Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

HC HIV-2 - HIV-2 ANTIBODIES

Facility

$113.00

Service Code	HCPCS 86702
Hospital Charge Code	3028670201
Hospital Revenue Code	302
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 HIV AG WITH HIV 1&2 ABS

Facility

$275.00

Service Code	HCPCS 87806
Hospital Charge Code	3068780601
Hospital Revenue Code	306
Min. Negotiated Rate	$233.75
Max. Negotiated Rate	$266.75
Rate for Payer: Cash Price	$165.00
Rate for Payer: Health Management Network Commercial	$233.75
Rate for Payer: MDX Hawaii PPO	$266.75

HC HIV AG WITH HIV 1&2 ABS

Facility

$275.00

Service Code	HCPCS 87806
Hospital Charge Code	3068780601
Hospital Revenue Code	306
Min. Negotiated Rate	$19.68
Max. Negotiated Rate	$266.75
Rate for Payer: AlohaCare Medicaid	$32.77
Rate for Payer: AlohaCare Medicare	$32.77
Rate for Payer: Cash Price	$165.00
Rate for Payer: Cash Price	$165.00
Rate for Payer: Devoted Health Medicare	$36.05
Rate for Payer: Hawaii Medical Service Association ABD	$19.68
Rate for Payer: Hawaii Medical Service Association Commercial	$40.96
Rate for Payer: Hawaii Medical Service Association Medicare	$32.77
Rate for Payer: Hawaii Medical Service Association Non-ABD	$30.90
Rate for Payer: Hawaii Western Management Group Commercial	$32.77
Rate for Payer: Health Management Network Commercial	$233.75
Rate for Payer: Humana Medicare	$32.77
Rate for Payer: Kaiser Permanente Commercial	$173.25
Rate for Payer: Kaiser Permanente Medicaid	$140.25
Rate for Payer: Kaiser Permanente Medicare	$32.77
Rate for Payer: MDX Hawaii PPO	$266.75
Rate for Payer: Ohana Health Plan Medicaid	$36.05
Rate for Payer: Ohana Health Plan Medicare	$32.77
Rate for Payer: UnitedHealthcare Medicaid	$24.58
Rate for Payer: UnitedHealthcare Medicare	$32.77
Rate for Payer: University Health Alliance Commercial	$200.45

HC HLA TYPING, A,B,OR C /SINGLE - HLA-B27 ANTIGEN

Facility

$217.00

Service Code	HCPCS 86812
Hospital Charge Code	3028681201
Hospital Revenue Code	302
Min. Negotiated Rate	$184.45
Max. Negotiated Rate	$210.49
Rate for Payer: Cash Price	$130.20
Rate for Payer: Health Management Network Commercial	$184.45
Rate for Payer: MDX Hawaii PPO	$210.49

HC HLA TYPING, A,B,OR C /SINGLE - HLA-B27 ANTIGEN

Facility

$217.00

Service Code	HCPCS 86812
Hospital Charge Code	3028681201
Hospital Revenue Code	302
Min. Negotiated Rate	$25.81
Max. Negotiated Rate	$210.49
Rate for Payer: AlohaCare Medicaid	$25.81
Rate for Payer: AlohaCare Medicare	$25.81
Rate for Payer: Cash Price	$130.20
Rate for Payer: Cash Price	$130.20
Rate for Payer: Devoted Health Medicare	$28.39
Rate for Payer: Hawaii Medical Service Association ABD	$35.66
Rate for Payer: Hawaii Medical Service Association Commercial	$32.26
Rate for Payer: Hawaii Medical Service Association Medicare	$25.81
Rate for Payer: Hawaii Medical Service Association Non-ABD	$37.44
Rate for Payer: Hawaii Western Management Group Commercial	$25.81
Rate for Payer: Health Management Network Commercial	$184.45
Rate for Payer: Humana Medicare	$25.81
Rate for Payer: Kaiser Permanente Commercial	$136.71
Rate for Payer: Kaiser Permanente Medicaid	$110.67
Rate for Payer: Kaiser Permanente Medicare	$25.81
Rate for Payer: MDX Hawaii PPO	$210.49
Rate for Payer: Ohana Health Plan Medicaid	$28.39
Rate for Payer: Ohana Health Plan Medicare	$25.81
Rate for Payer: UnitedHealthcare Medicaid	$35.66
Rate for Payer: UnitedHealthcare Medicare	$25.81
Rate for Payer: University Health Alliance Commercial	$66.71

HC HOSPICE GENERAL/RESIDENTIAL DAILY

Facility

$3,125.00

Hospital Charge Code	1250000002
Hospital Revenue Code	125
Min. Negotiated Rate	$2,656.25
Max. Negotiated Rate	$7,250.00
Rate for Payer: Cash Price	$1,875.00
Rate for Payer: Cash Price	$1,875.00
Rate for Payer: Hawaii Western Management Group Commercial	$7,250.00
Rate for Payer: Health Management Network Commercial	$2,656.25
Rate for Payer: MDX Hawaii PPO	$3,031.25
Rate for Payer: University Health Alliance Commercial	$5,923.00

HC HO W/O JOINTS CF

Facility

$977.00

Service Code	HCPCS L3919
Hospital Charge Code	274L391901
Hospital Revenue Code	274
Min. Negotiated Rate	$547.12
Max. Negotiated Rate	$947.69
Rate for Payer: Cash Price	$586.20
Rate for Payer: Hawaii Western Management Group Commercial	$683.90
Rate for Payer: Health Management Network Commercial	$830.45
Rate for Payer: MDX Hawaii PPO	$947.69
Rate for Payer: University Health Alliance Commercial	$547.12

HC HO W/O JOINTS CF

Facility

$977.00

Service Code	HCPCS L3919
Hospital Charge Code	274L391901
Hospital Revenue Code	274
Min. Negotiated Rate	$116.21
Max. Negotiated Rate	$947.69
Rate for Payer: Cash Price	$586.20
Rate for Payer: Cash Price	$586.20
Rate for Payer: Hawaii Western Management Group Commercial	$683.90
Rate for Payer: Health Management Network Commercial	$830.45
Rate for Payer: Kaiser Permanente Commercial	$615.51
Rate for Payer: Kaiser Permanente Medicaid	$498.27
Rate for Payer: MDX Hawaii PPO	$947.69
Rate for Payer: UnitedHealthcare Medicaid	$116.21
Rate for Payer: University Health Alliance Commercial	$547.12

HC HSV, DNA, AMP PROBE - EC HSV 1 AMP PROBE CSF/SWAB

Facility

$294.00

Service Code	HCPCS 87529
Hospital Charge Code	3068752902
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	$46.44
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	$48.76
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	$46.44
Rate for Payer: UnitedHealthcare Medicare	$35.09
Rate for Payer: University Health Alliance Commercial	$90.72

HC HSV, DNA, AMP PROBE - EC HSV 1 AMP PROBE CSF/SWAB

Facility

$294.00

Service Code	HCPCS 87529
Hospital Charge Code	3068752902
Hospital Revenue Code	306
Min. Negotiated Rate	$249.90
Max. Negotiated Rate	$285.18
Rate for Payer: Cash Price	$176.40
Rate for Payer: Health Management Network Commercial	$249.90
Rate for Payer: MDX Hawaii PPO	$285.18

HC HSV, DNA, AMP PROBE - EC HSV 2 AMP PROB CSF/SWAB

Facility

$294.00

Service Code	HCPCS 87529
Hospital Charge Code	3068752903
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	$46.44
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	$48.76
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	$46.44
Rate for Payer: UnitedHealthcare Medicare	$35.09
Rate for Payer: University Health Alliance Commercial	$90.72

HC HSV, DNA, AMP PROBE - EC HSV 2 AMP PROB CSF/SWAB

Facility

$294.00

Service Code	HCPCS 87529
Hospital Charge Code	3068752903
Hospital Revenue Code	306
Min. Negotiated Rate	$249.90
Max. Negotiated Rate	$285.18
Rate for Payer: Cash Price	$176.40
Rate for Payer: Health Management Network Commercial	$249.90
Rate for Payer: MDX Hawaii PPO	$285.18

HC HSV, DNA, AMP PROBE - HSV SUBTYPE BLD/OTHER SO

Facility

$294.00

Service Code	HCPCS 87529
Hospital Charge Code	3068752901
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	$46.44
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	$48.76
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	$46.44
Rate for Payer: UnitedHealthcare Medicare	$35.09
Rate for Payer: University Health Alliance Commercial	$90.72

HC HSV, DNA, AMP PROBE - HSV SUBTYPE BLD/OTHER SO

Facility

$294.00

Service Code	HCPCS 87529
Hospital Charge Code	3068752901
Hospital Revenue Code	306
Min. Negotiated Rate	$249.90
Max. Negotiated Rate	$285.18
Rate for Payer: Cash Price	$176.40
Rate for Payer: Health Management Network Commercial	$249.90
Rate for Payer: MDX Hawaii PPO	$285.18

HC HT MUSC IMAGE PLANAR MULT - NM HEART PERFUSION MULTIPLE

Facility

$6,494.00

Service Code	HCPCS 78454
Hospital Charge Code	3417845401
Hospital Revenue Code	341
Min. Negotiated Rate	$66.76
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	$66.76
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	$169.03
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	$66.76
Rate for Payer: UnitedHealthcare Medicare	$1,529.43
Rate for Payer: University Health Alliance Commercial	$384.13

HC HT MUSC IMAGE PLANAR MULT - NM HEART PERFUSION MULTIPLE

Facility

$6,494.00

Service Code	HCPCS 78454
Hospital Charge Code	3417845401
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 HT MUSCLE IMAGE PLANAR SING - NM HEART PERFUSION SINGLE

Facility

$6,494.00

Service Code	HCPCS 78453
Hospital Charge Code	3417845301
Hospital Revenue Code	341
Min. Negotiated Rate	$79.42
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	$79.42
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	$84.64
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	$79.42
Rate for Payer: UnitedHealthcare Medicare	$1,529.43
Rate for Payer: University Health Alliance Commercial	$403.67

HC HT MUSCLE IMAGE PLANAR SING - NM HEART PERFUSION SINGLE

Facility

$6,494.00

Service Code	HCPCS 78453
Hospital Charge Code	3417845301
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 HT MUSCLE IMAGE SPECT MULT

Facility

$6,494.00

Service Code	HCPCS 78452
Hospital Charge Code	3417845201
Hospital Revenue Code	341
Min. Negotiated Rate	$164.65
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	$164.65
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	$433.03
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	$164.65
Rate for Payer: UnitedHealthcare Medicare	$1,529.43
Rate for Payer: University Health Alliance Commercial	$796.17

HC HT MUSCLE IMAGE SPECT MULT

Facility

$6,494.00

Service Code	HCPCS 78452
Hospital Charge Code	3417845201
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 HT MUSCLE IMAGE SPECT MULT - STRESS TEST DOBUTAMINE W MYOCARD PERF

Facility

$6,494.00

Service Code	HCPCS 78452
Hospital Charge Code	3417845202
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 HT MUSCLE IMAGE SPECT MULT - STRESS TEST DOBUTAMINE W MYOCARD PERF

Facility

$6,494.00

Service Code	HCPCS 78452
Hospital Charge Code	3417845202
Hospital Revenue Code	341
Min. Negotiated Rate	$164.65
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	$164.65
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	$433.03
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	$164.65
Rate for Payer: UnitedHealthcare Medicare	$1,529.43
Rate for Payer: University Health Alliance Commercial	$796.17

HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST REGADENOSON W MYOCARD PERF

Facility

$6,494.00

Service Code	HCPCS 78452
Hospital Charge Code	3417845204
Hospital Revenue Code	341
Min. Negotiated Rate	$164.65
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	$164.65
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	$433.03
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	$164.65
Rate for Payer: UnitedHealthcare Medicare	$1,529.43
Rate for Payer: University Health Alliance Commercial	$796.17

HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST REGADENOSON W MYOCARD PERF

Facility

$6,494.00

Service Code	HCPCS 78452
Hospital Charge Code	3417845204
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 HT MUSCLE IMAGE SPECT SING - STRESS TEST DOBUTAMINE W MYOCARD PERF

Facility

$6,494.00

Service Code	HCPCS 78451
Hospital Charge Code	3417845102
Hospital Revenue Code	341
Min. Negotiated Rate	$85.15
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	$85.15
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	$253.12
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	$85.15
Rate for Payer: UnitedHealthcare Medicare	$1,529.43
Rate for Payer: University Health Alliance Commercial	$461.20

Know your out-of-pocket cost for care.

All Charges