Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

HC B CELLS, TOTAL COUNT - B CELLS, TOTAL COUNT

Facility

$317.00

Service Code	HCPCS 86355
Hospital Charge Code	3028635501
Hospital Revenue Code	302
Min. Negotiated Rate	$36.89
Max. Negotiated Rate	$307.49
Rate for Payer: AlohaCare Medicaid	$37.73
Rate for Payer: AlohaCare Medicare	$37.73
Rate for Payer: Cash Price	$190.20
Rate for Payer: Cash Price	$190.20
Rate for Payer: Devoted Health Medicare	$41.50
Rate for Payer: Hawaii Medical Service Association ABD	$36.89
Rate for Payer: Hawaii Medical Service Association Commercial	$47.16
Rate for Payer: Hawaii Medical Service Association Medicare	$37.73
Rate for Payer: Hawaii Medical Service Association Non-ABD	$52.10
Rate for Payer: Hawaii Western Management Group Commercial	$37.73
Rate for Payer: Health Management Network Commercial	$269.45
Rate for Payer: Humana Medicare	$37.73
Rate for Payer: Kaiser Permanente Commercial	$199.71
Rate for Payer: Kaiser Permanente Medicaid	$161.67
Rate for Payer: Kaiser Permanente Medicare	$37.73
Rate for Payer: MDX Hawaii PPO	$307.49
Rate for Payer: Ohana Health Plan Medicaid	$41.50
Rate for Payer: Ohana Health Plan Medicare	$37.73
Rate for Payer: UnitedHealthcare Medicaid	$36.89
Rate for Payer: UnitedHealthcare Medicare	$37.73
Rate for Payer: University Health Alliance Commercial	$97.50

HC B CELLS, TOTAL COUNT - B CELLS, TOTAL COUNT

Facility

$317.00

Service Code	HCPCS 86355
Hospital Charge Code	3028635501
Hospital Revenue Code	302
Min. Negotiated Rate	$269.45
Max. Negotiated Rate	$307.49
Rate for Payer: Cash Price	$190.20
Rate for Payer: Health Management Network Commercial	$269.45
Rate for Payer: MDX Hawaii PPO	$307.49

HC BCR-ABL1 P190 SO

Facility

$1,215.00

Service Code	HCPCS 81207
Hospital Charge Code	3108120701
Hospital Revenue Code	310
Min. Negotiated Rate	$54.19
Max. Negotiated Rate	$1,178.55
Rate for Payer: AlohaCare Medicaid	$144.84
Rate for Payer: AlohaCare Medicare	$144.84
Rate for Payer: Cash Price	$729.00
Rate for Payer: Cash Price	$729.00
Rate for Payer: Devoted Health Medicare	$159.32
Rate for Payer: Hawaii Medical Service Association Commercial	$181.05
Rate for Payer: Hawaii Medical Service Association Medicare	$144.84
Rate for Payer: Hawaii Medical Service Association Non-ABD	$193.87
Rate for Payer: Hawaii Western Management Group Commercial	$144.84
Rate for Payer: Health Management Network Commercial	$1,032.75
Rate for Payer: Humana Medicare	$144.84
Rate for Payer: Kaiser Permanente Commercial	$765.45
Rate for Payer: Kaiser Permanente Medicaid	$619.65
Rate for Payer: Kaiser Permanente Medicare	$144.84
Rate for Payer: MDX Hawaii PPO	$1,178.55
Rate for Payer: Ohana Health Plan Medicaid	$159.32
Rate for Payer: Ohana Health Plan Medicare	$144.84
Rate for Payer: UnitedHealthcare Medicaid	$54.19
Rate for Payer: UnitedHealthcare Medicare	$144.84
Rate for Payer: University Health Alliance Commercial	$167.07

HC BCR-ABL1 P190 SO

Facility

$1,215.00

Service Code	HCPCS 81207
Hospital Charge Code	3108120701
Hospital Revenue Code	310
Min. Negotiated Rate	$1,032.75
Max. Negotiated Rate	$1,178.55
Rate for Payer: Cash Price	$729.00
Rate for Payer: Health Management Network Commercial	$1,032.75
Rate for Payer: MDX Hawaii PPO	$1,178.55

HC BCR-ABL1 P210 SO

Facility

$1,376.00

Service Code	HCPCS 81206
Hospital Charge Code	3108120601
Hospital Revenue Code	310
Min. Negotiated Rate	$65.02
Max. Negotiated Rate	$1,334.72
Rate for Payer: AlohaCare Medicaid	$163.96
Rate for Payer: AlohaCare Medicare	$163.96
Rate for Payer: Cash Price	$825.60
Rate for Payer: Cash Price	$825.60
Rate for Payer: Devoted Health Medicare	$180.36
Rate for Payer: Hawaii Medical Service Association ABD	$219.48
Rate for Payer: Hawaii Medical Service Association Commercial	$204.95
Rate for Payer: Hawaii Medical Service Association Medicare	$163.96
Rate for Payer: Hawaii Medical Service Association Non-ABD	$219.48
Rate for Payer: Hawaii Western Management Group Commercial	$163.96
Rate for Payer: Health Management Network Commercial	$1,169.60
Rate for Payer: Humana Medicare	$163.96
Rate for Payer: Kaiser Permanente Commercial	$866.88
Rate for Payer: Kaiser Permanente Medicaid	$701.76
Rate for Payer: Kaiser Permanente Medicare	$163.96
Rate for Payer: MDX Hawaii PPO	$1,334.72
Rate for Payer: Ohana Health Plan Medicaid	$180.36
Rate for Payer: Ohana Health Plan Medicare	$163.96
Rate for Payer: UnitedHealthcare Medicaid	$65.02
Rate for Payer: UnitedHealthcare Medicare	$163.96
Rate for Payer: University Health Alliance Commercial	$200.48

HC BCR-ABL1 P210 SO

Facility

$1,376.00

Service Code	HCPCS 81206
Hospital Charge Code	3108120601
Hospital Revenue Code	310
Min. Negotiated Rate	$1,169.60
Max. Negotiated Rate	$1,334.72
Rate for Payer: Cash Price	$825.60
Rate for Payer: Health Management Network Commercial	$1,169.60
Rate for Payer: MDX Hawaii PPO	$1,334.72

HC BETA 2 GLYCOPROTEIN I ANTIBODY,EA - BETA-2 GLYCOPROTEIN ABS

Facility

$214.00

Service Code	HCPCS 86146
Hospital Charge Code	3028614601
Hospital Revenue Code	302
Min. Negotiated Rate	$25.45
Max. Negotiated Rate	$207.58
Rate for Payer: AlohaCare Medicaid	$25.45
Rate for Payer: AlohaCare Medicare	$25.45
Rate for Payer: Cash Price	$128.40
Rate for Payer: Cash Price	$128.40
Rate for Payer: Devoted Health Medicare	$28.00
Rate for Payer: Hawaii Medical Service Association ABD	$35.54
Rate for Payer: Hawaii Medical Service Association Commercial	$31.81
Rate for Payer: Hawaii Medical Service Association Medicare	$25.45
Rate for Payer: Hawaii Medical Service Association Non-ABD	$37.32
Rate for Payer: Hawaii Western Management Group Commercial	$25.45
Rate for Payer: Health Management Network Commercial	$181.90
Rate for Payer: Humana Medicare	$25.45
Rate for Payer: Kaiser Permanente Commercial	$134.82
Rate for Payer: Kaiser Permanente Medicaid	$109.14
Rate for Payer: Kaiser Permanente Medicare	$25.45
Rate for Payer: MDX Hawaii PPO	$207.58
Rate for Payer: Ohana Health Plan Medicaid	$28.00
Rate for Payer: Ohana Health Plan Medicare	$25.45
Rate for Payer: UnitedHealthcare Medicaid	$35.54
Rate for Payer: UnitedHealthcare Medicare	$25.45
Rate for Payer: University Health Alliance Commercial	$65.75

HC BETA 2 GLYCOPROTEIN I ANTIBODY,EA - BETA-2 GLYCOPROTEIN ABS

Facility

$214.00

Service Code	HCPCS 86146
Hospital Charge Code	3028614601
Hospital Revenue Code	302
Min. Negotiated Rate	$181.90
Max. Negotiated Rate	$207.58
Rate for Payer: Cash Price	$128.40
Rate for Payer: Health Management Network Commercial	$181.90
Rate for Payer: MDX Hawaii PPO	$207.58

HC BETA-2 PROTEIN - BETA2 MICROGLOB SERUM SO

Facility

$136.00

Service Code	HCPCS 82232
Hospital Charge Code	3018223201
Hospital Revenue Code	301
Min. Negotiated Rate	$115.60
Max. Negotiated Rate	$131.92
Rate for Payer: Cash Price	$81.60
Rate for Payer: Health Management Network Commercial	$115.60
Rate for Payer: MDX Hawaii PPO	$131.92

HC BETA-2 PROTEIN - BETA2 MICROGLOB SERUM SO

Facility

$136.00

Service Code	HCPCS 82232
Hospital Charge Code	3018223201
Hospital Revenue Code	301
Min. Negotiated Rate	$16.18
Max. Negotiated Rate	$131.92
Rate for Payer: AlohaCare Medicaid	$16.18
Rate for Payer: AlohaCare Medicare	$16.18
Rate for Payer: Cash Price	$81.60
Rate for Payer: Cash Price	$81.60
Rate for Payer: Devoted Health Medicare	$17.80
Rate for Payer: Hawaii Medical Service Association ABD	$22.36
Rate for Payer: Hawaii Medical Service Association Commercial	$20.23
Rate for Payer: Hawaii Medical Service Association Medicare	$16.18
Rate for Payer: Hawaii Medical Service Association Non-ABD	$23.48
Rate for Payer: Hawaii Western Management Group Commercial	$16.18
Rate for Payer: Health Management Network Commercial	$115.60
Rate for Payer: Humana Medicare	$16.18
Rate for Payer: Kaiser Permanente Commercial	$85.68
Rate for Payer: Kaiser Permanente Medicaid	$69.36
Rate for Payer: Kaiser Permanente Medicare	$16.18
Rate for Payer: MDX Hawaii PPO	$131.92
Rate for Payer: Ohana Health Plan Medicaid	$17.80
Rate for Payer: Ohana Health Plan Medicare	$16.18
Rate for Payer: UnitedHealthcare Medicaid	$22.36
Rate for Payer: UnitedHealthcare Medicare	$16.18
Rate for Payer: University Health Alliance Commercial	$41.83

HC BETA-AMYLOID 1-42 (ABETA 42)

Facility

$136.00

Service Code	HCPCS 82334
Hospital Charge Code	3018223401
Hospital Revenue Code	301
Min. Negotiated Rate	$69.36
Max. Negotiated Rate	$131.92
Rate for Payer: Cash Price	$81.60
Rate for Payer: Hawaii Western Management Group Commercial	$129.20
Rate for Payer: Health Management Network Commercial	$115.60
Rate for Payer: Kaiser Permanente Commercial	$85.68
Rate for Payer: Kaiser Permanente Medicaid	$69.36
Rate for Payer: MDX Hawaii PPO	$131.92
Rate for Payer: University Health Alliance Commercial	$99.13

HC BETA-AMYLOID 1-42 (ABETA 42)

Facility

$136.00

Service Code	HCPCS 82334
Hospital Charge Code	3018223401
Hospital Revenue Code	301
Min. Negotiated Rate	$115.60
Max. Negotiated Rate	$131.92
Rate for Payer: Cash Price	$81.60
Rate for Payer: Health Management Network Commercial	$115.60
Rate for Payer: MDX Hawaii PPO	$131.92

HC BETA HCG QUANT

Facility

$128.00

Service Code	HCPCS 84704
Hospital Charge Code	3018470401
Hospital Revenue Code	301
Min. Negotiated Rate	$108.80
Max. Negotiated Rate	$124.16
Rate for Payer: Cash Price	$76.80
Rate for Payer: Health Management Network Commercial	$108.80
Rate for Payer: MDX Hawaii PPO	$124.16

HC BETA HCG QUANT

Facility

$128.00

Service Code	HCPCS 84704
Hospital Charge Code	3018470401
Hospital Revenue Code	301
Min. Negotiated Rate	$15.29
Max. Negotiated Rate	$124.16
Rate for Payer: AlohaCare Medicaid	$15.29
Rate for Payer: AlohaCare Medicare	$15.29
Rate for Payer: Cash Price	$76.80
Rate for Payer: Cash Price	$76.80
Rate for Payer: Devoted Health Medicare	$16.82
Rate for Payer: Hawaii Medical Service Association ABD	$21.03
Rate for Payer: Hawaii Medical Service Association Commercial	$19.11
Rate for Payer: Hawaii Medical Service Association Medicare	$15.29
Rate for Payer: Hawaii Medical Service Association Non-ABD	$22.08
Rate for Payer: Hawaii Western Management Group Commercial	$15.29
Rate for Payer: Health Management Network Commercial	$108.80
Rate for Payer: Humana Medicare	$15.29
Rate for Payer: Kaiser Permanente Commercial	$80.64
Rate for Payer: Kaiser Permanente Medicaid	$65.28
Rate for Payer: Kaiser Permanente Medicare	$15.29
Rate for Payer: MDX Hawaii PPO	$124.16
Rate for Payer: Ohana Health Plan Medicaid	$16.82
Rate for Payer: Ohana Health Plan Medicare	$15.29
Rate for Payer: UnitedHealthcare Medicaid	$21.03
Rate for Payer: UnitedHealthcare Medicare	$15.29
Rate for Payer: University Health Alliance Commercial	$38.91

HC BILE ACIDS, TOTAL - BILE ACIDS, TOTAL

Facility

$144.00

Service Code	HCPCS 82239
Hospital Charge Code	3018223901
Hospital Revenue Code	301
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$139.68
Rate for Payer: AlohaCare Medicaid	$17.12
Rate for Payer: AlohaCare Medicare	$17.12
Rate for Payer: Cash Price	$86.40
Rate for Payer: Cash Price	$86.40
Rate for Payer: Devoted Health Medicare	$18.83
Rate for Payer: Hawaii Medical Service Association ABD	$23.67
Rate for Payer: Hawaii Medical Service Association Commercial	$21.40
Rate for Payer: Hawaii Medical Service Association Medicare	$17.12
Rate for Payer: Hawaii Medical Service Association Non-ABD	$24.85
Rate for Payer: Hawaii Western Management Group Commercial	$17.12
Rate for Payer: Health Management Network Commercial	$122.40
Rate for Payer: Humana Medicare	$17.12
Rate for Payer: Kaiser Permanente Commercial	$90.72
Rate for Payer: Kaiser Permanente Medicaid	$73.44
Rate for Payer: Kaiser Permanente Medicare	$17.12
Rate for Payer: MDX Hawaii PPO	$139.68
Rate for Payer: Ohana Health Plan Medicaid	$18.83
Rate for Payer: Ohana Health Plan Medicare	$17.12
Rate for Payer: UnitedHealthcare Medicaid	$23.67
Rate for Payer: UnitedHealthcare Medicare	$17.12
Rate for Payer: University Health Alliance Commercial	$44.29

HC BILE ACIDS, TOTAL - BILE ACIDS, TOTAL

Facility

$144.00

Service Code	HCPCS 82239
Hospital Charge Code	3018223901
Hospital Revenue Code	301
Min. Negotiated Rate	$122.40
Max. Negotiated Rate	$139.68
Rate for Payer: Cash Price	$86.40
Rate for Payer: Health Management Network Commercial	$122.40
Rate for Payer: MDX Hawaii PPO	$139.68

HC BILIARY ENDOSCOPY PERCUT,BIOPSY

Facility

$24,832.00

Service Code	HCPCS 47553
Hospital Charge Code	3614755301
Hospital Revenue Code	361
Min. Negotiated Rate	$521.33
Max. Negotiated Rate	$24,087.04
Rate for Payer: AlohaCare Medicaid	$7,647.81
Rate for Payer: AlohaCare Medicare	$7,647.81
Rate for Payer: Cash Price	$14,899.20
Rate for Payer: Cash Price	$14,899.20
Rate for Payer: Cash Price	$14,899.20
Rate for Payer: Devoted Health Medicare	$8,412.59
Rate for Payer: Hawaii Medical Service Association Commercial	$9,559.76
Rate for Payer: Hawaii Medical Service Association Medicare	$7,647.81
Rate for Payer: Health Management Network Commercial	$21,107.20
Rate for Payer: Humana Medicare	$7,647.81
Rate for Payer: Kaiser Permanente Commercial	$15,644.16
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$7,647.81
Rate for Payer: MDX Hawaii PPO	$24,087.04
Rate for Payer: Ohana Health Plan Medicaid	$8,412.59
Rate for Payer: Ohana Health Plan Medicare	$7,647.81
Rate for Payer: UnitedHealthcare Medicaid	$521.33
Rate for Payer: UnitedHealthcare Medicare	$7,647.81
Rate for Payer: University Health Alliance Commercial	$6,743.44

HC BILIARY ENDOSCOPY PERCUT,BIOPSY

Facility

$24,832.00

Service Code	HCPCS 47553
Hospital Charge Code	3614755301
Hospital Revenue Code	361
Min. Negotiated Rate	$21,107.20
Max. Negotiated Rate	$24,087.04
Rate for Payer: Cash Price	$14,899.20
Rate for Payer: Health Management Network Commercial	$21,107.20
Rate for Payer: MDX Hawaii PPO	$24,087.04

HC BILIARY ENDOSCOPY PERCUT,DIL STRICT

Facility

$14,044.00

Service Code	HCPCS 47555
Hospital Charge Code	3614755501
Hospital Revenue Code	361
Min. Negotiated Rate	$456.03
Max. Negotiated Rate	$13,622.68
Rate for Payer: AlohaCare Medicaid	$7,647.81
Rate for Payer: AlohaCare Medicare	$7,647.81
Rate for Payer: Cash Price	$8,426.40
Rate for Payer: Cash Price	$8,426.40
Rate for Payer: Cash Price	$8,426.40
Rate for Payer: Devoted Health Medicare	$8,412.59
Rate for Payer: Hawaii Medical Service Association ABD	$848.00
Rate for Payer: Hawaii Medical Service Association Commercial	$8,270.00
Rate for Payer: Hawaii Medical Service Association Medicare	$7,647.81
Rate for Payer: Hawaii Medical Service Association Non-ABD	$1,427.62
Rate for Payer: Health Management Network Commercial	$11,937.40
Rate for Payer: Humana Medicare	$7,647.81
Rate for Payer: Kaiser Permanente Commercial	$8,847.72
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$7,647.81
Rate for Payer: MDX Hawaii PPO	$13,622.68
Rate for Payer: Ohana Health Plan Medicaid	$8,412.59
Rate for Payer: Ohana Health Plan Medicare	$7,647.81
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$7,647.81
Rate for Payer: University Health Alliance Commercial	$6,743.44

HC BILIARY ENDOSCOPY PERCUT,DIL STRICT

Facility

$14,044.00

Service Code	HCPCS 47555
Hospital Charge Code	3614755501
Hospital Revenue Code	361
Min. Negotiated Rate	$11,937.40
Max. Negotiated Rate	$13,622.68
Rate for Payer: Cash Price	$8,426.40
Rate for Payer: Health Management Network Commercial	$11,937.40
Rate for Payer: MDX Hawaii PPO	$13,622.68

HC BILIARY ENDOSCOPY,PERCUT,W/REM, STONE(S)

Facility

$41,433.00

Service Code	HCPCS 47554
Hospital Charge Code	3614755401
Hospital Revenue Code	361
Min. Negotiated Rate	$521.33
Max. Negotiated Rate	$40,190.01
Rate for Payer: AlohaCare Medicaid	$12,557.50
Rate for Payer: AlohaCare Medicare	$12,557.50
Rate for Payer: Cash Price	$24,859.80
Rate for Payer: Cash Price	$24,859.80
Rate for Payer: Cash Price	$24,859.80
Rate for Payer: Devoted Health Medicare	$13,813.25
Rate for Payer: Hawaii Medical Service Association ABD	$695.00
Rate for Payer: Hawaii Medical Service Association Commercial	$5,509.00
Rate for Payer: Hawaii Medical Service Association Medicare	$12,557.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$1,028.67
Rate for Payer: Health Management Network Commercial	$35,218.05
Rate for Payer: Humana Medicare	$12,557.50
Rate for Payer: Kaiser Permanente Commercial	$26,102.79
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$12,557.50
Rate for Payer: MDX Hawaii PPO	$40,190.01
Rate for Payer: Ohana Health Plan Medicaid	$13,813.25
Rate for Payer: Ohana Health Plan Medicare	$12,557.50
Rate for Payer: UnitedHealthcare Medicaid	$521.33
Rate for Payer: UnitedHealthcare Medicare	$12,557.50
Rate for Payer: University Health Alliance Commercial	$6,743.44

HC BILIARY ENDOSCOPY,PERCUT,W/REM, STONE(S)

Facility

$41,433.00

Service Code	HCPCS 47554
Hospital Charge Code	3614755401
Hospital Revenue Code	361
Min. Negotiated Rate	$35,218.05
Max. Negotiated Rate	$40,190.01
Rate for Payer: Cash Price	$24,859.80
Rate for Payer: Health Management Network Commercial	$35,218.05
Rate for Payer: MDX Hawaii PPO	$40,190.01

HC BILIRUBIN DIRECT - BILIRUBIN DIRECT

Facility

$42.00

Service Code	HCPCS 82248
Hospital Charge Code	3018224801
Hospital Revenue Code	301
Min. Negotiated Rate	$35.70
Max. Negotiated Rate	$40.74
Rate for Payer: Cash Price	$25.20
Rate for Payer: Health Management Network Commercial	$35.70
Rate for Payer: MDX Hawaii PPO	$40.74

HC BILIRUBIN DIRECT - BILIRUBIN DIRECT

Facility

$42.00

Service Code	HCPCS 82248
Hospital Charge Code	3018224801
Hospital Revenue Code	301
Min. Negotiated Rate	$5.02
Max. Negotiated Rate	$40.74
Rate for Payer: AlohaCare Medicaid	$5.02
Rate for Payer: AlohaCare Medicare	$5.02
Rate for Payer: Cash Price	$25.20
Rate for Payer: Cash Price	$25.20
Rate for Payer: Devoted Health Medicare	$5.52
Rate for Payer: Hawaii Medical Service Association ABD	$6.94
Rate for Payer: Hawaii Medical Service Association Commercial	$6.28
Rate for Payer: Hawaii Medical Service Association Medicare	$5.02
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.29
Rate for Payer: Hawaii Western Management Group Commercial	$5.02
Rate for Payer: Health Management Network Commercial	$35.70
Rate for Payer: Humana Medicare	$5.02
Rate for Payer: Kaiser Permanente Commercial	$26.46
Rate for Payer: Kaiser Permanente Medicaid	$21.42
Rate for Payer: Kaiser Permanente Medicare	$5.02
Rate for Payer: MDX Hawaii PPO	$40.74
Rate for Payer: Ohana Health Plan Medicaid	$5.52
Rate for Payer: Ohana Health Plan Medicare	$5.02
Rate for Payer: UnitedHealthcare Medicaid	$6.94
Rate for Payer: UnitedHealthcare Medicare	$5.02
Rate for Payer: University Health Alliance Commercial	$12.99

HC BILIRUBIN TOTAL - BILIRUBIN TOTAL

Facility

$42.00

Service Code	HCPCS 82247
Hospital Charge Code	3018224703
Hospital Revenue Code	301
Min. Negotiated Rate	$5.02
Max. Negotiated Rate	$40.74
Rate for Payer: AlohaCare Medicaid	$5.02
Rate for Payer: AlohaCare Medicare	$5.02
Rate for Payer: Cash Price	$25.20
Rate for Payer: Cash Price	$25.20
Rate for Payer: Devoted Health Medicare	$5.52
Rate for Payer: Hawaii Medical Service Association ABD	$6.94
Rate for Payer: Hawaii Medical Service Association Commercial	$6.28
Rate for Payer: Hawaii Medical Service Association Medicare	$5.02
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.29
Rate for Payer: Hawaii Western Management Group Commercial	$5.02
Rate for Payer: Health Management Network Commercial	$35.70
Rate for Payer: Humana Medicare	$5.02
Rate for Payer: Kaiser Permanente Commercial	$26.46
Rate for Payer: Kaiser Permanente Medicaid	$21.42
Rate for Payer: Kaiser Permanente Medicare	$5.02
Rate for Payer: MDX Hawaii PPO	$40.74
Rate for Payer: Ohana Health Plan Medicaid	$5.52
Rate for Payer: Ohana Health Plan Medicare	$5.02
Rate for Payer: UnitedHealthcare Medicaid	$6.94
Rate for Payer: UnitedHealthcare Medicare	$5.02
Rate for Payer: University Health Alliance Commercial	$12.99

Know your out-of-pocket cost for care.

All Charges