|
11621 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 0.6-1.0cm
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11621
|
| Hospital Charge Code |
8037138
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$133.21 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$155.56
|
| Rate for Payer: AlohaCare Medicare |
$133.21
|
| 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 |
$146.53
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$238.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$150.28
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$159.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$155.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$133.21
|
| 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 |
$169.64
|
|
|
11622 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 1.1-2.0cm
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11622
|
| Hospital Charge Code |
8037139
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$148.08 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$176.28
|
| Rate for Payer: AlohaCare Medicare |
$148.08
|
| 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 |
$162.89
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$269.31
|
| 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 |
$179.92
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$177.70
|
| 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 |
$176.28
|
| Rate for Payer: Ohana Health Plan Medicare |
$148.08
|
| 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 |
$199.29
|
|
|
11623 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 2.1-3.0cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11623
|
| Hospital Charge Code |
8037140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$162.76 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$215.79
|
| Rate for Payer: AlohaCare Medicare |
$181.09
|
| 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 |
$199.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$331.58
|
| 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 |
$162.76
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$217.31
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$215.79
|
| Rate for Payer: Ohana Health Plan Medicare |
$181.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: University Health Alliance Commercial |
$245.37
|
|
|
11623 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 2.1-3.0cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11623
|
| Hospital Charge Code |
8037140
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$162.76 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$215.79
|
| Rate for Payer: AlohaCare Medicare |
$181.09
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Cash Price |
$1,494.35
|
| Rate for Payer: Devoted Health Medicare |
$199.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$215.79
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$331.58
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.09
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$215.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$162.76
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$217.31
|
| Rate for Payer: Kaiser Permanente Medicaid |
$217.31
|
| Rate for Payer: Kaiser Permanente Medicare |
$217.31
|
| Rate for Payer: Ohana Health Plan Medicaid |
$215.79
|
| Rate for Payer: Ohana Health Plan Medicare |
$181.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$215.79
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.09
|
| Rate for Payer: University Health Alliance Commercial |
$245.37
|
|
|
11624 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 3.1-4.0cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11624
|
| Hospital Charge Code |
8037141
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$243.81
|
| Rate for Payer: AlohaCare Medicare |
$205.80
|
| 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 |
$226.38
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$375.81
|
| 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 |
$255.58
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.96
|
| 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 |
$243.81
|
| Rate for Payer: Ohana Health Plan Medicare |
$205.80
|
| 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 |
$278.10
|
|
|
11626 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; >4.0cm
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 11626
|
| Hospital Charge Code |
8037142
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,436.55 |
| Rate for Payer: AlohaCare Medicaid |
$294.43
|
| Rate for Payer: AlohaCare Medicare |
$254.29
|
| 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 |
$279.72
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$459.38
|
| 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 |
$232.18
|
| Rate for Payer: Health Management Network Commercial |
$3,436.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$305.15
|
| 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 |
$294.43
|
| Rate for Payer: Ohana Health Plan Medicare |
$254.29
|
| 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 |
$346.49
|
|
|
11640 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; < 0.5 cm
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
8037143
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$114.90 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$133.33
|
| Rate for Payer: AlohaCare Medicare |
$114.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$126.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$133.33
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$202.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$114.90
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$133.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$131.30
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$137.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$137.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$137.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$133.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$114.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$133.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$114.90
|
| Rate for Payer: University Health Alliance Commercial |
$150.15
|
|
|
11640 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; < 0.5 cm
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
8037143
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$114.90 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$133.33
|
| Rate for Payer: AlohaCare Medicare |
$114.90
|
| 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 |
$126.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$202.91
|
| 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 |
$131.30
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$137.88
|
| 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 |
$133.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$114.90
|
| 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 |
$150.15
|
|
|
11640 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
8016447
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$114.90 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$133.33
|
| Rate for Payer: AlohaCare Medicare |
$114.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Cash Price |
$640.90
|
| Rate for Payer: Devoted Health Medicare |
$126.39
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$133.33
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$202.91
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$114.90
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$133.33
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$131.30
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$137.88
|
| Rate for Payer: Kaiser Permanente Medicaid |
$137.88
|
| Rate for Payer: Kaiser Permanente Medicare |
$137.88
|
| Rate for Payer: Ohana Health Plan Medicaid |
$133.33
|
| Rate for Payer: Ohana Health Plan Medicare |
$114.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$133.33
|
| Rate for Payer: UnitedHealthcare Medicare |
$114.90
|
| Rate for Payer: University Health Alliance Commercial |
$150.15
|
|
|
11641 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 0.6-1.0cm
|
Professional
|
Both
|
$903.00
|
|
|
Service Code
|
HCPCS 11641
|
| Hospital Charge Code |
8037144
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$138.50 |
| Max. Negotiated Rate |
$767.55 |
| Rate for Payer: AlohaCare Medicaid |
$162.19
|
| Rate for Payer: AlohaCare Medicare |
$138.50
|
| Rate for Payer: Cash Price |
$586.95
|
| Rate for Payer: Cash Price |
$586.95
|
| Rate for Payer: Cash Price |
$586.95
|
| Rate for Payer: Devoted Health Medicare |
$152.35
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$247.73
|
| 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 |
$180.44
|
| Rate for Payer: Health Management Network Commercial |
$767.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$166.20
|
| 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 |
$162.19
|
| Rate for Payer: Ohana Health Plan Medicare |
$138.50
|
| 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 |
$183.32
|
|
|
11642 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 1.1-2.0cm
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11642
|
| Hospital Charge Code |
8037145
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$158.57 |
| Max. Negotiated Rate |
$838.10 |
| Rate for Payer: AlohaCare Medicaid |
$188.80
|
| Rate for Payer: AlohaCare Medicare |
$158.57
|
| 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 |
$174.43
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$289.19
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$213.46
|
| Rate for Payer: Health Management Network Commercial |
$838.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$190.28
|
| 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 |
$188.80
|
| Rate for Payer: Ohana Health Plan Medicare |
$158.57
|
| 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 |
$214.00
|
|
|
11643 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 2.1-3.0cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11643
|
| Hospital Charge Code |
8037146
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$233.73
|
| Rate for Payer: AlohaCare Medicare |
$196.63
|
| 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 |
$216.29
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$359.91
|
| 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 |
$251.68
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$235.96
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$233.73
|
| Rate for Payer: Ohana Health Plan Medicare |
$196.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: University Health Alliance Commercial |
$266.33
|
|
|
11644 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 3.1-4.0cm
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 11644
|
| Hospital Charge Code |
8037147
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,954.15 |
| Rate for Payer: AlohaCare Medicaid |
$288.00
|
| Rate for Payer: AlohaCare Medicare |
$242.32
|
| 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 |
$266.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$445.55
|
| 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 |
$236.60
|
| Rate for Payer: Health Management Network Commercial |
$1,954.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$290.78
|
| 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 |
$288.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$242.32
|
| 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 |
$329.70
|
|
|
11646 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; < 4.0 cm
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 11646
|
| Hospital Charge Code |
8037148
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,436.55 |
| Rate for Payer: AlohaCare Medicaid |
$393.63
|
| Rate for Payer: AlohaCare Medicare |
$333.01
|
| 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 |
$366.31
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$613.65
|
| 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 |
$306.80
|
| Rate for Payer: Health Management Network Commercial |
$3,436.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$399.61
|
| 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 |
$393.63
|
| Rate for Payer: Ohana Health Plan Medicare |
$333.01
|
| 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 |
$454.10
|
|
|
1169771 US Upper Ext Venous Duplex Right
|
Facility
|
OP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279259
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$93.10 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: AlohaCare Medicaid |
$430.50
|
| Rate for Payer: AlohaCare Medicare |
$430.50
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Devoted Health Medicare |
$473.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$93.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$430.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$109.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$817.95
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Humana Medicare |
$430.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$439.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$430.50
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$430.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$93.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$430.50
|
| Rate for Payer: University Health Alliance Commercial |
$482.16
|
|
|
1169771 US Upper Ext Venous Duplex Right
|
Facility
|
IP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279259
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$731.85 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
|
|
1169773 US Upper Ext Venous Duplex Left
|
Facility
|
OP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279258
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$93.10 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: AlohaCare Medicaid |
$430.50
|
| Rate for Payer: AlohaCare Medicare |
$430.50
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Devoted Health Medicare |
$473.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$93.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$430.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$109.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$817.95
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Humana Medicare |
$430.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$439.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$430.50
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$430.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$93.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$430.50
|
| Rate for Payer: University Health Alliance Commercial |
$482.16
|
|
|
1169773 US Upper Ext Venous Duplex Left
|
Facility
|
IP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279258
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$731.85 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
|
|
1169861 US OB Transvaginal
|
Facility
|
IP
|
$858.00
|
|
|
Service Code
|
HCPCS 76817
|
| Hospital Charge Code |
9279260
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$729.30 |
| Max. Negotiated Rate |
$832.26 |
| Rate for Payer: Cash Price |
$557.70
|
| Rate for Payer: Health Management Network Commercial |
$729.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$772.20
|
| Rate for Payer: MDX Hawaii PPO |
$832.26
|
|
|
1169861 US OB Transvaginal
|
Facility
|
OP
|
$858.00
|
|
|
Service Code
|
HCPCS 76817
|
| Hospital Charge Code |
9279260
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$46.06 |
| Max. Negotiated Rate |
$832.26 |
| Rate for Payer: AlohaCare Medicaid |
$429.00
|
| Rate for Payer: AlohaCare Medicare |
$429.00
|
| Rate for Payer: Cash Price |
$557.70
|
| Rate for Payer: Cash Price |
$557.70
|
| Rate for Payer: Devoted Health Medicare |
$471.90
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$46.06
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$429.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$53.86
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$106.81
|
| Rate for Payer: Health Management Network Commercial |
$729.30
|
| Rate for Payer: Humana Medicare |
$429.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$772.20
|
| Rate for Payer: Kaiser Permanente Medicaid |
$437.58
|
| Rate for Payer: Kaiser Permanente Medicare |
$429.00
|
| Rate for Payer: MDX Hawaii PPO |
$832.26
|
| Rate for Payer: Ohana Health Plan Medicaid |
$429.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$429.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$46.06
|
| Rate for Payer: UnitedHealthcare Medicare |
$429.00
|
| Rate for Payer: University Health Alliance Commercial |
$193.75
|
|
|
1169903 US Lower Ext Venous Duplex Right
|
Facility
|
IP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279256
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$731.85 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
|
|
1169903 US Lower Ext Venous Duplex Right
|
Facility
|
OP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279256
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$93.10 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: AlohaCare Medicaid |
$430.50
|
| Rate for Payer: AlohaCare Medicare |
$430.50
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Devoted Health Medicare |
$473.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$93.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$430.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$109.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$817.95
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Humana Medicare |
$430.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$439.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$430.50
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$430.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$93.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$430.50
|
| Rate for Payer: University Health Alliance Commercial |
$482.16
|
|
|
1169905 US Lower Ext Venous Duplex Left
|
Facility
|
OP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279255
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$93.10 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: AlohaCare Medicaid |
$430.50
|
| Rate for Payer: AlohaCare Medicare |
$430.50
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Devoted Health Medicare |
$473.55
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$93.10
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$133.51
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$430.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$109.94
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$817.95
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Humana Medicare |
$430.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$439.11
|
| Rate for Payer: Kaiser Permanente Medicare |
$430.50
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
| Rate for Payer: Ohana Health Plan Medicaid |
$430.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$430.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$93.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$430.50
|
| Rate for Payer: University Health Alliance Commercial |
$482.16
|
|
|
1169905 US Lower Ext Venous Duplex Left
|
Facility
|
IP
|
$861.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
9279255
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$731.85 |
| Max. Negotiated Rate |
$835.17 |
| Rate for Payer: Cash Price |
$559.65
|
| Rate for Payer: Health Management Network Commercial |
$731.85
|
| Rate for Payer: Kaiser Permanente Commercial |
$774.90
|
| Rate for Payer: MDX Hawaii PPO |
$835.17
|
|
|
11719-Trimming Nails Nondystrophic
|
Facility
|
OP
|
$353.00
|
|
|
Service Code
|
HCPCS 11719
|
| Hospital Charge Code |
8080196
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.50 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$176.50
|
| Rate for Payer: AlohaCare Medicare |
$176.50
|
| Rate for Payer: Cash Price |
$229.45
|
| Rate for Payer: Cash Price |
$229.45
|
| Rate for Payer: Devoted Health Medicare |
$194.15
|
| 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 |
$176.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$335.35
|
| Rate for Payer: Health Management Network Commercial |
$300.05
|
| Rate for Payer: Humana Medicare |
$176.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$317.70
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$176.50
|
| Rate for Payer: MDX Hawaii PPO |
$342.41
|
| Rate for Payer: Ohana Health Plan Medicaid |
$176.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$176.50
|
| Rate for Payer: UnitedHealthcare Medicare |
$176.50
|
| Rate for Payer: University Health Alliance Commercial |
$257.30
|
|
