Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

MIRTAZAPINE 30 MG TABLET [17465]

Facility

IP

$10.00

Service Code	NDC 13107000334
Hospital Revenue Code	250
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$6.00
Rate for Payer: Health Management Network Commercial	$8.50
Rate for Payer: MDX Hawaii PPO	$9.70

MIRTAZAPINE 30 MG TABLET [17465]

Facility

IP

$5.00

Service Code	NDC 68084012001
Hospital Revenue Code	250
Min. Negotiated Rate	$4.25
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.00
Rate for Payer: Health Management Network Commercial	$4.25
Rate for Payer: MDX Hawaii PPO	$4.85

MIRTAZAPINE 30 MG TABLET [17465]

Facility

OP

$10.00

Service Code	NDC 13107000334
Hospital Revenue Code	637
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$6.00
Rate for Payer: Hawaii Western Management Group Commercial	$9.50
Rate for Payer: Health Management Network Commercial	$8.50
Rate for Payer: Kaiser Permanente Commercial	$6.30
Rate for Payer: Kaiser Permanente Medicaid	$5.10
Rate for Payer: MDX Hawaii PPO	$9.70
Rate for Payer: University Health Alliance Commercial	$7.29

MIRTAZAPINE 30 MG TABLET [17465]

Facility

OP

$5.00

Service Code	NDC 68084012011
Hospital Revenue Code	637
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.00
Rate for Payer: Hawaii Western Management Group Commercial	$4.75
Rate for Payer: Health Management Network Commercial	$4.25
Rate for Payer: Kaiser Permanente Commercial	$3.15
Rate for Payer: Kaiser Permanente Medicaid	$2.55
Rate for Payer: MDX Hawaii PPO	$4.85
Rate for Payer: University Health Alliance Commercial	$3.64

MIRTAZAPINE 30 MG TABLET [17465]

Facility

IP

$5.00

Service Code	NDC 68084012011
Hospital Revenue Code	250
Min. Negotiated Rate	$4.25
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.00
Rate for Payer: Health Management Network Commercial	$4.25
Rate for Payer: MDX Hawaii PPO	$4.85

MIRTAZAPINE 30 MG TABLET [17465]

Facility

OP

$5.00

Service Code	NDC 68084012001
Hospital Revenue Code	637
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.00
Rate for Payer: Hawaii Western Management Group Commercial	$4.75
Rate for Payer: Health Management Network Commercial	$4.25
Rate for Payer: Kaiser Permanente Commercial	$3.15
Rate for Payer: Kaiser Permanente Medicaid	$2.55
Rate for Payer: MDX Hawaii PPO	$4.85
Rate for Payer: University Health Alliance Commercial	$3.64

MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML INTRAVENOUS SOLUTION [188970]

Facility

OP

$31,498.00

Service Code	HCPCS J9063
Hospital Revenue Code	636
Min. Negotiated Rate	$69.52
Max. Negotiated Rate	$30,553.06
Rate for Payer: AlohaCare Medicaid	$71.13
Rate for Payer: AlohaCare Medicaid	$71.13
Rate for Payer: AlohaCare Medicare	$71.13
Rate for Payer: AlohaCare Medicare	$71.13
Rate for Payer: Cash Price	$18,898.80
Rate for Payer: Cash Price	$18,898.80
Rate for Payer: Cash Price	$7,325.40
Rate for Payer: Cash Price	$7,325.40
Rate for Payer: Devoted Health Medicare	$78.24
Rate for Payer: Devoted Health Medicare	$78.24
Rate for Payer: Hawaii Medical Service Association ABD	$69.52
Rate for Payer: Hawaii Medical Service Association ABD	$69.52
Rate for Payer: Hawaii Medical Service Association Commercial	$88.91
Rate for Payer: Hawaii Medical Service Association Commercial	$88.91
Rate for Payer: Hawaii Medical Service Association Medicare	$71.13
Rate for Payer: Hawaii Medical Service Association Medicare	$71.13
Rate for Payer: Hawaii Medical Service Association Non-ABD	$69.52
Rate for Payer: Hawaii Medical Service Association Non-ABD	$69.52
Rate for Payer: Hawaii Western Management Group Commercial	$11,598.55
Rate for Payer: Hawaii Western Management Group Commercial	$29,923.10
Rate for Payer: Health Management Network Commercial	$10,377.65
Rate for Payer: Health Management Network Commercial	$26,773.30
Rate for Payer: Humana Medicare	$71.13
Rate for Payer: Humana Medicare	$71.13
Rate for Payer: Kaiser Permanente Commercial	$7,691.67
Rate for Payer: Kaiser Permanente Commercial	$19,843.74
Rate for Payer: Kaiser Permanente Medicaid	$16,063.98
Rate for Payer: Kaiser Permanente Medicaid	$6,226.59
Rate for Payer: Kaiser Permanente Medicare	$71.13
Rate for Payer: Kaiser Permanente Medicare	$71.13
Rate for Payer: MDX Hawaii PPO	$30,553.06
Rate for Payer: MDX Hawaii PPO	$11,842.73
Rate for Payer: Ohana Health Plan Medicaid	$78.24
Rate for Payer: Ohana Health Plan Medicaid	$78.24
Rate for Payer: Ohana Health Plan Medicare	$71.13
Rate for Payer: Ohana Health Plan Medicare	$71.13
Rate for Payer: UnitedHealthcare Medicaid	$18,898.80
Rate for Payer: UnitedHealthcare Medicaid	$7,325.40
Rate for Payer: UnitedHealthcare Medicare	$71.13
Rate for Payer: UnitedHealthcare Medicare	$71.13
Rate for Payer: University Health Alliance Commercial	$22,958.89
Rate for Payer: University Health Alliance Commercial	$8,899.14

MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML INTRAVENOUS SOLUTION [188970]

Facility

IP

$12,209.00

Service Code	HCPCS J9063
Hospital Revenue Code	250
Min. Negotiated Rate	$10,377.65
Max. Negotiated Rate	$11,842.73
Rate for Payer: Cash Price	$7,325.40
Rate for Payer: Cash Price	$18,898.80
Rate for Payer: Health Management Network Commercial	$10,377.65
Rate for Payer: Health Management Network Commercial	$26,773.30
Rate for Payer: MDX Hawaii PPO	$11,842.73
Rate for Payer: MDX Hawaii PPO	$30,553.06

MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC

Facility

IP

$23,039.10

Service Code	MSDRG 640
Min. Negotiated Rate	$15,191.46
Max. Negotiated Rate	$23,039.10
Rate for Payer: AlohaCare Medicare	$15,191.46
Rate for Payer: Devoted Health Medicare	$16,710.61
Rate for Payer: Hawaii Medical Service Association Commercial	$20,698.90
Rate for Payer: Hawaii Medical Service Association Medicare	$15,191.46
Rate for Payer: Humana Medicare	$15,191.46
Rate for Payer: Kaiser Permanente Commercial	$23,039.10
Rate for Payer: Kaiser Permanente Medicare	$15,191.46
Rate for Payer: Ohana Health Plan Medicare	$15,191.46
Rate for Payer: UnitedHealthcare Medicare	$15,191.46

MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC

Facility

IP

$16,112.62

Service Code	MSDRG 641
Min. Negotiated Rate	$8,851.45
Max. Negotiated Rate	$16,112.62
Rate for Payer: AlohaCare Medicare	$8,851.45
Rate for Payer: Devoted Health Medicare	$9,736.59
Rate for Payer: Hawaii Medical Service Association Commercial	$16,112.62
Rate for Payer: Hawaii Medical Service Association Medicare	$8,851.45
Rate for Payer: Humana Medicare	$8,851.45
Rate for Payer: Kaiser Permanente Commercial	$13,423.95
Rate for Payer: Kaiser Permanente Medicare	$8,851.45
Rate for Payer: Ohana Health Plan Medicare	$8,851.45
Rate for Payer: UnitedHealthcare Medicare	$8,851.45

MISOPROSTOL 100 MCG TABLET [10628]

Facility

IP

$3.00

Service Code	NDC 59762500701
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$1.80
Rate for Payer: Health Management Network Commercial	$2.55
Rate for Payer: MDX Hawaii PPO	$2.91

MISOPROSTOL 100 MCG TABLET [10628]

Facility

OP

$3.00

Service Code	NDC 59762500701
Hospital Revenue Code	637
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$1.80
Rate for Payer: Hawaii Western Management Group Commercial	$2.85
Rate for Payer: Health Management Network Commercial	$2.55
Rate for Payer: Kaiser Permanente Commercial	$1.89
Rate for Payer: Kaiser Permanente Medicaid	$1.53
Rate for Payer: MDX Hawaii PPO	$2.91
Rate for Payer: University Health Alliance Commercial	$2.19

MISOPROSTOL 200 MCG TABLET [10629]

Facility

IP

$10.00

Service Code	NDC 60687074601
Hospital Revenue Code	250
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$6.00
Rate for Payer: Health Management Network Commercial	$8.50
Rate for Payer: MDX Hawaii PPO	$9.70

MISOPROSTOL 200 MCG TABLET [10629]

Facility

IP

$10.00

Service Code	NDC 60687074611
Hospital Revenue Code	250
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$6.00
Rate for Payer: Health Management Network Commercial	$8.50
Rate for Payer: MDX Hawaii PPO	$9.70

MISOPROSTOL 200 MCG TABLET [10629]

Facility

OP

$10.00

Service Code	NDC 60687074601
Hospital Revenue Code	637
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$6.00
Rate for Payer: Hawaii Western Management Group Commercial	$9.50
Rate for Payer: Health Management Network Commercial	$8.50
Rate for Payer: Kaiser Permanente Commercial	$6.30
Rate for Payer: Kaiser Permanente Medicaid	$5.10
Rate for Payer: MDX Hawaii PPO	$9.70
Rate for Payer: University Health Alliance Commercial	$7.29

MISOPROSTOL 200 MCG TABLET [10629]

Facility

OP

$10.00

Service Code	NDC 60687074611
Hospital Revenue Code	637
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$6.00
Rate for Payer: Hawaii Western Management Group Commercial	$9.50
Rate for Payer: Health Management Network Commercial	$8.50
Rate for Payer: Kaiser Permanente Commercial	$6.30
Rate for Payer: Kaiser Permanente Medicaid	$5.10
Rate for Payer: MDX Hawaii PPO	$9.70
Rate for Payer: University Health Alliance Commercial	$7.29

MISOPROSTOL 25 MCG QUARTER TABLET [400620]

Facility

IP

$1.00

Service Code	NDC 09999701554
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.60
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: MDX Hawaii PPO	$0.97

MISOPROSTOL 25 MCG QUARTER TABLET [400620]

Facility

OP

$1.00

Service Code	NDC 09999701554
Hospital Revenue Code	637
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.60
Rate for Payer: Hawaii Western Management Group Commercial	$0.95
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: Kaiser Permanente Commercial	$0.63
Rate for Payer: Kaiser Permanente Medicaid	$0.51
Rate for Payer: MDX Hawaii PPO	$0.97
Rate for Payer: University Health Alliance Commercial	$0.73

MITOMYCIN 20 MG INTRAVENOUS SOLUTION [10630]

Facility

IP

$810.00

Service Code	HCPCS J9280
Hospital Revenue Code	250
Min. Negotiated Rate	$688.50
Max. Negotiated Rate	$785.70
Rate for Payer: Cash Price	$486.00
Rate for Payer: Cash Price	$682.80
Rate for Payer: Cash Price	$1,365.60
Rate for Payer: Health Management Network Commercial	$967.30
Rate for Payer: Health Management Network Commercial	$1,934.60
Rate for Payer: Health Management Network Commercial	$688.50
Rate for Payer: MDX Hawaii PPO	$1,103.86
Rate for Payer: MDX Hawaii PPO	$785.70
Rate for Payer: MDX Hawaii PPO	$2,207.72

MITOMYCIN 20 MG INTRAVENOUS SOLUTION [10630]

Facility

OP

$810.00

Service Code	HCPCS J9280
Hospital Revenue Code	636
Min. Negotiated Rate	$28.27
Max. Negotiated Rate	$785.70
Rate for Payer: AlohaCare Medicaid	$28.46
Rate for Payer: AlohaCare Medicaid	$28.46
Rate for Payer: AlohaCare Medicaid	$28.46
Rate for Payer: AlohaCare Medicare	$28.46
Rate for Payer: AlohaCare Medicare	$28.46
Rate for Payer: AlohaCare Medicare	$28.46
Rate for Payer: Cash Price	$1,365.60
Rate for Payer: Cash Price	$486.00
Rate for Payer: Cash Price	$486.00
Rate for Payer: Cash Price	$1,365.60
Rate for Payer: Cash Price	$682.80
Rate for Payer: Cash Price	$682.80
Rate for Payer: Devoted Health Medicare	$31.31
Rate for Payer: Devoted Health Medicare	$31.31
Rate for Payer: Devoted Health Medicare	$31.31
Rate for Payer: Hawaii Medical Service Association ABD	$28.27
Rate for Payer: Hawaii Medical Service Association ABD	$28.27
Rate for Payer: Hawaii Medical Service Association ABD	$28.27
Rate for Payer: Hawaii Medical Service Association Commercial	$35.58
Rate for Payer: Hawaii Medical Service Association Commercial	$35.58
Rate for Payer: Hawaii Medical Service Association Commercial	$35.58
Rate for Payer: Hawaii Medical Service Association Medicare	$28.46
Rate for Payer: Hawaii Medical Service Association Medicare	$28.46
Rate for Payer: Hawaii Medical Service Association Medicare	$28.46
Rate for Payer: Hawaii Medical Service Association Non-ABD	$28.27
Rate for Payer: Hawaii Medical Service Association Non-ABD	$28.27
Rate for Payer: Hawaii Medical Service Association Non-ABD	$28.27
Rate for Payer: Hawaii Western Management Group Commercial	$2,162.20
Rate for Payer: Hawaii Western Management Group Commercial	$769.50
Rate for Payer: Hawaii Western Management Group Commercial	$1,081.10
Rate for Payer: Health Management Network Commercial	$1,934.60
Rate for Payer: Health Management Network Commercial	$967.30
Rate for Payer: Health Management Network Commercial	$688.50
Rate for Payer: Humana Medicare	$28.46
Rate for Payer: Humana Medicare	$28.46
Rate for Payer: Humana Medicare	$28.46
Rate for Payer: Kaiser Permanente Commercial	$510.30
Rate for Payer: Kaiser Permanente Commercial	$716.94
Rate for Payer: Kaiser Permanente Commercial	$1,433.88
Rate for Payer: Kaiser Permanente Medicaid	$580.38
Rate for Payer: Kaiser Permanente Medicaid	$1,160.76
Rate for Payer: Kaiser Permanente Medicaid	$413.10
Rate for Payer: Kaiser Permanente Medicare	$28.46
Rate for Payer: Kaiser Permanente Medicare	$28.46
Rate for Payer: Kaiser Permanente Medicare	$28.46
Rate for Payer: MDX Hawaii PPO	$785.70
Rate for Payer: MDX Hawaii PPO	$1,103.86
Rate for Payer: MDX Hawaii PPO	$2,207.72
Rate for Payer: Ohana Health Plan Medicaid	$31.31
Rate for Payer: Ohana Health Plan Medicaid	$31.31
Rate for Payer: Ohana Health Plan Medicaid	$31.31
Rate for Payer: Ohana Health Plan Medicare	$28.46
Rate for Payer: Ohana Health Plan Medicare	$28.46
Rate for Payer: Ohana Health Plan Medicare	$28.46
Rate for Payer: UnitedHealthcare Medicaid	$682.80
Rate for Payer: UnitedHealthcare Medicaid	$486.00
Rate for Payer: UnitedHealthcare Medicaid	$1,365.60
Rate for Payer: UnitedHealthcare Medicare	$28.46
Rate for Payer: UnitedHealthcare Medicare	$28.46
Rate for Payer: UnitedHealthcare Medicare	$28.46
Rate for Payer: University Health Alliance Commercial	$590.41
Rate for Payer: University Health Alliance Commercial	$1,658.98
Rate for Payer: University Health Alliance Commercial	$829.49

MITOMYCIN 40 MG INTRAVENOUS SOLUTION [10631]

Facility

OP

$2,017.00

Service Code	HCPCS J9280
Hospital Revenue Code	636
Min. Negotiated Rate	$28.27
Max. Negotiated Rate	$1,956.49
Rate for Payer: AlohaCare Medicaid	$28.46
Rate for Payer: AlohaCare Medicaid	$28.46
Rate for Payer: AlohaCare Medicare	$28.46
Rate for Payer: AlohaCare Medicare	$28.46
Rate for Payer: Cash Price	$1,210.20
Rate for Payer: Cash Price	$1,210.20
Rate for Payer: Cash Price	$1,020.00
Rate for Payer: Cash Price	$1,020.00
Rate for Payer: Devoted Health Medicare	$31.31
Rate for Payer: Devoted Health Medicare	$31.31
Rate for Payer: Hawaii Medical Service Association ABD	$28.27
Rate for Payer: Hawaii Medical Service Association ABD	$28.27
Rate for Payer: Hawaii Medical Service Association Commercial	$35.58
Rate for Payer: Hawaii Medical Service Association Commercial	$35.58
Rate for Payer: Hawaii Medical Service Association Medicare	$28.46
Rate for Payer: Hawaii Medical Service Association Medicare	$28.46
Rate for Payer: Hawaii Medical Service Association Non-ABD	$28.27
Rate for Payer: Hawaii Medical Service Association Non-ABD	$28.27
Rate for Payer: Hawaii Western Management Group Commercial	$1,615.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,916.15
Rate for Payer: Health Management Network Commercial	$1,445.00
Rate for Payer: Health Management Network Commercial	$1,714.45
Rate for Payer: Humana Medicare	$28.46
Rate for Payer: Humana Medicare	$28.46
Rate for Payer: Kaiser Permanente Commercial	$1,071.00
Rate for Payer: Kaiser Permanente Commercial	$1,270.71
Rate for Payer: Kaiser Permanente Medicaid	$1,028.67
Rate for Payer: Kaiser Permanente Medicaid	$867.00
Rate for Payer: Kaiser Permanente Medicare	$28.46
Rate for Payer: Kaiser Permanente Medicare	$28.46
Rate for Payer: MDX Hawaii PPO	$1,956.49
Rate for Payer: MDX Hawaii PPO	$1,649.00
Rate for Payer: Ohana Health Plan Medicaid	$31.31
Rate for Payer: Ohana Health Plan Medicaid	$31.31
Rate for Payer: Ohana Health Plan Medicare	$28.46
Rate for Payer: Ohana Health Plan Medicare	$28.46
Rate for Payer: UnitedHealthcare Medicaid	$1,210.20
Rate for Payer: UnitedHealthcare Medicaid	$1,020.00
Rate for Payer: UnitedHealthcare Medicare	$28.46
Rate for Payer: UnitedHealthcare Medicare	$28.46
Rate for Payer: University Health Alliance Commercial	$1,470.19
Rate for Payer: University Health Alliance Commercial	$1,239.13

MITOMYCIN 40 MG INTRAVENOUS SOLUTION [10631]

Facility

IP

$1,700.00

Service Code	HCPCS J9280
Hospital Revenue Code	250
Min. Negotiated Rate	$1,445.00
Max. Negotiated Rate	$1,649.00
Rate for Payer: Cash Price	$1,020.00
Rate for Payer: Cash Price	$1,210.20
Rate for Payer: Health Management Network Commercial	$1,445.00
Rate for Payer: Health Management Network Commercial	$1,714.45
Rate for Payer: MDX Hawaii PPO	$1,649.00
Rate for Payer: MDX Hawaii PPO	$1,956.49

MITOMYCIN 40 MG X 2 INTRA-PYELOCALYCEAL COMPOUNDED [4080435]

Facility

OP

$25,845.00

Service Code	HCPCS J9281
Hospital Revenue Code	636
Min. Negotiated Rate	$317.42
Max. Negotiated Rate	$25,069.65
Rate for Payer: AlohaCare Medicaid	$323.17
Rate for Payer: AlohaCare Medicare	$323.17
Rate for Payer: Cash Price	$15,507.00
Rate for Payer: Cash Price	$15,507.00
Rate for Payer: Devoted Health Medicare	$355.49
Rate for Payer: Hawaii Medical Service Association ABD	$317.42
Rate for Payer: Hawaii Medical Service Association Commercial	$403.96
Rate for Payer: Hawaii Medical Service Association Medicare	$323.17
Rate for Payer: Hawaii Medical Service Association Non-ABD	$317.42
Rate for Payer: Hawaii Western Management Group Commercial	$24,552.75
Rate for Payer: Health Management Network Commercial	$21,968.25
Rate for Payer: Humana Medicare	$323.17
Rate for Payer: Kaiser Permanente Commercial	$16,282.35
Rate for Payer: Kaiser Permanente Medicaid	$13,180.95
Rate for Payer: Kaiser Permanente Medicare	$323.17
Rate for Payer: MDX Hawaii PPO	$25,069.65
Rate for Payer: Ohana Health Plan Medicaid	$355.49
Rate for Payer: Ohana Health Plan Medicare	$323.17
Rate for Payer: UnitedHealthcare Medicaid	$15,507.00
Rate for Payer: UnitedHealthcare Medicare	$323.17
Rate for Payer: University Health Alliance Commercial	$18,838.42

MITOMYCIN 40 MG X 2 INTRA-PYELOCALYCEAL COMPOUNDED [4080435]

Facility

IP

$25,845.00

Service Code	HCPCS J9281
Hospital Revenue Code	250
Min. Negotiated Rate	$21,968.25
Max. Negotiated Rate	$25,069.65
Rate for Payer: Cash Price	$15,507.00
Rate for Payer: Health Management Network Commercial	$21,968.25
Rate for Payer: MDX Hawaii PPO	$25,069.65

MITOMYCIN 40 MG X 2 INTRA-PYELOCALYCEAL KIT [173366]

Facility

OP

$30,434.00

Service Code	HCPCS J9281
Hospital Revenue Code	636
Min. Negotiated Rate	$317.42
Max. Negotiated Rate	$29,520.98
Rate for Payer: AlohaCare Medicaid	$323.17
Rate for Payer: AlohaCare Medicare	$323.17
Rate for Payer: Cash Price	$18,260.40
Rate for Payer: Cash Price	$18,260.40
Rate for Payer: Devoted Health Medicare	$355.49
Rate for Payer: Hawaii Medical Service Association ABD	$317.42
Rate for Payer: Hawaii Medical Service Association Commercial	$403.96
Rate for Payer: Hawaii Medical Service Association Medicare	$323.17
Rate for Payer: Hawaii Medical Service Association Non-ABD	$317.42
Rate for Payer: Hawaii Western Management Group Commercial	$28,912.30
Rate for Payer: Health Management Network Commercial	$25,868.90
Rate for Payer: Humana Medicare	$323.17
Rate for Payer: Kaiser Permanente Commercial	$19,173.42
Rate for Payer: Kaiser Permanente Medicaid	$15,521.34
Rate for Payer: Kaiser Permanente Medicare	$323.17
Rate for Payer: MDX Hawaii PPO	$29,520.98
Rate for Payer: Ohana Health Plan Medicaid	$355.49
Rate for Payer: Ohana Health Plan Medicare	$323.17
Rate for Payer: UnitedHealthcare Medicaid	$18,260.40
Rate for Payer: UnitedHealthcare Medicare	$323.17
Rate for Payer: University Health Alliance Commercial	$22,183.34

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