Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

HC VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I

Facility

$45,131.00

Service Code	HCPCS 37241
Hospital Charge Code	3603724101
Hospital Revenue Code	360
Min. Negotiated Rate	$38,361.35
Max. Negotiated Rate	$43,777.07
Rate for Payer: Cash Price	$27,078.60
Rate for Payer: Health Management Network Commercial	$38,361.35
Rate for Payer: MDX Hawaii PPO	$43,777.07

HC VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT

Facility

$45,131.00

Service Code	HCPCS 37243
Hospital Charge Code	3603724301
Hospital Revenue Code	360
Min. Negotiated Rate	$644.55
Max. Negotiated Rate	$43,777.07
Rate for Payer: AlohaCare Medicaid	$13,637.67
Rate for Payer: AlohaCare Medicare	$13,637.67
Rate for Payer: Cash Price	$27,078.60
Rate for Payer: Cash Price	$27,078.60
Rate for Payer: Cash Price	$27,078.60
Rate for Payer: Devoted Health Medicare	$15,001.44
Rate for Payer: Hawaii Medical Service Association ABD	$1,900.00
Rate for Payer: Hawaii Medical Service Association Commercial	$14,395.00
Rate for Payer: Hawaii Medical Service Association Medicare	$13,637.67
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,695.11
Rate for Payer: Health Management Network Commercial	$38,361.35
Rate for Payer: Humana Medicare	$13,637.67
Rate for Payer: Kaiser Permanente Commercial	$28,432.53
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$13,637.67
Rate for Payer: MDX Hawaii PPO	$43,777.07
Rate for Payer: Ohana Health Plan Medicaid	$15,001.44
Rate for Payer: Ohana Health Plan Medicare	$13,637.67
Rate for Payer: UnitedHealthcare Medicaid	$644.55
Rate for Payer: UnitedHealthcare Medicare	$13,637.67
Rate for Payer: University Health Alliance Commercial	$24,500.00

HC VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT

Facility

$45,131.00

Service Code	HCPCS 37243
Hospital Charge Code	3603724301
Hospital Revenue Code	360
Min. Negotiated Rate	$38,361.35
Max. Negotiated Rate	$43,777.07
Rate for Payer: Cash Price	$27,078.60
Rate for Payer: Health Management Network Commercial	$38,361.35
Rate for Payer: MDX Hawaii PPO	$43,777.07

HC VEIN X-RAY LIVER W/HEMODYNAM - IR PERC TRANSHEPATIC PORTO W HEMO EVL

Facility

$15,658.00

Service Code	HCPCS 75885
Hospital Charge Code	3207588502
Hospital Revenue Code	320
Min. Negotiated Rate	$414.83
Max. Negotiated Rate	$15,188.26
Rate for Payer: AlohaCare Medicaid	$3,730.07
Rate for Payer: AlohaCare Medicare	$3,730.07
Rate for Payer: Cash Price	$9,394.80
Rate for Payer: Cash Price	$9,394.80
Rate for Payer: Devoted Health Medicare	$4,103.08
Rate for Payer: Hawaii Medical Service Association ABD	$414.83
Rate for Payer: Hawaii Medical Service Association Commercial	$4,662.59
Rate for Payer: Hawaii Medical Service Association Medicare	$3,730.07
Rate for Payer: Hawaii Medical Service Association Non-ABD	$425.32
Rate for Payer: Hawaii Western Management Group Commercial	$3,730.07
Rate for Payer: Health Management Network Commercial	$13,309.30
Rate for Payer: Humana Medicare	$3,730.07
Rate for Payer: Kaiser Permanente Commercial	$9,864.54
Rate for Payer: Kaiser Permanente Medicaid	$7,985.58
Rate for Payer: Kaiser Permanente Medicare	$3,730.07
Rate for Payer: MDX Hawaii PPO	$15,188.26
Rate for Payer: Ohana Health Plan Medicaid	$4,103.08
Rate for Payer: Ohana Health Plan Medicare	$3,730.07
Rate for Payer: UnitedHealthcare Medicaid	$414.83
Rate for Payer: UnitedHealthcare Medicare	$3,730.07
Rate for Payer: University Health Alliance Commercial	$777.22

HC VEIN X-RAY LIVER W/HEMODYNAM - IR PERC TRANSHEPATIC PORTO W HEMO EVL

Facility

$15,658.00

Service Code	HCPCS 75885
Hospital Charge Code	3207588502
Hospital Revenue Code	320
Min. Negotiated Rate	$13,309.30
Max. Negotiated Rate	$15,188.26
Rate for Payer: Cash Price	$9,394.80
Rate for Payer: Health Management Network Commercial	$13,309.30
Rate for Payer: MDX Hawaii PPO	$15,188.26

HC VENOGRAM EXTREM BILAT - IR VENOGRAM EXTREMITY BILATERAL CHARGE

Facility

$7,728.00

Service Code	HCPCS 75822
Hospital Charge Code	3237582204
Hospital Revenue Code	323
Min. Negotiated Rate	$48.85
Max. Negotiated Rate	$7,496.16
Rate for Payer: AlohaCare Medicaid	$1,859.62
Rate for Payer: AlohaCare Medicare	$1,859.62
Rate for Payer: Cash Price	$4,636.80
Rate for Payer: Cash Price	$4,636.80
Rate for Payer: Devoted Health Medicare	$2,045.58
Rate for Payer: Hawaii Medical Service Association ABD	$48.85
Rate for Payer: Hawaii Medical Service Association Commercial	$2,324.53
Rate for Payer: Hawaii Medical Service Association Medicare	$1,859.62
Rate for Payer: Hawaii Medical Service Association Non-ABD	$52.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,859.62
Rate for Payer: Health Management Network Commercial	$6,568.80
Rate for Payer: Humana Medicare	$1,859.62
Rate for Payer: Kaiser Permanente Commercial	$4,868.64
Rate for Payer: Kaiser Permanente Medicaid	$3,941.28
Rate for Payer: Kaiser Permanente Medicare	$1,859.62
Rate for Payer: MDX Hawaii PPO	$7,496.16
Rate for Payer: Ohana Health Plan Medicaid	$2,045.58
Rate for Payer: Ohana Health Plan Medicare	$1,859.62
Rate for Payer: UnitedHealthcare Medicaid	$48.85
Rate for Payer: UnitedHealthcare Medicare	$1,859.62
Rate for Payer: University Health Alliance Commercial	$272.52

HC VENOGRAM EXTREM BILAT - IR VENOGRAM EXTREMITY BILATERAL CHARGE

Facility

$7,728.00

Service Code	HCPCS 75822
Hospital Charge Code	3237582204
Hospital Revenue Code	323
Min. Negotiated Rate	$6,568.80
Max. Negotiated Rate	$7,496.16
Rate for Payer: Cash Price	$4,636.80
Rate for Payer: Health Management Network Commercial	$6,568.80
Rate for Payer: MDX Hawaii PPO	$7,496.16

HC VENOGRAM EXTREM UNILAT

Facility

$7,728.00

Service Code	HCPCS 75820
Hospital Charge Code	3207582009
Hospital Revenue Code	320
Min. Negotiated Rate	$31.51
Max. Negotiated Rate	$7,496.16
Rate for Payer: AlohaCare Medicaid	$1,859.62
Rate for Payer: AlohaCare Medicare	$1,859.62
Rate for Payer: Cash Price	$4,636.80
Rate for Payer: Cash Price	$4,636.80
Rate for Payer: Devoted Health Medicare	$2,045.58
Rate for Payer: Hawaii Medical Service Association ABD	$31.51
Rate for Payer: Hawaii Medical Service Association Commercial	$2,324.53
Rate for Payer: Hawaii Medical Service Association Medicare	$1,859.62
Rate for Payer: Hawaii Medical Service Association Non-ABD	$34.37
Rate for Payer: Hawaii Western Management Group Commercial	$1,859.62
Rate for Payer: Health Management Network Commercial	$6,568.80
Rate for Payer: Humana Medicare	$1,859.62
Rate for Payer: Kaiser Permanente Commercial	$4,868.64
Rate for Payer: Kaiser Permanente Medicaid	$3,941.28
Rate for Payer: Kaiser Permanente Medicare	$1,859.62
Rate for Payer: MDX Hawaii PPO	$7,496.16
Rate for Payer: Ohana Health Plan Medicaid	$2,045.58
Rate for Payer: Ohana Health Plan Medicare	$1,859.62
Rate for Payer: UnitedHealthcare Medicaid	$31.51
Rate for Payer: UnitedHealthcare Medicare	$1,859.62
Rate for Payer: University Health Alliance Commercial	$215.77

HC VENOGRAM EXTREM UNILAT

Facility

$7,728.00

Service Code	HCPCS 75820
Hospital Charge Code	3207582009
Hospital Revenue Code	320
Min. Negotiated Rate	$6,568.80
Max. Negotiated Rate	$7,496.16
Rate for Payer: Cash Price	$4,636.80
Rate for Payer: Health Management Network Commercial	$6,568.80
Rate for Payer: MDX Hawaii PPO	$7,496.16

HC VENOGRAM INFER VENA CAVA - IR VENO CAVAL INFERIOR W SERIALOGRAPHY

Facility

$15,658.00

Service Code	HCPCS 75825
Hospital Charge Code	3207582501
Hospital Revenue Code	320
Min. Negotiated Rate	$414.83
Max. Negotiated Rate	$15,188.26
Rate for Payer: AlohaCare Medicaid	$3,730.07
Rate for Payer: AlohaCare Medicare	$3,730.07
Rate for Payer: Cash Price	$9,394.80
Rate for Payer: Cash Price	$9,394.80
Rate for Payer: Devoted Health Medicare	$4,103.08
Rate for Payer: Hawaii Medical Service Association ABD	$414.83
Rate for Payer: Hawaii Medical Service Association Commercial	$4,662.59
Rate for Payer: Hawaii Medical Service Association Medicare	$3,730.07
Rate for Payer: Hawaii Medical Service Association Non-ABD	$435.57
Rate for Payer: Hawaii Western Management Group Commercial	$3,730.07
Rate for Payer: Health Management Network Commercial	$13,309.30
Rate for Payer: Humana Medicare	$3,730.07
Rate for Payer: Kaiser Permanente Commercial	$9,864.54
Rate for Payer: Kaiser Permanente Medicaid	$7,985.58
Rate for Payer: Kaiser Permanente Medicare	$3,730.07
Rate for Payer: MDX Hawaii PPO	$15,188.26
Rate for Payer: Ohana Health Plan Medicaid	$4,103.08
Rate for Payer: Ohana Health Plan Medicare	$3,730.07
Rate for Payer: UnitedHealthcare Medicaid	$414.83
Rate for Payer: UnitedHealthcare Medicare	$3,730.07
Rate for Payer: University Health Alliance Commercial	$745.07

HC VENOGRAM INFER VENA CAVA - IR VENO CAVAL INFERIOR W SERIALOGRAPHY

Facility

$15,658.00

Service Code	HCPCS 75825
Hospital Charge Code	3207582501
Hospital Revenue Code	320
Min. Negotiated Rate	$13,309.30
Max. Negotiated Rate	$15,188.26
Rate for Payer: Cash Price	$9,394.80
Rate for Payer: Health Management Network Commercial	$13,309.30
Rate for Payer: MDX Hawaii PPO	$15,188.26

HC VENOGRAM RENAL BILAT - IR VENOGRAM RENAL BILATERAL

Facility

$15,658.00

Service Code	HCPCS 75833
Hospital Charge Code	3207583301
Hospital Revenue Code	320
Min. Negotiated Rate	$13,309.30
Max. Negotiated Rate	$15,188.26
Rate for Payer: Cash Price	$9,394.80
Rate for Payer: Health Management Network Commercial	$13,309.30
Rate for Payer: MDX Hawaii PPO	$15,188.26

HC VENOGRAM RENAL BILAT - IR VENOGRAM RENAL BILATERAL

Facility

$15,658.00

Service Code	HCPCS 75833
Hospital Charge Code	3207583301
Hospital Revenue Code	320
Min. Negotiated Rate	$414.83
Max. Negotiated Rate	$15,188.26
Rate for Payer: AlohaCare Medicaid	$3,730.07
Rate for Payer: AlohaCare Medicare	$3,730.07
Rate for Payer: Cash Price	$9,394.80
Rate for Payer: Cash Price	$9,394.80
Rate for Payer: Devoted Health Medicare	$4,103.08
Rate for Payer: Hawaii Medical Service Association ABD	$414.83
Rate for Payer: Hawaii Medical Service Association Commercial	$4,662.59
Rate for Payer: Hawaii Medical Service Association Medicare	$3,730.07
Rate for Payer: Hawaii Medical Service Association Non-ABD	$435.57
Rate for Payer: Hawaii Western Management Group Commercial	$3,730.07
Rate for Payer: Health Management Network Commercial	$13,309.30
Rate for Payer: Humana Medicare	$3,730.07
Rate for Payer: Kaiser Permanente Commercial	$9,864.54
Rate for Payer: Kaiser Permanente Medicaid	$7,985.58
Rate for Payer: Kaiser Permanente Medicare	$3,730.07
Rate for Payer: MDX Hawaii PPO	$15,188.26
Rate for Payer: Ohana Health Plan Medicaid	$4,103.08
Rate for Payer: Ohana Health Plan Medicare	$3,730.07
Rate for Payer: UnitedHealthcare Medicaid	$414.83
Rate for Payer: UnitedHealthcare Medicare	$3,730.07
Rate for Payer: University Health Alliance Commercial	$802.40

HC VENOGRAM RENAL UNILAT - IR VENOGRAM RENAL LEFT

Facility

$15,658.00

Service Code	HCPCS 75831
Hospital Charge Code	3207583101
Hospital Revenue Code	320
Min. Negotiated Rate	$414.83
Max. Negotiated Rate	$15,188.26
Rate for Payer: AlohaCare Medicaid	$3,730.07
Rate for Payer: AlohaCare Medicare	$3,730.07
Rate for Payer: Cash Price	$9,394.80
Rate for Payer: Cash Price	$9,394.80
Rate for Payer: Devoted Health Medicare	$4,103.08
Rate for Payer: Hawaii Medical Service Association ABD	$414.83
Rate for Payer: Hawaii Medical Service Association Commercial	$4,662.59
Rate for Payer: Hawaii Medical Service Association Medicare	$3,730.07
Rate for Payer: Hawaii Medical Service Association Non-ABD	$435.57
Rate for Payer: Hawaii Western Management Group Commercial	$3,730.07
Rate for Payer: Health Management Network Commercial	$13,309.30
Rate for Payer: Humana Medicare	$3,730.07
Rate for Payer: Kaiser Permanente Commercial	$9,864.54
Rate for Payer: Kaiser Permanente Medicaid	$7,985.58
Rate for Payer: Kaiser Permanente Medicare	$3,730.07
Rate for Payer: MDX Hawaii PPO	$15,188.26
Rate for Payer: Ohana Health Plan Medicaid	$4,103.08
Rate for Payer: Ohana Health Plan Medicare	$3,730.07
Rate for Payer: UnitedHealthcare Medicaid	$414.83
Rate for Payer: UnitedHealthcare Medicare	$3,730.07
Rate for Payer: University Health Alliance Commercial	$748.57

HC VENOGRAM RENAL UNILAT - IR VENOGRAM RENAL LEFT

Facility

$15,658.00

Service Code	HCPCS 75831
Hospital Charge Code	3207583101
Hospital Revenue Code	320
Min. Negotiated Rate	$13,309.30
Max. Negotiated Rate	$15,188.26
Rate for Payer: Cash Price	$9,394.80
Rate for Payer: Health Management Network Commercial	$13,309.30
Rate for Payer: MDX Hawaii PPO	$15,188.26

HC VENOGRAM SUPER VENA CAVA - IR VENO CAVAL SUPERIOR W SERIALOGRAPHY

Facility

$7,728.00

Service Code	HCPCS 75827
Hospital Charge Code	3207582701
Hospital Revenue Code	320
Min. Negotiated Rate	$414.83
Max. Negotiated Rate	$7,496.16
Rate for Payer: AlohaCare Medicaid	$1,859.62
Rate for Payer: AlohaCare Medicare	$1,859.62
Rate for Payer: Cash Price	$4,636.80
Rate for Payer: Cash Price	$4,636.80
Rate for Payer: Devoted Health Medicare	$2,045.58
Rate for Payer: Hawaii Medical Service Association ABD	$414.83
Rate for Payer: Hawaii Medical Service Association Commercial	$2,324.53
Rate for Payer: Hawaii Medical Service Association Medicare	$1,859.62
Rate for Payer: Hawaii Medical Service Association Non-ABD	$435.57
Rate for Payer: Hawaii Western Management Group Commercial	$1,859.62
Rate for Payer: Health Management Network Commercial	$6,568.80
Rate for Payer: Humana Medicare	$1,859.62
Rate for Payer: Kaiser Permanente Commercial	$4,868.64
Rate for Payer: Kaiser Permanente Medicaid	$3,941.28
Rate for Payer: Kaiser Permanente Medicare	$1,859.62
Rate for Payer: MDX Hawaii PPO	$7,496.16
Rate for Payer: Ohana Health Plan Medicaid	$2,045.58
Rate for Payer: Ohana Health Plan Medicare	$1,859.62
Rate for Payer: UnitedHealthcare Medicaid	$414.83
Rate for Payer: UnitedHealthcare Medicare	$1,859.62
Rate for Payer: University Health Alliance Commercial	$744.85

HC VENOGRAM SUPER VENA CAVA - IR VENO CAVAL SUPERIOR W SERIALOGRAPHY

Facility

$7,728.00

Service Code	HCPCS 75827
Hospital Charge Code	3207582701
Hospital Revenue Code	320
Min. Negotiated Rate	$6,568.80
Max. Negotiated Rate	$7,496.16
Rate for Payer: Cash Price	$4,636.80
Rate for Payer: Health Management Network Commercial	$6,568.80
Rate for Payer: MDX Hawaii PPO	$7,496.16

HC VENT MGMT PER DAY-SNF

Facility

$837.00

Service Code	HCPCS 94004
Hospital Charge Code	4109400401
Hospital Revenue Code	410
Min. Negotiated Rate	$31.91
Max. Negotiated Rate	$811.89
Rate for Payer: Cash Price	$502.20
Rate for Payer: Cash Price	$502.20
Rate for Payer: Hawaii Western Management Group Commercial	$795.15
Rate for Payer: Health Management Network Commercial	$711.45
Rate for Payer: Kaiser Permanente Commercial	$527.31
Rate for Payer: Kaiser Permanente Medicaid	$426.87
Rate for Payer: MDX Hawaii PPO	$811.89
Rate for Payer: UnitedHealthcare Medicaid	$31.91
Rate for Payer: University Health Alliance Commercial	$610.09

HC VENT MGMT PER DAY-SNF

Facility

$837.00

Service Code	HCPCS 94004
Hospital Charge Code	4109400401
Hospital Revenue Code	410
Min. Negotiated Rate	$711.45
Max. Negotiated Rate	$811.89
Rate for Payer: Cash Price	$502.20
Rate for Payer: Health Management Network Commercial	$711.45
Rate for Payer: MDX Hawaii PPO	$811.89

HC VIRAL AB NOS SO

Facility

$108.00

Service Code	HCPCS 86790
Hospital Charge Code	3028679001
Hospital Revenue Code	302
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$104.76
Rate for Payer: Cash Price	$64.80
Rate for Payer: Health Management Network Commercial	$91.80
Rate for Payer: MDX Hawaii PPO	$104.76

HC VIRAL AB NOS SO

Facility

$108.00

Service Code	HCPCS 86790
Hospital Charge Code	3028679001
Hospital Revenue Code	302
Min. Negotiated Rate	$12.88
Max. Negotiated Rate	$104.76
Rate for Payer: AlohaCare Medicaid	$12.88
Rate for Payer: AlohaCare Medicare	$12.88
Rate for Payer: Cash Price	$64.80
Rate for Payer: Cash Price	$64.80
Rate for Payer: Devoted Health Medicare	$14.17
Rate for Payer: Hawaii Medical Service Association ABD	$17.81
Rate for Payer: Hawaii Medical Service Association Commercial	$16.10
Rate for Payer: Hawaii Medical Service Association Medicare	$12.88
Rate for Payer: Hawaii Medical Service Association Non-ABD	$18.70
Rate for Payer: Hawaii Western Management Group Commercial	$12.88
Rate for Payer: Health Management Network Commercial	$91.80
Rate for Payer: Humana Medicare	$12.88
Rate for Payer: Kaiser Permanente Commercial	$68.04
Rate for Payer: Kaiser Permanente Medicaid	$55.08
Rate for Payer: Kaiser Permanente Medicare	$12.88
Rate for Payer: MDX Hawaii PPO	$104.76
Rate for Payer: Ohana Health Plan Medicaid	$14.17
Rate for Payer: Ohana Health Plan Medicare	$12.88
Rate for Payer: UnitedHealthcare Medicaid	$17.81
Rate for Payer: UnitedHealthcare Medicare	$12.88
Rate for Payer: University Health Alliance Commercial	$33.30

HC VIRAL ID TISS CULT ADD SO

Facility

$169.00

Service Code	HCPCS 87253
Hospital Charge Code	3068725301
Hospital Revenue Code	306
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$163.93
Rate for Payer: AlohaCare Medicaid	$20.20
Rate for Payer: AlohaCare Medicare	$20.20
Rate for Payer: Cash Price	$101.40
Rate for Payer: Cash Price	$101.40
Rate for Payer: Devoted Health Medicare	$22.22
Rate for Payer: Hawaii Medical Service Association ABD	$12.39
Rate for Payer: Hawaii Medical Service Association Commercial	$25.25
Rate for Payer: Hawaii Medical Service Association Medicare	$20.20
Rate for Payer: Hawaii Medical Service Association Non-ABD	$13.01
Rate for Payer: Hawaii Western Management Group Commercial	$20.20
Rate for Payer: Health Management Network Commercial	$143.65
Rate for Payer: Humana Medicare	$20.20
Rate for Payer: Kaiser Permanente Commercial	$106.47
Rate for Payer: Kaiser Permanente Medicaid	$86.19
Rate for Payer: Kaiser Permanente Medicare	$20.20
Rate for Payer: MDX Hawaii PPO	$163.93
Rate for Payer: Ohana Health Plan Medicaid	$22.22
Rate for Payer: Ohana Health Plan Medicare	$20.20
Rate for Payer: UnitedHealthcare Medicaid	$12.39
Rate for Payer: UnitedHealthcare Medicare	$20.20
Rate for Payer: University Health Alliance Commercial	$23.18

HC VIRAL ID TISS CULT ADD SO

Facility

$169.00

Service Code	HCPCS 87253
Hospital Charge Code	3068725301
Hospital Revenue Code	306
Min. Negotiated Rate	$143.65
Max. Negotiated Rate	$163.93
Rate for Payer: Cash Price	$101.40
Rate for Payer: Health Management Network Commercial	$143.65
Rate for Payer: MDX Hawaii PPO	$163.93

HC VITAL CAPACITY TOTAL

Facility

$623.00

Service Code	HCPCS 94150
Hospital Charge Code	4609415001
Hospital Revenue Code	460
Min. Negotiated Rate	$529.55
Max. Negotiated Rate	$604.31
Rate for Payer: Cash Price	$373.80
Rate for Payer: Health Management Network Commercial	$529.55
Rate for Payer: MDX Hawaii PPO	$604.31

HC VITAL CAPACITY TOTAL

Facility

$623.00

Service Code	HCPCS 94150
Hospital Charge Code	4609415001
Hospital Revenue Code	460
Min. Negotiated Rate	$3.05
Max. Negotiated Rate	$604.31
Rate for Payer: AlohaCare Medicaid	$152.01
Rate for Payer: AlohaCare Medicare	$152.01
Rate for Payer: Cash Price	$373.80
Rate for Payer: Cash Price	$373.80
Rate for Payer: Devoted Health Medicare	$167.21
Rate for Payer: Hawaii Medical Service Association ABD	$7.54
Rate for Payer: Hawaii Medical Service Association Commercial	$190.01
Rate for Payer: Hawaii Medical Service Association Medicare	$152.01
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3.05
Rate for Payer: Hawaii Western Management Group Commercial	$591.85
Rate for Payer: Health Management Network Commercial	$529.55
Rate for Payer: Humana Medicare	$152.01
Rate for Payer: Kaiser Permanente Commercial	$392.49
Rate for Payer: Kaiser Permanente Medicaid	$317.73
Rate for Payer: Kaiser Permanente Medicare	$152.01
Rate for Payer: MDX Hawaii PPO	$604.31
Rate for Payer: Ohana Health Plan Medicaid	$167.21
Rate for Payer: Ohana Health Plan Medicare	$152.01
Rate for Payer: UnitedHealthcare Medicaid	$7.54
Rate for Payer: UnitedHealthcare Medicare	$152.01
Rate for Payer: University Health Alliance Commercial	$454.10

Know your out-of-pocket cost for care.

All Charges