|
29260 Strapping of Elbow or Wrist LT
|
Facility
|
IP
|
$428.00
|
|
|
Service Code
|
HCPCS 29260 LT
|
| Hospital Charge Code |
8222670
|
|
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 of Elbow or Wrist LT
|
Facility
|
OP
|
$428.00
|
|
|
Service Code
|
HCPCS 29260 LT
|
| Hospital Charge Code |
8222670
|
|
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 of Elbow or Wrist RT
|
Facility
|
IP
|
$428.00
|
|
|
Service Code
|
HCPCS 29260 RT
|
| Hospital Charge Code |
8222672
|
|
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 of Elbow or Wrist RT
|
Facility
|
OP
|
$428.00
|
|
|
Service Code
|
HCPCS 29260 RT
|
| Hospital Charge Code |
8222672
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$21.56 |
| Max. Negotiated Rate |
$415.16 |
| Rate for Payer: AlohaCare Medicare |
$214.00
|
| Rate for Payer: AlohaCare Medicaid |
$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
|
|
|
29280 STRAPPING HAND/FINGER TechFee
|
Facility
|
IP
|
$528.00
|
|
|
Service Code
|
HCPCS 29280
|
| Hospital Charge Code |
8023344
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$448.80 |
| Max. Negotiated Rate |
$512.16 |
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Health Management Network Commercial |
$448.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$475.20
|
| Rate for Payer: MDX Hawaii PPO |
$512.16
|
|
|
29280 STRAPPING HAND/FINGER TechFee
|
Facility
|
OP
|
$528.00
|
|
|
Service Code
|
HCPCS 29280
|
| Hospital Charge Code |
8023344
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$264.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$264.00
|
| Rate for Payer: AlohaCare Medicare |
$264.00
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Devoted Health Medicare |
$290.40
|
| 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 |
$264.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$501.60
|
| Rate for Payer: Health Management Network Commercial |
$448.80
|
| Rate for Payer: Humana Medicare |
$264.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$475.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$264.00
|
| Rate for Payer: MDX Hawaii PPO |
$512.16
|
| Rate for Payer: Ohana Health Plan Medicaid |
$264.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$264.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$264.00
|
| Rate for Payer: University Health Alliance Commercial |
$384.86
|
|
|
29280 Strapping; hand or finger
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 29280
|
| Hospital Charge Code |
8282284
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$16.88 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$20.04
|
| Rate for Payer: AlohaCare Medicare |
$16.88
|
| Rate for Payer: Cash Price |
$78.65
|
| Rate for Payer: Cash Price |
$78.65
|
| Rate for Payer: Cash Price |
$78.65
|
| Rate for Payer: Devoted Health Medicare |
$18.57
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$47.27
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$22.36
|
| Rate for Payer: Health Management Network Commercial |
$102.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$20.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| 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 |
$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: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Ohana Health Plan Medicaid |
$20.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$16.88
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: University Health Alliance Commercial |
$26.04
|
|
|
29305 Application of hip spica cast; 1 leg
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 29305
|
| Hospital Charge Code |
8038446
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$152.36 |
| Max. Negotiated Rate |
$587.35 |
| Rate for Payer: AlohaCare Medicaid |
$164.73
|
| Rate for Payer: AlohaCare Medicare |
$155.53
|
| Rate for Payer: Cash Price |
$449.15
|
| Rate for Payer: Cash Price |
$449.15
|
| Rate for Payer: Cash Price |
$449.15
|
| Rate for Payer: Devoted Health Medicare |
$171.08
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$250.14
|
| 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 |
$152.36
|
| Rate for Payer: Health Management Network Commercial |
$587.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$186.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$164.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$155.53
|
| 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 |
$211.79
|
|
|
29325 Application of hip spica cast; 1 and one-half spica or both legs
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 29325
|
| Hospital Charge Code |
8038447
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$172.30 |
| Max. Negotiated Rate |
$650.25 |
| Rate for Payer: AlohaCare Medicaid |
$183.92
|
| Rate for Payer: AlohaCare Medicare |
$172.30
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Devoted Health Medicare |
$189.53
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$279.90
|
| 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 |
$650.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$206.76
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$183.92
|
| Rate for Payer: Ohana Health Plan Medicare |
$172.30
|
| 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 |
$236.98
|
|
|
29345 Application of long leg cast (thigh to toes)
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 29345
|
| Hospital Charge Code |
8038448
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$92.94 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$101.94
|
| Rate for Payer: AlohaCare Medicare |
$92.94
|
| Rate for Payer: Cash Price |
$248.95
|
| Rate for Payer: Cash Price |
$248.95
|
| Rate for Payer: Cash Price |
$248.95
|
| Rate for Payer: Devoted Health Medicare |
$102.23
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$157.02
|
| 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 |
$107.38
|
| Rate for Payer: Health Management Network Commercial |
$325.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$111.53
|
| 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 |
$101.94
|
| Rate for Payer: Ohana Health Plan Medicare |
$92.94
|
| 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 |
$127.46
|
|
|
29355 Application of long leg cast (thigh to toes); walker or ambulatory type
|
Professional
|
Both
|
$395.00
|
|
|
Service Code
|
HCPCS 29355
|
| Hospital Charge Code |
8038449
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$98.10 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$108.93
|
| Rate for Payer: AlohaCare Medicare |
$98.10
|
| Rate for Payer: Cash Price |
$256.75
|
| Rate for Payer: Cash Price |
$256.75
|
| Rate for Payer: Cash Price |
$256.75
|
| Rate for Payer: Devoted Health Medicare |
$107.91
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$167.51
|
| 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 |
$131.30
|
| Rate for Payer: Health Management Network Commercial |
$335.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$117.72
|
| 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 |
$108.93
|
| Rate for Payer: Ohana Health Plan Medicare |
$98.10
|
| 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 |
$141.82
|
|
|
29358 Application of long leg cast brace
|
Professional
|
Both
|
$448.00
|
|
|
Service Code
|
HCPCS 29358
|
| Hospital Charge Code |
8038450
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$97.23 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$105.98
|
| Rate for Payer: AlohaCare Medicare |
$97.23
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Devoted Health Medicare |
$106.95
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$162.27
|
| 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 |
$131.56
|
| Rate for Payer: Health Management Network Commercial |
$380.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$116.68
|
| 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 |
$105.98
|
| Rate for Payer: Ohana Health Plan Medicare |
$97.23
|
| 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 |
$137.39
|
|
|
29365 Application of cylinder cast (thigh to ankle)
|
Professional
|
Both
|
$389.00
|
|
|
Service Code
|
HCPCS 29365
|
| Hospital Charge Code |
8038451
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$76.44 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$90.81
|
| Rate for Payer: AlohaCare Medicare |
$83.87
|
| Rate for Payer: Cash Price |
$252.85
|
| Rate for Payer: Cash Price |
$252.85
|
| Rate for Payer: Cash Price |
$252.85
|
| Rate for Payer: Devoted Health Medicare |
$92.26
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$137.91
|
| 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 |
$76.44
|
| Rate for Payer: Health Management Network Commercial |
$330.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$100.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$90.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$83.87
|
| 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 |
$116.76
|
|
|
29405 Application of short leg cast (below knee to toes)
|
Professional
|
Both
|
$389.00
|
|
|
Service Code
|
HCPCS 29405
|
| Hospital Charge Code |
8038452
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$57.43 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$61.19
|
| Rate for Payer: AlohaCare Medicare |
$57.43
|
| Rate for Payer: Cash Price |
$252.85
|
| Rate for Payer: Cash Price |
$252.85
|
| Rate for Payer: Cash Price |
$252.85
|
| Rate for Payer: Devoted Health Medicare |
$63.17
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$92.43
|
| 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 |
$83.46
|
| Rate for Payer: Health Management Network Commercial |
$330.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$68.92
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$61.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$57.43
|
| 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 |
$76.45
|
|
|
29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE TechFee
|
Facility
|
OP
|
$1,058.00
|
|
|
Service Code
|
HCPCS 29405
|
| Hospital Charge Code |
8023348
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$529.00
|
| Rate for Payer: AlohaCare Medicare |
$529.00
|
| Rate for Payer: Cash Price |
$687.70
|
| Rate for Payer: Cash Price |
$687.70
|
| Rate for Payer: Devoted Health Medicare |
$581.90
|
| 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 |
$529.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,005.10
|
| Rate for Payer: Health Management Network Commercial |
$899.30
|
| Rate for Payer: Humana Medicare |
$529.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$952.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$529.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,026.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$529.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$529.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$529.00
|
| Rate for Payer: University Health Alliance Commercial |
$771.18
|
|
|
29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE TechFee
|
Facility
|
IP
|
$1,058.00
|
|
|
Service Code
|
HCPCS 29405
|
| Hospital Charge Code |
8023348
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$899.30 |
| Max. Negotiated Rate |
$1,026.26 |
| Rate for Payer: Cash Price |
$687.70
|
| Rate for Payer: Health Management Network Commercial |
$899.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$952.20
|
| Rate for Payer: MDX Hawaii PPO |
$1,026.26
|
|
|
29425 Application of short leg cast (below knee to toes); walking or ambulatory type
|
Professional
|
Both
|
$389.00
|
|
|
Service Code
|
HCPCS 29425
|
| Hospital Charge Code |
8038453
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$52.86 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$56.42
|
| Rate for Payer: AlohaCare Medicare |
$52.86
|
| Rate for Payer: Cash Price |
$252.85
|
| Rate for Payer: Cash Price |
$252.85
|
| Rate for Payer: Cash Price |
$252.85
|
| Rate for Payer: Devoted Health Medicare |
$58.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$93.67
|
| 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 |
$95.42
|
| Rate for Payer: Health Management Network Commercial |
$330.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$63.43
|
| 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 |
$56.42
|
| Rate for Payer: Ohana Health Plan Medicare |
$52.86
|
| 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 |
$70.57
|
|
|
29435 Application of patellar tendon bearing (PTB) cast
|
Professional
|
Both
|
$389.00
|
|
|
Service Code
|
HCPCS 29435
|
| Hospital Charge Code |
8038454
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$82.55 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$89.28
|
| Rate for Payer: AlohaCare Medicare |
$82.55
|
| Rate for Payer: Cash Price |
$252.85
|
| Rate for Payer: Cash Price |
$252.85
|
| Rate for Payer: Cash Price |
$252.85
|
| Rate for Payer: Devoted Health Medicare |
$90.81
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$125.84
|
| 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 |
$112.84
|
| Rate for Payer: Health Management Network Commercial |
$330.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$99.06
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$89.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$82.55
|
| 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 |
$111.59
|
|
|
29440 Adding walker to previously applied cast
|
Professional
|
Both
|
$226.00
|
|
|
Service Code
|
HCPCS 29440
|
| Hospital Charge Code |
8038455
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$22.88 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$28.32
|
| Rate for Payer: AlohaCare Medicare |
$25.75
|
| 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 |
$28.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$44.97
|
| 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 |
$22.88
|
| Rate for Payer: Health Management Network Commercial |
$192.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$30.90
|
| 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 |
$28.32
|
| Rate for Payer: Ohana Health Plan Medicare |
$25.75
|
| 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 |
$36.83
|
|
|
29445 Application of rigid total contact leg cast
|
Professional
|
Both
|
$399.00
|
|
|
Service Code
|
HCPCS 29445
|
| Hospital Charge Code |
8038456
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$37.96 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$100.09
|
| Rate for Payer: AlohaCare Medicare |
$91.23
|
| Rate for Payer: Cash Price |
$259.35
|
| Rate for Payer: Cash Price |
$259.35
|
| Rate for Payer: Cash Price |
$259.35
|
| Rate for Payer: Devoted Health Medicare |
$100.35
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$155.51
|
| 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 |
$37.96
|
| Rate for Payer: Health Management Network Commercial |
$339.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$109.48
|
| 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 |
$100.09
|
| Rate for Payer: Ohana Health Plan Medicare |
$91.23
|
| 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 |
$131.66
|
|
|
29450 Application of clubfoot cast with molding or manipulation, long or short leg
|
Professional
|
Both
|
$408.00
|
|
|
Service Code
|
HCPCS 29450
|
| Hospital Charge Code |
8038457
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$38.22 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$114.08
|
| Rate for Payer: AlohaCare Medicare |
$100.35
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Devoted Health Medicare |
$110.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$178.34
|
| 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 |
$38.22
|
| Rate for Payer: Health Management Network Commercial |
$346.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$120.42
|
| 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 |
$114.08
|
| Rate for Payer: Ohana Health Plan Medicare |
$100.35
|
| 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 |
$150.99
|
|
|
29505 APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES TechFee
|
Facility
|
IP
|
$613.00
|
|
|
Service Code
|
HCPCS 29505
|
| Hospital Charge Code |
8023349
|
|
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
|
|
|
29505 APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES TechFee
|
Facility
|
OP
|
$613.00
|
|
|
Service Code
|
HCPCS 29505
|
| Hospital Charge Code |
8023349
|
|
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
|
|
|
29505 Application of long leg splint (thigh to ankle or toes)
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 29505
|
| Hospital Charge Code |
8038458
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$54.66 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$54.66
|
| Rate for Payer: AlohaCare Medicare |
$56.79
|
| Rate for Payer: Cash Price |
$187.85
|
| Rate for Payer: Cash Price |
$187.85
|
| Rate for Payer: Cash Price |
$187.85
|
| Rate for Payer: Devoted Health Medicare |
$62.47
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$81.56
|
| 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 |
$65.26
|
| Rate for Payer: Health Management Network Commercial |
$245.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$68.15
|
| 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 |
$54.66
|
| Rate for Payer: Ohana Health Plan Medicare |
$56.79
|
| 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 |
$69.05
|
|
|
29505-Long Leg
|
Facility
|
OP
|
$533.00
|
|
|
Service Code
|
HCPCS 29505
|
| Hospital Charge Code |
8080074
|
|
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
|
|
