|
32488 Removal of lung, completion pneumonectomy
|
Professional
|
Both
|
$5,908.00
|
|
|
Service Code
|
HCPCS 32488
|
| Hospital Charge Code |
8038692
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$5,021.80 |
| Rate for Payer: AlohaCare Medicaid |
$2,275.53
|
| Rate for Payer: AlohaCare Medicare |
$2,157.14
|
| Rate for Payer: Cash Price |
$3,840.20
|
| Rate for Payer: Cash Price |
$3,840.20
|
| Rate for Payer: Cash Price |
$3,840.20
|
| Rate for Payer: Devoted Health Medicare |
$2,372.85
|
| 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 |
$1,309.62
|
| Rate for Payer: Health Management Network Commercial |
$5,021.80
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,588.57
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$2,275.53
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,157.14
|
| 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
|
|
|
32540 Extrapleural enucleation of empyema (empyemectomy)
|
Professional
|
Both
|
$4,385.00
|
|
|
Service Code
|
HCPCS 32540
|
| Hospital Charge Code |
8038695
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,727.25 |
| Rate for Payer: AlohaCare Medicaid |
$1,655.95
|
| Rate for Payer: AlohaCare Medicare |
$1,583.19
|
| Rate for Payer: Cash Price |
$2,850.25
|
| Rate for Payer: Cash Price |
$2,850.25
|
| Rate for Payer: Cash Price |
$2,850.25
|
| Rate for Payer: Devoted Health Medicare |
$1,741.51
|
| 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 |
$813.80
|
| Rate for Payer: Health Management Network Commercial |
$3,727.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,899.83
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$246.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$265.97
|
| Rate for Payer: Kaiser Permanente Commercial |
$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 |
$1,655.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,583.19
|
| 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
|
|
|
32550 Insertion of indwelling tunneled pleural catheter with cuff
|
Professional
|
Both
|
$4,983.00
|
|
|
Service Code
|
HCPCS 32550
|
| Hospital Charge Code |
8038696
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$179.23 |
| Max. Negotiated Rate |
$4,235.55 |
| Rate for Payer: AlohaCare Medicaid |
$199.47
|
| Rate for Payer: AlohaCare Medicare |
$179.23
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Cash Price |
$3,238.95
|
| Rate for Payer: Devoted Health Medicare |
$197.15
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$315.23
|
| 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 |
$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 Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Health Management Network Commercial |
$4,235.55
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$215.08
|
| 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 |
$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 |
$199.47
|
| Rate for Payer: Ohana Health Plan Medicare |
$179.23
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: University Health Alliance Commercial |
$247.60
|
|
|
32550-Insertion Tunneled Pleural Cath
|
Facility
|
OP
|
$14,669.00
|
|
|
Service Code
|
HCPCS 32550
|
| Hospital Charge Code |
8080185
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$14,228.93 |
| Rate for Payer: AlohaCare Medicaid |
$7,334.50
|
| Rate for Payer: AlohaCare Medicare |
$7,334.50
|
| Rate for Payer: Cash Price |
$9,534.85
|
| Rate for Payer: Cash Price |
$9,534.85
|
| Rate for Payer: Devoted Health Medicare |
$8,067.95
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$7,334.50
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$13,935.55
|
| Rate for Payer: Health Management Network Commercial |
$12,468.65
|
| Rate for Payer: Humana Medicare |
$7,334.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$13,202.10
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$7,334.50
|
| Rate for Payer: MDX Hawaii PPO |
$14,228.93
|
| Rate for Payer: Ohana Health Plan Medicaid |
$7,334.50
|
| Rate for Payer: Ohana Health Plan Medicare |
$7,334.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$456.03
|
| Rate for Payer: UnitedHealthcare Medicare |
$7,334.50
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
32550-Insertion Tunneled Pleural Cath
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
HCPCS 32550
|
| Hospital Charge Code |
8080185
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$12,468.65 |
| Max. Negotiated Rate |
$14,228.93 |
| Rate for Payer: Cash Price |
$9,534.85
|
| Rate for Payer: Health Management Network Commercial |
$12,468.65
|
| Rate for Payer: Kaiser Permanente Commercial |
$13,202.10
|
| Rate for Payer: MDX Hawaii PPO |
$14,228.93
|
|
|
32551-Insertion Chest Tube
|
Facility
|
IP
|
$2,672.00
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
8080171
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,271.20 |
| Max. Negotiated Rate |
$2,591.84 |
| Rate for Payer: Cash Price |
$1,736.80
|
| Rate for Payer: Health Management Network Commercial |
$2,271.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,404.80
|
| Rate for Payer: MDX Hawaii PPO |
$2,591.84
|
|
|
32551-Insertion Chest Tube
|
Facility
|
OP
|
$2,672.00
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
8080171
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$2,591.84 |
| Rate for Payer: AlohaCare Medicaid |
$1,336.00
|
| Rate for Payer: AlohaCare Medicare |
$1,336.00
|
| Rate for Payer: Cash Price |
$1,736.80
|
| Rate for Payer: Cash Price |
$1,736.80
|
| Rate for Payer: Devoted Health Medicare |
$1,469.60
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$469.00
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$1,600.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,336.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,538.40
|
| Rate for Payer: Health Management Network Commercial |
$2,271.20
|
| Rate for Payer: Humana Medicare |
$1,336.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,404.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,336.00
|
| Rate for Payer: MDX Hawaii PPO |
$2,591.84
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,336.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,336.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,336.00
|
| Rate for Payer: University Health Alliance Commercial |
$1,947.62
|
|
|
32551 INSERTION OF CHEST TUBE BILAT CHARGE
|
Facility
|
OP
|
$2,632.00
|
|
|
Service Code
|
HCPCS 32551 50
|
| Hospital Charge Code |
8408895
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$2,553.04 |
| Rate for Payer: AlohaCare Medicaid |
$1,316.00
|
| Rate for Payer: AlohaCare Medicare |
$1,316.00
|
| Rate for Payer: Cash Price |
$1,710.80
|
| Rate for Payer: Cash Price |
$1,710.80
|
| Rate for Payer: Devoted Health Medicare |
$1,447.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,316.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,500.40
|
| Rate for Payer: Health Management Network Commercial |
$2,237.20
|
| Rate for Payer: Humana Medicare |
$1,316.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,368.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,342.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,316.00
|
| Rate for Payer: MDX Hawaii PPO |
$2,553.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,316.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,316.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,316.00
|
| Rate for Payer: University Health Alliance Commercial |
$1,473.92
|
|
|
32551 INSERTION OF CHEST TUBE BILAT CHARGE
|
Facility
|
IP
|
$2,632.00
|
|
|
Service Code
|
HCPCS 32551 50
|
| Hospital Charge Code |
8408895
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,237.20 |
| Max. Negotiated Rate |
$2,553.04 |
| Rate for Payer: Cash Price |
$1,710.80
|
| Rate for Payer: Health Management Network Commercial |
$2,237.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,368.80
|
| Rate for Payer: MDX Hawaii PPO |
$2,553.04
|
|
|
32551 INSERTION OF CHEST TUBE LT CHARGE
|
Facility
|
OP
|
$2,632.00
|
|
|
Service Code
|
HCPCS 32551 LT
|
| Hospital Charge Code |
8408902
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$2,553.04 |
| Rate for Payer: AlohaCare Medicaid |
$1,316.00
|
| Rate for Payer: AlohaCare Medicare |
$1,316.00
|
| Rate for Payer: Cash Price |
$1,710.80
|
| Rate for Payer: Cash Price |
$1,710.80
|
| Rate for Payer: Devoted Health Medicare |
$1,447.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,316.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,500.40
|
| Rate for Payer: Health Management Network Commercial |
$2,237.20
|
| Rate for Payer: Humana Medicare |
$1,316.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,368.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,342.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,316.00
|
| Rate for Payer: MDX Hawaii PPO |
$2,553.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,316.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,316.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,316.00
|
| Rate for Payer: University Health Alliance Commercial |
$1,473.92
|
|
|
32551 INSERTION OF CHEST TUBE LT CHARGE
|
Facility
|
IP
|
$2,632.00
|
|
|
Service Code
|
HCPCS 32551 LT
|
| Hospital Charge Code |
8408902
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,237.20 |
| Max. Negotiated Rate |
$2,553.04 |
| Rate for Payer: Cash Price |
$1,710.80
|
| Rate for Payer: Health Management Network Commercial |
$2,237.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,368.80
|
| Rate for Payer: MDX Hawaii PPO |
$2,553.04
|
|
|
32551 INSERTION OF CHEST TUBE RT CHARGE
|
Facility
|
OP
|
$2,632.00
|
|
|
Service Code
|
HCPCS 32551 RT
|
| Hospital Charge Code |
8408916
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$2,553.04 |
| Rate for Payer: AlohaCare Medicaid |
$1,316.00
|
| Rate for Payer: AlohaCare Medicare |
$1,316.00
|
| Rate for Payer: Cash Price |
$1,710.80
|
| Rate for Payer: Cash Price |
$1,710.80
|
| Rate for Payer: Devoted Health Medicare |
$1,447.60
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$1,316.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,500.40
|
| Rate for Payer: Health Management Network Commercial |
$2,237.20
|
| Rate for Payer: Humana Medicare |
$1,316.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,368.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,342.32
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,316.00
|
| Rate for Payer: MDX Hawaii PPO |
$2,553.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,316.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,316.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,316.00
|
| Rate for Payer: University Health Alliance Commercial |
$1,473.92
|
|
|
32551 INSERTION OF CHEST TUBE RT CHARGE
|
Facility
|
IP
|
$2,632.00
|
|
|
Service Code
|
HCPCS 32551 RT
|
| Hospital Charge Code |
8408916
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,237.20 |
| Max. Negotiated Rate |
$2,553.04 |
| Rate for Payer: Cash Price |
$1,710.80
|
| Rate for Payer: Health Management Network Commercial |
$2,237.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,368.80
|
| Rate for Payer: MDX Hawaii PPO |
$2,553.04
|
|
|
32551 TUBE THORACOSTOMY ER SERV PROCEDURE
|
Professional
|
Both
|
$2,191.00
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
8051025
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$138.75 |
| Max. Negotiated Rate |
$1,862.35 |
| Rate for Payer: AlohaCare Medicaid |
$150.10
|
| Rate for Payer: AlohaCare Medicare |
$138.75
|
| Rate for Payer: Cash Price |
$1,424.15
|
| Rate for Payer: Cash Price |
$1,424.15
|
| Rate for Payer: Cash Price |
$1,424.15
|
| Rate for Payer: Devoted Health Medicare |
$152.62
|
| 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 |
$160.16
|
| Rate for Payer: Health Management Network Commercial |
$1,862.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$166.50
|
| 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 |
$150.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$138.75
|
| 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
|
|
|
32551 TUBE THORACOSTOMY, INCLUDES CONNECTION TO DRAINAGE SYSTEM (EG, WATER SEAL), WHEN PERFO ProFee
|
Professional
|
Both
|
$2,191.00
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
8018681
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$138.75 |
| Max. Negotiated Rate |
$1,862.35 |
| Rate for Payer: AlohaCare Medicaid |
$150.10
|
| Rate for Payer: AlohaCare Medicare |
$138.75
|
| Rate for Payer: Cash Price |
$1,424.15
|
| Rate for Payer: Cash Price |
$1,424.15
|
| Rate for Payer: Devoted Health Medicare |
$152.62
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$138.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$160.16
|
| Rate for Payer: Health Management Network Commercial |
$1,862.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$166.50
|
| Rate for Payer: Kaiser Permanente Medicaid |
$166.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$166.50
|
| Rate for Payer: Ohana Health Plan Medicaid |
$150.10
|
| Rate for Payer: Ohana Health Plan Medicare |
$138.75
|
| Rate for Payer: UnitedHealthcare Medicaid |
$150.10
|
| Rate for Payer: UnitedHealthcare Medicare |
$138.75
|
|
|
32551 TUBE THORACOSTOMY INCLUDES WATER SEAL TechFee
|
Facility
|
OP
|
$3,190.00
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
8211298
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$3,094.30 |
| Rate for Payer: AlohaCare Medicaid |
$1,595.00
|
| Rate for Payer: AlohaCare Medicare |
$1,595.00
|
| Rate for Payer: Cash Price |
$2,073.50
|
| Rate for Payer: Cash Price |
$2,073.50
|
| Rate for Payer: Devoted Health Medicare |
$1,754.50
|
| 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 |
$1,595.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$3,030.50
|
| Rate for Payer: Health Management Network Commercial |
$2,711.50
|
| Rate for Payer: Humana Medicare |
$1,595.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,871.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$1,595.00
|
| Rate for Payer: MDX Hawaii PPO |
$3,094.30
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,595.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,595.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$1,595.00
|
| Rate for Payer: University Health Alliance Commercial |
$2,325.19
|
|
|
32551 TUBE THORACOSTOMY INCLUDES WATER SEAL TechFee
|
Facility
|
IP
|
$3,190.00
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
8211298
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,711.50 |
| Max. Negotiated Rate |
$3,094.30 |
| Rate for Payer: Cash Price |
$2,073.50
|
| Rate for Payer: Health Management Network Commercial |
$2,711.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,871.00
|
| Rate for Payer: MDX Hawaii PPO |
$3,094.30
|
|
|
32552 Removal of indwelling tunneled pleural catheter with cuff
|
Professional
|
Both
|
$873.00
|
|
|
Service Code
|
HCPCS 32552
|
| Hospital Charge Code |
8038698
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$149.85 |
| Max. Negotiated Rate |
$742.05 |
| Rate for Payer: AlohaCare Medicaid |
$158.44
|
| Rate for Payer: AlohaCare Medicare |
$149.85
|
| Rate for Payer: Cash Price |
$567.45
|
| Rate for Payer: Cash Price |
$567.45
|
| Rate for Payer: Cash Price |
$567.45
|
| Rate for Payer: Devoted Health Medicare |
$164.84
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$248.15
|
| 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 |
$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 Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Health Management Network Commercial |
$742.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$179.82
|
| 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 |
$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 |
$158.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$149.85
|
| 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 |
$196.25
|
|
|
32554 Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance
|
Professional
|
Both
|
$873.00
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
8038699
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$77.99 |
| Max. Negotiated Rate |
$742.05 |
| Rate for Payer: AlohaCare Medicaid |
$86.69
|
| Rate for Payer: AlohaCare Medicare |
$77.99
|
| Rate for Payer: Cash Price |
$567.45
|
| Rate for Payer: Cash Price |
$567.45
|
| Rate for Payer: Devoted Health Medicare |
$85.79
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$86.69
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$135.41
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$77.99
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$86.69
|
| Rate for Payer: Health Management Network Commercial |
$742.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$93.59
|
| Rate for Payer: Kaiser Permanente Medicaid |
$93.59
|
| Rate for Payer: Kaiser Permanente Medicare |
$93.59
|
| Rate for Payer: Ohana Health Plan Medicaid |
$86.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$77.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$86.69
|
| Rate for Payer: UnitedHealthcare Medicare |
$77.99
|
| Rate for Payer: University Health Alliance Commercial |
$116.87
|
|
|
32554 Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance
|
Professional
|
Both
|
$873.00
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
8038699
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$77.99 |
| Max. Negotiated Rate |
$742.05 |
| Rate for Payer: AlohaCare Medicaid |
$86.69
|
| Rate for Payer: AlohaCare Medicare |
$77.99
|
| Rate for Payer: Cash Price |
$567.45
|
| Rate for Payer: Cash Price |
$567.45
|
| Rate for Payer: Cash Price |
$567.45
|
| Rate for Payer: Devoted Health Medicare |
$85.79
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$135.41
|
| 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 |
$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 Medicare |
$209.49
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Health Management Network Commercial |
$742.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$93.59
|
| 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 |
$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 |
$86.69
|
| Rate for Payer: Ohana Health Plan Medicare |
$77.99
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: University Health Alliance Commercial |
$116.87
|
|
|
32554 Thoracentesis w/o Imaging
|
Facility
|
IP
|
$1,652.00
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
11464803
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,404.20 |
| Max. Negotiated Rate |
$1,602.44 |
| Rate for Payer: Cash Price |
$1,073.80
|
| Rate for Payer: Health Management Network Commercial |
$1,404.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,486.80
|
| Rate for Payer: MDX Hawaii PPO |
$1,602.44
|
|
|
32554 Thoracentesis w/o Imaging
|
Facility
|
OP
|
$1,652.00
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
11464803
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$4,035.20 |
| Rate for Payer: AlohaCare Medicaid |
$826.00
|
| Rate for Payer: AlohaCare Medicare |
$826.00
|
| Rate for Payer: Cash Price |
$1,073.80
|
| Rate for Payer: Cash Price |
$1,073.80
|
| Rate for Payer: Devoted Health Medicare |
$908.60
|
| 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 |
$826.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,569.40
|
| Rate for Payer: Health Management Network Commercial |
$1,404.20
|
| Rate for Payer: Humana Medicare |
$826.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,486.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$826.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,602.44
|
| Rate for Payer: Ohana Health Plan Medicaid |
$826.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$826.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$826.00
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
32554-Thoracentesis w/o Imaging Guidance
|
Facility
|
IP
|
$1,832.00
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
8080187
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,557.20 |
| Max. Negotiated Rate |
$1,777.04 |
| Rate for Payer: Cash Price |
$1,190.80
|
| Rate for Payer: Health Management Network Commercial |
$1,557.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,648.80
|
| Rate for Payer: MDX Hawaii PPO |
$1,777.04
|
|
|
32554-Thoracentesis w/o Imaging Guidance
|
Facility
|
OP
|
$1,832.00
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
8080187
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$4,035.20 |
| Rate for Payer: AlohaCare Medicaid |
$916.00
|
| Rate for Payer: AlohaCare Medicare |
$916.00
|
| Rate for Payer: Cash Price |
$1,190.80
|
| Rate for Payer: Cash Price |
$1,190.80
|
| Rate for Payer: Devoted Health Medicare |
$1,007.60
|
| 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 |
$916.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,740.40
|
| Rate for Payer: Health Management Network Commercial |
$1,557.20
|
| Rate for Payer: Humana Medicare |
$916.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,648.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$916.00
|
| Rate for Payer: MDX Hawaii PPO |
$1,777.04
|
| Rate for Payer: Ohana Health Plan Medicaid |
$916.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$916.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$916.00
|
| Rate for Payer: University Health Alliance Commercial |
$4,035.20
|
|
|
32554 THORACENTESIS w/o IMAGING LT CHARGE
|
Facility
|
IP
|
$1,402.00
|
|
|
Service Code
|
HCPCS 32554 LT
|
| Hospital Charge Code |
8408927
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,191.70 |
| Max. Negotiated Rate |
$1,359.94 |
| Rate for Payer: Cash Price |
$911.30
|
| Rate for Payer: Health Management Network Commercial |
$1,191.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,261.80
|
| Rate for Payer: MDX Hawaii PPO |
$1,359.94
|
|
