|
11400-Excision Lesion Benign Trunk/Extremity <= 0.5 cm
|
Facility
|
IP
|
$3,625.00
|
|
|
Service Code
|
HCPCS 11400
|
| Hospital Charge Code |
8080188
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,081.25 |
| Max. Negotiated Rate |
$3,516.25 |
| Rate for Payer: Cash Price |
$2,356.25
|
| Rate for Payer: Health Management Network Commercial |
$3,081.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,262.50
|
| Rate for Payer: MDX Hawaii PPO |
$3,516.25
|
|
|
11400-Excision Lesion Benign Trunk/Extremity <= 0.5 cm
|
Facility
|
OP
|
$3,625.00
|
|
|
Service Code
|
HCPCS 11400
|
| Hospital Charge Code |
8080188
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$4,035.20 |
| Rate for Payer: AlohaCare Medicaid |
$1,812.50
|
| Rate for Payer: AlohaCare Medicare |
$1,812.50
|
| Rate for Payer: Cash Price |
$2,356.25
|
| Rate for Payer: Cash Price |
$2,356.25
|
| Rate for Payer: Devoted Health Medicare |
$1,993.75
|
| 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 |
$1,812.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3,443.75
|
| Rate for Payer: Health Management Network Commercial |
$3,081.25
|
| Rate for Payer: Humana Medicare |
$1,812.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,262.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,812.50
|
| Rate for Payer: MDX Hawaii PPO |
$3,516.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,812.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,812.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,812.50
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
11401 Excision, benign lesion including margins; trunk, arms or legs; 0.6-1.0cm
|
Professional
|
Both
|
$556.00
|
|
|
Service Code
|
HCPCS 11401
|
| Hospital Charge Code |
8037109
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$88.66 |
| Max. Negotiated Rate |
$472.60 |
| Rate for Payer: AlohaCare Medicaid |
$112.53
|
| Rate for Payer: AlohaCare Medicare |
$98.77
|
| Rate for Payer: Cash Price |
$361.40
|
| Rate for Payer: Cash Price |
$361.40
|
| Rate for Payer: Devoted Health Medicare |
$108.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$112.53
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$170.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$98.77
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$112.53
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$88.66
|
| Rate for Payer: Health Management Network Commercial |
$472.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$118.52
|
| Rate for Payer: Kaiser Permanente Medicaid |
$118.52
|
| Rate for Payer: Kaiser Permanente Medicare |
$118.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$112.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$98.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$112.53
|
| Rate for Payer: UnitedHealthcare Medicare |
$98.77
|
| Rate for Payer: University Health Alliance Commercial |
$122.20
|
|
|
11401 Excision, benign lesion including margins; trunk, arms or legs; 0.6-1.0cm
|
Professional
|
Both
|
$556.00
|
|
|
Service Code
|
HCPCS 11401
|
| Hospital Charge Code |
8037109
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$88.66 |
| Max. Negotiated Rate |
$472.60 |
| Rate for Payer: AlohaCare Medicaid |
$112.53
|
| Rate for Payer: AlohaCare Medicare |
$98.77
|
| Rate for Payer: Cash Price |
$361.40
|
| Rate for Payer: Cash Price |
$361.40
|
| Rate for Payer: Cash Price |
$361.40
|
| Rate for Payer: Devoted Health Medicare |
$108.65
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$170.97
|
| 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 |
$88.66
|
| Rate for Payer: Health Management Network Commercial |
$472.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$118.52
|
| 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 |
$112.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$98.77
|
| 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 |
$122.20
|
|
|
11402 Excision, benign lesion including margins; trunk, arms or legs; 1.1-2.0cm
|
Professional
|
Both
|
$618.00
|
|
|
Service Code
|
HCPCS 11402
|
| Hospital Charge Code |
8037110
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$106.78 |
| Max. Negotiated Rate |
$525.30 |
| Rate for Payer: AlohaCare Medicaid |
$122.57
|
| Rate for Payer: AlohaCare Medicare |
$106.78
|
| Rate for Payer: Cash Price |
$401.70
|
| Rate for Payer: Cash Price |
$401.70
|
| Rate for Payer: Devoted Health Medicare |
$117.46
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$122.57
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$186.86
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$106.78
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$122.57
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$107.12
|
| Rate for Payer: Health Management Network Commercial |
$525.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$128.14
|
| Rate for Payer: Kaiser Permanente Medicaid |
$128.14
|
| Rate for Payer: Kaiser Permanente Medicare |
$128.14
|
| Rate for Payer: Ohana Health Plan Medicaid |
$122.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$106.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$122.57
|
| Rate for Payer: UnitedHealthcare Medicare |
$106.78
|
| Rate for Payer: University Health Alliance Commercial |
$133.24
|
|
|
11402 Excision, benign lesion including margins; trunk, arms or legs; 1.1-2.0cm
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11402
|
| Hospital Charge Code |
8037110
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$106.78 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$122.57
|
| Rate for Payer: AlohaCare Medicare |
$106.78
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$117.46
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$186.86
|
| 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 |
$107.12
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$128.14
|
| 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 |
$122.57
|
| Rate for Payer: Ohana Health Plan Medicare |
$106.78
|
| 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 |
$133.24
|
|
|
11402-Excision Lesion Benign Trunk/Extremity 1.1-2.0 cm
|
Facility
|
IP
|
$3,625.00
|
|
|
Service Code
|
HCPCS 11402
|
| Hospital Charge Code |
8080190
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,081.25 |
| Max. Negotiated Rate |
$3,516.25 |
| Rate for Payer: Cash Price |
$2,356.25
|
| Rate for Payer: Health Management Network Commercial |
$3,081.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,262.50
|
| Rate for Payer: MDX Hawaii PPO |
$3,516.25
|
|
|
11402-Excision Lesion Benign Trunk/Extremity 1.1-2.0 cm
|
Facility
|
OP
|
$3,625.00
|
|
|
Service Code
|
HCPCS 11402
|
| Hospital Charge Code |
8080190
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$4,035.20 |
| Rate for Payer: AlohaCare Medicaid |
$1,812.50
|
| Rate for Payer: AlohaCare Medicare |
$1,812.50
|
| Rate for Payer: Cash Price |
$2,356.25
|
| Rate for Payer: Cash Price |
$2,356.25
|
| Rate for Payer: Devoted Health Medicare |
$1,993.75
|
| 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 |
$1,812.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3,443.75
|
| Rate for Payer: Health Management Network Commercial |
$3,081.25
|
| Rate for Payer: Humana Medicare |
$1,812.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,262.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,812.50
|
| Rate for Payer: MDX Hawaii PPO |
$3,516.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,812.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,812.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,812.50
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
11403 Excision, benign lesion including margins; trunk, arms or legs; 2.1-3.0cm
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11403
|
| Hospital Charge Code |
8037111
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$125.58 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$158.47
|
| Rate for Payer: AlohaCare Medicare |
$141.34
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$155.47
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$239.33
|
| 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 |
$125.58
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$169.61
|
| 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 |
$158.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$141.34
|
| 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 |
$172.78
|
|
|
11403 Excision, benign lesion including margins; trunk, arms or legs; 2.1-3.0cm
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11403
|
| Hospital Charge Code |
8037111
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$125.58 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$158.47
|
| Rate for Payer: AlohaCare Medicare |
$141.34
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$155.47
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$158.47
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$239.33
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$141.34
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$158.47
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$125.58
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$169.61
|
| Rate for Payer: Kaiser Permanente Medicaid |
$169.61
|
| Rate for Payer: Kaiser Permanente Medicare |
$169.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$158.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$141.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$158.47
|
| Rate for Payer: UnitedHealthcare Medicare |
$141.34
|
| Rate for Payer: University Health Alliance Commercial |
$172.78
|
|
|
11404 Excision, benign lesion including margins; trunk, arms or legs; 3.1-4.0cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11404
|
| Hospital Charge Code |
8037112
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$144.30 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$172.77
|
| Rate for Payer: AlohaCare Medicare |
$156.66
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$172.33
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$263.16
|
| 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 |
$144.30
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$187.99
|
| 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 |
$172.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$156.66
|
| 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 |
$188.62
|
|
|
11406 Excision, benign lesion including margins; trunk, arms or legs; >4.0cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11406
|
| Hospital Charge Code |
8037113
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$190.84 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$256.10
|
| Rate for Payer: AlohaCare Medicare |
$231.38
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$254.52
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$256.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$393.63
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$231.38
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$256.10
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$190.84
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$277.66
|
| Rate for Payer: Kaiser Permanente Medicaid |
$277.66
|
| Rate for Payer: Kaiser Permanente Medicare |
$277.66
|
| Rate for Payer: Ohana Health Plan Medicaid |
$256.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$231.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$256.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$231.38
|
| Rate for Payer: University Health Alliance Commercial |
$279.13
|
|
|
11406 Excision, benign lesion including margins; trunk, arms or legs; >4.0cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11406
|
| Hospital Charge Code |
8037113
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$256.10
|
| Rate for Payer: AlohaCare Medicare |
$231.38
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$254.52
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$393.63
|
| 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 |
$190.84
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$277.66
|
| 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 |
$256.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$231.38
|
| 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 |
$279.13
|
|
|
11420-Excise Lesion BN Scalp/Nose/Hand/Feet/Genital <=0.5 cm
|
Facility
|
IP
|
$7,249.00
|
|
|
Service Code
|
HCPCS 11420
|
| Hospital Charge Code |
8080192
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6,161.65 |
| Max. Negotiated Rate |
$7,031.53 |
| Rate for Payer: Cash Price |
$4,711.85
|
| Rate for Payer: Health Management Network Commercial |
$6,161.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,524.10
|
| Rate for Payer: MDX Hawaii PPO |
$7,031.53
|
|
|
11420-Excise Lesion BN Scalp/Nose/Hand/Feet/Genital <=0.5 cm
|
Facility
|
OP
|
$7,249.00
|
|
|
Service Code
|
HCPCS 11420
|
| Hospital Charge Code |
8080192
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$7,031.53 |
| Rate for Payer: AlohaCare Medicaid |
$3,624.50
|
| Rate for Payer: AlohaCare Medicare |
$3,624.50
|
| Rate for Payer: Cash Price |
$4,711.85
|
| Rate for Payer: Cash Price |
$4,711.85
|
| Rate for Payer: Devoted Health Medicare |
$3,986.95
|
| 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 |
$3,624.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6,886.55
|
| Rate for Payer: Health Management Network Commercial |
$6,161.65
|
| Rate for Payer: Humana Medicare |
$3,624.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,524.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,624.50
|
| Rate for Payer: MDX Hawaii PPO |
$7,031.53
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3,624.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,624.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,624.50
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
11420 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; < 0.5cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11420
|
| Hospital Charge Code |
8037114
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$70.98 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$87.79
|
| Rate for Payer: AlohaCare Medicare |
$79.96
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$87.96
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.46
|
| 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 |
$70.98
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$95.95
|
| 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 |
$87.79
|
| Rate for Payer: Ohana Health Plan Medicare |
$79.96
|
| 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 |
$95.50
|
|
|
11421 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; 0.6-1.0cm
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11421
|
| Hospital Charge Code |
8037115
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$96.46 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$115.22
|
| Rate for Payer: AlohaCare Medicare |
$102.70
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$112.97
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$175.59
|
| 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 |
$96.46
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$123.24
|
| 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 |
$115.22
|
| Rate for Payer: Ohana Health Plan Medicare |
$102.70
|
| 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 |
$125.31
|
|
|
11422 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; 1.1-2.0cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11422
|
| Hospital Charge Code |
8037116
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$114.14 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$144.37
|
| Rate for Payer: AlohaCare Medicare |
$129.86
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$142.85
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$218.85
|
| 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 |
$114.14
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$155.83
|
| 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 |
$144.37
|
| Rate for Payer: Ohana Health Plan Medicare |
$129.86
|
| 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 |
$157.79
|
|
|
11423 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; 2.1-3.0cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11423
|
| Hospital Charge Code |
8037117
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$140.40 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$165.79
|
| Rate for Payer: AlohaCare Medicare |
$149.07
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$163.98
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$249.78
|
| 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 |
$140.40
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$178.88
|
| 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 |
$165.79
|
| Rate for Payer: Ohana Health Plan Medicare |
$149.07
|
| 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 |
$181.51
|
|
|
11424 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; 3.1-4.0cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11424
|
| Hospital Charge Code |
8037118
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$160.16 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$189.29
|
| Rate for Payer: AlohaCare Medicare |
$169.64
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$186.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$283.50
|
| 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 |
$160.16
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$203.57
|
| 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 |
$189.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$169.64
|
| 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 |
$206.64
|
|
|
11424 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; 3.1-4.0cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11424
|
| Hospital Charge Code |
8037118
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$160.16 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$189.29
|
| Rate for Payer: AlohaCare Medicare |
$169.64
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$186.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$189.29
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$283.50
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$169.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$189.29
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$160.16
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$203.57
|
| Rate for Payer: Kaiser Permanente Medicaid |
$203.57
|
| Rate for Payer: Kaiser Permanente Medicare |
$203.57
|
| Rate for Payer: Ohana Health Plan Medicaid |
$189.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$169.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$189.29
|
| Rate for Payer: UnitedHealthcare Medicare |
$169.64
|
| Rate for Payer: University Health Alliance Commercial |
$206.64
|
|
|
11426 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; > 4.0cm
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 11426
|
| Hospital Charge Code |
8037119
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$227.24 |
| Max. Negotiated Rate |
$3,436.55 |
| Rate for Payer: AlohaCare Medicaid |
$275.66
|
| Rate for Payer: AlohaCare Medicare |
$248.18
|
| Rate for Payer: Cash Price |
$2,627.95
|
| Rate for Payer: Cash Price |
$2,627.95
|
| Rate for Payer: Devoted Health Medicare |
$273.00
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$275.66
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$430.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$248.18
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$275.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$227.24
|
| Rate for Payer: Health Management Network Commercial |
$3,436.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$297.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$297.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$297.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$275.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$248.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$275.66
|
| Rate for Payer: UnitedHealthcare Medicare |
$248.18
|
| Rate for Payer: University Health Alliance Commercial |
$301.65
|
|
|
11426 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; > 4.0cm
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 11426
|
| Hospital Charge Code |
8037119
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,436.55 |
| Rate for Payer: AlohaCare Medicaid |
$275.66
|
| Rate for Payer: AlohaCare Medicare |
$248.18
|
| Rate for Payer: Cash Price |
$2,627.95
|
| Rate for Payer: Cash Price |
$2,627.95
|
| Rate for Payer: Cash Price |
$2,627.95
|
| Rate for Payer: Devoted Health Medicare |
$273.00
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$430.64
|
| 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 |
$227.24
|
| Rate for Payer: Health Management Network Commercial |
$3,436.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$297.82
|
| 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 |
$275.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$248.18
|
| 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 |
$301.65
|
|
|
11440-Excise Lesion Benign Face Less Than/Equal to 0.5 cm
|
Facility
|
OP
|
$3,625.00
|
|
|
Service Code
|
HCPCS 11440
|
| Hospital Charge Code |
8080194
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$3,516.25 |
| Rate for Payer: AlohaCare Medicaid |
$1,812.50
|
| Rate for Payer: AlohaCare Medicare |
$1,812.50
|
| Rate for Payer: Cash Price |
$2,356.25
|
| Rate for Payer: Cash Price |
$2,356.25
|
| Rate for Payer: Devoted Health Medicare |
$1,993.75
|
| 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 |
$1,812.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3,443.75
|
| Rate for Payer: Health Management Network Commercial |
$3,081.25
|
| Rate for Payer: Humana Medicare |
$1,812.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,262.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,812.50
|
| Rate for Payer: MDX Hawaii PPO |
$3,516.25
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,812.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,812.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,812.50
|
| Rate for Payer: University Health Alliance Commercial |
$2,642.26
|
|
|
11440-Excise Lesion Benign Face Less Than/Equal to 0.5 cm
|
Facility
|
IP
|
$3,625.00
|
|
|
Service Code
|
HCPCS 11440
|
| Hospital Charge Code |
8080194
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,081.25 |
| Max. Negotiated Rate |
$3,516.25 |
| Rate for Payer: Cash Price |
$2,356.25
|
| Rate for Payer: Health Management Network Commercial |
$3,081.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,262.50
|
| Rate for Payer: MDX Hawaii PPO |
$3,516.25
|
|
