Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

HC MYCOPLASMA - MYCOPLASMA AB SO

Facility

$111.00

Service Code	HCPCS 86738
Hospital Charge Code	3028673801
Hospital Revenue Code	302
Min. Negotiated Rate	$13.24
Max. Negotiated Rate	$107.67
Rate for Payer: AlohaCare Medicaid	$13.24
Rate for Payer: AlohaCare Medicare	$13.24
Rate for Payer: Cash Price	$66.60
Rate for Payer: Cash Price	$66.60
Rate for Payer: Devoted Health Medicare	$14.56
Rate for Payer: Hawaii Medical Service Association ABD	$18.31
Rate for Payer: Hawaii Medical Service Association Commercial	$16.55
Rate for Payer: Hawaii Medical Service Association Medicare	$13.24
Rate for Payer: Hawaii Medical Service Association Non-ABD	$19.23
Rate for Payer: Hawaii Western Management Group Commercial	$13.24
Rate for Payer: Health Management Network Commercial	$94.35
Rate for Payer: Humana Medicare	$13.24
Rate for Payer: Kaiser Permanente Commercial	$69.93
Rate for Payer: Kaiser Permanente Medicaid	$56.61
Rate for Payer: Kaiser Permanente Medicare	$13.24
Rate for Payer: MDX Hawaii PPO	$107.67
Rate for Payer: Ohana Health Plan Medicaid	$14.56
Rate for Payer: Ohana Health Plan Medicare	$13.24
Rate for Payer: UnitedHealthcare Medicaid	$18.31
Rate for Payer: UnitedHealthcare Medicare	$13.24
Rate for Payer: University Health Alliance Commercial	$34.24

HC MYCOPLASMA - MYCOPLASMA AB SO

Facility

$111.00

Service Code	HCPCS 86738
Hospital Charge Code	3028673801
Hospital Revenue Code	302
Min. Negotiated Rate	$94.35
Max. Negotiated Rate	$107.67
Rate for Payer: Cash Price	$66.60
Rate for Payer: Health Management Network Commercial	$94.35
Rate for Payer: MDX Hawaii PPO	$107.67

HC MYCOPLASMA - MYCOPLASMA PNEUMONIAE ANTIBODY, IGM

Facility

$111.00

Service Code	HCPCS 86738
Hospital Charge Code	3028673802
Hospital Revenue Code	302
Min. Negotiated Rate	$13.24
Max. Negotiated Rate	$107.67
Rate for Payer: AlohaCare Medicaid	$13.24
Rate for Payer: AlohaCare Medicare	$13.24
Rate for Payer: Cash Price	$66.60
Rate for Payer: Cash Price	$66.60
Rate for Payer: Devoted Health Medicare	$14.56
Rate for Payer: Hawaii Medical Service Association ABD	$18.31
Rate for Payer: Hawaii Medical Service Association Commercial	$16.55
Rate for Payer: Hawaii Medical Service Association Medicare	$13.24
Rate for Payer: Hawaii Medical Service Association Non-ABD	$19.23
Rate for Payer: Hawaii Western Management Group Commercial	$13.24
Rate for Payer: Health Management Network Commercial	$94.35
Rate for Payer: Humana Medicare	$13.24
Rate for Payer: Kaiser Permanente Commercial	$69.93
Rate for Payer: Kaiser Permanente Medicaid	$56.61
Rate for Payer: Kaiser Permanente Medicare	$13.24
Rate for Payer: MDX Hawaii PPO	$107.67
Rate for Payer: Ohana Health Plan Medicaid	$14.56
Rate for Payer: Ohana Health Plan Medicare	$13.24
Rate for Payer: UnitedHealthcare Medicaid	$18.31
Rate for Payer: UnitedHealthcare Medicare	$13.24
Rate for Payer: University Health Alliance Commercial	$34.24

HC MYCOPLASMA - MYCOPLASMA PNEUMONIAE ANTIBODY, IGM

Facility

$111.00

Service Code	HCPCS 86738
Hospital Charge Code	3028673802
Hospital Revenue Code	302
Min. Negotiated Rate	$94.35
Max. Negotiated Rate	$107.67
Rate for Payer: Cash Price	$66.60
Rate for Payer: Health Management Network Commercial	$94.35
Rate for Payer: MDX Hawaii PPO	$107.67

HC MYD88 MUT ANALYSIS SO

Facility

$1,472.00

Service Code	HCPCS 81305
Hospital Charge Code	3108130501
Hospital Revenue Code	310
Min. Negotiated Rate	$1,251.20
Max. Negotiated Rate	$1,427.84
Rate for Payer: Cash Price	$883.20
Rate for Payer: Health Management Network Commercial	$1,251.20
Rate for Payer: MDX Hawaii PPO	$1,427.84

HC MYD88 MUT ANALYSIS SO

Facility

$1,472.00

Service Code	HCPCS 81305
Hospital Charge Code	3108130501
Hospital Revenue Code	310
Min. Negotiated Rate	$105.24
Max. Negotiated Rate	$1,427.84
Rate for Payer: Ohana Health Plan Medicare	$175.40
Rate for Payer: AlohaCare Medicaid	$175.40
Rate for Payer: AlohaCare Medicare	$175.40
Rate for Payer: Cash Price	$883.20
Rate for Payer: Cash Price	$883.20
Rate for Payer: Devoted Health Medicare	$192.94
Rate for Payer: Hawaii Medical Service Association ABD	$175.87
Rate for Payer: Hawaii Medical Service Association Commercial	$219.25
Rate for Payer: Hawaii Medical Service Association Medicare	$175.40
Rate for Payer: Hawaii Medical Service Association Non-ABD	$175.87
Rate for Payer: Hawaii Western Management Group Commercial	$175.40
Rate for Payer: Health Management Network Commercial	$1,251.20
Rate for Payer: Humana Medicare	$175.40
Rate for Payer: Kaiser Permanente Commercial	$927.36
Rate for Payer: Kaiser Permanente Medicaid	$750.72
Rate for Payer: Kaiser Permanente Medicare	$175.40
Rate for Payer: MDX Hawaii PPO	$1,427.84
Rate for Payer: Ohana Health Plan Medicaid	$192.94
Rate for Payer: UnitedHealthcare Medicaid	$105.24
Rate for Payer: UnitedHealthcare Medicare	$175.40
Rate for Payer: University Health Alliance Commercial	$1,072.94

HC MYELOGRAPHY CERV SPINE - FL CERVICAL SPINE MYELOGRAM

Facility

$3,930.00

Service Code	HCPCS 72240
Hospital Charge Code	3207224001
Hospital Revenue Code	320
Min. Negotiated Rate	$156.47
Max. Negotiated Rate	$3,812.10
Rate for Payer: AlohaCare Medicaid	$926.08
Rate for Payer: AlohaCare Medicare	$926.08
Rate for Payer: Cash Price	$2,358.00
Rate for Payer: Cash Price	$2,358.00
Rate for Payer: Devoted Health Medicare	$1,018.69
Rate for Payer: Hawaii Medical Service Association ABD	$156.47
Rate for Payer: Hawaii Medical Service Association Commercial	$1,157.60
Rate for Payer: Hawaii Medical Service Association Medicare	$926.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$160.48
Rate for Payer: Hawaii Western Management Group Commercial	$926.08
Rate for Payer: Health Management Network Commercial	$3,340.50
Rate for Payer: Humana Medicare	$926.08
Rate for Payer: Kaiser Permanente Commercial	$2,475.90
Rate for Payer: Kaiser Permanente Medicaid	$2,004.30
Rate for Payer: Kaiser Permanente Medicare	$926.08
Rate for Payer: MDX Hawaii PPO	$3,812.10
Rate for Payer: Ohana Health Plan Medicaid	$1,018.69
Rate for Payer: Ohana Health Plan Medicare	$926.08
Rate for Payer: UnitedHealthcare Medicaid	$156.47
Rate for Payer: UnitedHealthcare Medicare	$926.08
Rate for Payer: University Health Alliance Commercial	$375.70

HC MYELOGRAPHY CERV SPINE - FL CERVICAL SPINE MYELOGRAM

Facility

$3,930.00

Service Code	HCPCS 72240
Hospital Charge Code	3207224001
Hospital Revenue Code	320
Min. Negotiated Rate	$3,340.50
Max. Negotiated Rate	$3,812.10
Rate for Payer: Cash Price	$2,358.00
Rate for Payer: Health Management Network Commercial	$3,340.50
Rate for Payer: MDX Hawaii PPO	$3,812.10

HC MYELOGRAPHY LUMBAR SPINE - FL LUMBAR SPINE MYELOGRAM

Facility

$3,930.00

Service Code	HCPCS 72265
Hospital Charge Code	3207226501
Hospital Revenue Code	320
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$5,509.00
Rate for Payer: AlohaCare Medicaid	$926.08
Rate for Payer: AlohaCare Medicare	$926.08
Rate for Payer: Cash Price	$2,358.00
Rate for Payer: Cash Price	$2,358.00
Rate for Payer: Cash Price	$2,358.00
Rate for Payer: Devoted Health Medicare	$1,018.69
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	$926.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$1,028.67
Rate for Payer: Hawaii Western Management Group Commercial	$926.08
Rate for Payer: Health Management Network Commercial	$3,340.50
Rate for Payer: Humana Medicare	$926.08
Rate for Payer: Kaiser Permanente Commercial	$2,475.90
Rate for Payer: Kaiser Permanente Medicaid	$2,004.30
Rate for Payer: Kaiser Permanente Medicare	$926.08
Rate for Payer: MDX Hawaii PPO	$3,812.10
Rate for Payer: Ohana Health Plan Medicaid	$1,018.69
Rate for Payer: Ohana Health Plan Medicare	$926.08
Rate for Payer: UnitedHealthcare Medicaid	$134.20
Rate for Payer: UnitedHealthcare Medicare	$926.08
Rate for Payer: University Health Alliance Commercial	$339.59

HC MYELOGRAPHY LUMBAR SPINE - FL LUMBAR SPINE MYELOGRAM

Facility

$3,930.00

Service Code	HCPCS 72265
Hospital Charge Code	3207226501
Hospital Revenue Code	320
Min. Negotiated Rate	$3,340.50
Max. Negotiated Rate	$3,812.10
Rate for Payer: Cash Price	$2,358.00
Rate for Payer: Health Management Network Commercial	$3,340.50
Rate for Payer: MDX Hawaii PPO	$3,812.10

HC MYELOGRAPHY THORAX SPINE - FL THORACIC SPINE MYELOGRAM

Facility

$3,930.00

Service Code	HCPCS 72255
Hospital Charge Code	3207225501
Hospital Revenue Code	320
Min. Negotiated Rate	$142.62
Max. Negotiated Rate	$3,812.10
Rate for Payer: AlohaCare Medicaid	$926.08
Rate for Payer: AlohaCare Medicare	$926.08
Rate for Payer: Cash Price	$2,358.00
Rate for Payer: Cash Price	$2,358.00
Rate for Payer: Devoted Health Medicare	$1,018.69
Rate for Payer: Hawaii Medical Service Association ABD	$142.62
Rate for Payer: Hawaii Medical Service Association Commercial	$1,157.60
Rate for Payer: Hawaii Medical Service Association Medicare	$926.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$149.75
Rate for Payer: Hawaii Western Management Group Commercial	$926.08
Rate for Payer: Health Management Network Commercial	$3,340.50
Rate for Payer: Humana Medicare	$926.08
Rate for Payer: Kaiser Permanente Commercial	$2,475.90
Rate for Payer: Kaiser Permanente Medicaid	$2,004.30
Rate for Payer: Kaiser Permanente Medicare	$926.08
Rate for Payer: MDX Hawaii PPO	$3,812.10
Rate for Payer: Ohana Health Plan Medicaid	$1,018.69
Rate for Payer: Ohana Health Plan Medicare	$926.08
Rate for Payer: UnitedHealthcare Medicaid	$142.62
Rate for Payer: UnitedHealthcare Medicare	$926.08
Rate for Payer: University Health Alliance Commercial	$344.53

HC MYELOGRAPHY THORAX SPINE - FL THORACIC SPINE MYELOGRAM

Facility

$3,930.00

Service Code	HCPCS 72255
Hospital Charge Code	3207225501
Hospital Revenue Code	320
Min. Negotiated Rate	$3,340.50
Max. Negotiated Rate	$3,812.10
Rate for Payer: Cash Price	$2,358.00
Rate for Payer: Health Management Network Commercial	$3,340.50
Rate for Payer: MDX Hawaii PPO	$3,812.10

HC MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS

Facility

$3,079.00

Service Code	HCPCS 62305
Hospital Charge Code	3616230501
Hospital Revenue Code	361
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$2,986.63
Rate for Payer: AlohaCare Medicaid	$926.08
Rate for Payer: AlohaCare Medicare	$926.08
Rate for Payer: Cash Price	$1,847.40
Rate for Payer: Cash Price	$1,847.40
Rate for Payer: Cash Price	$1,847.40
Rate for Payer: Devoted Health Medicare	$1,018.69
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	$926.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$496.75
Rate for Payer: Health Management Network Commercial	$2,617.15
Rate for Payer: Humana Medicare	$926.08
Rate for Payer: Kaiser Permanente Commercial	$1,939.77
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$926.08
Rate for Payer: MDX Hawaii PPO	$2,986.63
Rate for Payer: Ohana Health Plan Medicaid	$1,018.69
Rate for Payer: Ohana Health Plan Medicare	$926.08
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$926.08
Rate for Payer: University Health Alliance Commercial	$2,244.28

HC MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS

Facility

$3,079.00

Service Code	HCPCS 62305
Hospital Charge Code	3616230501
Hospital Revenue Code	361
Min. Negotiated Rate	$2,617.15
Max. Negotiated Rate	$2,986.63
Rate for Payer: Cash Price	$1,847.40
Rate for Payer: Health Management Network Commercial	$2,617.15
Rate for Payer: MDX Hawaii PPO	$2,986.63

HC MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL

Facility

$3,079.00

Service Code	HCPCS 62302
Hospital Charge Code	3616230201
Hospital Revenue Code	361
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$2,986.63
Rate for Payer: AlohaCare Medicaid	$926.08
Rate for Payer: AlohaCare Medicare	$926.08
Rate for Payer: Cash Price	$1,847.40
Rate for Payer: Cash Price	$1,847.40
Rate for Payer: Cash Price	$1,847.40
Rate for Payer: Devoted Health Medicare	$1,018.69
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	$926.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$496.75
Rate for Payer: Health Management Network Commercial	$2,617.15
Rate for Payer: Humana Medicare	$926.08
Rate for Payer: Kaiser Permanente Commercial	$1,939.77
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$926.08
Rate for Payer: MDX Hawaii PPO	$2,986.63
Rate for Payer: Ohana Health Plan Medicaid	$1,018.69
Rate for Payer: Ohana Health Plan Medicare	$926.08
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$926.08
Rate for Payer: University Health Alliance Commercial	$2,244.28

HC MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL

Facility

$3,079.00

Service Code	HCPCS 62302
Hospital Charge Code	3616230201
Hospital Revenue Code	361
Min. Negotiated Rate	$2,617.15
Max. Negotiated Rate	$2,986.63
Rate for Payer: Cash Price	$1,847.40
Rate for Payer: Health Management Network Commercial	$2,617.15
Rate for Payer: MDX Hawaii PPO	$2,986.63

HC MYOCARDIAL PERF SPECT SGL

Facility

$6,494.00

Service Code	HCPCS 78451
Hospital Charge Code	3417845101
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 MYOCARDIAL PERF SPECT SGL

Facility

$6,494.00

Service Code	HCPCS 78451
Hospital Charge Code	3417845101
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

HC MYOCRD STRAIN IMG SPCKL TRCK

Facility

$315.00

Service Code	HCPCS 93356
Hospital Charge Code	4839335601
Hospital Revenue Code	483
Min. Negotiated Rate	$11.42
Max. Negotiated Rate	$305.55
Rate for Payer: Cash Price	$189.00
Rate for Payer: Cash Price	$189.00
Rate for Payer: Hawaii Western Management Group Commercial	$299.25
Rate for Payer: Health Management Network Commercial	$267.75
Rate for Payer: Kaiser Permanente Commercial	$198.45
Rate for Payer: Kaiser Permanente Medicaid	$160.65
Rate for Payer: MDX Hawaii PPO	$305.55
Rate for Payer: UnitedHealthcare Medicaid	$11.42
Rate for Payer: University Health Alliance Commercial	$229.60

HC MYOCRD STRAIN IMG SPCKL TRCK

Facility

$315.00

Service Code	HCPCS 93356
Hospital Charge Code	4839335601
Hospital Revenue Code	483
Min. Negotiated Rate	$267.75
Max. Negotiated Rate	$305.55
Rate for Payer: Cash Price	$189.00
Rate for Payer: Health Management Network Commercial	$267.75
Rate for Payer: MDX Hawaii PPO	$305.55

HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP)

Facility

$329.00

Service Code	HCPCS 83880
Hospital Charge Code	3018388001
Hospital Revenue Code	301
Min. Negotiated Rate	$28.46
Max. Negotiated Rate	$319.13
Rate for Payer: AlohaCare Medicaid	$39.26
Rate for Payer: AlohaCare Medicare	$39.26
Rate for Payer: Cash Price	$197.40
Rate for Payer: Cash Price	$197.40
Rate for Payer: Devoted Health Medicare	$43.19
Rate for Payer: Hawaii Medical Service Association ABD	$28.46
Rate for Payer: Hawaii Medical Service Association Commercial	$49.08
Rate for Payer: Hawaii Medical Service Association Medicare	$39.26
Rate for Payer: Hawaii Medical Service Association Non-ABD	$46.89
Rate for Payer: Hawaii Western Management Group Commercial	$39.26
Rate for Payer: Health Management Network Commercial	$279.65
Rate for Payer: Humana Medicare	$39.26
Rate for Payer: Kaiser Permanente Commercial	$207.27
Rate for Payer: Kaiser Permanente Medicaid	$167.79
Rate for Payer: Kaiser Permanente Medicare	$39.26
Rate for Payer: MDX Hawaii PPO	$319.13
Rate for Payer: Ohana Health Plan Medicaid	$43.19
Rate for Payer: Ohana Health Plan Medicare	$39.26
Rate for Payer: UnitedHealthcare Medicaid	$28.46
Rate for Payer: UnitedHealthcare Medicare	$39.26
Rate for Payer: University Health Alliance Commercial	$87.75

HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP)

Facility

$329.00

Service Code	HCPCS 83880
Hospital Charge Code	3018388001
Hospital Revenue Code	301
Min. Negotiated Rate	$279.65
Max. Negotiated Rate	$319.13
Rate for Payer: Cash Price	$197.40
Rate for Payer: Health Management Network Commercial	$279.65
Rate for Payer: MDX Hawaii PPO	$319.13

HC NECROPSY GROSS & MICROSCOPIC W/BRAIN

Facility

$4,167.00

Service Code	HCPCS 88025
Hospital Charge Code	3108802501
Hospital Revenue Code	310
Min. Negotiated Rate	$3,541.95
Max. Negotiated Rate	$4,041.99
Rate for Payer: Cash Price	$2,500.20
Rate for Payer: Health Management Network Commercial	$3,541.95
Rate for Payer: MDX Hawaii PPO	$4,041.99

HC NECROPSY GROSS & MICROSCOPIC W/BRAIN

Facility

$4,167.00

Service Code	HCPCS 88025
Hospital Charge Code	3108802501
Hospital Revenue Code	310
Min. Negotiated Rate	$2,125.17
Max. Negotiated Rate	$4,041.99
Rate for Payer: Cash Price	$2,500.20
Rate for Payer: Hawaii Western Management Group Commercial	$3,958.65
Rate for Payer: Health Management Network Commercial	$3,541.95
Rate for Payer: Kaiser Permanente Commercial	$2,625.21
Rate for Payer: Kaiser Permanente Medicaid	$2,125.17
Rate for Payer: MDX Hawaii PPO	$4,041.99
Rate for Payer: University Health Alliance Commercial	$3,037.33

HC NEEDLE BIOPSY LIVER

Facility

$6,448.00

Service Code	HCPCS 47000
Hospital Charge Code	3614700001
Hospital Revenue Code	361
Min. Negotiated Rate	$393.00
Max. Negotiated Rate	$6,254.56
Rate for Payer: AlohaCare Medicaid	$1,951.11
Rate for Payer: AlohaCare Medicare	$1,951.11
Rate for Payer: Cash Price	$3,868.80
Rate for Payer: Cash Price	$3,868.80
Rate for Payer: Cash Price	$3,868.80
Rate for Payer: Devoted Health Medicare	$2,146.22
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	$1,951.11
Rate for Payer: Hawaii Medical Service Association Non-ABD	$496.75
Rate for Payer: Health Management Network Commercial	$5,480.80
Rate for Payer: Humana Medicare	$1,951.11
Rate for Payer: Kaiser Permanente Commercial	$4,062.24
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$1,951.11
Rate for Payer: MDX Hawaii PPO	$6,254.56
Rate for Payer: Ohana Health Plan Medicaid	$2,146.22
Rate for Payer: Ohana Health Plan Medicare	$1,951.11
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$1,951.11
Rate for Payer: University Health Alliance Commercial	$4,699.95

Know your out-of-pocket cost for care.

All Charges