Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

HC ASSAY OF APOLIPOPROTEIN - LIPOPROTEIN A (LPA)

Facility

$177.00

Service Code	HCPCS 82172
Hospital Charge Code	3018217201
Hospital Revenue Code	301
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$171.69
Rate for Payer: AlohaCare Medicaid	$21.09
Rate for Payer: AlohaCare Medicare	$21.09
Rate for Payer: Cash Price	$106.20
Rate for Payer: Cash Price	$106.20
Rate for Payer: Devoted Health Medicare	$23.20
Rate for Payer: Hawaii Medical Service Association ABD	$21.41
Rate for Payer: Hawaii Medical Service Association Commercial	$26.36
Rate for Payer: Hawaii Medical Service Association Medicare	$21.09
Rate for Payer: Hawaii Medical Service Association Non-ABD	$22.48
Rate for Payer: Hawaii Western Management Group Commercial	$21.09
Rate for Payer: Health Management Network Commercial	$150.45
Rate for Payer: Humana Medicare	$21.09
Rate for Payer: Kaiser Permanente Commercial	$111.51
Rate for Payer: Kaiser Permanente Medicaid	$90.27
Rate for Payer: Kaiser Permanente Medicare	$21.09
Rate for Payer: MDX Hawaii PPO	$171.69
Rate for Payer: Ohana Health Plan Medicaid	$23.20
Rate for Payer: Ohana Health Plan Medicare	$21.09
Rate for Payer: UnitedHealthcare Medicaid	$21.41
Rate for Payer: UnitedHealthcare Medicare	$21.09
Rate for Payer: University Health Alliance Commercial	$40.05

HC ASSAY OF APOLIPOPROTEIN - LIPOPROTEIN A (LPA)

Facility

$177.00

Service Code	HCPCS 82172
Hospital Charge Code	3018217201
Hospital Revenue Code	301
Min. Negotiated Rate	$150.45
Max. Negotiated Rate	$171.69
Rate for Payer: Cash Price	$106.20
Rate for Payer: Health Management Network Commercial	$150.45
Rate for Payer: MDX Hawaii PPO	$171.69

HC ASSAY OF ARSENIC - ARSENIC BLOOD SO

Facility

$159.00

Service Code	HCPCS 82175
Hospital Charge Code	3018217501
Hospital Revenue Code	301
Min. Negotiated Rate	$18.97
Max. Negotiated Rate	$154.23
Rate for Payer: AlohaCare Medicaid	$18.97
Rate for Payer: AlohaCare Medicare	$18.97
Rate for Payer: Cash Price	$95.40
Rate for Payer: Cash Price	$95.40
Rate for Payer: Devoted Health Medicare	$20.87
Rate for Payer: Hawaii Medical Service Association ABD	$26.22
Rate for Payer: Hawaii Medical Service Association Commercial	$23.71
Rate for Payer: Hawaii Medical Service Association Medicare	$18.97
Rate for Payer: Hawaii Medical Service Association Non-ABD	$27.53
Rate for Payer: Hawaii Western Management Group Commercial	$18.97
Rate for Payer: Health Management Network Commercial	$135.15
Rate for Payer: Humana Medicare	$18.97
Rate for Payer: Kaiser Permanente Commercial	$100.17
Rate for Payer: Kaiser Permanente Medicaid	$81.09
Rate for Payer: Kaiser Permanente Medicare	$18.97
Rate for Payer: MDX Hawaii PPO	$154.23
Rate for Payer: Ohana Health Plan Medicaid	$20.87
Rate for Payer: Ohana Health Plan Medicare	$18.97
Rate for Payer: UnitedHealthcare Medicaid	$26.22
Rate for Payer: UnitedHealthcare Medicare	$18.97
Rate for Payer: University Health Alliance Commercial	$49.04

HC ASSAY OF ARSENIC - ARSENIC BLOOD SO

Facility

$159.00

Service Code	HCPCS 82175
Hospital Charge Code	3018217501
Hospital Revenue Code	301
Min. Negotiated Rate	$135.15
Max. Negotiated Rate	$154.23
Rate for Payer: Cash Price	$95.40
Rate for Payer: Health Management Network Commercial	$135.15
Rate for Payer: MDX Hawaii PPO	$154.23

HC ASSAY OF BLOOD CHLORIDE - CHLORIDE

Facility

$39.00

Service Code	HCPCS 82435
Hospital Charge Code	3018243501
Hospital Revenue Code	301
Min. Negotiated Rate	$4.60
Max. Negotiated Rate	$37.83
Rate for Payer: AlohaCare Medicaid	$4.60
Rate for Payer: AlohaCare Medicare	$4.60
Rate for Payer: Cash Price	$23.40
Rate for Payer: Cash Price	$23.40
Rate for Payer: Devoted Health Medicare	$5.06
Rate for Payer: Hawaii Medical Service Association ABD	$6.35
Rate for Payer: Hawaii Medical Service Association Commercial	$5.75
Rate for Payer: Hawaii Medical Service Association Medicare	$4.60
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6.67
Rate for Payer: Hawaii Western Management Group Commercial	$4.60
Rate for Payer: Health Management Network Commercial	$33.15
Rate for Payer: Humana Medicare	$4.60
Rate for Payer: Kaiser Permanente Commercial	$24.57
Rate for Payer: Kaiser Permanente Medicaid	$19.89
Rate for Payer: Kaiser Permanente Medicare	$4.60
Rate for Payer: MDX Hawaii PPO	$37.83
Rate for Payer: Ohana Health Plan Medicaid	$5.06
Rate for Payer: Ohana Health Plan Medicare	$4.60
Rate for Payer: UnitedHealthcare Medicaid	$6.35
Rate for Payer: UnitedHealthcare Medicare	$4.60
Rate for Payer: University Health Alliance Commercial	$11.88

HC ASSAY OF BLOOD CHLORIDE - CHLORIDE

Facility

$39.00

Service Code	HCPCS 82435
Hospital Charge Code	3018243501
Hospital Revenue Code	301
Min. Negotiated Rate	$33.15
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$23.40
Rate for Payer: Health Management Network Commercial	$33.15
Rate for Payer: MDX Hawaii PPO	$37.83

HC ASSAY OF BLOOD LIPOPROTEIN,LDL CHOLEST - LDL CHOLESTEROL DIRECT

Facility

$88.00

Service Code	HCPCS 83721
Hospital Charge Code	3018372101
Hospital Revenue Code	301
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$85.36
Rate for Payer: AlohaCare Medicaid	$10.50
Rate for Payer: AlohaCare Medicare	$10.50
Rate for Payer: Cash Price	$52.80
Rate for Payer: Cash Price	$52.80
Rate for Payer: Devoted Health Medicare	$11.55
Rate for Payer: Hawaii Medical Service Association ABD	$13.18
Rate for Payer: Hawaii Medical Service Association Commercial	$13.12
Rate for Payer: Hawaii Medical Service Association Medicare	$10.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$13.84
Rate for Payer: Hawaii Western Management Group Commercial	$10.50
Rate for Payer: Health Management Network Commercial	$74.80
Rate for Payer: Humana Medicare	$10.50
Rate for Payer: Kaiser Permanente Commercial	$55.44
Rate for Payer: Kaiser Permanente Medicaid	$44.88
Rate for Payer: Kaiser Permanente Medicare	$10.50
Rate for Payer: MDX Hawaii PPO	$85.36
Rate for Payer: Ohana Health Plan Medicaid	$11.55
Rate for Payer: Ohana Health Plan Medicare	$10.50
Rate for Payer: UnitedHealthcare Medicaid	$13.18
Rate for Payer: UnitedHealthcare Medicare	$10.50
Rate for Payer: University Health Alliance Commercial	$24.66

HC ASSAY OF BLOOD LIPOPROTEIN,LDL CHOLEST - LDL CHOLESTEROL DIRECT

Facility

$88.00

Service Code	HCPCS 83721
Hospital Charge Code	3018372101
Hospital Revenue Code	301
Min. Negotiated Rate	$74.80
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$52.80
Rate for Payer: Health Management Network Commercial	$74.80
Rate for Payer: MDX Hawaii PPO	$85.36

HC ASSAY OF BLOOD OSMOLALITY - OSMOLALITY

Facility

$55.00

Service Code	HCPCS 83930
Hospital Charge Code	3018393001
Hospital Revenue Code	301
Min. Negotiated Rate	$6.61
Max. Negotiated Rate	$53.35
Rate for Payer: AlohaCare Medicaid	$6.61
Rate for Payer: AlohaCare Medicare	$6.61
Rate for Payer: Cash Price	$33.00
Rate for Payer: Cash Price	$33.00
Rate for Payer: Devoted Health Medicare	$7.27
Rate for Payer: Hawaii Medical Service Association ABD	$9.13
Rate for Payer: Hawaii Medical Service Association Commercial	$8.26
Rate for Payer: Hawaii Medical Service Association Medicare	$6.61
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9.59
Rate for Payer: Hawaii Western Management Group Commercial	$6.61
Rate for Payer: Health Management Network Commercial	$46.75
Rate for Payer: Humana Medicare	$6.61
Rate for Payer: Kaiser Permanente Commercial	$34.65
Rate for Payer: Kaiser Permanente Medicaid	$28.05
Rate for Payer: Kaiser Permanente Medicare	$6.61
Rate for Payer: MDX Hawaii PPO	$53.35
Rate for Payer: Ohana Health Plan Medicaid	$7.27
Rate for Payer: Ohana Health Plan Medicare	$6.61
Rate for Payer: UnitedHealthcare Medicaid	$9.13
Rate for Payer: UnitedHealthcare Medicare	$6.61
Rate for Payer: University Health Alliance Commercial	$17.09

HC ASSAY OF BLOOD OSMOLALITY - OSMOLALITY

Facility

$55.00

Service Code	HCPCS 83930
Hospital Charge Code	3018393001
Hospital Revenue Code	301
Min. Negotiated Rate	$46.75
Max. Negotiated Rate	$53.35
Rate for Payer: Cash Price	$33.00
Rate for Payer: Health Management Network Commercial	$46.75
Rate for Payer: MDX Hawaii PPO	$53.35

HC ASSAY OF CALCITONIN - CALCITONIN

Facility

$225.00

Service Code	HCPCS 82308
Hospital Charge Code	3018230801
Hospital Revenue Code	301
Min. Negotiated Rate	$26.79
Max. Negotiated Rate	$218.25
Rate for Payer: AlohaCare Medicaid	$26.79
Rate for Payer: AlohaCare Medicare	$26.79
Rate for Payer: Cash Price	$135.00
Rate for Payer: Cash Price	$135.00
Rate for Payer: Devoted Health Medicare	$29.47
Rate for Payer: Hawaii Medical Service Association ABD	$37.01
Rate for Payer: Hawaii Medical Service Association Commercial	$33.49
Rate for Payer: Hawaii Medical Service Association Medicare	$26.79
Rate for Payer: Hawaii Medical Service Association Non-ABD	$38.86
Rate for Payer: Hawaii Western Management Group Commercial	$26.79
Rate for Payer: Health Management Network Commercial	$191.25
Rate for Payer: Humana Medicare	$26.79
Rate for Payer: Kaiser Permanente Commercial	$141.75
Rate for Payer: Kaiser Permanente Medicaid	$114.75
Rate for Payer: Kaiser Permanente Medicare	$26.79
Rate for Payer: MDX Hawaii PPO	$218.25
Rate for Payer: Ohana Health Plan Medicaid	$29.47
Rate for Payer: Ohana Health Plan Medicare	$26.79
Rate for Payer: UnitedHealthcare Medicaid	$37.01
Rate for Payer: UnitedHealthcare Medicare	$26.79
Rate for Payer: University Health Alliance Commercial	$69.21

HC ASSAY OF CALCITONIN - CALCITONIN

Facility

$225.00

Service Code	HCPCS 82308
Hospital Charge Code	3018230801
Hospital Revenue Code	301
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$218.25
Rate for Payer: Cash Price	$135.00
Rate for Payer: Health Management Network Commercial	$191.25
Rate for Payer: MDX Hawaii PPO	$218.25

HC ASSAY OF CALCIUM IN URINE - CALCIUM TIMED URINE

Facility

$51.00

Service Code	HCPCS 82340
Hospital Charge Code	3018234002
Hospital Revenue Code	301
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$49.47
Rate for Payer: AlohaCare Medicaid	$6.03
Rate for Payer: AlohaCare Medicare	$6.03
Rate for Payer: Cash Price	$30.60
Rate for Payer: Cash Price	$30.60
Rate for Payer: Devoted Health Medicare	$6.63
Rate for Payer: Hawaii Medical Service Association ABD	$8.34
Rate for Payer: Hawaii Medical Service Association Commercial	$7.54
Rate for Payer: Hawaii Medical Service Association Medicare	$6.03
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8.76
Rate for Payer: Hawaii Western Management Group Commercial	$6.03
Rate for Payer: Health Management Network Commercial	$43.35
Rate for Payer: Humana Medicare	$6.03
Rate for Payer: Kaiser Permanente Commercial	$32.13
Rate for Payer: Kaiser Permanente Medicaid	$26.01
Rate for Payer: Kaiser Permanente Medicare	$6.03
Rate for Payer: MDX Hawaii PPO	$49.47
Rate for Payer: Ohana Health Plan Medicaid	$6.63
Rate for Payer: Ohana Health Plan Medicare	$6.03
Rate for Payer: UnitedHealthcare Medicaid	$8.34
Rate for Payer: UnitedHealthcare Medicare	$6.03
Rate for Payer: University Health Alliance Commercial	$15.60

HC ASSAY OF CALCIUM IN URINE - CALCIUM TIMED URINE

Facility

$51.00

Service Code	HCPCS 82340
Hospital Charge Code	3018234002
Hospital Revenue Code	301
Min. Negotiated Rate	$43.35
Max. Negotiated Rate	$49.47
Rate for Payer: Cash Price	$30.60
Rate for Payer: Health Management Network Commercial	$43.35
Rate for Payer: MDX Hawaii PPO	$49.47

HC ASSAY OF CALCIUM, IONIZED - CALCIUM IONIZED

Facility

$115.00

Service Code	HCPCS 82330
Hospital Charge Code	3018233002
Hospital Revenue Code	301
Min. Negotiated Rate	$97.75
Max. Negotiated Rate	$111.55
Rate for Payer: Cash Price	$69.00
Rate for Payer: Health Management Network Commercial	$97.75
Rate for Payer: MDX Hawaii PPO	$111.55

HC ASSAY OF CALCIUM, IONIZED - CALCIUM IONIZED

Facility

$115.00

Service Code	HCPCS 82330
Hospital Charge Code	3018233002
Hospital Revenue Code	301
Min. Negotiated Rate	$13.68
Max. Negotiated Rate	$111.55
Rate for Payer: AlohaCare Medicaid	$13.68
Rate for Payer: AlohaCare Medicare	$13.68
Rate for Payer: Cash Price	$69.00
Rate for Payer: Cash Price	$69.00
Rate for Payer: Devoted Health Medicare	$15.05
Rate for Payer: Hawaii Medical Service Association ABD	$18.88
Rate for Payer: Hawaii Medical Service Association Commercial	$17.10
Rate for Payer: Hawaii Medical Service Association Medicare	$13.68
Rate for Payer: Hawaii Medical Service Association Non-ABD	$19.82
Rate for Payer: Hawaii Western Management Group Commercial	$13.68
Rate for Payer: Health Management Network Commercial	$97.75
Rate for Payer: Humana Medicare	$13.68
Rate for Payer: Kaiser Permanente Commercial	$72.45
Rate for Payer: Kaiser Permanente Medicaid	$58.65
Rate for Payer: Kaiser Permanente Medicare	$13.68
Rate for Payer: MDX Hawaii PPO	$111.55
Rate for Payer: Ohana Health Plan Medicaid	$15.05
Rate for Payer: Ohana Health Plan Medicare	$13.68
Rate for Payer: UnitedHealthcare Medicaid	$18.88
Rate for Payer: UnitedHealthcare Medicare	$13.68
Rate for Payer: University Health Alliance Commercial	$35.32

HC ASSAY OF CALCIUM, TOTAL - CALCIUM

Facility

$43.00

Service Code	HCPCS 82310
Hospital Charge Code	3018231001
Hospital Revenue Code	301
Min. Negotiated Rate	$36.55
Max. Negotiated Rate	$41.71
Rate for Payer: Cash Price	$25.80
Rate for Payer: Health Management Network Commercial	$36.55
Rate for Payer: MDX Hawaii PPO	$41.71

HC ASSAY OF CALCIUM, TOTAL - CALCIUM

Facility

$43.00

Service Code	HCPCS 82310
Hospital Charge Code	3018231001
Hospital Revenue Code	301
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$41.71
Rate for Payer: AlohaCare Medicaid	$5.16
Rate for Payer: AlohaCare Medicare	$5.16
Rate for Payer: Cash Price	$25.80
Rate for Payer: Cash Price	$25.80
Rate for Payer: Devoted Health Medicare	$5.68
Rate for Payer: Hawaii Medical Service Association ABD	$7.12
Rate for Payer: Hawaii Medical Service Association Commercial	$6.45
Rate for Payer: Hawaii Medical Service Association Medicare	$5.16
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.48
Rate for Payer: Hawaii Western Management Group Commercial	$5.16
Rate for Payer: Health Management Network Commercial	$36.55
Rate for Payer: Humana Medicare	$5.16
Rate for Payer: Kaiser Permanente Commercial	$27.09
Rate for Payer: Kaiser Permanente Medicaid	$21.93
Rate for Payer: Kaiser Permanente Medicare	$5.16
Rate for Payer: MDX Hawaii PPO	$41.71
Rate for Payer: Ohana Health Plan Medicaid	$5.68
Rate for Payer: Ohana Health Plan Medicare	$5.16
Rate for Payer: UnitedHealthcare Medicaid	$7.12
Rate for Payer: UnitedHealthcare Medicare	$5.16
Rate for Payer: University Health Alliance Commercial	$13.32

HC ASSAY OF CARBAMAZEPINE TOTAL - CARBAMAZEPINE TOTAL

Facility

$122.00

Service Code	HCPCS 80156
Hospital Charge Code	3018015601
Hospital Revenue Code	301
Min. Negotiated Rate	$14.57
Max. Negotiated Rate	$118.34
Rate for Payer: AlohaCare Medicaid	$14.57
Rate for Payer: AlohaCare Medicare	$14.57
Rate for Payer: Cash Price	$73.20
Rate for Payer: Cash Price	$73.20
Rate for Payer: Devoted Health Medicare	$16.03
Rate for Payer: Hawaii Medical Service Association ABD	$20.12
Rate for Payer: Hawaii Medical Service Association Commercial	$18.21
Rate for Payer: Hawaii Medical Service Association Medicare	$14.57
Rate for Payer: Hawaii Medical Service Association Non-ABD	$21.13
Rate for Payer: Hawaii Western Management Group Commercial	$14.57
Rate for Payer: Health Management Network Commercial	$103.70
Rate for Payer: Humana Medicare	$14.57
Rate for Payer: Kaiser Permanente Commercial	$76.86
Rate for Payer: Kaiser Permanente Medicaid	$62.22
Rate for Payer: Kaiser Permanente Medicare	$14.57
Rate for Payer: MDX Hawaii PPO	$118.34
Rate for Payer: Ohana Health Plan Medicaid	$16.03
Rate for Payer: Ohana Health Plan Medicare	$14.57
Rate for Payer: UnitedHealthcare Medicaid	$20.12
Rate for Payer: UnitedHealthcare Medicare	$14.57
Rate for Payer: University Health Alliance Commercial	$37.63

HC ASSAY OF CARBAMAZEPINE TOTAL - CARBAMAZEPINE TOTAL

Facility

$122.00

Service Code	HCPCS 80156
Hospital Charge Code	3018015601
Hospital Revenue Code	301
Min. Negotiated Rate	$103.70
Max. Negotiated Rate	$118.34
Rate for Payer: Cash Price	$73.20
Rate for Payer: Health Management Network Commercial	$103.70
Rate for Payer: MDX Hawaii PPO	$118.34

HC ASSAY OF CARNITINE - CARNITINE

Facility

$142.00

Service Code	HCPCS 82379
Hospital Charge Code	3018237901
Hospital Revenue Code	301
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$137.74
Rate for Payer: AlohaCare Medicaid	$16.87
Rate for Payer: AlohaCare Medicare	$16.87
Rate for Payer: Cash Price	$85.20
Rate for Payer: Cash Price	$85.20
Rate for Payer: Devoted Health Medicare	$18.56
Rate for Payer: Hawaii Medical Service Association ABD	$23.31
Rate for Payer: Hawaii Medical Service Association Commercial	$21.09
Rate for Payer: Hawaii Medical Service Association Medicare	$16.87
Rate for Payer: Hawaii Medical Service Association Non-ABD	$24.48
Rate for Payer: Hawaii Western Management Group Commercial	$16.87
Rate for Payer: Health Management Network Commercial	$120.70
Rate for Payer: Humana Medicare	$16.87
Rate for Payer: Kaiser Permanente Commercial	$89.46
Rate for Payer: Kaiser Permanente Medicaid	$72.42
Rate for Payer: Kaiser Permanente Medicare	$16.87
Rate for Payer: MDX Hawaii PPO	$137.74
Rate for Payer: Ohana Health Plan Medicaid	$18.56
Rate for Payer: Ohana Health Plan Medicare	$16.87
Rate for Payer: UnitedHealthcare Medicaid	$23.31
Rate for Payer: UnitedHealthcare Medicare	$16.87
Rate for Payer: University Health Alliance Commercial	$43.60

HC ASSAY OF CARNITINE - CARNITINE

Facility

$142.00

Service Code	HCPCS 82379
Hospital Charge Code	3018237901
Hospital Revenue Code	301
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$137.74
Rate for Payer: Cash Price	$85.20
Rate for Payer: Health Management Network Commercial	$120.70
Rate for Payer: MDX Hawaii PPO	$137.74

HC ASSAY OF CERULOPLASMIN - CERULOPLASMIN

Facility

$90.00

Service Code	HCPCS 82390
Hospital Charge Code	3018239001
Hospital Revenue Code	301
Min. Negotiated Rate	$76.50
Max. Negotiated Rate	$87.30
Rate for Payer: Cash Price	$54.00
Rate for Payer: Health Management Network Commercial	$76.50
Rate for Payer: MDX Hawaii PPO	$87.30

HC ASSAY OF CERULOPLASMIN - CERULOPLASMIN

Facility

$90.00

Service Code	HCPCS 82390
Hospital Charge Code	3018239001
Hospital Revenue Code	301
Min. Negotiated Rate	$10.74
Max. Negotiated Rate	$87.30
Rate for Payer: AlohaCare Medicaid	$10.74
Rate for Payer: AlohaCare Medicare	$10.74
Rate for Payer: Cash Price	$54.00
Rate for Payer: Cash Price	$54.00
Rate for Payer: Devoted Health Medicare	$11.81
Rate for Payer: Hawaii Medical Service Association ABD	$14.84
Rate for Payer: Hawaii Medical Service Association Commercial	$13.43
Rate for Payer: Hawaii Medical Service Association Medicare	$10.74
Rate for Payer: Hawaii Medical Service Association Non-ABD	$15.58
Rate for Payer: Hawaii Western Management Group Commercial	$10.74
Rate for Payer: Health Management Network Commercial	$76.50
Rate for Payer: Humana Medicare	$10.74
Rate for Payer: Kaiser Permanente Commercial	$56.70
Rate for Payer: Kaiser Permanente Medicaid	$45.90
Rate for Payer: Kaiser Permanente Medicare	$10.74
Rate for Payer: MDX Hawaii PPO	$87.30
Rate for Payer: Ohana Health Plan Medicaid	$11.81
Rate for Payer: Ohana Health Plan Medicare	$10.74
Rate for Payer: UnitedHealthcare Medicaid	$14.84
Rate for Payer: UnitedHealthcare Medicare	$10.74
Rate for Payer: University Health Alliance Commercial	$27.77

HC ASSAY OF CK (CPK) - CK

Facility

$55.00

Service Code	HCPCS 82550
Hospital Charge Code	3018255001
Hospital Revenue Code	301
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$53.35
Rate for Payer: AlohaCare Medicaid	$6.51
Rate for Payer: AlohaCare Medicare	$6.51
Rate for Payer: Cash Price	$33.00
Rate for Payer: Cash Price	$33.00
Rate for Payer: Devoted Health Medicare	$7.16
Rate for Payer: Hawaii Medical Service Association ABD	$9.01
Rate for Payer: Hawaii Medical Service Association Commercial	$8.14
Rate for Payer: Hawaii Medical Service Association Medicare	$6.51
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9.46
Rate for Payer: Hawaii Western Management Group Commercial	$6.51
Rate for Payer: Health Management Network Commercial	$46.75
Rate for Payer: Humana Medicare	$6.51
Rate for Payer: Kaiser Permanente Commercial	$34.65
Rate for Payer: Kaiser Permanente Medicaid	$28.05
Rate for Payer: Kaiser Permanente Medicare	$6.51
Rate for Payer: MDX Hawaii PPO	$53.35
Rate for Payer: Ohana Health Plan Medicaid	$7.16
Rate for Payer: Ohana Health Plan Medicare	$6.51
Rate for Payer: UnitedHealthcare Medicaid	$9.01
Rate for Payer: UnitedHealthcare Medicare	$6.51
Rate for Payer: University Health Alliance Commercial	$16.84

Know your out-of-pocket cost for care.

All Charges