate for Payer: MDX Hawaii PPO |
$586.85
|
|
|
16025 DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM TechFee
|
Facility
|
OP
|
$605.00
|
|
|
Service Code
|
HCPCS 16025
|
| Hospital Charge Code |
8022704
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$302.50 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$302.50
|
| Rate for Payer: AlohaCare Medicare |
$302.50
|
| Rate for Payer: Cash Price |
$393.25
|
| Rate for Payer: Cash Price |
$393.25
|
| Rate for Payer: Devoted Health Medicare |
$332.75
|
| 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 |
$302.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$574.75
|
| Rate for Payer: Health Management Network Commercial |
$514.25
|
| Rate for Payer: Humana Medicare |
$302.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$544.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$302.50
|
| Rate for Payer: MDX Hawaii PPO |
$586.85
|
| Rate for Payer: Ohana Health Plan Medicaid |
$302.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$302.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$302.50
|
| Rate for Payer: University Health Alliance Commercial |
$440.98
|
|
|
16030-Burn Dressings/Debridement Large
|
Facility
|
IP
|
$2,189.00
|
|
|
Service Code
|
HCPCS 16030
|
| Hospital Charge Code |
8080216
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,860.65 |
| Max. Negotiated Rate |
$2,123.33 |
| Rate for Payer: Cash Price |
$1,422.85
|
| Rate for Payer: Health Management Network Commercial |
$1,860.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,970.10
|
| Rate for Payer: MDX Hawaii PPO |
$2,123.33
|
|
|
16030-Burn Dressings/Debridement Large
|
Facility
|
OP
|
$2,189.00
|
|
|
Service Code
|
HCPCS 16030
|
| Hospital Charge Code |
8080216
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$2,123.33 |
| Rate for Payer: AlohaCare Medicaid |
$1,094.50
|
| Rate for Payer: AlohaCare Medicare |
$1,094.50
|
| Rate for Payer: Cash Price |
$1,422.85
|
| Rate for Payer: Cash Price |
$1,422.85
|
| Rate for Payer: Devoted Health Medicare |
$1,203.95
|
| 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 |
$1,094.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,079.55
|
| Rate for Payer: Health Management Network Commercial |
$1,860.65
|
| Rate for Payer: Humana Medicare |
$1,094.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,970.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,094.50
|
| Rate for Payer: MDX Hawaii PPO |
$2,123.33
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,094.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,094.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,094.50
|
| Rate for Payer: University Health Alliance Commercial |
$1,595.56
|
|
|
16030 Dressings and/or debridement of partial-thickness burns, initial or subsequent; large
|
Professional
|
Both
|
$566.00
|
|
|
Service Code
|
HCPCS 16030
|
| Hospital Charge Code |
8037314
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$481.10 |
| Rate for Payer: AlohaCare Medicaid |
$132.54
|
| Rate for Payer: AlohaCare Medicare |
$122.45
|
| Rate for Payer: Cash Price |
$367.90
|
| Rate for Payer: Cash Price |
$367.90
|
| Rate for Payer: Cash Price |
$367.90
|
| Rate for Payer: Devoted Health Medicare |
$134.69
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$205.79
|
| 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 |
$95.42
|
| Rate for Payer: Health Management Network Commercial |
$481.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$146.94
|
| 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 |
$132.54
|
| Rate for Payer: Ohana Health Plan Medicare |
$122.45
|
| 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
|
|
|
16030 Dressings and/or debridement of partial-thickness burns, initial or subsequent; large
|
Professional
|
Both
|
$566.00
|
|
|
Service Code
|
HCPCS 16030
|
| Hospital Charge Code |
8037314
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$481.10 |
| Rate for Payer: AlohaCare Medicaid |
$132.54
|
| Rate for Payer: AlohaCare Medicare |
$122.45
|
| Rate for Payer: Cash Price |
$367.90
|
| Rate for Payer: Cash Price |
$367.90
|
| Rate for Payer: Devoted Health Medicare |
$134.69
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$132.54
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$205.79
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$122.45
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$132.54
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$95.42
|
| Rate for Payer: Health Management Network Commercial |
$481.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$146.94
|
| Rate for Payer: Kaiser Permanente Medicaid |
$146.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$146.94
|
| Rate for Payer: Ohana Health Plan Medicaid |
$132.54
|
| Rate for Payer: Ohana Health Plan Medicare |
$122.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$132.54
|
| Rate for Payer: UnitedHealthcare Medicare |
$122.45
|
|
|
16035 Escharotomy; initial incision
|
Professional
|
Both
|
$558.00
|
|
|
Service Code
|
HCPCS 16035
|
| Hospital Charge Code |
8037315
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$174.36 |
| Max. Negotiated Rate |
$474.30 |
| Rate for Payer: AlohaCare Medicaid |
$192.69
|
| Rate for Payer: AlohaCare Medicare |
$174.36
|
| Rate for Payer: Cash Price |
$362.70
|
| Rate for Payer: Cash Price |
$362.70
|
| Rate for Payer: Cash Price |
$362.70
|
| Rate for Payer: Devoted Health Medicare |
$191.80
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$198.38
|
| Rate for Payer: Health Management Network Commercial |
$474.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.23
|
| 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 |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$192.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$174.36
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| 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
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
|
|
17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettemen
|
Professional
|
Both
|
$280.00
|
|
|
Service Code
|
HCPCS 17000
|
| Hospital Charge Code |
8037316
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$42.12 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$59.29
|
| Rate for Payer: AlohaCare Medicare |
$50.49
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Cash Price |
$182.00
|
| Rate for Payer: Devoted Health Medicare |
$55.54
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$89.61
|
| 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 |
$42.12
|
| Rate for Payer: Health Management Network Commercial |
$238.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$60.59
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$59.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$50.49
|
| 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 |
$66.31
|
|
|
17003 Destruction, premalignant lesions; second through 14 lesions, each
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 17003
|
| Hospital Charge Code |
8037317
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$1.72 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$2.10
|
| Rate for Payer: AlohaCare Medicare |
$1.72
|
| Rate for Payer: Cash Price |
$18.85
|
| Rate for Payer: Cash Price |
$18.85
|
| Rate for Payer: Cash Price |
$18.85
|
| Rate for Payer: Devoted Health Medicare |
$1.89
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$9.77
|
| 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 |
$15.08
|
| Rate for Payer: Health Management Network Commercial |
$24.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$2.06
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$1.72
|
| 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 |
$2.43
|
|
|
17004 Destruction, premalignant lesions, 15 or more lesions
|
Professional
|
Both
|
$566.00
|
|
|
Service Code
|
HCPCS 17004
|
| Hospital Charge Code |
8037318
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$481.10 |
| Rate for Payer: AlohaCare Medicaid |
$103.10
|
| Rate for Payer: AlohaCare Medicare |
$85.63
|
| Rate for Payer: Cash Price |
$367.90
|
| Rate for Payer: Cash Price |
$367.90
|
| Rate for Payer: Cash Price |
$367.90
|
| Rate for Payer: Devoted Health Medicare |
$94.19
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$188.17
|
| 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 |
$178.88
|
| Rate for Payer: Health Management Network Commercial |
$481.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$102.76
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$103.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$85.63
|
| 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 |
$115.54
|
|
|
17106 Destruction of cutaneous vascular proliferative lesions (laser technique); less than 10 sq cm
|
Professional
|
Both
|
$998.00
|
|
|
Service Code
|
HCPCS 17106
|
| Hospital Charge Code |
8037319
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$848.30 |
| Rate for Payer: AlohaCare Medicaid |
$291.12
|
| Rate for Payer: AlohaCare Medicare |
$247.99
|
| Rate for Payer: Cash Price |
$648.70
|
| Rate for Payer: Cash Price |
$648.70
|
| Rate for Payer: Cash Price |
$648.70
|
| Rate for Payer: Devoted Health Medicare |
$272.79
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$441.24
|
| 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 |
$256.62
|
| Rate for Payer: Health Management Network Commercial |
$848.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$297.59
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$291.12
|
| Rate for Payer: Ohana Health Plan Medicare |
$247.99
|
| 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 |
$326.52
|
|
|
17107 Destruction of cutaneous vascular proliferative lesions; 10.0 to 50.0 sq cm
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 17107
|
| Hospital Charge Code |
8037320
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,099.90 |
| Rate for Payer: AlohaCare Medicaid |
$379.32
|
| Rate for Payer: AlohaCare Medicare |
$320.78
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Cash Price |
$841.10
|
| Rate for Payer: Devoted Health Medicare |
$352.86
|
| 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 |
$380.12
|
| Rate for Payer: Health Management Network Commercial |
$1,099.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$384.94
|
| 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 |
$379.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$320.78
|
| 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 |
$425.15
|
|
|
17110 Destruction of benign lesions 1-14 lesions
|
Professional
|
Both
|
$431.00
|
|
|
Service Code
|
HCPCS 17110
|
| Hospital Charge Code |
8037321
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$44.20 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$74.33
|
| Rate for Payer: AlohaCare Medicare |
$66.60
|
| Rate for Payer: Cash Price |
$280.15
|
| Rate for Payer: Cash Price |
$280.15
|
| Rate for Payer: Cash Price |
$280.15
|
| Rate for Payer: Devoted Health Medicare |
$73.26
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$108.92
|
| 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 |
$44.20
|
| Rate for Payer: Health Management Network Commercial |
$366.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$79.92
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$74.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$66.60
|
| 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 |
$81.21
|
|
|
17111 Destruction of benign lesions 15 + lesions
|
Professional
|
Both
|
$391.00
|
|
|
Service Code
|
HCPCS 17111
|
| Hospital Charge Code |
8037322
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$62.66 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$89.23
|
| Rate for Payer: AlohaCare Medicare |
$78.09
|
| Rate for Payer: Cash Price |
$254.15
|
| Rate for Payer: Cash Price |
$254.15
|
| Rate for Payer: Cash Price |
$254.15
|
| Rate for Payer: Devoted Health Medicare |
$85.90
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$132.09
|
| 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 |
$62.66
|
| Rate for Payer: Health Management Network Commercial |
$332.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$93.71
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$89.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$78.09
|
| 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 |
$97.90
|
|
