|
31500 INTUBATION ENDOTRACHEAL - ER SERV PROCED
|
Facility
|
OP
|
$1,160.00
|
|
|
Service Code
|
HCPCS 31500
|
| Hospital Charge Code |
8051020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.64 |
| Max. Negotiated Rate |
$4,035.20 |
| Rate for Payer: AlohaCare Medicaid |
$580.00
|
| Rate for Payer: AlohaCare Medicare |
$580.00
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Devoted Health Medicare |
$638.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$302.48
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$580.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,102.00
|
| Rate for Payer: Health Management Network Commercial |
$986.00
|
| Rate for Payer: Humana Medicare |
$580.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,044.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$591.60
|
| Rate for Payer: Kaiser Permanente Medicare |
$580.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,125.20
|
| Rate for Payer: Ohana Health Plan Medicaid |
$580.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$580.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$93.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$580.00
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
31500 INTUBATION ENDOTRACHEAL - ER SERV PROCED
|
Professional
|
Both
|
$388.00
|
|
|
Service Code
|
HCPCS 31500
|
| Hospital Charge Code |
8051020
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$119.08 |
| Max. Negotiated Rate |
$329.80 |
| Rate for Payer: AlohaCare Medicaid |
$136.20
|
| Rate for Payer: AlohaCare Medicare |
$128.79
|
| Rate for Payer: Cash Price |
$252.20
|
| Rate for Payer: Cash Price |
$252.20
|
| Rate for Payer: Devoted Health Medicare |
$141.67
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$128.79
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$119.08
|
| Rate for Payer: Health Management Network Commercial |
$329.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$154.55
|
| Rate for Payer: Kaiser Permanente Medicaid |
$154.55
|
| Rate for Payer: Kaiser Permanente Medicare |
$154.55
|
| Rate for Payer: Ohana Health Plan Medicaid |
$136.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$128.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$136.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$128.79
|
|
|
31500 INTUBATION ENDOTRACHEAL - ER SERV PROCED
|
Professional
|
Both
|
$388.00
|
|
|
Service Code
|
HCPCS 31500
|
| Hospital Charge Code |
8051020
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$119.08 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$136.20
|
| Rate for Payer: AlohaCare Medicare |
$128.79
|
| Rate for Payer: Cash Price |
$252.20
|
| Rate for Payer: Cash Price |
$252.20
|
| Rate for Payer: Cash Price |
$252.20
|
| Rate for Payer: Devoted Health Medicare |
$141.67
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$119.08
|
| Rate for Payer: Health Management Network Commercial |
$329.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$154.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$136.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$128.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
31500 INTUBATION ENDOTRACHEAL - ER SERV PROCED
|
Facility
|
IP
|
$1,160.00
|
|
|
Service Code
|
HCPCS 31500
|
| Hospital Charge Code |
8051020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$986.00 |
| Max. Negotiated Rate |
$1,125.20 |
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Health Management Network Commercial |
$986.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,044.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,125.20
|
|
|
31502-Tracheotomy Tube Change
|
Facility
|
IP
|
$1,316.00
|
|
|
Service Code
|
HCPCS 31502
|
| Hospital Charge Code |
8080234
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,118.60 |
| Max. Negotiated Rate |
$1,276.52 |
| Rate for Payer: Cash Price |
$855.40
|
| Rate for Payer: Health Management Network Commercial |
$1,118.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,184.40
|
| Rate for Payer: MDX Hawaii PPO |
$1,276.52
|
|
|
31502-Tracheotomy Tube Change
|
Facility
|
OP
|
$1,316.00
|
|
|
Service Code
|
HCPCS 31502
|
| Hospital Charge Code |
8080234
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$658.00
|
| Rate for Payer: AlohaCare Medicare |
$658.00
|
| Rate for Payer: Cash Price |
$855.40
|
| Rate for Payer: Cash Price |
$855.40
|
| Rate for Payer: Devoted Health Medicare |
$723.80
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$658.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,250.20
|
| Rate for Payer: Health Management Network Commercial |
$1,118.60
|
| Rate for Payer: Humana Medicare |
$658.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,184.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$658.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,276.52
|
| Rate for Payer: Ohana Health Plan Medicaid |
$658.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$658.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$658.00
|
| Rate for Payer: University Health Alliance Commercial |
$959.23
|
|
|
31502 TRACHEOTOMY TUBE CHANGE - ER SERV PROCED
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 31502
|
| Hospital Charge Code |
8051021
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$30.19 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$34.79
|
| Rate for Payer: AlohaCare Medicare |
$30.19
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Cash Price |
$214.50
|
| Rate for Payer: Devoted Health Medicare |
$33.21
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$55.64
|
| Rate for Payer: Health Management Network Commercial |
$280.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$36.23
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$34.79
|
| Rate for Payer: Ohana Health Plan Medicare |
$30.19
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
31505-Indirect Laryngoscopy
|
Facility
|
OP
|
$1,056.00
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
8080237
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$1,600.00 |
| Rate for Payer: AlohaCare Medicaid |
$528.00
|
| Rate for Payer: AlohaCare Medicare |
$528.00
|
| Rate for Payer: Cash Price |
$686.40
|
| Rate for Payer: Cash Price |
$686.40
|
| Rate for Payer: Devoted Health Medicare |
$580.80
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$528.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,003.20
|
| Rate for Payer: Health Management Network Commercial |
$897.60
|
| Rate for Payer: Humana Medicare |
$528.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$950.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$528.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,024.32
|
| Rate for Payer: Ohana Health Plan Medicaid |
$528.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$528.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$528.00
|
| Rate for Payer: University Health Alliance Commercial |
$769.72
|
|
|
31505-Indirect Laryngoscopy
|
Facility
|
IP
|
$1,056.00
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
8080237
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$897.60 |
| Max. Negotiated Rate |
$1,024.32 |
| Rate for Payer: Cash Price |
$686.40
|
| Rate for Payer: Health Management Network Commercial |
$897.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$950.40
|
| Rate for Payer: MDX Hawaii PPO |
$1,024.32
|
|
|
31505 Laryngoscopy, indirect; diagnostic (separate procedure)
|
Professional
|
Both
|
$253.00
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
8038612
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$46.88 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$52.40
|
| Rate for Payer: AlohaCare Medicare |
$46.88
|
| Rate for Payer: Cash Price |
$164.45
|
| Rate for Payer: Cash Price |
$164.45
|
| Rate for Payer: Cash Price |
$164.45
|
| Rate for Payer: Devoted Health Medicare |
$51.57
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$79.04
|
| 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 |
$50.44
|
| Rate for Payer: Health Management Network Commercial |
$215.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$56.26
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$52.40
|
| Rate for Payer: Ohana Health Plan Medicare |
$46.88
|
| 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 |
$66.97
|
|
|
31511 Laryngoscopy, indirect; with removal of foreign body
|
Professional
|
Both
|
$626.00
|
|
|
Service Code
|
HCPCS 31511
|
| Hospital Charge Code |
8038613
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$71.50 |
| Max. Negotiated Rate |
$532.10 |
| Rate for Payer: AlohaCare Medicaid |
$137.16
|
| Rate for Payer: AlohaCare Medicare |
$117.29
|
| Rate for Payer: Cash Price |
$406.90
|
| Rate for Payer: Cash Price |
$406.90
|
| Rate for Payer: Cash Price |
$406.90
|
| Rate for Payer: Devoted Health Medicare |
$129.02
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$207.29
|
| 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 |
$71.50
|
| Rate for Payer: Health Management Network Commercial |
$532.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$140.75
|
| 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 |
$137.16
|
| Rate for Payer: Ohana Health Plan Medicare |
$117.29
|
| 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 |
$175.50
|
|
|
31512 Laryngoscopy, indirect; with removal of lesion
|
Professional
|
Both
|
$5,189.00
|
|
|
Service Code
|
HCPCS 31512
|
| Hospital Charge Code |
8038614
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$113.33 |
| Max. Negotiated Rate |
$4,410.65 |
| Rate for Payer: AlohaCare Medicaid |
$132.26
|
| Rate for Payer: AlohaCare Medicare |
$113.33
|
| Rate for Payer: Cash Price |
$3,372.85
|
| Rate for Payer: Cash Price |
$3,372.85
|
| Rate for Payer: Cash Price |
$3,372.85
|
| Rate for Payer: Devoted Health Medicare |
$124.66
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$202.59
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$120.38
|
| Rate for Payer: Health Management Network Commercial |
$4,410.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$136.00
|
| 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 |
$132.26
|
| Rate for Payer: Ohana Health Plan Medicare |
$113.33
|
| 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 |
$171.53
|
|
|
31513 Laryngoscopy, indirect; with vocal cord injection
|
Professional
|
Both
|
$544.00
|
|
|
Service Code
|
HCPCS 31513
|
| Hospital Charge Code |
8038615
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$114.34 |
| Max. Negotiated Rate |
$462.40 |
| Rate for Payer: AlohaCare Medicaid |
$133.83
|
| Rate for Payer: AlohaCare Medicare |
$114.34
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Devoted Health Medicare |
$125.77
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$131.04
|
| Rate for Payer: Health Management Network Commercial |
$462.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$137.21
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$133.83
|
| Rate for Payer: Ohana Health Plan Medicare |
$114.34
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
31515 Laryngoscopy direct, with or without tracheoscopy; for aspiration
|
Professional
|
Both
|
$628.00
|
|
|
Service Code
|
HCPCS 31515
|
| Hospital Charge Code |
8038616
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$95.42 |
| Max. Negotiated Rate |
$533.80 |
| Rate for Payer: AlohaCare Medicaid |
$113.36
|
| Rate for Payer: AlohaCare Medicare |
$102.55
|
| Rate for Payer: Cash Price |
$408.20
|
| Rate for Payer: Cash Price |
$408.20
|
| Rate for Payer: Cash Price |
$408.20
|
| Rate for Payer: Devoted Health Medicare |
$112.81
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$175.52
|
| 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 |
$533.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$123.06
|
| 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 |
$113.36
|
| Rate for Payer: Ohana Health Plan Medicare |
$102.55
|
| 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 |
$148.60
|
|
|
31520 Laryngoscopy direct, with or without tracheoscopy; diagnostic, newborn
|
Professional
|
Both
|
$544.00
|
|
|
Service Code
|
HCPCS 31520
|
| Hospital Charge Code |
8038617
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$122.20 |
| Max. Negotiated Rate |
$462.40 |
| Rate for Payer: AlohaCare Medicaid |
$158.86
|
| Rate for Payer: AlohaCare Medicare |
$135.09
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Devoted Health Medicare |
$148.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$122.20
|
| Rate for Payer: Health Management Network Commercial |
$462.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$162.11
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$158.86
|
| Rate for Payer: Ohana Health Plan Medicare |
$135.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
31525-Direct Laryngoscopy Diagnostic
|
Facility
|
OP
|
$4,064.00
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
8080239
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$4,035.20 |
| Rate for Payer: AlohaCare Medicaid |
$2,032.00
|
| Rate for Payer: AlohaCare Medicare |
$2,032.00
|
| Rate for Payer: Cash Price |
$2,641.60
|
| Rate for Payer: Cash Price |
$2,641.60
|
| Rate for Payer: Devoted Health Medicare |
$2,235.20
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2,032.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3,860.80
|
| Rate for Payer: Health Management Network Commercial |
$3,454.40
|
| Rate for Payer: Humana Medicare |
$2,032.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,657.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,032.00
|
| Rate for Payer: MDX Hawaii PPO |
$3,942.08
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,032.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,032.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,032.00
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
31525-Direct Laryngoscopy Diagnostic
|
Facility
|
IP
|
$4,064.00
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
8080239
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,454.40 |
| Max. Negotiated Rate |
$3,942.08 |
| Rate for Payer: Cash Price |
$2,641.60
|
| Rate for Payer: Health Management Network Commercial |
$3,454.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$3,657.60
|
| Rate for Payer: MDX Hawaii PPO |
$3,942.08
|
|
|
31525 Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn
|
Professional
|
Both
|
$2,477.00
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
8038618
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$137.67 |
| Max. Negotiated Rate |
$2,105.45 |
| Rate for Payer: AlohaCare Medicaid |
$162.53
|
| Rate for Payer: AlohaCare Medicare |
$137.67
|
| Rate for Payer: Cash Price |
$1,610.05
|
| Rate for Payer: Cash Price |
$1,610.05
|
| Rate for Payer: Cash Price |
$1,610.05
|
| Rate for Payer: Devoted Health Medicare |
$151.44
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$250.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$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 |
$178.88
|
| Rate for Payer: Health Management Network Commercial |
$2,105.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$165.20
|
| 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 |
$162.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$137.67
|
| 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 |
$201.52
|
|
|
31525 LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN TechFee
|
Facility
|
IP
|
$4,930.00
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
8211216
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,190.50 |
| Max. Negotiated Rate |
$4,782.10 |
| Rate for Payer: Cash Price |
$3,204.50
|
| Rate for Payer: Health Management Network Commercial |
$4,190.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,437.00
|
| Rate for Payer: MDX Hawaii PPO |
$4,782.10
|
|
|
31525 LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN TechFee
|
Facility
|
OP
|
$4,930.00
|
|
|
Service Code
|
HCPCS 31525
|
| Hospital Charge Code |
8211216
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$4,782.10 |
| Rate for Payer: AlohaCare Medicaid |
$2,465.00
|
| Rate for Payer: AlohaCare Medicare |
$2,465.00
|
| Rate for Payer: Cash Price |
$3,204.50
|
| Rate for Payer: Cash Price |
$3,204.50
|
| Rate for Payer: Devoted Health Medicare |
$2,711.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2,465.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4,683.50
|
| Rate for Payer: Health Management Network Commercial |
$4,190.50
|
| Rate for Payer: Humana Medicare |
$2,465.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,437.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,465.00
|
| Rate for Payer: MDX Hawaii PPO |
$4,782.10
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,465.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,465.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,465.00
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
31526 Laryngoscopy direct, w/ or w/o tracheoscopy; diagnostic, w/ operating microscope or telescope
|
Professional
|
Both
|
$2,477.00
|
|
|
Service Code
|
HCPCS 31526
|
| Hospital Charge Code |
8038619
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$135.42 |
| Max. Negotiated Rate |
$2,105.45 |
| Rate for Payer: AlohaCare Medicaid |
$159.20
|
| Rate for Payer: AlohaCare Medicare |
$135.42
|
| Rate for Payer: Cash Price |
$1,610.05
|
| Rate for Payer: Cash Price |
$1,610.05
|
| Rate for Payer: Cash Price |
$1,610.05
|
| Rate for Payer: Devoted Health Medicare |
$148.96
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$158.08
|
| Rate for Payer: Health Management Network Commercial |
$2,105.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$162.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$159.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$135.42
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
31528 Laryngoscopy direct, with or without tracheoscopy; with dilation, initial
|
Professional
|
Both
|
$5,189.00
|
|
|
Service Code
|
HCPCS 31528
|
| Hospital Charge Code |
8038620
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$124.94 |
| Max. Negotiated Rate |
$4,410.65 |
| Rate for Payer: AlohaCare Medicaid |
$146.24
|
| Rate for Payer: AlohaCare Medicare |
$124.94
|
| Rate for Payer: Cash Price |
$3,372.85
|
| Rate for Payer: Cash Price |
$3,372.85
|
| Rate for Payer: Cash Price |
$3,372.85
|
| Rate for Payer: Devoted Health Medicare |
$137.43
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$144.04
|
| Rate for Payer: Health Management Network Commercial |
$4,410.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$149.93
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$146.24
|
| Rate for Payer: Ohana Health Plan Medicare |
$124.94
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
31529 Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent
|
Professional
|
Both
|
$5,189.00
|
|
|
Service Code
|
HCPCS 31529
|
| Hospital Charge Code |
8038621
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$137.82 |
| Max. Negotiated Rate |
$4,410.65 |
| Rate for Payer: AlohaCare Medicaid |
$163.04
|
| Rate for Payer: AlohaCare Medicare |
$137.82
|
| Rate for Payer: Cash Price |
$3,372.85
|
| Rate for Payer: Cash Price |
$3,372.85
|
| Rate for Payer: Cash Price |
$3,372.85
|
| Rate for Payer: Devoted Health Medicare |
$151.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$149.50
|
| Rate for Payer: Health Management Network Commercial |
$4,410.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$165.38
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$163.04
|
| Rate for Payer: Ohana Health Plan Medicare |
$137.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
31530 Laryngoscopy, direct, operative, with foreign body removal;
|
Professional
|
Both
|
$2,477.00
|
|
|
Service Code
|
HCPCS 31530
|
| Hospital Charge Code |
8038622
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$172.11 |
| Max. Negotiated Rate |
$2,105.45 |
| Rate for Payer: AlohaCare Medicaid |
$200.06
|
| Rate for Payer: AlohaCare Medicare |
$172.11
|
| Rate for Payer: Cash Price |
$1,610.05
|
| Rate for Payer: Cash Price |
$1,610.05
|
| Rate for Payer: Cash Price |
$1,610.05
|
| Rate for Payer: Devoted Health Medicare |
$189.32
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$181.39
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$199.94
|
| Rate for Payer: Health Management Network Commercial |
$2,105.45
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$206.53
|
| 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 |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$237.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$265.97
|
| Rate for Payer: Ohana Health Plan Medicaid |
$200.06
|
| Rate for Payer: Ohana Health Plan Medicare |
$172.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
|
|
31530 Laryngoscopy w Fb Removal Tech Fee
|
Facility
|
OP
|
$5,570.00
|
|
|
Service Code
|
HCPCS 31530
|
| Hospital Charge Code |
8343972
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$5,402.90 |
| Rate for Payer: AlohaCare Medicaid |
$2,785.00
|
| Rate for Payer: AlohaCare Medicare |
$2,785.00
|
| Rate for Payer: Cash Price |
$3,620.50
|
| Rate for Payer: Cash Price |
$3,620.50
|
| Rate for Payer: Devoted Health Medicare |
$3,063.50
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$2,785.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$5,291.50
|
| Rate for Payer: Health Management Network Commercial |
$4,734.50
|
| Rate for Payer: Humana Medicare |
$2,785.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$5,013.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,785.00
|
| Rate for Payer: MDX Hawaii PPO |
$5,402.90
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,785.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,785.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,785.00
|
| Rate for Payer: University Health Alliance Commercial |
$5,160.40
|
|
