Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

HC CHG CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY

Facility

$604.00

Service Code	HCPCS 70472
Hospital Charge Code	3507047201
Hospital Revenue Code	350
Min. Negotiated Rate	$308.04
Max. Negotiated Rate	$585.88
Rate for Payer: Cash Price	$362.40
Rate for Payer: Hawaii Western Management Group Commercial	$573.80
Rate for Payer: Health Management Network Commercial	$513.40
Rate for Payer: Kaiser Permanente Commercial	$380.52
Rate for Payer: Kaiser Permanente Medicaid	$308.04
Rate for Payer: MDX Hawaii PPO	$585.88
Rate for Payer: University Health Alliance Commercial	$440.26

HC CHG CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY

Facility

$604.00

Service Code	HCPCS 70472
Hospital Charge Code	3507047201
Hospital Revenue Code	350
Min. Negotiated Rate	$513.40
Max. Negotiated Rate	$585.88
Rate for Payer: Cash Price	$362.40
Rate for Payer: Health Management Network Commercial	$513.40
Rate for Payer: MDX Hawaii PPO	$585.88

HC CHG CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY

Facility

$604.00

Service Code	HCPCS 70473
Hospital Charge Code	3507047301
Hospital Revenue Code	350
Min. Negotiated Rate	$207.21
Max. Negotiated Rate	$585.88
Rate for Payer: AlohaCare Medicaid	$207.21
Rate for Payer: AlohaCare Medicare	$207.21
Rate for Payer: Cash Price	$362.40
Rate for Payer: Cash Price	$362.40
Rate for Payer: Devoted Health Medicare	$227.93
Rate for Payer: Hawaii Medical Service Association Commercial	$259.01
Rate for Payer: Hawaii Medical Service Association Medicare	$207.21
Rate for Payer: Hawaii Western Management Group Commercial	$207.21
Rate for Payer: Health Management Network Commercial	$513.40
Rate for Payer: Humana Medicare	$207.21
Rate for Payer: Kaiser Permanente Commercial	$380.52
Rate for Payer: Kaiser Permanente Medicaid	$308.04
Rate for Payer: Kaiser Permanente Medicare	$207.21
Rate for Payer: MDX Hawaii PPO	$585.88
Rate for Payer: Ohana Health Plan Medicaid	$227.93
Rate for Payer: Ohana Health Plan Medicare	$207.21
Rate for Payer: UnitedHealthcare Medicare	$207.21
Rate for Payer: University Health Alliance Commercial	$440.26

HC CHG CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY

Facility

$604.00

Service Code	HCPCS 70473
Hospital Charge Code	3507047301
Hospital Revenue Code	350
Min. Negotiated Rate	$513.40
Max. Negotiated Rate	$585.88
Rate for Payer: Cash Price	$362.40
Rate for Payer: Health Management Network Commercial	$513.40
Rate for Payer: MDX Hawaii PPO	$585.88

HC CHG US, RETROPERITNL ABD, LTD - CV US ABDOMINAL AORTA LIMITED

Facility

$529.00

Service Code	HCPCS 76775
Hospital Charge Code	4027677503
Hospital Revenue Code	402
Min. Negotiated Rate	$46.98
Max. Negotiated Rate	$513.13
Rate for Payer: AlohaCare Medicaid	$123.50
Rate for Payer: AlohaCare Medicare	$123.50
Rate for Payer: Cash Price	$317.40
Rate for Payer: Cash Price	$317.40
Rate for Payer: Devoted Health Medicare	$135.85
Rate for Payer: Hawaii Medical Service Association ABD	$46.98
Rate for Payer: Hawaii Medical Service Association Commercial	$154.38
Rate for Payer: Hawaii Medical Service Association Medicare	$123.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$50.90
Rate for Payer: Hawaii Western Management Group Commercial	$123.50
Rate for Payer: Health Management Network Commercial	$449.65
Rate for Payer: Humana Medicare	$123.50
Rate for Payer: Kaiser Permanente Commercial	$333.27
Rate for Payer: Kaiser Permanente Medicaid	$269.79
Rate for Payer: Kaiser Permanente Medicare	$123.50
Rate for Payer: MDX Hawaii PPO	$513.13
Rate for Payer: Ohana Health Plan Medicaid	$135.85
Rate for Payer: Ohana Health Plan Medicare	$123.50
Rate for Payer: UnitedHealthcare Medicaid	$46.98
Rate for Payer: UnitedHealthcare Medicare	$123.50
Rate for Payer: University Health Alliance Commercial	$202.63

HC CHG US, RETROPERITNL ABD, LTD - CV US ABDOMINAL AORTA LIMITED

Facility

$529.00

Service Code	HCPCS 76775
Hospital Charge Code	4027677503
Hospital Revenue Code	402
Min. Negotiated Rate	$449.65
Max. Negotiated Rate	$513.13
Rate for Payer: Cash Price	$317.40
Rate for Payer: Health Management Network Commercial	$449.65
Rate for Payer: MDX Hawaii PPO	$513.13

HC CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL

Facility

$7,982.00

Service Code	HCPCS 50688
Hospital Charge Code	3615068801
Hospital Revenue Code	361
Min. Negotiated Rate	$393.00
Max. Negotiated Rate	$7,742.54
Rate for Payer: AlohaCare Medicaid	$2,469.46
Rate for Payer: AlohaCare Medicare	$2,469.46
Rate for Payer: Cash Price	$4,789.20
Rate for Payer: Cash Price	$4,789.20
Rate for Payer: Cash Price	$4,789.20
Rate for Payer: Devoted Health Medicare	$2,716.41
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 Medicare	$2,469.46
Rate for Payer: Hawaii Medical Service Association Non-ABD	$496.75
Rate for Payer: Health Management Network Commercial	$6,784.70
Rate for Payer: Humana Medicare	$2,469.46
Rate for Payer: Kaiser Permanente Commercial	$5,028.66
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$2,469.46
Rate for Payer: MDX Hawaii PPO	$7,742.54
Rate for Payer: Ohana Health Plan Medicaid	$2,716.41
Rate for Payer: Ohana Health Plan Medicare	$2,469.46
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$2,469.46
Rate for Payer: University Health Alliance Commercial	$5,818.08

HC CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL

Facility

$7,982.00

Service Code	HCPCS 50688
Hospital Charge Code	3615068801
Hospital Revenue Code	361
Min. Negotiated Rate	$6,784.70
Max. Negotiated Rate	$7,742.54
Rate for Payer: Cash Price	$4,789.20
Rate for Payer: Health Management Network Commercial	$6,784.70
Rate for Payer: MDX Hawaii PPO	$7,742.54

HC CHOLECYSTOSTOMY,PERCUTANEOUS, COMPLETE

Facility

$14,044.00

Service Code	HCPCS 47490
Hospital Charge Code	3614749001
Hospital Revenue Code	361
Min. Negotiated Rate	$456.03
Max. Negotiated Rate	$13,622.68
Rate for Payer: AlohaCare Medicaid	$4,229.69
Rate for Payer: AlohaCare Medicare	$4,229.69
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	$4,652.66
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	$4,229.69
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	$4,229.69
Rate for Payer: Kaiser Permanente Commercial	$8,847.72
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$4,229.69
Rate for Payer: MDX Hawaii PPO	$13,622.68
Rate for Payer: Ohana Health Plan Medicaid	$4,652.66
Rate for Payer: Ohana Health Plan Medicare	$4,229.69
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$4,229.69
Rate for Payer: University Health Alliance Commercial	$10,236.67

HC CHOLECYSTOSTOMY,PERCUTANEOUS, COMPLETE

Facility

$14,044.00

Service Code	HCPCS 47490
Hospital Charge Code	3614749001
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 CHOLINESTERASE SERUM SO

Facility

$66.00

Service Code	HCPCS 82480
Hospital Charge Code	3018248003
Hospital Revenue Code	301
Min. Negotiated Rate	$7.87
Max. Negotiated Rate	$64.02
Rate for Payer: AlohaCare Medicaid	$7.87
Rate for Payer: AlohaCare Medicare	$7.87
Rate for Payer: Cash Price	$39.60
Rate for Payer: Cash Price	$39.60
Rate for Payer: Devoted Health Medicare	$8.66
Rate for Payer: Hawaii Medical Service Association ABD	$10.89
Rate for Payer: Hawaii Medical Service Association Commercial	$9.84
Rate for Payer: Hawaii Medical Service Association Medicare	$7.87
Rate for Payer: Hawaii Medical Service Association Non-ABD	$11.43
Rate for Payer: Hawaii Western Management Group Commercial	$7.87
Rate for Payer: Health Management Network Commercial	$56.10
Rate for Payer: Humana Medicare	$7.87
Rate for Payer: Kaiser Permanente Commercial	$41.58
Rate for Payer: Kaiser Permanente Medicaid	$33.66
Rate for Payer: Kaiser Permanente Medicare	$7.87
Rate for Payer: MDX Hawaii PPO	$64.02
Rate for Payer: Ohana Health Plan Medicaid	$8.66
Rate for Payer: Ohana Health Plan Medicare	$7.87
Rate for Payer: UnitedHealthcare Medicaid	$10.89
Rate for Payer: UnitedHealthcare Medicare	$7.87
Rate for Payer: University Health Alliance Commercial	$20.37

HC CHOLINESTERASE SERUM SO

Facility

$66.00

Service Code	HCPCS 82480
Hospital Charge Code	3018248003
Hospital Revenue Code	301
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$64.02
Rate for Payer: Cash Price	$39.60
Rate for Payer: Health Management Network Commercial	$56.10
Rate for Payer: MDX Hawaii PPO	$64.02

HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE URINE

Facility

$63.00

Service Code	HCPCS 84703
Hospital Charge Code	3018470301
Hospital Revenue Code	301
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$61.11
Rate for Payer: Cash Price	$37.80
Rate for Payer: Health Management Network Commercial	$53.55
Rate for Payer: MDX Hawaii PPO	$61.11

HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE URINE

Facility

$63.00

Service Code	HCPCS 84703
Hospital Charge Code	3018470301
Hospital Revenue Code	301
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$61.11
Rate for Payer: AlohaCare Medicaid	$7.52
Rate for Payer: AlohaCare Medicare	$7.52
Rate for Payer: Cash Price	$37.80
Rate for Payer: Cash Price	$37.80
Rate for Payer: Devoted Health Medicare	$8.27
Rate for Payer: Hawaii Medical Service Association ABD	$10.38
Rate for Payer: Hawaii Medical Service Association Commercial	$9.40
Rate for Payer: Hawaii Medical Service Association Medicare	$7.52
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10.90
Rate for Payer: Hawaii Western Management Group Commercial	$7.52
Rate for Payer: Health Management Network Commercial	$53.55
Rate for Payer: Humana Medicare	$7.52
Rate for Payer: Kaiser Permanente Commercial	$39.69
Rate for Payer: Kaiser Permanente Medicaid	$32.13
Rate for Payer: Kaiser Permanente Medicare	$7.52
Rate for Payer: MDX Hawaii PPO	$61.11
Rate for Payer: Ohana Health Plan Medicaid	$8.27
Rate for Payer: Ohana Health Plan Medicare	$7.52
Rate for Payer: UnitedHealthcare Medicaid	$10.38
Rate for Payer: UnitedHealthcare Medicare	$7.52
Rate for Payer: University Health Alliance Commercial	$19.41

HC CHORIONIC GONADOTROPIN, QUAL - HCG QUAL SERUM

Facility

$63.00

Service Code	HCPCS 84703
Hospital Charge Code	3018470302
Hospital Revenue Code	301
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$61.11
Rate for Payer: Cash Price	$37.80
Rate for Payer: Health Management Network Commercial	$53.55
Rate for Payer: MDX Hawaii PPO	$61.11

HC CHORIONIC GONADOTROPIN, QUAL - HCG QUAL SERUM

Facility

$63.00

Service Code	HCPCS 84703
Hospital Charge Code	3018470302
Hospital Revenue Code	301
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$61.11
Rate for Payer: AlohaCare Medicaid	$7.52
Rate for Payer: AlohaCare Medicare	$7.52
Rate for Payer: Cash Price	$37.80
Rate for Payer: Cash Price	$37.80
Rate for Payer: Devoted Health Medicare	$8.27
Rate for Payer: Hawaii Medical Service Association ABD	$10.38
Rate for Payer: Hawaii Medical Service Association Commercial	$9.40
Rate for Payer: Hawaii Medical Service Association Medicare	$7.52
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10.90
Rate for Payer: Hawaii Western Management Group Commercial	$7.52
Rate for Payer: Health Management Network Commercial	$53.55
Rate for Payer: Humana Medicare	$7.52
Rate for Payer: Kaiser Permanente Commercial	$39.69
Rate for Payer: Kaiser Permanente Medicaid	$32.13
Rate for Payer: Kaiser Permanente Medicare	$7.52
Rate for Payer: MDX Hawaii PPO	$61.11
Rate for Payer: Ohana Health Plan Medicaid	$8.27
Rate for Payer: Ohana Health Plan Medicare	$7.52
Rate for Payer: UnitedHealthcare Medicaid	$10.38
Rate for Payer: UnitedHealthcare Medicare	$7.52
Rate for Payer: University Health Alliance Commercial	$19.41

HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD

Facility

$126.00

Service Code	HCPCS 84702
Hospital Charge Code	3018470201
Hospital Revenue Code	301
Min. Negotiated Rate	$15.05
Max. Negotiated Rate	$122.22
Rate for Payer: AlohaCare Medicaid	$15.05
Rate for Payer: AlohaCare Medicare	$15.05
Rate for Payer: Cash Price	$75.60
Rate for Payer: Cash Price	$75.60
Rate for Payer: Devoted Health Medicare	$16.55
Rate for Payer: Hawaii Medical Service Association ABD	$20.80
Rate for Payer: Hawaii Medical Service Association Commercial	$18.81
Rate for Payer: Hawaii Medical Service Association Medicare	$15.05
Rate for Payer: Hawaii Medical Service Association Non-ABD	$21.84
Rate for Payer: Hawaii Western Management Group Commercial	$15.05
Rate for Payer: Health Management Network Commercial	$107.10
Rate for Payer: Humana Medicare	$15.05
Rate for Payer: Kaiser Permanente Commercial	$79.38
Rate for Payer: Kaiser Permanente Medicaid	$64.26
Rate for Payer: Kaiser Permanente Medicare	$15.05
Rate for Payer: MDX Hawaii PPO	$122.22
Rate for Payer: Ohana Health Plan Medicaid	$16.55
Rate for Payer: Ohana Health Plan Medicare	$15.05
Rate for Payer: UnitedHealthcare Medicaid	$20.80
Rate for Payer: UnitedHealthcare Medicare	$15.05
Rate for Payer: University Health Alliance Commercial	$38.91

HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD

Facility

$126.00

Service Code	HCPCS 84702
Hospital Charge Code	3018470201
Hospital Revenue Code	301
Min. Negotiated Rate	$107.10
Max. Negotiated Rate	$122.22
Rate for Payer: Cash Price	$75.60
Rate for Payer: Health Management Network Commercial	$107.10
Rate for Payer: MDX Hawaii PPO	$122.22

HC CHROMO ANAL 15-20C/2K SO

Facility

$1,053.00

Service Code	HCPCS 88262
Hospital Charge Code	3118826201
Hospital Revenue Code	311
Min. Negotiated Rate	$124.02
Max. Negotiated Rate	$1,021.41
Rate for Payer: AlohaCare Medicaid	$125.49
Rate for Payer: AlohaCare Medicare	$125.49
Rate for Payer: Cash Price	$631.80
Rate for Payer: Cash Price	$631.80
Rate for Payer: Devoted Health Medicare	$138.04
Rate for Payer: Hawaii Medical Service Association ABD	$124.02
Rate for Payer: Hawaii Medical Service Association Commercial	$156.86
Rate for Payer: Hawaii Medical Service Association Medicare	$125.49
Rate for Payer: Hawaii Medical Service Association Non-ABD	$172.14
Rate for Payer: Hawaii Western Management Group Commercial	$125.49
Rate for Payer: Health Management Network Commercial	$895.05
Rate for Payer: Humana Medicare	$125.49
Rate for Payer: Kaiser Permanente Commercial	$663.39
Rate for Payer: Kaiser Permanente Medicaid	$537.03
Rate for Payer: Kaiser Permanente Medicare	$125.49
Rate for Payer: MDX Hawaii PPO	$1,021.41
Rate for Payer: Ohana Health Plan Medicaid	$138.04
Rate for Payer: Ohana Health Plan Medicare	$125.49
Rate for Payer: UnitedHealthcare Medicaid	$124.02
Rate for Payer: UnitedHealthcare Medicare	$125.49
Rate for Payer: University Health Alliance Commercial	$322.16

HC CHROMO ANAL 15-20C/2K SO

Facility

$1,053.00

Service Code	HCPCS 88262
Hospital Charge Code	3118826201
Hospital Revenue Code	311
Min. Negotiated Rate	$895.05
Max. Negotiated Rate	$1,021.41
Rate for Payer: Cash Price	$631.80
Rate for Payer: Health Management Network Commercial	$895.05
Rate for Payer: MDX Hawaii PPO	$1,021.41

HC CHROMO ANAL ADD KARY SO

Facility

$281.00

Service Code	HCPCS 88280
Hospital Charge Code	3118828001
Hospital Revenue Code	311
Min. Negotiated Rate	$238.85
Max. Negotiated Rate	$272.57
Rate for Payer: Cash Price	$168.60
Rate for Payer: Health Management Network Commercial	$238.85
Rate for Payer: MDX Hawaii PPO	$272.57

HC CHROMO ANAL ADD KARY SO

Facility

$281.00

Service Code	HCPCS 88280
Hospital Charge Code	3118828001
Hospital Revenue Code	311
Min. Negotiated Rate	$33.47
Max. Negotiated Rate	$272.57
Rate for Payer: AlohaCare Medicaid	$33.47
Rate for Payer: AlohaCare Medicare	$33.47
Rate for Payer: Cash Price	$168.60
Rate for Payer: Cash Price	$168.60
Rate for Payer: Devoted Health Medicare	$36.82
Rate for Payer: Hawaii Medical Service Association ABD	$34.68
Rate for Payer: Hawaii Medical Service Association Commercial	$41.84
Rate for Payer: Hawaii Medical Service Association Medicare	$33.47
Rate for Payer: Hawaii Medical Service Association Non-ABD	$36.41
Rate for Payer: Hawaii Western Management Group Commercial	$33.47
Rate for Payer: Health Management Network Commercial	$238.85
Rate for Payer: Humana Medicare	$33.47
Rate for Payer: Kaiser Permanente Commercial	$177.03
Rate for Payer: Kaiser Permanente Medicaid	$143.31
Rate for Payer: Kaiser Permanente Medicare	$33.47
Rate for Payer: MDX Hawaii PPO	$272.57
Rate for Payer: Ohana Health Plan Medicaid	$36.82
Rate for Payer: Ohana Health Plan Medicare	$33.47
Rate for Payer: UnitedHealthcare Medicaid	$34.68
Rate for Payer: UnitedHealthcare Medicare	$33.47
Rate for Payer: University Health Alliance Commercial	$64.88

HC CHROMOSOME ANALY 20-25 SO

Facility

$1,213.00

Service Code	HCPCS 88264
Hospital Charge Code	3118826401
Hospital Revenue Code	311
Min. Negotiated Rate	$104.48
Max. Negotiated Rate	$1,176.61
Rate for Payer: AlohaCare Medicaid	$144.61
Rate for Payer: AlohaCare Medicare	$144.61
Rate for Payer: Cash Price	$727.80
Rate for Payer: Cash Price	$727.80
Rate for Payer: Devoted Health Medicare	$159.07
Rate for Payer: Hawaii Medical Service Association ABD	$104.48
Rate for Payer: Hawaii Medical Service Association Commercial	$180.76
Rate for Payer: Hawaii Medical Service Association Medicare	$144.61
Rate for Payer: Hawaii Medical Service Association Non-ABD	$172.14
Rate for Payer: Hawaii Western Management Group Commercial	$144.61
Rate for Payer: Health Management Network Commercial	$1,031.05
Rate for Payer: Humana Medicare	$144.61
Rate for Payer: Kaiser Permanente Commercial	$764.19
Rate for Payer: Kaiser Permanente Medicaid	$618.63
Rate for Payer: Kaiser Permanente Medicare	$144.61
Rate for Payer: MDX Hawaii PPO	$1,176.61
Rate for Payer: Ohana Health Plan Medicaid	$159.07
Rate for Payer: Ohana Health Plan Medicare	$144.61
Rate for Payer: UnitedHealthcare Medicaid	$104.48
Rate for Payer: UnitedHealthcare Medicare	$144.61
Rate for Payer: University Health Alliance Commercial	$322.16

HC CHROMOSOME ANALY 20-25 SO

Facility

$1,213.00

Service Code	HCPCS 88264
Hospital Charge Code	3118826401
Hospital Revenue Code	311
Min. Negotiated Rate	$1,031.05
Max. Negotiated Rate	$1,176.61
Rate for Payer: Cash Price	$727.80
Rate for Payer: Health Management Network Commercial	$1,031.05
Rate for Payer: MDX Hawaii PPO	$1,176.61

HC CHYLMD TRACH, DNA, AMP PROBE - CHLAMYDIA AMP PROBE

Facility

$294.00

Service Code	HCPCS 87491
Hospital Charge Code	3068749102
Hospital Revenue Code	306
Min. Negotiated Rate	$35.09
Max. Negotiated Rate	$285.18
Rate for Payer: AlohaCare Medicaid	$35.09
Rate for Payer: AlohaCare Medicare	$35.09
Rate for Payer: Cash Price	$176.40
Rate for Payer: Cash Price	$176.40
Rate for Payer: Devoted Health Medicare	$38.60
Rate for Payer: Hawaii Medical Service Association ABD	$48.50
Rate for Payer: Hawaii Medical Service Association Commercial	$43.86
Rate for Payer: Hawaii Medical Service Association Medicare	$35.09
Rate for Payer: Hawaii Medical Service Association Non-ABD	$50.93
Rate for Payer: Hawaii Western Management Group Commercial	$35.09
Rate for Payer: Health Management Network Commercial	$249.90
Rate for Payer: Humana Medicare	$35.09
Rate for Payer: Kaiser Permanente Commercial	$185.22
Rate for Payer: Kaiser Permanente Medicaid	$149.94
Rate for Payer: Kaiser Permanente Medicare	$35.09
Rate for Payer: MDX Hawaii PPO	$285.18
Rate for Payer: Ohana Health Plan Medicaid	$38.60
Rate for Payer: Ohana Health Plan Medicare	$35.09
Rate for Payer: UnitedHealthcare Medicaid	$48.50
Rate for Payer: UnitedHealthcare Medicare	$35.09
Rate for Payer: University Health Alliance Commercial	$90.72

Know your out-of-pocket cost for care.

All Charges