|
24600-Elbow w/o Anesthesia
|
Facility
|
IP
|
$848.00
|
|
|
Service Code
|
HCPCS 24600
|
| Hospital Charge Code |
8080087
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$720.80 |
| Max. Negotiated Rate |
$822.56 |
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Health Management Network Commercial |
$720.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$763.20
|
| Rate for Payer: MDX Hawaii PPO |
$822.56
|
|
|
24600-Elbow w/o Anesthesia
|
Facility
|
OP
|
$848.00
|
|
|
Service Code
|
HCPCS 24600
|
| Hospital Charge Code |
8080087
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$424.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$424.00
|
| Rate for Payer: AlohaCare Medicare |
$424.00
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Devoted Health Medicare |
$466.40
|
| 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 |
$424.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$805.60
|
| Rate for Payer: Health Management Network Commercial |
$720.80
|
| Rate for Payer: Humana Medicare |
$424.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$763.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$424.00
|
| Rate for Payer: MDX Hawaii PPO |
$822.56
|
| Rate for Payer: Ohana Health Plan Medicaid |
$424.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$424.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$424.00
|
| Rate for Payer: University Health Alliance Commercial |
$618.11
|
|
|
24600 Treatment of closed elbow dislocation; without anesthesia
|
Professional
|
Both
|
$1,000.00
|
|
|
Service Code
|
HCPCS 24600
|
| Hospital Charge Code |
8037747
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: AlohaCare Medicaid |
$368.23
|
| Rate for Payer: AlohaCare Medicare |
$418.74
|
| Rate for Payer: Cash Price |
$650.00
|
| Rate for Payer: Cash Price |
$650.00
|
| Rate for Payer: Cash Price |
$650.00
|
| Rate for Payer: Devoted Health Medicare |
$460.61
|
| 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 |
$233.22
|
| Rate for Payer: Health Management Network Commercial |
$850.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$502.49
|
| 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 |
$368.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$418.74
|
| 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 |
$475.00
|
|
|
24605-Elbow w/ Anesthesia
|
Facility
|
OP
|
$7,364.00
|
|
|
Service Code
|
HCPCS 24605
|
| Hospital Charge Code |
8080089
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$7,143.08 |
| Rate for Payer: AlohaCare Medicaid |
$3,682.00
|
| Rate for Payer: AlohaCare Medicare |
$3,682.00
|
| Rate for Payer: Cash Price |
$4,786.60
|
| Rate for Payer: Cash Price |
$4,786.60
|
| Rate for Payer: Devoted Health Medicare |
$4,050.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3,682.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6,995.80
|
| Rate for Payer: Health Management Network Commercial |
$6,259.40
|
| Rate for Payer: Humana Medicare |
$3,682.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,627.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,682.00
|
| Rate for Payer: MDX Hawaii PPO |
$7,143.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3,682.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,682.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,682.00
|
| Rate for Payer: University Health Alliance Commercial |
$5,160.40
|
|
|
24605-Elbow w/ Anesthesia
|
Facility
|
IP
|
$7,364.00
|
|
|
Service Code
|
HCPCS 24605
|
| Hospital Charge Code |
8080089
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6,259.40 |
| Max. Negotiated Rate |
$7,143.08 |
| Rate for Payer: Cash Price |
$4,786.60
|
| Rate for Payer: Health Management Network Commercial |
$6,259.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,627.60
|
| Rate for Payer: MDX Hawaii PPO |
$7,143.08
|
|
|
24605 Treatment of closed elbow dislocation; requiring anesthesia
|
Professional
|
Both
|
$2,238.00
|
|
|
Service Code
|
HCPCS 24605
|
| Hospital Charge Code |
8037748
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,902.30 |
| Rate for Payer: AlohaCare Medicaid |
$513.09
|
| Rate for Payer: AlohaCare Medicare |
$497.43
|
| Rate for Payer: Cash Price |
$1,454.70
|
| Rate for Payer: Cash Price |
$1,454.70
|
| Rate for Payer: Cash Price |
$1,454.70
|
| Rate for Payer: Devoted Health Medicare |
$547.17
|
| 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 |
$236.34
|
| Rate for Payer: Health Management Network Commercial |
$1,902.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$596.92
|
| 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 |
$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 |
$513.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$497.43
|
| 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
|
|
|
24615 Open treatment of acute or chronic elbow dislocation
|
Professional
|
Both
|
$10,099.00
|
|
|
Service Code
|
HCPCS 24615
|
| Hospital Charge Code |
8037749
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$8,584.15 |
| Rate for Payer: AlohaCare Medicaid |
$743.23
|
| Rate for Payer: AlohaCare Medicare |
$675.37
|
| Rate for Payer: Cash Price |
$6,564.35
|
| Rate for Payer: Cash Price |
$6,564.35
|
| Rate for Payer: Cash Price |
$6,564.35
|
| Rate for Payer: Devoted Health Medicare |
$742.91
|
| 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 |
$555.62
|
| Rate for Payer: Health Management Network Commercial |
$8,584.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$810.44
|
| 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 |
$743.23
|
| Rate for Payer: Ohana Health Plan Medicare |
$675.37
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
24620 Closed treatment of Monteggia type of fracture dislocation at elbow, with manipulation
|
Professional
|
Both
|
$2,238.00
|
|
|
Service Code
|
HCPCS 24620
|
| Hospital Charge Code |
8037750
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,902.30 |
| Rate for Payer: AlohaCare Medicaid |
$626.72
|
| Rate for Payer: AlohaCare Medicare |
$585.62
|
| Rate for Payer: Cash Price |
$1,454.70
|
| Rate for Payer: Cash Price |
$1,454.70
|
| Rate for Payer: Cash Price |
$1,454.70
|
| Rate for Payer: Devoted Health Medicare |
$644.18
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$327.86
|
| Rate for Payer: Health Management Network Commercial |
$1,902.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$702.74
|
| 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 |
$626.72
|
| Rate for Payer: Ohana Health Plan Medicare |
$585.62
|
| 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
|
|
|
24620-Elbow/ Monteggia w/ Manipulation
|
Facility
|
IP
|
$7,364.00
|
|
|
Service Code
|
HCPCS 24620
|
| Hospital Charge Code |
8080109
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6,259.40 |
| Max. Negotiated Rate |
$7,143.08 |
| Rate for Payer: Cash Price |
$4,786.60
|
| Rate for Payer: Health Management Network Commercial |
$6,259.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,627.60
|
| Rate for Payer: MDX Hawaii PPO |
$7,143.08
|
|
|
24620-Elbow/ Monteggia w/ Manipulation
|
Facility
|
OP
|
$7,364.00
|
|
|
Service Code
|
HCPCS 24620
|
| Hospital Charge Code |
8080109
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$7,143.08 |
| Rate for Payer: AlohaCare Medicaid |
$3,682.00
|
| Rate for Payer: AlohaCare Medicare |
$3,682.00
|
| Rate for Payer: Cash Price |
$4,786.60
|
| Rate for Payer: Cash Price |
$4,786.60
|
| Rate for Payer: Devoted Health Medicare |
$4,050.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$3,682.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6,995.80
|
| Rate for Payer: Health Management Network Commercial |
$6,259.40
|
| Rate for Payer: Humana Medicare |
$3,682.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,627.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,682.00
|
| Rate for Payer: MDX Hawaii PPO |
$7,143.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3,682.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,682.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,682.00
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
24635 Open tx of Monteggia type of fracture dislocation at elbow, includes internal fixation
|
Professional
|
Both
|
$10,099.00
|
|
|
Service Code
|
HCPCS 24635
|
| Hospital Charge Code |
8037751
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$8,584.15 |
| Rate for Payer: AlohaCare Medicaid |
$710.57
|
| Rate for Payer: AlohaCare Medicare |
$655.94
|
| Rate for Payer: Cash Price |
$6,564.35
|
| Rate for Payer: Cash Price |
$6,564.35
|
| Rate for Payer: Cash Price |
$6,564.35
|
| Rate for Payer: Devoted Health Medicare |
$721.53
|
| 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 |
$795.08
|
| Rate for Payer: Health Management Network Commercial |
$8,584.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$787.13
|
| 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 |
$710.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$655.94
|
| 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
|
|
|
24640 Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation
|
Professional
|
Both
|
$396.00
|
|
|
Service Code
|
HCPCS 24640
|
| Hospital Charge Code |
8037752
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$84.60
|
| Rate for Payer: AlohaCare Medicare |
$74.38
|
| Rate for Payer: Cash Price |
$257.40
|
| Rate for Payer: Cash Price |
$257.40
|
| Rate for Payer: Cash Price |
$257.40
|
| Rate for Payer: Devoted Health Medicare |
$81.82
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$130.40
|
| 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 |
$93.60
|
| Rate for Payer: Health Management Network Commercial |
$336.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$89.26
|
| 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 |
$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 |
$84.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$74.38
|
| 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 |
$202.00
|
|
|
24640 CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ TechFee
|
Facility
|
IP
|
$823.00
|
|
|
Service Code
|
HCPCS 24640
|
| Hospital Charge Code |
8022936
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$699.55 |
| Max. Negotiated Rate |
$798.31 |
| Rate for Payer: Cash Price |
$534.95
|
| Rate for Payer: Health Management Network Commercial |
$699.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$740.70
|
| Rate for Payer: MDX Hawaii PPO |
$798.31
|
|
|
24640 CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ TechFee
|
Facility
|
OP
|
$823.00
|
|
|
Service Code
|
HCPCS 24640
|
| Hospital Charge Code |
8022936
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$411.50 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$411.50
|
| Rate for Payer: AlohaCare Medicare |
$411.50
|
| Rate for Payer: Cash Price |
$534.95
|
| Rate for Payer: Cash Price |
$534.95
|
| Rate for Payer: Devoted Health Medicare |
$452.65
|
| 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 |
$411.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$781.85
|
| Rate for Payer: Health Management Network Commercial |
$699.55
|
| Rate for Payer: Humana Medicare |
$411.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$740.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$411.50
|
| Rate for Payer: MDX Hawaii PPO |
$798.31
|
| Rate for Payer: Ohana Health Plan Medicaid |
$411.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$411.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$411.50
|
| Rate for Payer: University Health Alliance Commercial |
$599.88
|
|
|
24640-Nursemaid Elbow
|
Facility
|
IP
|
$848.00
|
|
|
Service Code
|
HCPCS 24640
|
| Hospital Charge Code |
8080091
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$720.80 |
| Max. Negotiated Rate |
$822.56 |
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Health Management Network Commercial |
$720.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$763.20
|
| Rate for Payer: MDX Hawaii PPO |
$822.56
|
|
|
24640-Nursemaid Elbow
|
Facility
|
OP
|
$848.00
|
|
|
Service Code
|
HCPCS 24640
|
| Hospital Charge Code |
8080091
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$424.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$424.00
|
| Rate for Payer: AlohaCare Medicare |
$424.00
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Devoted Health Medicare |
$466.40
|
| 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 |
$424.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$805.60
|
| Rate for Payer: Health Management Network Commercial |
$720.80
|
| Rate for Payer: Humana Medicare |
$424.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$763.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$424.00
|
| Rate for Payer: MDX Hawaii PPO |
$822.56
|
| Rate for Payer: Ohana Health Plan Medicaid |
$424.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$424.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$424.00
|
| Rate for Payer: University Health Alliance Commercial |
$618.11
|
|
|
24650 Closed treatment of radial head or neck fracture; without manipulation
|
Professional
|
Both
|
$731.00
|
|
|
Service Code
|
HCPCS 24650
|
| Hospital Charge Code |
8037753
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$621.35 |
| Rate for Payer: AlohaCare Medicaid |
$275.77
|
| Rate for Payer: AlohaCare Medicare |
$275.26
|
| Rate for Payer: Cash Price |
$475.15
|
| Rate for Payer: Cash Price |
$475.15
|
| Rate for Payer: Cash Price |
$475.15
|
| Rate for Payer: Devoted Health Medicare |
$302.79
|
| 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 |
$212.42
|
| Rate for Payer: Health Management Network Commercial |
$621.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$330.31
|
| 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 |
$275.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$275.26
|
| 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 |
$350.00
|
|
|
24655 Closed treatment of radial head or neck fracture; with manipulation
|
Professional
|
Both
|
$2,238.00
|
|
|
Service Code
|
HCPCS 24655
|
| Hospital Charge Code |
8037754
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,902.30 |
| Rate for Payer: AlohaCare Medicaid |
$442.70
|
| Rate for Payer: AlohaCare Medicare |
$462.64
|
| Rate for Payer: Cash Price |
$1,454.70
|
| Rate for Payer: Cash Price |
$1,454.70
|
| Rate for Payer: Cash Price |
$1,454.70
|
| Rate for Payer: Devoted Health Medicare |
$508.90
|
| 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 |
$258.44
|
| Rate for Payer: Health Management Network Commercial |
$1,902.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$555.17
|
| 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 |
$442.70
|
| Rate for Payer: Ohana Health Plan Medicare |
$462.64
|
| 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 |
$563.21
|
|
|
24665 Open tx of radial head or neck fracture, includes internal fixation or radial head excision
|
Professional
|
Both
|
$10,099.00
|
|
|
Service Code
|
HCPCS 24665
|
| Hospital Charge Code |
8037755
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$8,584.15 |
| Rate for Payer: AlohaCare Medicaid |
$694.44
|
| Rate for Payer: AlohaCare Medicare |
$639.65
|
| Rate for Payer: Cash Price |
$6,564.35
|
| Rate for Payer: Cash Price |
$6,564.35
|
| Rate for Payer: Cash Price |
$6,564.35
|
| Rate for Payer: Devoted Health Medicare |
$703.62
|
| 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 |
$468.26
|
| Rate for Payer: Health Management Network Commercial |
$8,584.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$767.58
|
| 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 |
$694.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$639.65
|
| 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
|
|
|
24666 Open tx of radial head/neck fx, w/ int fixation/radial head excsn; w/ radial head replacement
|
Professional
|
Both
|
$17,868.00
|
|
|
Service Code
|
HCPCS 24666
|
| Hospital Charge Code |
8037756
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$15,187.80 |
| Rate for Payer: AlohaCare Medicaid |
$765.27
|
| Rate for Payer: AlohaCare Medicare |
$698.59
|
| Rate for Payer: Cash Price |
$11,614.20
|
| Rate for Payer: Cash Price |
$11,614.20
|
| Rate for Payer: Cash Price |
$11,614.20
|
| Rate for Payer: Devoted Health Medicare |
$768.45
|
| 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 |
$596.44
|
| Rate for Payer: Health Management Network Commercial |
$15,187.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$838.31
|
| 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 |
$765.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$698.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
24670 Closed treatment of ulnar fracture, proximal end; without manipulation
|
Professional
|
Both
|
$814.00
|
|
|
Service Code
|
HCPCS 24670
|
| Hospital Charge Code |
8037757
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$691.90 |
| Rate for Payer: AlohaCare Medicaid |
$297.56
|
| Rate for Payer: AlohaCare Medicare |
$298.09
|
| Rate for Payer: Cash Price |
$529.10
|
| Rate for Payer: Cash Price |
$529.10
|
| Rate for Payer: Cash Price |
$529.10
|
| Rate for Payer: Devoted Health Medicare |
$327.90
|
| 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 |
$213.72
|
| Rate for Payer: Health Management Network Commercial |
$691.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$357.71
|
| 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 |
$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 |
$297.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$298.09
|
| 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 |
$378.56
|
|
|
24675 Closed treatment of ulnar fracture, proximal end; with manipulation
|
Professional
|
Both
|
$2,238.00
|
|
|
Service Code
|
HCPCS 24675
|
| Hospital Charge Code |
8037758
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,902.30 |
| Rate for Payer: AlohaCare Medicaid |
$452.34
|
| Rate for Payer: AlohaCare Medicare |
$440.80
|
| Rate for Payer: Cash Price |
$1,454.70
|
| Rate for Payer: Cash Price |
$1,454.70
|
| Rate for Payer: Cash Price |
$1,454.70
|
| Rate for Payer: Devoted Health Medicare |
$484.88
|
| 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 |
$228.80
|
| Rate for Payer: Health Management Network Commercial |
$1,902.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$528.96
|
| 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 |
$452.34
|
| Rate for Payer: Ohana Health Plan Medicare |
$440.80
|
| 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 |
$586.19
|
|
|
24675-Ulna Proximal End w/ Manipulation
|
Facility
|
OP
|
$7,150.00
|
|
|
Service Code
|
HCPCS 24675
|
| Hospital Charge Code |
8080111
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$6,935.50 |
| Rate for Payer: AlohaCare Medicaid |
$3,575.00
|
| Rate for Payer: AlohaCare Medicare |
$3,575.00
|
| Rate for Payer: Cash Price |
$4,647.50
|
| Rate for Payer: Cash Price |
$4,647.50
|
| Rate for Payer: Devoted Health Medicare |
$3,932.50
|
| 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 |
$3,575.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6,792.50
|
| Rate for Payer: Health Management Network Commercial |
$6,077.50
|
| Rate for Payer: Humana Medicare |
$3,575.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,435.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,575.00
|
| Rate for Payer: MDX Hawaii PPO |
$6,935.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3,575.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,575.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,575.00
|
| Rate for Payer: University Health Alliance Commercial |
$5,211.64
|
|
|
24675-Ulna Proximal End w/ Manipulation
|
Facility
|
IP
|
$7,150.00
|
|
|
Service Code
|
HCPCS 24675
|
| Hospital Charge Code |
8080111
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6,077.50 |
| Max. Negotiated Rate |
$6,935.50 |
| Rate for Payer: Cash Price |
$4,647.50
|
| Rate for Payer: Health Management Network Commercial |
$6,077.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,435.00
|
| Rate for Payer: MDX Hawaii PPO |
$6,935.50
|
|
|
24685 Open tx of ulnar fx, proximal end, includes internal fixation
|
Professional
|
Both
|
$10,099.00
|
|
|
Service Code
|
HCPCS 24685
|
| Hospital Charge Code |
8037759
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$8,584.15 |
| Rate for Payer: AlohaCare Medicaid |
$689.60
|
| Rate for Payer: AlohaCare Medicare |
$639.04
|
| Rate for Payer: Cash Price |
$6,564.35
|
| Rate for Payer: Cash Price |
$6,564.35
|
| Rate for Payer: Cash Price |
$6,564.35
|
| Rate for Payer: Devoted Health Medicare |
$702.94
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$686.92
|
| Rate for Payer: Health Management Network Commercial |
$8,584.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$766.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$689.60
|
| Rate for Payer: Ohana Health Plan Medicare |
$639.04
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
