Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

HC ADRENAL NUCLEAR IMAGING - NM ADRENAL

Facility

$6,494.00

Service Code	HCPCS 78075
Hospital Charge Code	3417807501
Hospital Revenue Code	341
Min. Negotiated Rate	$178.75
Max. Negotiated Rate	$6,299.18
Rate for Payer: AlohaCare Medicaid	$1,529.43
Rate for Payer: AlohaCare Medicare	$1,529.43
Rate for Payer: Cash Price	$3,896.40
Rate for Payer: Cash Price	$3,896.40
Rate for Payer: Devoted Health Medicare	$1,682.37
Rate for Payer: Hawaii Medical Service Association ABD	$178.75
Rate for Payer: Hawaii Medical Service Association Commercial	$1,911.79
Rate for Payer: Hawaii Medical Service Association Medicare	$1,529.43
Rate for Payer: Hawaii Medical Service Association Non-ABD	$194.22
Rate for Payer: Hawaii Western Management Group Commercial	$1,529.43
Rate for Payer: Health Management Network Commercial	$5,519.90
Rate for Payer: Humana Medicare	$1,529.43
Rate for Payer: Kaiser Permanente Commercial	$4,091.22
Rate for Payer: Kaiser Permanente Medicaid	$3,311.94
Rate for Payer: Kaiser Permanente Medicare	$1,529.43
Rate for Payer: MDX Hawaii PPO	$6,299.18
Rate for Payer: Ohana Health Plan Medicaid	$1,682.37
Rate for Payer: Ohana Health Plan Medicare	$1,529.43
Rate for Payer: UnitedHealthcare Medicaid	$178.75
Rate for Payer: UnitedHealthcare Medicare	$1,529.43
Rate for Payer: University Health Alliance Commercial	$755.21

HC ADRENAL NUCLEAR IMAGING - NM ADRENAL

Facility

$6,494.00

Service Code	HCPCS 78075
Hospital Charge Code	3417807501
Hospital Revenue Code	341
Min. Negotiated Rate	$5,519.90
Max. Negotiated Rate	$6,299.18
Rate for Payer: Cash Price	$3,896.40
Rate for Payer: Health Management Network Commercial	$5,519.90
Rate for Payer: MDX Hawaii PPO	$6,299.18

HC AFB ID MALDI TOF SO

Facility

$65.00

Service Code	HCPCS 87158
Hospital Charge Code	3068715801
Hospital Revenue Code	306
Min. Negotiated Rate	$4.39
Max. Negotiated Rate	$63.05
Rate for Payer: AlohaCare Medicaid	$7.74
Rate for Payer: AlohaCare Medicare	$7.74
Rate for Payer: Cash Price	$39.00
Rate for Payer: Cash Price	$39.00
Rate for Payer: Devoted Health Medicare	$8.51
Rate for Payer: Hawaii Medical Service Association ABD	$4.39
Rate for Payer: Hawaii Medical Service Association Commercial	$9.68
Rate for Payer: Hawaii Medical Service Association Medicare	$7.74
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.23
Rate for Payer: Hawaii Western Management Group Commercial	$7.74
Rate for Payer: Health Management Network Commercial	$55.25
Rate for Payer: Humana Medicare	$7.74
Rate for Payer: Kaiser Permanente Commercial	$40.95
Rate for Payer: Kaiser Permanente Medicaid	$33.15
Rate for Payer: Kaiser Permanente Medicare	$7.74
Rate for Payer: MDX Hawaii PPO	$63.05
Rate for Payer: Ohana Health Plan Medicaid	$8.51
Rate for Payer: Ohana Health Plan Medicare	$7.74
Rate for Payer: UnitedHealthcare Medicaid	$4.39
Rate for Payer: UnitedHealthcare Medicare	$7.74
Rate for Payer: University Health Alliance Commercial	$13.52

HC AFB ID MALDI TOF SO

Facility

$65.00

Service Code	HCPCS 87158
Hospital Charge Code	3068715801
Hospital Revenue Code	306
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$63.05
Rate for Payer: Cash Price	$39.00
Rate for Payer: Health Management Network Commercial	$55.25
Rate for Payer: MDX Hawaii PPO	$63.05

HC AFB SUSC MACRO BROTH SO

Facility

$56.00

Service Code	HCPCS 87188
Hospital Charge Code	3068718801
Hospital Revenue Code	306
Min. Negotiated Rate	$5.56
Max. Negotiated Rate	$54.32
Rate for Payer: AlohaCare Medicaid	$6.64
Rate for Payer: AlohaCare Medicare	$6.64
Rate for Payer: Cash Price	$33.60
Rate for Payer: Cash Price	$33.60
Rate for Payer: Devoted Health Medicare	$7.30
Rate for Payer: Hawaii Medical Service Association ABD	$5.56
Rate for Payer: Hawaii Medical Service Association Commercial	$8.30
Rate for Payer: Hawaii Medical Service Association Medicare	$6.64
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9.17
Rate for Payer: Hawaii Western Management Group Commercial	$6.64
Rate for Payer: Health Management Network Commercial	$47.60
Rate for Payer: Humana Medicare	$6.64
Rate for Payer: Kaiser Permanente Commercial	$35.28
Rate for Payer: Kaiser Permanente Medicaid	$28.56
Rate for Payer: Kaiser Permanente Medicare	$6.64
Rate for Payer: MDX Hawaii PPO	$54.32
Rate for Payer: Ohana Health Plan Medicaid	$7.30
Rate for Payer: Ohana Health Plan Medicare	$6.64
Rate for Payer: UnitedHealthcare Medicaid	$5.56
Rate for Payer: UnitedHealthcare Medicare	$6.64
Rate for Payer: University Health Alliance Commercial	$17.15

HC AFB SUSC MACRO BROTH SO

Facility

$56.00

Service Code	HCPCS 87188
Hospital Charge Code	3068718801
Hospital Revenue Code	306
Min. Negotiated Rate	$47.60
Max. Negotiated Rate	$54.32
Rate for Payer: Cash Price	$33.60
Rate for Payer: Health Management Network Commercial	$47.60
Rate for Payer: MDX Hawaii PPO	$54.32

HC AGENT NOS ASSAY W/OPTIC - CAMPY ANTIGEN DIRECT

Facility

$135.00

Service Code	HCPCS 87899
Hospital Charge Code	3068789901
Hospital Revenue Code	306
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$130.95
Rate for Payer: AlohaCare Medicaid	$16.07
Rate for Payer: AlohaCare Medicare	$16.07
Rate for Payer: Cash Price	$81.00
Rate for Payer: Cash Price	$81.00
Rate for Payer: Devoted Health Medicare	$17.68
Rate for Payer: Hawaii Medical Service Association ABD	$16.58
Rate for Payer: Hawaii Medical Service Association Commercial	$20.09
Rate for Payer: Hawaii Medical Service Association Medicare	$16.07
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17.41
Rate for Payer: Hawaii Western Management Group Commercial	$16.07
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: Humana Medicare	$16.07
Rate for Payer: Kaiser Permanente Commercial	$85.05
Rate for Payer: Kaiser Permanente Medicaid	$68.85
Rate for Payer: Kaiser Permanente Medicare	$16.07
Rate for Payer: MDX Hawaii PPO	$130.95
Rate for Payer: Ohana Health Plan Medicaid	$17.68
Rate for Payer: Ohana Health Plan Medicare	$16.07
Rate for Payer: UnitedHealthcare Medicaid	$16.58
Rate for Payer: UnitedHealthcare Medicare	$16.07
Rate for Payer: University Health Alliance Commercial	$31.01

HC AGENT NOS ASSAY W/OPTIC - CAMPY ANTIGEN DIRECT

Facility

$135.00

Service Code	HCPCS 87899
Hospital Charge Code	3068789901
Hospital Revenue Code	306
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$130.95
Rate for Payer: Cash Price	$81.00
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: MDX Hawaii PPO	$130.95

HC AGENT NOS ASSAY W/OPTIC - SHIGA TOXIN 1

Facility

$135.00

Service Code	HCPCS 87899
Hospital Charge Code	3068789902
Hospital Revenue Code	306
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$130.95
Rate for Payer: AlohaCare Medicaid	$16.07
Rate for Payer: AlohaCare Medicare	$16.07
Rate for Payer: Cash Price	$81.00
Rate for Payer: Cash Price	$81.00
Rate for Payer: Devoted Health Medicare	$17.68
Rate for Payer: Hawaii Medical Service Association ABD	$16.58
Rate for Payer: Hawaii Medical Service Association Commercial	$20.09
Rate for Payer: Hawaii Medical Service Association Medicare	$16.07
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17.41
Rate for Payer: Hawaii Western Management Group Commercial	$16.07
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: Humana Medicare	$16.07
Rate for Payer: Kaiser Permanente Commercial	$85.05
Rate for Payer: Kaiser Permanente Medicaid	$68.85
Rate for Payer: Kaiser Permanente Medicare	$16.07
Rate for Payer: MDX Hawaii PPO	$130.95
Rate for Payer: Ohana Health Plan Medicaid	$17.68
Rate for Payer: Ohana Health Plan Medicare	$16.07
Rate for Payer: UnitedHealthcare Medicaid	$16.58
Rate for Payer: UnitedHealthcare Medicare	$16.07
Rate for Payer: University Health Alliance Commercial	$31.01

HC AGENT NOS ASSAY W/OPTIC - SHIGA TOXIN 1

Facility

$135.00

Service Code	HCPCS 87899
Hospital Charge Code	3068789902
Hospital Revenue Code	306
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$130.95
Rate for Payer: Cash Price	$81.00
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: MDX Hawaii PPO	$130.95

HC AGENT NOS ASSAY W/OPTIC - SHIGA TOXIN 2

Facility

$135.00

Service Code	HCPCS 87899
Hospital Charge Code	3068789903
Hospital Revenue Code	306
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$130.95
Rate for Payer: AlohaCare Medicaid	$16.07
Rate for Payer: AlohaCare Medicare	$16.07
Rate for Payer: Cash Price	$81.00
Rate for Payer: Cash Price	$81.00
Rate for Payer: Devoted Health Medicare	$17.68
Rate for Payer: Hawaii Medical Service Association ABD	$16.58
Rate for Payer: Hawaii Medical Service Association Commercial	$20.09
Rate for Payer: Hawaii Medical Service Association Medicare	$16.07
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17.41
Rate for Payer: Hawaii Western Management Group Commercial	$16.07
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: Humana Medicare	$16.07
Rate for Payer: Kaiser Permanente Commercial	$85.05
Rate for Payer: Kaiser Permanente Medicaid	$68.85
Rate for Payer: Kaiser Permanente Medicare	$16.07
Rate for Payer: MDX Hawaii PPO	$130.95
Rate for Payer: Ohana Health Plan Medicaid	$17.68
Rate for Payer: Ohana Health Plan Medicare	$16.07
Rate for Payer: UnitedHealthcare Medicaid	$16.58
Rate for Payer: UnitedHealthcare Medicare	$16.07
Rate for Payer: University Health Alliance Commercial	$31.01

HC AGENT NOS ASSAY W/OPTIC - SHIGA TOXIN 2

Facility

$135.00

Service Code	HCPCS 87899
Hospital Charge Code	3068789903
Hospital Revenue Code	306
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$130.95
Rate for Payer: Cash Price	$81.00
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: MDX Hawaii PPO	$130.95

HC AGENT NOS ASSAY W/OPTIC - STREP PNEUMO AG

Facility

$135.00

Service Code	HCPCS 87899
Hospital Charge Code	3068789904
Hospital Revenue Code	306
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$130.95
Rate for Payer: AlohaCare Medicaid	$16.07
Rate for Payer: AlohaCare Medicare	$16.07
Rate for Payer: Cash Price	$81.00
Rate for Payer: Cash Price	$81.00
Rate for Payer: Devoted Health Medicare	$17.68
Rate for Payer: Hawaii Medical Service Association ABD	$16.58
Rate for Payer: Hawaii Medical Service Association Commercial	$20.09
Rate for Payer: Hawaii Medical Service Association Medicare	$16.07
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17.41
Rate for Payer: Hawaii Western Management Group Commercial	$16.07
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: Humana Medicare	$16.07
Rate for Payer: Kaiser Permanente Commercial	$85.05
Rate for Payer: Kaiser Permanente Medicaid	$68.85
Rate for Payer: Kaiser Permanente Medicare	$16.07
Rate for Payer: MDX Hawaii PPO	$130.95
Rate for Payer: Ohana Health Plan Medicaid	$17.68
Rate for Payer: Ohana Health Plan Medicare	$16.07
Rate for Payer: UnitedHealthcare Medicaid	$16.58
Rate for Payer: UnitedHealthcare Medicare	$16.07
Rate for Payer: University Health Alliance Commercial	$31.01

HC AGENT NOS ASSAY W/OPTIC - STREP PNEUMO AG

Facility

$135.00

Service Code	HCPCS 87899
Hospital Charge Code	3068789904
Hospital Revenue Code	306
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$130.95
Rate for Payer: Cash Price	$81.00
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: MDX Hawaii PPO	$130.95

HC AIR/CONTRAST INJECT INTO ABDOMEN

Facility

$1,221.00

Service Code	HCPCS 49400
Hospital Charge Code	3614940001
Hospital Revenue Code	361
Min. Negotiated Rate	$80.29
Max. Negotiated Rate	$2,837.00
Rate for Payer: Cash Price	$732.60
Rate for Payer: Cash Price	$732.60
Rate for Payer: Cash Price	$732.60
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,536.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$496.75
Rate for Payer: Health Management Network Commercial	$1,037.85
Rate for Payer: Kaiser Permanente Commercial	$769.23
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: MDX Hawaii PPO	$1,184.37
Rate for Payer: UnitedHealthcare Medicaid	$80.29
Rate for Payer: University Health Alliance Commercial	$889.99

HC AIR/CONTRAST INJECT INTO ABDOMEN

Facility

$1,221.00

Service Code	HCPCS 49400
Hospital Charge Code	3614940001
Hospital Revenue Code	361
Min. Negotiated Rate	$1,037.85
Max. Negotiated Rate	$1,184.37
Rate for Payer: Cash Price	$732.60
Rate for Payer: Health Management Network Commercial	$1,037.85
Rate for Payer: MDX Hawaii PPO	$1,184.37

HC ALKALOIDS NOT OTHERWISE SPECIFIED - MITRAGYNINE SO

Facility

$960.00

Service Code	HCPCS 80323
Hospital Charge Code	3018032301
Hospital Revenue Code	301
Min. Negotiated Rate	$816.00
Max. Negotiated Rate	$931.20
Rate for Payer: Cash Price	$576.00
Rate for Payer: Health Management Network Commercial	$816.00
Rate for Payer: MDX Hawaii PPO	$931.20

HC ALKALOIDS NOT OTHERWISE SPECIFIED - MITRAGYNINE SO

Facility

$960.00

Service Code	HCPCS 80323
Hospital Charge Code	3018032301
Hospital Revenue Code	301
Min. Negotiated Rate	$19.85
Max. Negotiated Rate	$931.20
Rate for Payer: Cash Price	$576.00
Rate for Payer: Cash Price	$576.00
Rate for Payer: Hawaii Medical Service Association ABD	$19.85
Rate for Payer: Hawaii Medical Service Association Non-ABD	$32.71
Rate for Payer: Hawaii Western Management Group Commercial	$912.00
Rate for Payer: Health Management Network Commercial	$816.00
Rate for Payer: Kaiser Permanente Commercial	$604.80
Rate for Payer: Kaiser Permanente Medicaid	$489.60
Rate for Payer: MDX Hawaii PPO	$931.20
Rate for Payer: University Health Alliance Commercial	$699.74

HC ALLERGEN SPEC IGE - ALLERGEN IGE QUANT

Facility

$44.00

Service Code	HCPCS 86003
Hospital Charge Code	3028600302
Hospital Revenue Code	302
Min. Negotiated Rate	$37.40
Max. Negotiated Rate	$42.68
Rate for Payer: Cash Price	$26.40
Rate for Payer: Health Management Network Commercial	$37.40
Rate for Payer: MDX Hawaii PPO	$42.68

HC ALLERGEN SPEC IGE - ALLERGEN IGE QUANT

Facility

$44.00

Service Code	HCPCS 86003
Hospital Charge Code	3028600302
Hospital Revenue Code	302
Min. Negotiated Rate	$5.22
Max. Negotiated Rate	$42.68
Rate for Payer: AlohaCare Medicaid	$5.22
Rate for Payer: AlohaCare Medicare	$5.22
Rate for Payer: Cash Price	$26.40
Rate for Payer: Cash Price	$26.40
Rate for Payer: Devoted Health Medicare	$5.74
Rate for Payer: Hawaii Medical Service Association ABD	$7.22
Rate for Payer: Hawaii Medical Service Association Commercial	$6.53
Rate for Payer: Hawaii Medical Service Association Medicare	$5.22
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.58
Rate for Payer: Hawaii Western Management Group Commercial	$5.22
Rate for Payer: Health Management Network Commercial	$37.40
Rate for Payer: Humana Medicare	$5.22
Rate for Payer: Kaiser Permanente Commercial	$27.72
Rate for Payer: Kaiser Permanente Medicaid	$22.44
Rate for Payer: Kaiser Permanente Medicare	$5.22
Rate for Payer: MDX Hawaii PPO	$42.68
Rate for Payer: Ohana Health Plan Medicaid	$5.74
Rate for Payer: Ohana Health Plan Medicare	$5.22
Rate for Payer: UnitedHealthcare Medicaid	$7.22
Rate for Payer: UnitedHealthcare Medicare	$5.22
Rate for Payer: University Health Alliance Commercial	$13.51

HC ALLERGEN SPEC IGE - EC ALLERGEN PNL HI FOOD SO

Facility

$44.00

Service Code	HCPCS 86003
Hospital Charge Code	3028600301
Hospital Revenue Code	302
Min. Negotiated Rate	$5.22
Max. Negotiated Rate	$42.68
Rate for Payer: AlohaCare Medicaid	$5.22
Rate for Payer: AlohaCare Medicare	$5.22
Rate for Payer: Cash Price	$26.40
Rate for Payer: Cash Price	$26.40
Rate for Payer: Devoted Health Medicare	$5.74
Rate for Payer: Hawaii Medical Service Association ABD	$7.22
Rate for Payer: Hawaii Medical Service Association Commercial	$6.53
Rate for Payer: Hawaii Medical Service Association Medicare	$5.22
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.58
Rate for Payer: Hawaii Western Management Group Commercial	$5.22
Rate for Payer: Health Management Network Commercial	$37.40
Rate for Payer: Humana Medicare	$5.22
Rate for Payer: Kaiser Permanente Commercial	$27.72
Rate for Payer: Kaiser Permanente Medicaid	$22.44
Rate for Payer: Kaiser Permanente Medicare	$5.22
Rate for Payer: MDX Hawaii PPO	$42.68
Rate for Payer: Ohana Health Plan Medicaid	$5.74
Rate for Payer: Ohana Health Plan Medicare	$5.22
Rate for Payer: UnitedHealthcare Medicaid	$7.22
Rate for Payer: UnitedHealthcare Medicare	$5.22
Rate for Payer: University Health Alliance Commercial	$13.51

HC ALLERGEN SPEC IGE - EC ALLERGEN PNL HI FOOD SO

Facility

$44.00

Service Code	HCPCS 86003
Hospital Charge Code	3028600301
Hospital Revenue Code	302
Min. Negotiated Rate	$37.40
Max. Negotiated Rate	$42.68
Rate for Payer: Cash Price	$26.40
Rate for Payer: Health Management Network Commercial	$37.40
Rate for Payer: MDX Hawaii PPO	$42.68

HC ALPHA-1-ANTITRYPSIN, TOTAL - ALPHA-1-ANTITRYPSIN

Facility

$113.00

Service Code	HCPCS 82103
Hospital Charge Code	3018210301
Hospital Revenue Code	301
Min. Negotiated Rate	$96.05
Max. Negotiated Rate	$109.61
Rate for Payer: Cash Price	$67.80
Rate for Payer: Health Management Network Commercial	$96.05
Rate for Payer: MDX Hawaii PPO	$109.61

HC ALPHA-1-ANTITRYPSIN, TOTAL - ALPHA-1-ANTITRYPSIN

Facility

$113.00

Service Code	HCPCS 82103
Hospital Charge Code	3018210301
Hospital Revenue Code	301
Min. Negotiated Rate	$13.44
Max. Negotiated Rate	$109.61
Rate for Payer: AlohaCare Medicaid	$13.44
Rate for Payer: AlohaCare Medicare	$13.44
Rate for Payer: Cash Price	$67.80
Rate for Payer: Cash Price	$67.80
Rate for Payer: Devoted Health Medicare	$14.78
Rate for Payer: Hawaii Medical Service Association ABD	$18.56
Rate for Payer: Hawaii Medical Service Association Commercial	$16.80
Rate for Payer: Hawaii Medical Service Association Medicare	$13.44
Rate for Payer: Hawaii Medical Service Association Non-ABD	$19.49
Rate for Payer: Hawaii Western Management Group Commercial	$13.44
Rate for Payer: Health Management Network Commercial	$96.05
Rate for Payer: Humana Medicare	$13.44
Rate for Payer: Kaiser Permanente Commercial	$71.19
Rate for Payer: Kaiser Permanente Medicaid	$57.63
Rate for Payer: Kaiser Permanente Medicare	$13.44
Rate for Payer: MDX Hawaii PPO	$109.61
Rate for Payer: Ohana Health Plan Medicaid	$14.78
Rate for Payer: Ohana Health Plan Medicare	$13.44
Rate for Payer: UnitedHealthcare Medicaid	$18.56
Rate for Payer: UnitedHealthcare Medicare	$13.44
Rate for Payer: University Health Alliance Commercial	$34.72

HC ALPHA-FETOPROTEIN, SERUM

Facility

$141.00

Service Code	HCPCS 82105
Hospital Charge Code	3018210501
Hospital Revenue Code	301
Min. Negotiated Rate	$16.77
Max. Negotiated Rate	$136.77
Rate for Payer: AlohaCare Medicaid	$16.77
Rate for Payer: AlohaCare Medicare	$16.77
Rate for Payer: Cash Price	$84.60
Rate for Payer: Cash Price	$84.60
Rate for Payer: Devoted Health Medicare	$18.45
Rate for Payer: Hawaii Medical Service Association ABD	$23.18
Rate for Payer: Hawaii Medical Service Association Commercial	$20.96
Rate for Payer: Hawaii Medical Service Association Medicare	$16.77
Rate for Payer: Hawaii Medical Service Association Non-ABD	$24.34
Rate for Payer: Hawaii Western Management Group Commercial	$16.77
Rate for Payer: Health Management Network Commercial	$119.85
Rate for Payer: Humana Medicare	$16.77
Rate for Payer: Kaiser Permanente Commercial	$88.83
Rate for Payer: Kaiser Permanente Medicaid	$71.91
Rate for Payer: Kaiser Permanente Medicare	$16.77
Rate for Payer: MDX Hawaii PPO	$136.77
Rate for Payer: Ohana Health Plan Medicaid	$18.45
Rate for Payer: Ohana Health Plan Medicare	$16.77
Rate for Payer: UnitedHealthcare Medicaid	$23.18
Rate for Payer: UnitedHealthcare Medicare	$16.77
Rate for Payer: University Health Alliance Commercial	$43.36

Know your out-of-pocket cost for care.

All Charges