|
29130 APPLICATION FINGER SPLINT STATIC
|
Facility
|
IP
|
$613.00
|
|
|
Service Code
|
HCPCS 29130
|
| Hospital Charge Code |
8023339
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$521.05 |
| Max. Negotiated Rate |
$594.61 |
| Rate for Payer: Cash Price |
$398.45
|
| Rate for Payer: Health Management Network Commercial |
$521.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$551.70
|
| Rate for Payer: MDX Hawaii PPO |
$594.61
|
|
|
29130 APPLICATION FINGER SPLINT STATIC
|
Facility
|
OP
|
$613.00
|
|
|
Service Code
|
HCPCS 29130
|
| Hospital Charge Code |
8023339
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$306.50 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$306.50
|
| Rate for Payer: AlohaCare Medicare |
$306.50
|
| Rate for Payer: Cash Price |
$398.45
|
| Rate for Payer: Cash Price |
$398.45
|
| Rate for Payer: Devoted Health Medicare |
$337.15
|
| 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 |
$306.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$582.35
|
| Rate for Payer: Health Management Network Commercial |
$521.05
|
| Rate for Payer: Humana Medicare |
$306.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$551.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$306.50
|
| Rate for Payer: MDX Hawaii PPO |
$594.61
|
| Rate for Payer: Ohana Health Plan Medicaid |
$306.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$306.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$306.50
|
| Rate for Payer: University Health Alliance Commercial |
$446.82
|
|
|
29130 Application of finger splint static
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 29130
|
| Hospital Charge Code |
8038442
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$23.92 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$29.03
|
| Rate for Payer: AlohaCare Medicare |
$25.51
|
| Rate for Payer: Cash Price |
$120.25
|
| Rate for Payer: Cash Price |
$120.25
|
| Rate for Payer: Cash Price |
$120.25
|
| Rate for Payer: Devoted Health Medicare |
$28.06
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$45.39
|
| 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 |
$23.92
|
| Rate for Payer: Health Management Network Commercial |
$157.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$30.61
|
| 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 |
$29.03
|
| Rate for Payer: Ohana Health Plan Medicare |
$25.51
|
| 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 |
$36.07
|
|
|
29130 Apply Finger Splint Bilat
|
Facility
|
OP
|
$641.00
|
|
|
Service Code
|
HCPCS 29130 50
|
| Hospital Charge Code |
8222654
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$18.15 |
| Max. Negotiated Rate |
$621.77 |
| Rate for Payer: AlohaCare Medicaid |
$320.50
|
| Rate for Payer: AlohaCare Medicare |
$320.50
|
| Rate for Payer: Cash Price |
$416.65
|
| Rate for Payer: Cash Price |
$416.65
|
| Rate for Payer: Devoted Health Medicare |
$352.55
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$320.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$608.95
|
| Rate for Payer: Health Management Network Commercial |
$544.85
|
| Rate for Payer: Humana Medicare |
$320.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$576.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$326.91
|
| Rate for Payer: Kaiser Permanente Medicare |
$320.50
|
| Rate for Payer: MDX Hawaii PPO |
$621.77
|
| Rate for Payer: Ohana Health Plan Medicaid |
$320.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$320.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$18.15
|
| Rate for Payer: UnitedHealthcare Medicare |
$320.50
|
| Rate for Payer: University Health Alliance Commercial |
$358.96
|
|
|
29130 Apply Finger Splint Bilat
|
Facility
|
IP
|
$641.00
|
|
|
Service Code
|
HCPCS 29130 50
|
| Hospital Charge Code |
8222654
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$544.85 |
| Max. Negotiated Rate |
$621.77 |
| Rate for Payer: Cash Price |
$416.65
|
| Rate for Payer: Health Management Network Commercial |
$544.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$576.90
|
| Rate for Payer: MDX Hawaii PPO |
$621.77
|
|
|
29130-Finger
|
Facility
|
OP
|
$533.00
|
|
|
Service Code
|
HCPCS 29130
|
| Hospital Charge Code |
8080073
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$266.50 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$266.50
|
| Rate for Payer: AlohaCare Medicare |
$266.50
|
| Rate for Payer: Cash Price |
$346.45
|
| Rate for Payer: Cash Price |
$346.45
|
| Rate for Payer: Devoted Health Medicare |
$293.15
|
| 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 |
$266.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$506.35
|
| Rate for Payer: Health Management Network Commercial |
$453.05
|
| Rate for Payer: Humana Medicare |
$266.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$479.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$266.50
|
| Rate for Payer: MDX Hawaii PPO |
$517.01
|
| Rate for Payer: Ohana Health Plan Medicaid |
$266.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$266.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$266.50
|
| Rate for Payer: University Health Alliance Commercial |
$388.50
|
|
|
29130-Finger
|
Facility
|
IP
|
$533.00
|
|
|
Service Code
|
HCPCS 29130
|
| Hospital Charge Code |
8080073
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$453.05 |
| Max. Negotiated Rate |
$517.01 |
| Rate for Payer: Cash Price |
$346.45
|
| Rate for Payer: Health Management Network Commercial |
$453.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$479.70
|
| Rate for Payer: MDX Hawaii PPO |
$517.01
|
|
|
29131 Appl Finger Splint Dynamic Bil
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
HCPCS 29131 50
|
| Hospital Charge Code |
8223394
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$22.28 |
| Max. Negotiated Rate |
$443.29 |
| Rate for Payer: AlohaCare Medicaid |
$228.50
|
| Rate for Payer: AlohaCare Medicare |
$228.50
|
| Rate for Payer: Cash Price |
$297.05
|
| Rate for Payer: Cash Price |
$297.05
|
| Rate for Payer: Devoted Health Medicare |
$251.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$228.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$434.15
|
| Rate for Payer: Health Management Network Commercial |
$388.45
|
| Rate for Payer: Humana Medicare |
$228.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$411.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$233.07
|
| Rate for Payer: Kaiser Permanente Medicare |
$228.50
|
| Rate for Payer: MDX Hawaii PPO |
$443.29
|
| Rate for Payer: Ohana Health Plan Medicaid |
$228.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$228.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$228.50
|
| Rate for Payer: University Health Alliance Commercial |
$255.92
|
|
|
29131 Appl Finger Splint Dynamic Bil
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
HCPCS 29131 50
|
| Hospital Charge Code |
8223394
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$388.45 |
| Max. Negotiated Rate |
$443.29 |
| Rate for Payer: Cash Price |
$297.05
|
| Rate for Payer: Health Management Network Commercial |
$388.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$411.30
|
| Rate for Payer: MDX Hawaii PPO |
$443.29
|
|
|
29131 Appl Finger Splint Dynamic LT
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
HCPCS 29131 LT
|
| Hospital Charge Code |
8222612
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$388.45 |
| Max. Negotiated Rate |
$443.29 |
| Rate for Payer: Cash Price |
$297.05
|
| Rate for Payer: Health Management Network Commercial |
$388.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$411.30
|
| Rate for Payer: MDX Hawaii PPO |
$443.29
|
|
|
29131 Appl Finger Splint Dynamic LT
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
HCPCS 29131 LT
|
| Hospital Charge Code |
8222612
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$22.28 |
| Max. Negotiated Rate |
$443.29 |
| Rate for Payer: AlohaCare Medicaid |
$228.50
|
| Rate for Payer: AlohaCare Medicare |
$228.50
|
| Rate for Payer: Cash Price |
$297.05
|
| Rate for Payer: Cash Price |
$297.05
|
| Rate for Payer: Devoted Health Medicare |
$251.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$228.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$434.15
|
| Rate for Payer: Health Management Network Commercial |
$388.45
|
| Rate for Payer: Humana Medicare |
$228.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$411.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$233.07
|
| Rate for Payer: Kaiser Permanente Medicare |
$228.50
|
| Rate for Payer: MDX Hawaii PPO |
$443.29
|
| Rate for Payer: Ohana Health Plan Medicaid |
$228.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$228.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$228.50
|
| Rate for Payer: University Health Alliance Commercial |
$255.92
|
|
|
29131 Appl Finger Splint Dynamic RT
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
HCPCS 29131 RT
|
| Hospital Charge Code |
8222626
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$388.45 |
| Max. Negotiated Rate |
$443.29 |
| Rate for Payer: Cash Price |
$297.05
|
| Rate for Payer: Health Management Network Commercial |
$388.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$411.30
|
| Rate for Payer: MDX Hawaii PPO |
$443.29
|
|
|
29131 Appl Finger Splint Dynamic RT
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
HCPCS 29131 RT
|
| Hospital Charge Code |
8222626
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$22.28 |
| Max. Negotiated Rate |
$443.29 |
| Rate for Payer: AlohaCare Medicaid |
$228.50
|
| Rate for Payer: AlohaCare Medicare |
$228.50
|
| Rate for Payer: Cash Price |
$297.05
|
| Rate for Payer: Cash Price |
$297.05
|
| Rate for Payer: Devoted Health Medicare |
$251.35
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$228.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$434.15
|
| Rate for Payer: Health Management Network Commercial |
$388.45
|
| Rate for Payer: Humana Medicare |
$228.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$411.30
|
| Rate for Payer: Kaiser Permanente Medicaid |
$233.07
|
| Rate for Payer: Kaiser Permanente Medicare |
$228.50
|
| Rate for Payer: MDX Hawaii PPO |
$443.29
|
| Rate for Payer: Ohana Health Plan Medicaid |
$228.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$228.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.28
|
| Rate for Payer: UnitedHealthcare Medicare |
$228.50
|
| Rate for Payer: University Health Alliance Commercial |
$255.92
|
|
|
29131 Application of finger splint; dynamic
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 29131
|
| Hospital Charge Code |
8038443
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$31.36 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$35.29
|
| Rate for Payer: AlohaCare Medicare |
$31.36
|
| Rate for Payer: Cash Price |
$94.90
|
| Rate for Payer: Cash Price |
$94.90
|
| Rate for Payer: Cash Price |
$94.90
|
| Rate for Payer: Devoted Health Medicare |
$34.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$53.94
|
| 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 |
$33.28
|
| Rate for Payer: Health Management Network Commercial |
$124.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$37.63
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$35.29
|
| Rate for Payer: Ohana Health Plan Medicare |
$31.36
|
| 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 |
$45.67
|
|
|
29200 Strapping, thorax
|
Professional
|
Both
|
$226.00
|
|
|
Service Code
|
HCPCS 29200
|
| Hospital Charge Code |
8038444
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$15.54 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$18.33
|
| Rate for Payer: AlohaCare Medicare |
$15.54
|
| Rate for Payer: Cash Price |
$146.90
|
| Rate for Payer: Cash Price |
$146.90
|
| Rate for Payer: Cash Price |
$146.90
|
| Rate for Payer: Devoted Health Medicare |
$17.09
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$52.94
|
| 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 |
$30.68
|
| Rate for Payer: Health Management Network Commercial |
$192.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$18.65
|
| 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 |
$18.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$15.54
|
| 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 |
$24.94
|
|
|
29200 STRAPPING; THORAX TechFee
|
Facility
|
OP
|
$359.00
|
|
|
Service Code
|
HCPCS 29200
|
| Hospital Charge Code |
8023341
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$179.50 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$179.50
|
| Rate for Payer: AlohaCare Medicare |
$179.50
|
| Rate for Payer: Cash Price |
$233.35
|
| Rate for Payer: Cash Price |
$233.35
|
| Rate for Payer: Devoted Health Medicare |
$197.45
|
| 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 |
$179.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$341.05
|
| Rate for Payer: Health Management Network Commercial |
$305.15
|
| Rate for Payer: Humana Medicare |
$179.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$323.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$179.50
|
| Rate for Payer: MDX Hawaii PPO |
$348.23
|
| Rate for Payer: Ohana Health Plan Medicaid |
$179.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$179.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$179.50
|
| Rate for Payer: University Health Alliance Commercial |
$261.68
|
|
|
29200 STRAPPING; THORAX TechFee
|
Facility
|
IP
|
$359.00
|
|
|
Service Code
|
HCPCS 29200
|
| Hospital Charge Code |
8023341
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$305.15 |
| Max. Negotiated Rate |
$348.23 |
| Rate for Payer: Cash Price |
$233.35
|
| Rate for Payer: Health Management Network Commercial |
$305.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$323.10
|
| Rate for Payer: MDX Hawaii PPO |
$348.23
|
|
|
29240 Strapping of Shoulder
|
Facility
|
IP
|
$451.00
|
|
|
Service Code
|
HCPCS 29240
|
| Hospital Charge Code |
8222673
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$383.35 |
| Max. Negotiated Rate |
$437.47 |
| Rate for Payer: Cash Price |
$293.15
|
| Rate for Payer: Health Management Network Commercial |
$383.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$405.90
|
| Rate for Payer: MDX Hawaii PPO |
$437.47
|
|
|
29240 Strapping of Shoulder
|
Facility
|
OP
|
$451.00
|
|
|
Service Code
|
HCPCS 29240
|
| Hospital Charge Code |
8222673
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$27.92 |
| Max. Negotiated Rate |
$437.47 |
| Rate for Payer: AlohaCare Medicaid |
$225.50
|
| Rate for Payer: AlohaCare Medicare |
$225.50
|
| Rate for Payer: Cash Price |
$293.15
|
| Rate for Payer: Cash Price |
$293.15
|
| Rate for Payer: Devoted Health Medicare |
$248.05
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$169.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$225.50
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$428.45
|
| Rate for Payer: Health Management Network Commercial |
$383.35
|
| Rate for Payer: Humana Medicare |
$225.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$405.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$230.01
|
| Rate for Payer: Kaiser Permanente Medicare |
$225.50
|
| Rate for Payer: MDX Hawaii PPO |
$437.47
|
| Rate for Payer: Ohana Health Plan Medicaid |
$225.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$225.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$27.92
|
| Rate for Payer: UnitedHealthcare Medicare |
$225.50
|
| Rate for Payer: University Health Alliance Commercial |
$252.56
|
|
|
29240 Strapping, shoulder
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 29240
|
| Hospital Charge Code |
8038445
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$15.54 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$17.95
|
| Rate for Payer: AlohaCare Medicare |
$15.54
|
| Rate for Payer: Cash Price |
$120.25
|
| Rate for Payer: Cash Price |
$120.25
|
| Rate for Payer: Cash Price |
$120.25
|
| Rate for Payer: Devoted Health Medicare |
$17.09
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$59.25
|
| 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 |
$33.02
|
| Rate for Payer: Health Management Network Commercial |
$157.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$18.65
|
| 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 |
$17.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$15.54
|
| 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 |
$22.39
|
|
|
29260 Strapping; elbow or wrist
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 29260
|
| Hospital Charge Code |
8282290
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$15.74 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$18.90
|
| Rate for Payer: AlohaCare Medicare |
$15.74
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Devoted Health Medicare |
$17.31
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$49.12
|
| 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 |
$19.24
|
| Rate for Payer: Health Management Network Commercial |
$100.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$18.89
|
| 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 |
$18.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$15.74
|
| 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 |
$23.32
|
|
|
29260 Strapping Elbow or Wrist Bilat
|
Facility
|
OP
|
$428.00
|
|
|
Service Code
|
HCPCS 29260 50
|
| Hospital Charge Code |
8222669
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$21.56 |
| Max. Negotiated Rate |
$415.16 |
| Rate for Payer: AlohaCare Medicaid |
$214.00
|
| Rate for Payer: AlohaCare Medicare |
$214.00
|
| Rate for Payer: Cash Price |
$278.20
|
| Rate for Payer: Cash Price |
$278.20
|
| Rate for Payer: Devoted Health Medicare |
$235.40
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$214.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$406.60
|
| Rate for Payer: Health Management Network Commercial |
$363.80
|
| Rate for Payer: Humana Medicare |
$214.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$385.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$218.28
|
| Rate for Payer: Kaiser Permanente Medicare |
$214.00
|
| Rate for Payer: MDX Hawaii PPO |
$415.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$214.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$214.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$21.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$214.00
|
| Rate for Payer: University Health Alliance Commercial |
$239.68
|
|
|
29260 Strapping Elbow or Wrist Bilat
|
Facility
|
IP
|
$428.00
|
|
|
Service Code
|
HCPCS 29260 50
|
| Hospital Charge Code |
8222669
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$363.80 |
| Max. Negotiated Rate |
$415.16 |
| Rate for Payer: Cash Price |
$278.20
|
| Rate for Payer: Health Management Network Commercial |
$363.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$385.20
|
| Rate for Payer: MDX Hawaii PPO |
$415.16
|
|
|
29260 STRAPPING ELBOW/WRIST TechFee
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
HCPCS 29260
|
| Hospital Charge Code |
8023343
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$138.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$138.00
|
| Rate for Payer: AlohaCare Medicare |
$138.00
|
| Rate for Payer: Cash Price |
$179.40
|
| Rate for Payer: Cash Price |
$179.40
|
| Rate for Payer: Devoted Health Medicare |
$151.80
|
| 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 |
$138.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$262.20
|
| Rate for Payer: Health Management Network Commercial |
$234.60
|
| Rate for Payer: Humana Medicare |
$138.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$248.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$138.00
|
| Rate for Payer: MDX Hawaii PPO |
$267.72
|
| Rate for Payer: Ohana Health Plan Medicaid |
$138.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$138.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$138.00
|
| Rate for Payer: University Health Alliance Commercial |
$201.18
|
|
|
29260 STRAPPING ELBOW/WRIST TechFee
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
HCPCS 29260
|
| Hospital Charge Code |
8023343
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$234.60 |
| Max. Negotiated Rate |
$267.72 |
| Rate for Payer: Cash Price |
$179.40
|
| Rate for Payer: Health Management Network Commercial |
$234.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$248.40
|
| Rate for Payer: MDX Hawaii PPO |
$267.72
|
|
