Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

HC HBMC ICF WAITLIST ROOM DAILY

Facility

$1,250.00

Hospital Charge Code	1210000003
Hospital Revenue Code	121
Min. Negotiated Rate	$486.76
Max. Negotiated Rate	$7,250.00
Rate for Payer: AlohaCare Medicaid	$486.76
Rate for Payer: Cash Price	$750.00
Rate for Payer: Cash Price	$750.00
Rate for Payer: Hawaii Medical Service Association ABD	$486.76
Rate for Payer: Hawaii Medical Service Association Non-ABD	$486.76
Rate for Payer: Hawaii Western Management Group Commercial	$7,250.00
Rate for Payer: Health Management Network Commercial	$1,062.50
Rate for Payer: Kaiser Permanente Medicaid	$486.76
Rate for Payer: MDX Hawaii PPO	$1,212.50
Rate for Payer: Ohana Health Plan Medicaid	$486.76
Rate for Payer: UnitedHealthcare Medicaid	$486.76
Rate for Payer: University Health Alliance Commercial	$2,320.00

HC HEART FIRST PASS ADD-ON - NM HEART BLOOD POOL MUGA WITH RVEF

Facility

$968.00

Service Code	HCPCS 78496
Hospital Charge Code	3417849601
Hospital Revenue Code	341
Min. Negotiated Rate	$822.80
Max. Negotiated Rate	$938.96
Rate for Payer: Cash Price	$580.80
Rate for Payer: Health Management Network Commercial	$822.80
Rate for Payer: MDX Hawaii PPO	$938.96

HC HEART FIRST PASS ADD-ON - NM HEART BLOOD POOL MUGA WITH RVEF

Facility

$968.00

Service Code	HCPCS 78496
Hospital Charge Code	3417849601
Hospital Revenue Code	341
Min. Negotiated Rate	$184.57
Max. Negotiated Rate	$938.96
Rate for Payer: Cash Price	$580.80
Rate for Payer: Cash Price	$580.80
Rate for Payer: Hawaii Medical Service Association ABD	$184.57
Rate for Payer: Hawaii Medical Service Association Non-ABD	$237.29
Rate for Payer: Hawaii Western Management Group Commercial	$919.60
Rate for Payer: Health Management Network Commercial	$822.80
Rate for Payer: Kaiser Permanente Commercial	$609.84
Rate for Payer: Kaiser Permanente Medicaid	$493.68
Rate for Payer: MDX Hawaii PPO	$938.96
Rate for Payer: UnitedHealthcare Medicaid	$184.57
Rate for Payer: University Health Alliance Commercial	$372.66

HC HEART FIRST PASS MULTIPLE

Facility

$2,097.00

Service Code	HCPCS 78483
Hospital Charge Code	3417848301
Hospital Revenue Code	341
Min. Negotiated Rate	$1,782.45
Max. Negotiated Rate	$2,034.09
Rate for Payer: Cash Price	$1,258.20
Rate for Payer: Health Management Network Commercial	$1,782.45
Rate for Payer: MDX Hawaii PPO	$2,034.09

HC HEART FIRST PASS MULTIPLE

Facility

$2,097.00

Service Code	HCPCS 78483
Hospital Charge Code	3417848301
Hospital Revenue Code	341
Min. Negotiated Rate	$259.23
Max. Negotiated Rate	$2,034.09
Rate for Payer: AlohaCare Medicaid	$641.43
Rate for Payer: AlohaCare Medicare	$641.43
Rate for Payer: Cash Price	$1,258.20
Rate for Payer: Cash Price	$1,258.20
Rate for Payer: Devoted Health Medicare	$705.57
Rate for Payer: Hawaii Medical Service Association ABD	$259.23
Rate for Payer: Hawaii Medical Service Association Commercial	$801.79
Rate for Payer: Hawaii Medical Service Association Medicare	$641.43
Rate for Payer: Hawaii Medical Service Association Non-ABD	$281.37
Rate for Payer: Hawaii Western Management Group Commercial	$641.43
Rate for Payer: Health Management Network Commercial	$1,782.45
Rate for Payer: Humana Medicare	$641.43
Rate for Payer: Kaiser Permanente Commercial	$1,321.11
Rate for Payer: Kaiser Permanente Medicaid	$1,069.47
Rate for Payer: Kaiser Permanente Medicare	$641.43
Rate for Payer: MDX Hawaii PPO	$2,034.09
Rate for Payer: Ohana Health Plan Medicaid	$705.57
Rate for Payer: Ohana Health Plan Medicare	$641.43
Rate for Payer: UnitedHealthcare Medicaid	$259.23
Rate for Payer: UnitedHealthcare Medicare	$641.43
Rate for Payer: University Health Alliance Commercial	$726.59

HC HEART FIRST PASS SINGLE

Facility

$2,097.00

Service Code	HCPCS 78481
Hospital Charge Code	3417848101
Hospital Revenue Code	341
Min. Negotiated Rate	$1,782.45
Max. Negotiated Rate	$2,034.09
Rate for Payer: Cash Price	$1,258.20
Rate for Payer: Health Management Network Commercial	$1,782.45
Rate for Payer: MDX Hawaii PPO	$2,034.09

HC HEART FIRST PASS SINGLE

Facility

$2,097.00

Service Code	HCPCS 78481
Hospital Charge Code	3417848101
Hospital Revenue Code	341
Min. Negotiated Rate	$172.26
Max. Negotiated Rate	$2,034.09
Rate for Payer: AlohaCare Medicaid	$641.43
Rate for Payer: AlohaCare Medicare	$641.43
Rate for Payer: Cash Price	$1,258.20
Rate for Payer: Cash Price	$1,258.20
Rate for Payer: Devoted Health Medicare	$705.57
Rate for Payer: Hawaii Medical Service Association ABD	$172.26
Rate for Payer: Hawaii Medical Service Association Commercial	$801.79
Rate for Payer: Hawaii Medical Service Association Medicare	$641.43
Rate for Payer: Hawaii Medical Service Association Non-ABD	$186.62
Rate for Payer: Hawaii Western Management Group Commercial	$641.43
Rate for Payer: Health Management Network Commercial	$1,782.45
Rate for Payer: Humana Medicare	$641.43
Rate for Payer: Kaiser Permanente Commercial	$1,321.11
Rate for Payer: Kaiser Permanente Medicaid	$1,069.47
Rate for Payer: Kaiser Permanente Medicare	$641.43
Rate for Payer: MDX Hawaii PPO	$2,034.09
Rate for Payer: Ohana Health Plan Medicaid	$705.57
Rate for Payer: Ohana Health Plan Medicare	$641.43
Rate for Payer: UnitedHealthcare Medicaid	$172.26
Rate for Payer: UnitedHealthcare Medicare	$641.43
Rate for Payer: University Health Alliance Commercial	$503.51

HC HEART IMAGE (PET) MULTIPLE

Facility

$5,684.00

Service Code	HCPCS 78492
Hospital Charge Code	4047849201
Hospital Revenue Code	404
Min. Negotiated Rate	$4,831.40
Max. Negotiated Rate	$5,513.48
Rate for Payer: Cash Price	$3,410.40
Rate for Payer: Health Management Network Commercial	$4,831.40
Rate for Payer: MDX Hawaii PPO	$5,513.48

HC HEART IMAGE (PET) MULTIPLE

Facility

$5,684.00

Service Code	HCPCS 78492
Hospital Charge Code	4047849201
Hospital Revenue Code	404
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$5,513.48
Rate for Payer: AlohaCare Medicaid	$1,689.26
Rate for Payer: AlohaCare Medicare	$1,689.26
Rate for Payer: Cash Price	$3,410.40
Rate for Payer: Cash Price	$3,410.40
Rate for Payer: Devoted Health Medicare	$1,858.19
Rate for Payer: Hawaii Medical Service Association Commercial	$2,111.57
Rate for Payer: Hawaii Medical Service Association Medicare	$1,689.26
Rate for Payer: Hawaii Medical Service Association Non-ABD	$1,779.65
Rate for Payer: Hawaii Western Management Group Commercial	$1,689.26
Rate for Payer: Health Management Network Commercial	$4,831.40
Rate for Payer: Humana Medicare	$1,689.26
Rate for Payer: Kaiser Permanente Commercial	$3,580.92
Rate for Payer: Kaiser Permanente Medicaid	$2,898.84
Rate for Payer: Kaiser Permanente Medicare	$1,689.26
Rate for Payer: MDX Hawaii PPO	$5,513.48
Rate for Payer: Ohana Health Plan Medicaid	$1,858.19
Rate for Payer: Ohana Health Plan Medicare	$1,689.26
Rate for Payer: UnitedHealthcare Medicaid	$1.00
Rate for Payer: UnitedHealthcare Medicare	$1,689.26
Rate for Payer: University Health Alliance Commercial	$4,143.07

HC HEART IMAGE (PET) SINGLE

Facility

$5,684.00

Service Code	HCPCS 78491
Hospital Charge Code	3417849101
Hospital Revenue Code	341
Min. Negotiated Rate	$4,831.40
Max. Negotiated Rate	$5,513.48
Rate for Payer: Cash Price	$3,410.40
Rate for Payer: Health Management Network Commercial	$4,831.40
Rate for Payer: MDX Hawaii PPO	$5,513.48

HC HEART IMAGE (PET) SINGLE

Facility

$5,684.00

Service Code	HCPCS 78491
Hospital Charge Code	3417849101
Hospital Revenue Code	341
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$5,513.48
Rate for Payer: AlohaCare Medicaid	$1,689.26
Rate for Payer: AlohaCare Medicare	$1,689.26
Rate for Payer: Cash Price	$3,410.40
Rate for Payer: Cash Price	$3,410.40
Rate for Payer: Devoted Health Medicare	$1,858.19
Rate for Payer: Hawaii Medical Service Association Commercial	$2,111.57
Rate for Payer: Hawaii Medical Service Association Medicare	$1,689.26
Rate for Payer: Hawaii Medical Service Association Non-ABD	$1,779.65
Rate for Payer: Hawaii Western Management Group Commercial	$1,689.26
Rate for Payer: Health Management Network Commercial	$4,831.40
Rate for Payer: Humana Medicare	$1,689.26
Rate for Payer: Kaiser Permanente Commercial	$3,580.92
Rate for Payer: Kaiser Permanente Medicaid	$2,898.84
Rate for Payer: Kaiser Permanente Medicare	$1,689.26
Rate for Payer: MDX Hawaii PPO	$5,513.48
Rate for Payer: Ohana Health Plan Medicaid	$1,858.19
Rate for Payer: Ohana Health Plan Medicare	$1,689.26
Rate for Payer: UnitedHealthcare Medicaid	$1.00
Rate for Payer: UnitedHealthcare Medicare	$1,689.26
Rate for Payer: University Health Alliance Commercial	$4,143.07

HC HEART IMAGE SPECT - NM HEART BLOOD POOL GATED SPECT

Facility

$1,566.00

Service Code	HCPCS 78494
Hospital Charge Code	4047849401
Hospital Revenue Code	404
Min. Negotiated Rate	$227.96
Max. Negotiated Rate	$1,519.02
Rate for Payer: AlohaCare Medicaid	$472.27
Rate for Payer: AlohaCare Medicare	$472.27
Rate for Payer: Cash Price	$939.60
Rate for Payer: Cash Price	$939.60
Rate for Payer: Devoted Health Medicare	$519.50
Rate for Payer: Hawaii Medical Service Association ABD	$227.96
Rate for Payer: Hawaii Medical Service Association Commercial	$590.34
Rate for Payer: Hawaii Medical Service Association Medicare	$472.27
Rate for Payer: Hawaii Medical Service Association Non-ABD	$251.53
Rate for Payer: Hawaii Western Management Group Commercial	$472.27
Rate for Payer: Health Management Network Commercial	$1,331.10
Rate for Payer: Humana Medicare	$472.27
Rate for Payer: Kaiser Permanente Commercial	$986.58
Rate for Payer: Kaiser Permanente Medicaid	$798.66
Rate for Payer: Kaiser Permanente Medicare	$472.27
Rate for Payer: MDX Hawaii PPO	$1,519.02
Rate for Payer: Ohana Health Plan Medicaid	$519.50
Rate for Payer: Ohana Health Plan Medicare	$472.27
Rate for Payer: UnitedHealthcare Medicaid	$227.96
Rate for Payer: UnitedHealthcare Medicare	$472.27
Rate for Payer: University Health Alliance Commercial	$641.54

HC HEART IMAGE SPECT - NM HEART BLOOD POOL GATED SPECT

Facility

$1,566.00

Service Code	HCPCS 78494
Hospital Charge Code	4047849401
Hospital Revenue Code	404
Min. Negotiated Rate	$1,331.10
Max. Negotiated Rate	$1,519.02
Rate for Payer: Cash Price	$939.60
Rate for Payer: Health Management Network Commercial	$1,331.10
Rate for Payer: MDX Hawaii PPO	$1,519.02

HC HEART INFARCT IMAGE - NM HEART INFARCTION

Facility

$1,999.00

Service Code	HCPCS 78466
Hospital Charge Code	4047846601
Hospital Revenue Code	404
Min. Negotiated Rate	$1,699.15
Max. Negotiated Rate	$1,939.03
Rate for Payer: Cash Price	$1,199.40
Rate for Payer: Health Management Network Commercial	$1,699.15
Rate for Payer: MDX Hawaii PPO	$1,939.03

HC HEART INFARCT IMAGE - NM HEART INFARCTION

Facility

$1,999.00

Service Code	HCPCS 78466
Hospital Charge Code	4047846601
Hospital Revenue Code	404
Min. Negotiated Rate	$86.28
Max. Negotiated Rate	$1,939.03
Rate for Payer: AlohaCare Medicaid	$472.27
Rate for Payer: AlohaCare Medicare	$472.27
Rate for Payer: Cash Price	$1,199.40
Rate for Payer: Cash Price	$1,199.40
Rate for Payer: Devoted Health Medicare	$519.50
Rate for Payer: Hawaii Medical Service Association ABD	$86.28
Rate for Payer: Hawaii Medical Service Association Commercial	$590.34
Rate for Payer: Hawaii Medical Service Association Medicare	$472.27
Rate for Payer: Hawaii Medical Service Association Non-ABD	$93.99
Rate for Payer: Hawaii Western Management Group Commercial	$472.27
Rate for Payer: Health Management Network Commercial	$1,699.15
Rate for Payer: Humana Medicare	$472.27
Rate for Payer: Kaiser Permanente Commercial	$1,259.37
Rate for Payer: Kaiser Permanente Medicaid	$1,019.49
Rate for Payer: Kaiser Permanente Medicare	$472.27
Rate for Payer: MDX Hawaii PPO	$1,939.03
Rate for Payer: Ohana Health Plan Medicaid	$519.50
Rate for Payer: Ohana Health Plan Medicare	$472.27
Rate for Payer: UnitedHealthcare Medicaid	$86.28
Rate for Payer: UnitedHealthcare Medicare	$472.27
Rate for Payer: University Health Alliance Commercial	$349.74

HC HEART INFARCT IMAGE SPECT - NM HEART INFARCTION SPECT

Facility

$2,678.00

Service Code	HCPCS 78469
Hospital Charge Code	3417846901
Hospital Revenue Code	341
Min. Negotiated Rate	$172.26
Max. Negotiated Rate	$2,597.66
Rate for Payer: AlohaCare Medicaid	$641.43
Rate for Payer: AlohaCare Medicare	$641.43
Rate for Payer: Cash Price	$1,606.80
Rate for Payer: Cash Price	$1,606.80
Rate for Payer: Devoted Health Medicare	$705.57
Rate for Payer: Hawaii Medical Service Association ABD	$172.26
Rate for Payer: Hawaii Medical Service Association Commercial	$801.79
Rate for Payer: Hawaii Medical Service Association Medicare	$641.43
Rate for Payer: Hawaii Medical Service Association Non-ABD	$186.62
Rate for Payer: Hawaii Western Management Group Commercial	$641.43
Rate for Payer: Health Management Network Commercial	$2,276.30
Rate for Payer: Humana Medicare	$641.43
Rate for Payer: Kaiser Permanente Commercial	$1,687.14
Rate for Payer: Kaiser Permanente Medicaid	$1,365.78
Rate for Payer: Kaiser Permanente Medicare	$641.43
Rate for Payer: MDX Hawaii PPO	$2,597.66
Rate for Payer: Ohana Health Plan Medicaid	$705.57
Rate for Payer: Ohana Health Plan Medicare	$641.43
Rate for Payer: UnitedHealthcare Medicaid	$172.26
Rate for Payer: UnitedHealthcare Medicare	$641.43
Rate for Payer: University Health Alliance Commercial	$547.27

HC HEART INFARCT IMAGE SPECT - NM HEART INFARCTION SPECT

Facility

$2,678.00

Service Code	HCPCS 78469
Hospital Charge Code	3417846901
Hospital Revenue Code	341
Min. Negotiated Rate	$2,276.30
Max. Negotiated Rate	$2,597.66
Rate for Payer: Cash Price	$1,606.80
Rate for Payer: Health Management Network Commercial	$2,276.30
Rate for Payer: MDX Hawaii PPO	$2,597.66

HC HEART INFARCT IMAGE W EF - NM HEART INFARCTION FIRST PASS

Facility

$2,097.00

Service Code	HCPCS 78468
Hospital Charge Code	3417846801
Hospital Revenue Code	341
Min. Negotiated Rate	$1,782.45
Max. Negotiated Rate	$2,034.09
Rate for Payer: Cash Price	$1,258.20
Rate for Payer: Health Management Network Commercial	$1,782.45
Rate for Payer: MDX Hawaii PPO	$2,034.09

HC HEART INFARCT IMAGE W EF - NM HEART INFARCTION FIRST PASS

Facility

$2,097.00

Service Code	HCPCS 78468
Hospital Charge Code	3417846801
Hospital Revenue Code	341
Min. Negotiated Rate	$120.66
Max. Negotiated Rate	$2,034.09
Rate for Payer: AlohaCare Medicaid	$641.43
Rate for Payer: AlohaCare Medicare	$641.43
Rate for Payer: Cash Price	$1,258.20
Rate for Payer: Cash Price	$1,258.20
Rate for Payer: Devoted Health Medicare	$705.57
Rate for Payer: Hawaii Medical Service Association ABD	$120.66
Rate for Payer: Hawaii Medical Service Association Commercial	$801.79
Rate for Payer: Hawaii Medical Service Association Medicare	$641.43
Rate for Payer: Hawaii Medical Service Association Non-ABD	$131.22
Rate for Payer: Hawaii Western Management Group Commercial	$641.43
Rate for Payer: Health Management Network Commercial	$1,782.45
Rate for Payer: Humana Medicare	$641.43
Rate for Payer: Kaiser Permanente Commercial	$1,321.11
Rate for Payer: Kaiser Permanente Medicaid	$1,069.47
Rate for Payer: Kaiser Permanente Medicare	$641.43
Rate for Payer: MDX Hawaii PPO	$2,034.09
Rate for Payer: Ohana Health Plan Medicaid	$705.57
Rate for Payer: Ohana Health Plan Medicare	$641.43
Rate for Payer: UnitedHealthcare Medicaid	$120.66
Rate for Payer: UnitedHealthcare Medicare	$641.43
Rate for Payer: University Health Alliance Commercial	$453.18

HC HEART/LUNG RESUSCITATION (CPR)

Facility

$1,549.00

Service Code	HCPCS 92950
Hospital Charge Code	4809295001
Hospital Revenue Code	480
Min. Negotiated Rate	$168.25
Max. Negotiated Rate	$5,509.00
Rate for Payer: AlohaCare Medicaid	$255.08
Rate for Payer: AlohaCare Medicare	$255.08
Rate for Payer: Cash Price	$929.40
Rate for Payer: Cash Price	$929.40
Rate for Payer: Cash Price	$929.40
Rate for Payer: Devoted Health Medicare	$280.59
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	$255.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$1,028.67
Rate for Payer: Hawaii Western Management Group Commercial	$1,471.55
Rate for Payer: Health Management Network Commercial	$1,316.65
Rate for Payer: Humana Medicare	$255.08
Rate for Payer: Kaiser Permanente Commercial	$975.87
Rate for Payer: Kaiser Permanente Medicaid	$789.99
Rate for Payer: Kaiser Permanente Medicare	$255.08
Rate for Payer: MDX Hawaii PPO	$1,502.53
Rate for Payer: Ohana Health Plan Medicaid	$280.59
Rate for Payer: Ohana Health Plan Medicare	$255.08
Rate for Payer: UnitedHealthcare Medicaid	$168.25
Rate for Payer: UnitedHealthcare Medicare	$255.08
Rate for Payer: University Health Alliance Commercial	$1,129.07

HC HEART/LUNG RESUSCITATION (CPR)

Facility

$1,549.00

Service Code	HCPCS 92950
Hospital Charge Code	4809295001
Hospital Revenue Code	480
Min. Negotiated Rate	$1,316.65
Max. Negotiated Rate	$1,502.53
Rate for Payer: Cash Price	$929.40
Rate for Payer: Health Management Network Commercial	$1,316.65
Rate for Payer: MDX Hawaii PPO	$1,502.53

HC HELICOBACTER PYLORI - H PYLORI AB

Facility

$141.00

Service Code	HCPCS 86677
Hospital Charge Code	3028667701
Hospital Revenue Code	302
Min. Negotiated Rate	$119.85
Max. Negotiated Rate	$136.77
Rate for Payer: Cash Price	$84.60
Rate for Payer: Health Management Network Commercial	$119.85
Rate for Payer: MDX Hawaii PPO	$136.77

HC HELICOBACTER PYLORI - H PYLORI AB

Facility

$141.00

Service Code	HCPCS 86677
Hospital Charge Code	3028667701
Hospital Revenue Code	302
Min. Negotiated Rate	$16.85
Max. Negotiated Rate	$136.77
Rate for Payer: AlohaCare Medicaid	$16.85
Rate for Payer: AlohaCare Medicare	$16.85
Rate for Payer: Cash Price	$84.60
Rate for Payer: Cash Price	$84.60
Rate for Payer: Devoted Health Medicare	$18.54
Rate for Payer: Hawaii Medical Service Association ABD	$20.05
Rate for Payer: Hawaii Medical Service Association Commercial	$21.06
Rate for Payer: Hawaii Medical Service Association Medicare	$16.85
Rate for Payer: Hawaii Medical Service Association Non-ABD	$21.05
Rate for Payer: Hawaii Western Management Group Commercial	$16.85
Rate for Payer: Health Management Network Commercial	$119.85
Rate for Payer: Humana Medicare	$16.85
Rate for Payer: Kaiser Permanente Commercial	$88.83
Rate for Payer: Kaiser Permanente Medicaid	$71.91
Rate for Payer: Kaiser Permanente Medicare	$16.85
Rate for Payer: MDX Hawaii PPO	$136.77
Rate for Payer: Ohana Health Plan Medicaid	$18.54
Rate for Payer: Ohana Health Plan Medicare	$16.85
Rate for Payer: UnitedHealthcare Medicaid	$20.05
Rate for Payer: UnitedHealthcare Medicare	$16.85
Rate for Payer: University Health Alliance Commercial	$37.52

HC HELMINTH, ANTIBODY - HELMINTH AB NOS SO

Facility

$109.00

Service Code	HCPCS 86682
Hospital Charge Code	3028668201
Hospital Revenue Code	302
Min. Negotiated Rate	$92.65
Max. Negotiated Rate	$105.73
Rate for Payer: Cash Price	$65.40
Rate for Payer: Health Management Network Commercial	$92.65
Rate for Payer: MDX Hawaii PPO	$105.73

HC HELMINTH, ANTIBODY - HELMINTH AB NOS SO

Facility

$109.00

Service Code	HCPCS 86682
Hospital Charge Code	3028668201
Hospital Revenue Code	302
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$105.73
Rate for Payer: AlohaCare Medicaid	$13.01
Rate for Payer: AlohaCare Medicare	$13.01
Rate for Payer: Cash Price	$65.40
Rate for Payer: Cash Price	$65.40
Rate for Payer: Devoted Health Medicare	$14.31
Rate for Payer: Hawaii Medical Service Association ABD	$12.60
Rate for Payer: Hawaii Medical Service Association Commercial	$16.26
Rate for Payer: Hawaii Medical Service Association Medicare	$13.01
Rate for Payer: Hawaii Medical Service Association Non-ABD	$13.30
Rate for Payer: Hawaii Western Management Group Commercial	$13.01
Rate for Payer: Health Management Network Commercial	$92.65
Rate for Payer: Humana Medicare	$13.01
Rate for Payer: Kaiser Permanente Commercial	$68.67
Rate for Payer: Kaiser Permanente Medicaid	$55.59
Rate for Payer: Kaiser Permanente Medicare	$13.01
Rate for Payer: MDX Hawaii PPO	$105.73
Rate for Payer: Ohana Health Plan Medicaid	$14.31
Rate for Payer: Ohana Health Plan Medicare	$13.01
Rate for Payer: UnitedHealthcare Medicaid	$12.60
Rate for Payer: UnitedHealthcare Medicare	$13.01
Rate for Payer: University Health Alliance Commercial	$24.88

Know your out-of-pocket cost for care.

All Charges