|
32900 Resection of ribs, extrapleural, all stages
|
Professional
|
Both
|
$3,527.00
|
|
|
Service Code
|
HCPCS 32900
|
| Hospital Charge Code |
8038716
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,997.95 |
| Rate for Payer: AlohaCare Medicaid |
$1,307.22
|
| Rate for Payer: AlohaCare Medicare |
$1,253.71
|
| Rate for Payer: Cash Price |
$2,292.55
|
| Rate for Payer: Cash Price |
$2,292.55
|
| Rate for Payer: Cash Price |
$2,292.55
|
| Rate for Payer: Devoted Health Medicare |
$1,379.08
|
| 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 |
$871.78
|
| Rate for Payer: Health Management Network Commercial |
$2,997.95
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,504.45
|
| 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 |
$1,307.22
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,253.71
|
| 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
|
|
|
32905 Thoracoplasty, Schede type or extrapleural (all stages)
|
Professional
|
Both
|
$3,465.00
|
|
|
Service Code
|
HCPCS 32905
|
| Hospital Charge Code |
8038717
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,945.25 |
| Rate for Payer: AlohaCare Medicaid |
$1,281.95
|
| Rate for Payer: AlohaCare Medicare |
$1,230.69
|
| Rate for Payer: Cash Price |
$2,252.25
|
| Rate for Payer: Cash Price |
$2,252.25
|
| Rate for Payer: Cash Price |
$2,252.25
|
| Rate for Payer: Devoted Health Medicare |
$1,353.76
|
| 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 |
$1,017.64
|
| Rate for Payer: Health Management Network Commercial |
$2,945.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,476.83
|
| 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 |
$1,281.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,230.69
|
| 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
|
|
|
32998 Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s), unilateral
|
Professional
|
Both
|
$9,145.00
|
|
|
Service Code
|
HCPCS 32998
|
| Hospital Charge Code |
8038718
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$7,773.25 |
| Rate for Payer: AlohaCare Medicaid |
$425.41
|
| Rate for Payer: AlohaCare Medicare |
$373.66
|
| Rate for Payer: Cash Price |
$5,944.25
|
| Rate for Payer: Cash Price |
$5,944.25
|
| Rate for Payer: Cash Price |
$5,944.25
|
| Rate for Payer: Devoted Health Medicare |
$411.03
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Commercial |
$518.82
|
| 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 |
$7,773.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$448.39
|
| 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 |
$425.41
|
| Rate for Payer: Ohana Health Plan Medicare |
$373.66
|
| 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 |
$567.51
|
|
|
33016 Pericardiocentesis W/Imaging
|
Professional
|
Both
|
$458.00
|
|
|
Service Code
|
HCPCS 33016
|
| Hospital Charge Code |
8881992
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$221.95
|
| Rate for Payer: AlohaCare Medicare |
$193.96
|
| Rate for Payer: Cash Price |
$297.70
|
| Rate for Payer: Cash Price |
$297.70
|
| Rate for Payer: Cash Price |
$297.70
|
| Rate for Payer: Devoted Health Medicare |
$213.36
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| 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 Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Health Management Network Commercial |
$389.30
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$232.75
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| 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 Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| 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 |
$221.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$193.96
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
|
|
33016 Pericardiocentesis W/Imaging
|
Professional
|
Both
|
$2,191.00
|
|
|
Service Code
|
HCPCS 33016
|
| Hospital Charge Code |
8881992
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$193.96 |
| Max. Negotiated Rate |
$1,862.35 |
| Rate for Payer: AlohaCare Medicaid |
$221.95
|
| Rate for Payer: AlohaCare Medicare |
$193.96
|
| Rate for Payer: Cash Price |
$1,424.15
|
| Rate for Payer: Cash Price |
$1,424.15
|
| Rate for Payer: Devoted Health Medicare |
$213.36
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$193.96
|
| Rate for Payer: Health Management Network Commercial |
$1,862.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$232.75
|
| Rate for Payer: Kaiser Permanente Medicaid |
$232.75
|
| Rate for Payer: Kaiser Permanente Medicare |
$232.75
|
| Rate for Payer: Ohana Health Plan Medicaid |
$221.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$193.96
|
| Rate for Payer: UnitedHealthcare Medicaid |
$221.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$193.96
|
|
|
33016 Pericardiocentesis W/Imaging ED Tech
|
Facility
|
OP
|
$7,342.00
|
|
|
Service Code
|
HCPCS 33016
|
| Hospital Charge Code |
8882006
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$340.18 |
| Max. Negotiated Rate |
$7,121.74 |
| Rate for Payer: AlohaCare Medicaid |
$3,671.00
|
| Rate for Payer: AlohaCare Medicare |
$3,671.00
|
| Rate for Payer: Cash Price |
$4,772.30
|
| Rate for Payer: Cash Price |
$4,772.30
|
| Rate for Payer: Devoted Health Medicare |
$4,038.10
|
| 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 |
$3,671.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6,974.90
|
| Rate for Payer: Health Management Network Commercial |
$6,240.70
|
| Rate for Payer: Humana Medicare |
$3,671.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,607.80
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$3,671.00
|
| Rate for Payer: MDX Hawaii PPO |
$7,121.74
|
| Rate for Payer: Ohana Health Plan Medicaid |
$3,671.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$3,671.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$340.18
|
| Rate for Payer: UnitedHealthcare Medicare |
$3,671.00
|
| Rate for Payer: University Health Alliance Commercial |
$5,351.58
|
|
|
33016 Pericardiocentesis W/Imaging ED Tech
|
Facility
|
IP
|
$7,342.00
|
|
|
Service Code
|
HCPCS 33016
|
| Hospital Charge Code |
8882006
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6,240.70 |
| Max. Negotiated Rate |
$7,121.74 |
| Rate for Payer: Cash Price |
$4,772.30
|
| Rate for Payer: Health Management Network Commercial |
$6,240.70
|
| Rate for Payer: Kaiser Permanente Commercial |
$6,607.80
|
| Rate for Payer: MDX Hawaii PPO |
$7,121.74
|
|
|
33016 Pericardiocentesis W/Imaging Rad ProFee
|
Professional
|
Both
|
$2,191.00
|
|
|
Service Code
|
HCPCS 33016
|
| Hospital Charge Code |
8882002
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$193.96 |
| Max. Negotiated Rate |
$1,862.35 |
| Rate for Payer: AlohaCare Medicaid |
$221.95
|
| Rate for Payer: AlohaCare Medicare |
$193.96
|
| Rate for Payer: Cash Price |
$1,424.15
|
| Rate for Payer: Cash Price |
$1,424.15
|
| Rate for Payer: Devoted Health Medicare |
$213.36
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$193.96
|
| Rate for Payer: Health Management Network Commercial |
$1,862.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$232.75
|
| Rate for Payer: Kaiser Permanente Medicaid |
$232.75
|
| Rate for Payer: Kaiser Permanente Medicare |
$232.75
|
| Rate for Payer: Ohana Health Plan Medicaid |
$221.95
|
| Rate for Payer: Ohana Health Plan Medicare |
$193.96
|
| Rate for Payer: UnitedHealthcare Medicaid |
$221.95
|
| Rate for Payer: UnitedHealthcare Medicare |
$193.96
|
|
|
33017 Prcrd Drg 6Yr+ W/O Cgen Car
|
Professional
|
Both
|
$476.00
|
|
|
Service Code
|
HCPCS 33017
|
| Hospital Charge Code |
8881991
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$234.02
|
| Rate for Payer: AlohaCare Medicare |
$203.46
|
| Rate for Payer: Cash Price |
$309.40
|
| Rate for Payer: Cash Price |
$309.40
|
| Rate for Payer: Cash Price |
$309.40
|
| Rate for Payer: Devoted Health Medicare |
$223.81
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| 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 Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Health Management Network Commercial |
$404.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$244.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| 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 Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| 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 |
$234.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$203.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
|
|
33017 Prcrd Drg 6Yr+ W/O Cgen Car
|
Professional
|
Both
|
$476.00
|
|
|
Service Code
|
HCPCS 33017
|
| Hospital Charge Code |
8881991
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$203.46 |
| Max. Negotiated Rate |
$404.60 |
| Rate for Payer: AlohaCare Medicaid |
$234.02
|
| Rate for Payer: AlohaCare Medicare |
$203.46
|
| Rate for Payer: Cash Price |
$309.40
|
| Rate for Payer: Cash Price |
$309.40
|
| Rate for Payer: Devoted Health Medicare |
$223.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$203.46
|
| Rate for Payer: Health Management Network Commercial |
$404.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$244.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$244.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$244.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$234.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$203.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$234.02
|
| Rate for Payer: UnitedHealthcare Medicare |
$203.46
|
|
|
33017 Prcrd Drg 6Yr+ W/O Cgen Car ED Tech
|
Facility
|
OP
|
$4,910.00
|
|
|
Service Code
|
HCPCS 33017
|
| Hospital Charge Code |
8882005
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$4,762.70 |
| Rate for Payer: AlohaCare Medicaid |
$2,455.00
|
| Rate for Payer: AlohaCare Medicare |
$2,455.00
|
| Rate for Payer: Cash Price |
$3,191.50
|
| Rate for Payer: Cash Price |
$3,191.50
|
| Rate for Payer: Devoted Health Medicare |
$2,700.50
|
| 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 |
$2,455.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4,664.50
|
| Rate for Payer: Health Management Network Commercial |
$4,173.50
|
| Rate for Payer: Humana Medicare |
$2,455.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,419.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,455.00
|
| Rate for Payer: MDX Hawaii PPO |
$4,762.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,455.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,455.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,455.00
|
| Rate for Payer: University Health Alliance Commercial |
$3,578.90
|
|
|
33017 Prcrd Drg 6Yr+ W/O Cgen Car ED Tech
|
Facility
|
IP
|
$4,910.00
|
|
|
Service Code
|
HCPCS 33017
|
| Hospital Charge Code |
8882005
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,173.50 |
| Max. Negotiated Rate |
$4,762.70 |
| Rate for Payer: Cash Price |
$3,191.50
|
| Rate for Payer: Health Management Network Commercial |
$4,173.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,419.00
|
| Rate for Payer: MDX Hawaii PPO |
$4,762.70
|
|
|
33017 Prcrd Drg 6Yr+ W/O Cgen Car Rad ProFee
|
Professional
|
Both
|
$476.00
|
|
|
Service Code
|
HCPCS 33017
|
| Hospital Charge Code |
8882001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$203.46 |
| Max. Negotiated Rate |
$404.60 |
| Rate for Payer: AlohaCare Medicaid |
$234.02
|
| Rate for Payer: AlohaCare Medicare |
$203.46
|
| Rate for Payer: Cash Price |
$309.40
|
| Rate for Payer: Cash Price |
$309.40
|
| Rate for Payer: Devoted Health Medicare |
$223.81
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$203.46
|
| Rate for Payer: Health Management Network Commercial |
$404.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$244.15
|
| Rate for Payer: Kaiser Permanente Medicaid |
$244.15
|
| Rate for Payer: Kaiser Permanente Medicare |
$244.15
|
| Rate for Payer: Ohana Health Plan Medicaid |
$234.02
|
| Rate for Payer: Ohana Health Plan Medicare |
$203.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$234.02
|
| Rate for Payer: UnitedHealthcare Medicare |
$203.46
|
|
|
33018 Prcrd Drg 0-5Yr Or W/Anomly
|
Professional
|
Both
|
$545.00
|
|
|
Service Code
|
HCPCS 33018
|
| Hospital Charge Code |
8881994
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$238.18 |
| Max. Negotiated Rate |
$463.25 |
| Rate for Payer: AlohaCare Medicaid |
$272.90
|
| Rate for Payer: AlohaCare Medicare |
$238.18
|
| Rate for Payer: Cash Price |
$354.25
|
| Rate for Payer: Cash Price |
$354.25
|
| Rate for Payer: Devoted Health Medicare |
$262.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$238.18
|
| Rate for Payer: Health Management Network Commercial |
$463.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$285.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$285.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$285.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$272.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$238.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$272.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$238.18
|
|
|
33018 Prcrd Drg 0-5Yr Or W/Anomly
|
Professional
|
Both
|
$545.00
|
|
|
Service Code
|
HCPCS 33018
|
| Hospital Charge Code |
8881994
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$463.25 |
| Rate for Payer: AlohaCare Medicaid |
$272.90
|
| Rate for Payer: AlohaCare Medicare |
$238.18
|
| Rate for Payer: Cash Price |
$354.25
|
| Rate for Payer: Cash Price |
$354.25
|
| Rate for Payer: Cash Price |
$354.25
|
| Rate for Payer: Devoted Health Medicare |
$262.00
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| 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 Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Health Management Network Commercial |
$463.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$285.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| 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 Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| 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 |
$272.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$238.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
|
|
33018 Prcrd Drg 0-5Yr Or W/Anomly ED Tech
|
Facility
|
OP
|
$4,910.00
|
|
|
Service Code
|
HCPCS 33018
|
| Hospital Charge Code |
8882008
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$4,762.70 |
| Rate for Payer: AlohaCare Medicaid |
$2,455.00
|
| Rate for Payer: AlohaCare Medicare |
$2,455.00
|
| Rate for Payer: Cash Price |
$3,191.50
|
| Rate for Payer: Cash Price |
$3,191.50
|
| Rate for Payer: Devoted Health Medicare |
$2,700.50
|
| 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 |
$2,455.00
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$450.00
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$4,664.50
|
| Rate for Payer: Health Management Network Commercial |
$4,173.50
|
| Rate for Payer: Humana Medicare |
$2,455.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,419.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$937.50
|
| Rate for Payer: Kaiser Permanente Medicare |
$2,455.00
|
| Rate for Payer: MDX Hawaii PPO |
$4,762.70
|
| Rate for Payer: Ohana Health Plan Medicaid |
$2,455.00
|
| Rate for Payer: Ohana Health Plan Medicare |
$2,455.00
|
| Rate for Payer: UnitedHealthcare Medicare |
$2,455.00
|
| Rate for Payer: University Health Alliance Commercial |
$3,578.90
|
|
|
33018 Prcrd Drg 0-5Yr Or W/Anomly ED Tech
|
Facility
|
IP
|
$4,910.00
|
|
|
Service Code
|
HCPCS 33018
|
| Hospital Charge Code |
8882008
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,173.50 |
| Max. Negotiated Rate |
$4,762.70 |
| Rate for Payer: Cash Price |
$3,191.50
|
| Rate for Payer: Health Management Network Commercial |
$4,173.50
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,419.00
|
| Rate for Payer: MDX Hawaii PPO |
$4,762.70
|
|
|
33018 Prcrd Drg 0-5Yr Or W/Anomly Rad ProFee
|
Professional
|
Both
|
$545.00
|
|
|
Service Code
|
HCPCS 33018
|
| Hospital Charge Code |
8882003
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$238.18 |
| Max. Negotiated Rate |
$463.25 |
| Rate for Payer: AlohaCare Medicaid |
$272.90
|
| Rate for Payer: AlohaCare Medicare |
$238.18
|
| Rate for Payer: Cash Price |
$354.25
|
| Rate for Payer: Cash Price |
$354.25
|
| Rate for Payer: Devoted Health Medicare |
$262.00
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$238.18
|
| Rate for Payer: Health Management Network Commercial |
$463.25
|
| Rate for Payer: Kaiser Permanente Commercial |
$285.82
|
| Rate for Payer: Kaiser Permanente Medicaid |
$285.82
|
| Rate for Payer: Kaiser Permanente Medicare |
$285.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$272.90
|
| Rate for Payer: Ohana Health Plan Medicare |
$238.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$272.90
|
| Rate for Payer: UnitedHealthcare Medicare |
$238.18
|
|
|
33019 Perq Prcrd Drg Insj Cath Ct
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 33019
|
| Hospital Charge Code |
8881993
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$175.30 |
| Max. Negotiated Rate |
$434.26 |
| Rate for Payer: AlohaCare Medicaid |
$203.77
|
| Rate for Payer: AlohaCare Medicare |
$175.30
|
| Rate for Payer: Cash Price |
$190.45
|
| Rate for Payer: Cash Price |
$190.45
|
| Rate for Payer: Cash Price |
$190.45
|
| Rate for Payer: Devoted Health Medicare |
$192.83
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$246.64
|
| 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 Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$265.97
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$303.73
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$339.46
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Health Management Network Commercial |
$249.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$303.73
|
| Rate for Payer: Kaiser Permanente Commercial |
$210.36
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| 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 Medicaid |
$434.26
|
| Rate for Payer: Kaiser Permanente Medicare |
$209.49
|
| Rate for Payer: Kaiser Permanente Medicare |
$181.39
|
| 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 |
$203.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$175.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
|
|
33019 Perq Prcrd Drg Insj Cath Ct
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 33019
|
| Hospital Charge Code |
8881993
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$175.30 |
| Max. Negotiated Rate |
$249.05 |
| Rate for Payer: AlohaCare Medicaid |
$203.77
|
| Rate for Payer: AlohaCare Medicare |
$175.30
|
| Rate for Payer: Cash Price |
$190.45
|
| Rate for Payer: Cash Price |
$190.45
|
| Rate for Payer: Devoted Health Medicare |
$192.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$175.30
|
| Rate for Payer: Health Management Network Commercial |
$249.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$210.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$210.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$210.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$203.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$175.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$203.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$175.30
|
|
|
33019 Perq Prcrd Drg Insj Cath Ct ED Tech
|
Professional
|
Both
|
$4,676.00
|
|
|
Service Code
|
HCPCS 33019
|
| Hospital Charge Code |
8882007
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$175.30 |
| Max. Negotiated Rate |
$3,974.60 |
| Rate for Payer: AlohaCare Medicaid |
$203.77
|
| Rate for Payer: AlohaCare Medicare |
$175.30
|
| Rate for Payer: Cash Price |
$3,039.40
|
| Rate for Payer: Cash Price |
$3,039.40
|
| Rate for Payer: Devoted Health Medicare |
$192.83
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$175.30
|
| Rate for Payer: Health Management Network Commercial |
$3,974.60
|
| Rate for Payer: Kaiser Permanente Commercial |
$210.36
|
| Rate for Payer: Kaiser Permanente Medicaid |
$210.36
|
| Rate for Payer: Kaiser Permanente Medicare |
$210.36
|
| Rate for Payer: Ohana Health Plan Medicaid |
$203.77
|
| Rate for Payer: Ohana Health Plan Medicare |
$175.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$203.77
|
| Rate for Payer: UnitedHealthcare Medicare |
$175.30
|
|
|
33025 Creation of pericardial window or partial resection for drainage
|
Professional
|
Both
|
$2,144.00
|
|
|
Service Code
|
HCPCS 33025
|
| Hospital Charge Code |
8038721
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$1,822.40 |
| Rate for Payer: AlohaCare Medicaid |
$744.91
|
| Rate for Payer: AlohaCare Medicare |
$723.41
|
| Rate for Payer: Cash Price |
$1,393.60
|
| Rate for Payer: Cash Price |
$1,393.60
|
| Rate for Payer: Cash Price |
$1,393.60
|
| Rate for Payer: Devoted Health Medicare |
$795.75
|
| 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 |
$982.80
|
| Rate for Payer: Health Management Network Commercial |
$1,822.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$868.09
|
| 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 |
$744.91
|
| Rate for Payer: Ohana Health Plan Medicare |
$723.41
|
| 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
|
|
|
33050 Resection of pericardial cyst or tumor
|
Professional
|
Both
|
$2,713.00
|
|
|
Service Code
|
HCPCS 33050
|
| Hospital Charge Code |
8038722
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$2,306.05 |
| Rate for Payer: AlohaCare Medicaid |
$976.27
|
| Rate for Payer: AlohaCare Medicare |
$948.64
|
| Rate for Payer: Cash Price |
$1,763.45
|
| Rate for Payer: Cash Price |
$1,763.45
|
| Rate for Payer: Cash Price |
$1,763.45
|
| Rate for Payer: Devoted Health Medicare |
$1,043.50
|
| 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 |
$716.56
|
| Rate for Payer: Health Management Network Commercial |
$2,306.05
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,138.37
|
| 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 |
$976.27
|
| Rate for Payer: Ohana Health Plan Medicare |
$948.64
|
| 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
|
|
|
33120 Excision of intracardiac tumor, resection with cardiopulmonary bypass
|
Professional
|
Both
|
$4,399.00
|
|
|
Service Code
|
HCPCS 33120
|
| Hospital Charge Code |
8038723
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,739.15 |
| Rate for Payer: AlohaCare Medicaid |
$1,979.51
|
| Rate for Payer: AlohaCare Medicare |
$1,875.22
|
| Rate for Payer: Cash Price |
$2,859.35
|
| Rate for Payer: Cash Price |
$2,859.35
|
| Rate for Payer: Cash Price |
$2,859.35
|
| Rate for Payer: Devoted Health Medicare |
$2,062.74
|
| 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 |
$1,593.28
|
| Rate for Payer: Health Management Network Commercial |
$3,739.15
|
| Rate for Payer: Kaiser Permanente Commercial |
$339.46
|
| Rate for Payer: Kaiser Permanente Commercial |
$2,250.26
|
| 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 |
$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 |
$1,979.51
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,875.22
|
| 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
|
|
|
33140 Transmyocardial laser revascularization, by thoracotomy; (separate procedure)
|
Professional
|
Both
|
$3,944.00
|
|
|
Service Code
|
HCPCS 33140
|
| Hospital Charge Code |
8038724
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$181.39 |
| Max. Negotiated Rate |
$3,352.40 |
| Rate for Payer: AlohaCare Medicaid |
$1,476.65
|
| Rate for Payer: AlohaCare Medicare |
$1,425.53
|
| Rate for Payer: Cash Price |
$2,563.60
|
| Rate for Payer: Cash Price |
$2,563.60
|
| Rate for Payer: Cash Price |
$2,563.60
|
| Rate for Payer: Devoted Health Medicare |
$1,568.08
|
| Rate for Payer: Hawaii Medical Service Association ABD |
$434.26
|
| 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 |
$246.64
|
| 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 Medicare |
$237.64
|
| Rate for Payer: Hawaii Medical Service Association Non-ABD |
$434.26
|
| Rate for Payer: Health Management Network Commercial |
$3,352.40
|
| Rate for Payer: Kaiser Permanente Commercial |
$237.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,710.64
|
| Rate for Payer: Kaiser Permanente Commercial |
$181.39
|
| Rate for Payer: Kaiser Permanente Commercial |
$209.49
|
| 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 Commercial |
$339.46
|
| 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 |
$265.97
|
| Rate for Payer: Kaiser Permanente Medicare |
$303.73
|
| Rate for Payer: Kaiser Permanente Medicare |
$339.46
|
| Rate for Payer: Kaiser Permanente Medicare |
$246.64
|
| Rate for Payer: Ohana Health Plan Medicaid |
$1,476.65
|
| Rate for Payer: Ohana Health Plan Medicare |
$1,425.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$434.26
|
| Rate for Payer: UnitedHealthcare Medicare |
$265.97
|
| Rate for Payer: UnitedHealthcare Medicare |
$339.46
|
| Rate for Payer: UnitedHealthcare Medicare |
$181.39
|
| Rate for Payer: UnitedHealthcare Medicare |
$209.49
|
| Rate for Payer: UnitedHealthcare Medicare |
$237.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$246.64
|
| Rate for Payer: UnitedHealthcare Medicare |
$303.73
|
|
