Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

HC MOD SED SAME PHYS/QHP EACH ADDL 15 MINS

Facility

$83.00

Service Code	HCPCS 99153
Hospital Charge Code	3709915301
Hospital Revenue Code	370
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$80.51
Rate for Payer: AlohaCare Medicaid	$41.50
Rate for Payer: AlohaCare Medicare	$63.08
Rate for Payer: Cash Price	$49.80
Rate for Payer: Cash Price	$49.80
Rate for Payer: Devoted Health Medicare	$69.72
Rate for Payer: Hawaii Medical Service Association Medicare	$63.08
Rate for Payer: Hawaii Western Management Group Commercial	$78.85
Rate for Payer: Health Management Network Commercial	$70.55
Rate for Payer: Humana Medicare	$63.08
Rate for Payer: Kaiser Permanente Commercial	$74.70
Rate for Payer: Kaiser Permanente Medicaid	$42.33
Rate for Payer: Kaiser Permanente Medicare	$63.08
Rate for Payer: MDX Hawaii PPO	$80.51
Rate for Payer: Ohana Health Plan Medicaid	$63.08
Rate for Payer: Ohana Health Plan Medicare	$63.08
Rate for Payer: UnitedHealthcare Medicaid	$13.00
Rate for Payer: UnitedHealthcare Medicare	$63.08
Rate for Payer: University Health Alliance Commercial	$60.50

HC MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS

Facility

$510.00

Service Code	HCPCS 99151
Hospital Charge Code	3719915101
Hospital Revenue Code	371
Min. Negotiated Rate	$17.23
Max. Negotiated Rate	$494.70
Rate for Payer: AlohaCare Medicaid	$255.00
Rate for Payer: AlohaCare Medicare	$387.60
Rate for Payer: Cash Price	$306.00
Rate for Payer: Cash Price	$306.00
Rate for Payer: Devoted Health Medicare	$428.40
Rate for Payer: Hawaii Medical Service Association Medicare	$387.60
Rate for Payer: Hawaii Western Management Group Commercial	$484.50
Rate for Payer: Health Management Network Commercial	$433.50
Rate for Payer: Humana Medicare	$387.60
Rate for Payer: Kaiser Permanente Commercial	$459.00
Rate for Payer: Kaiser Permanente Medicaid	$260.10
Rate for Payer: Kaiser Permanente Medicare	$387.60
Rate for Payer: MDX Hawaii PPO	$494.70
Rate for Payer: Ohana Health Plan Medicaid	$387.60
Rate for Payer: Ohana Health Plan Medicare	$387.60
Rate for Payer: UnitedHealthcare Medicaid	$17.23
Rate for Payer: UnitedHealthcare Medicare	$387.60
Rate for Payer: University Health Alliance Commercial	$371.74

HC MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS

Facility

$510.00

Service Code	HCPCS 99151
Hospital Charge Code	3719915101
Hospital Revenue Code	371
Min. Negotiated Rate	$433.50
Max. Negotiated Rate	$494.70
Rate for Payer: Cash Price	$306.00
Rate for Payer: Health Management Network Commercial	$433.50
Rate for Payer: Kaiser Permanente Commercial	$459.00
Rate for Payer: MDX Hawaii PPO	$494.70

HC MORPHOMETRIC ANALYSIS TUMOR

Facility

$1,662.00

Service Code	HCPCS 88358
Hospital Charge Code	3108835801
Hospital Revenue Code	310
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$1,612.14
Rate for Payer: AlohaCare Medicaid	$831.00
Rate for Payer: AlohaCare Medicare	$1,263.12
Rate for Payer: Cash Price	$997.20
Rate for Payer: Cash Price	$997.20
Rate for Payer: Devoted Health Medicare	$1,396.08
Rate for Payer: Hawaii Medical Service Association ABD	$12.39
Rate for Payer: Hawaii Medical Service Association Commercial	$217.57
Rate for Payer: Hawaii Medical Service Association Medicare	$1,263.12
Rate for Payer: Hawaii Medical Service Association Non-ABD	$43.60
Rate for Payer: Hawaii Western Management Group Commercial	$174.06
Rate for Payer: Health Management Network Commercial	$1,412.70
Rate for Payer: Humana Medicare	$1,263.12
Rate for Payer: Kaiser Permanente Commercial	$1,495.80
Rate for Payer: Kaiser Permanente Medicaid	$847.62
Rate for Payer: Kaiser Permanente Medicare	$1,263.12
Rate for Payer: MDX Hawaii PPO	$1,612.14
Rate for Payer: Ohana Health Plan Medicaid	$1,263.12
Rate for Payer: Ohana Health Plan Medicare	$1,263.12
Rate for Payer: UnitedHealthcare Medicaid	$12.39
Rate for Payer: UnitedHealthcare Medicare	$1,263.12
Rate for Payer: University Health Alliance Commercial	$145.65

HC MORPHOMETRIC ANALYSIS TUMOR

Facility

$1,662.00

Service Code	HCPCS 88358
Hospital Charge Code	3108835801
Hospital Revenue Code	310
Min. Negotiated Rate	$1,412.70
Max. Negotiated Rate	$1,612.14
Rate for Payer: Cash Price	$997.20
Rate for Payer: Health Management Network Commercial	$1,412.70
Rate for Payer: Kaiser Permanente Commercial	$1,495.80
Rate for Payer: MDX Hawaii PPO	$1,612.14

HC M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH

Facility

$643.00

Service Code	HCPCS 88373
Hospital Charge Code	3108837301
Hospital Revenue Code	310
Min. Negotiated Rate	$38.89
Max. Negotiated Rate	$623.71
Rate for Payer: AlohaCare Medicaid	$321.50
Rate for Payer: AlohaCare Medicare	$488.68
Rate for Payer: Cash Price	$385.80
Rate for Payer: Cash Price	$385.80
Rate for Payer: Devoted Health Medicare	$540.12
Rate for Payer: Hawaii Medical Service Association Medicare	$488.68
Rate for Payer: Hawaii Medical Service Association Non-ABD	$38.89
Rate for Payer: Hawaii Western Management Group Commercial	$610.85
Rate for Payer: Health Management Network Commercial	$546.55
Rate for Payer: Humana Medicare	$488.68
Rate for Payer: Kaiser Permanente Commercial	$578.70
Rate for Payer: Kaiser Permanente Medicaid	$327.93
Rate for Payer: Kaiser Permanente Medicare	$488.68
Rate for Payer: MDX Hawaii PPO	$623.71
Rate for Payer: Ohana Health Plan Medicaid	$488.68
Rate for Payer: Ohana Health Plan Medicare	$488.68
Rate for Payer: UnitedHealthcare Medicaid	$44.74
Rate for Payer: UnitedHealthcare Medicare	$488.68
Rate for Payer: University Health Alliance Commercial	$149.66

HC M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH

Facility

$643.00

Service Code	HCPCS 88373
Hospital Charge Code	3108837301
Hospital Revenue Code	310
Min. Negotiated Rate	$546.55
Max. Negotiated Rate	$623.71
Rate for Payer: Cash Price	$385.80
Rate for Payer: Health Management Network Commercial	$546.55
Rate for Payer: Kaiser Permanente Commercial	$578.70
Rate for Payer: MDX Hawaii PPO	$623.71

HC M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST

Facility

$3,490.00

Service Code	HCPCS 88361
Hospital Charge Code	3108836101
Hospital Revenue Code	310
Min. Negotiated Rate	$67.41
Max. Negotiated Rate	$3,385.30
Rate for Payer: AlohaCare Medicaid	$1,745.00
Rate for Payer: AlohaCare Medicare	$2,652.40
Rate for Payer: Cash Price	$2,094.00
Rate for Payer: Cash Price	$2,094.00
Rate for Payer: Devoted Health Medicare	$2,931.60
Rate for Payer: Hawaii Medical Service Association ABD	$67.41
Rate for Payer: Hawaii Medical Service Association Commercial	$457.76
Rate for Payer: Hawaii Medical Service Association Medicare	$2,652.40
Rate for Payer: Hawaii Medical Service Association Non-ABD	$83.58
Rate for Payer: Hawaii Western Management Group Commercial	$366.21
Rate for Payer: Health Management Network Commercial	$2,966.50
Rate for Payer: Humana Medicare	$2,652.40
Rate for Payer: Kaiser Permanente Commercial	$3,141.00
Rate for Payer: Kaiser Permanente Medicaid	$1,779.90
Rate for Payer: Kaiser Permanente Medicare	$2,652.40
Rate for Payer: MDX Hawaii PPO	$3,385.30
Rate for Payer: Ohana Health Plan Medicaid	$2,652.40
Rate for Payer: Ohana Health Plan Medicare	$2,652.40
Rate for Payer: UnitedHealthcare Medicaid	$67.41
Rate for Payer: UnitedHealthcare Medicare	$2,652.40
Rate for Payer: University Health Alliance Commercial	$315.18

HC M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST

Facility

$3,490.00

Service Code	HCPCS 88361
Hospital Charge Code	3108836101
Hospital Revenue Code	310
Min. Negotiated Rate	$2,966.50
Max. Negotiated Rate	$3,385.30
Rate for Payer: Cash Price	$2,094.00
Rate for Payer: Health Management Network Commercial	$2,966.50
Rate for Payer: Kaiser Permanente Commercial	$3,141.00
Rate for Payer: MDX Hawaii PPO	$3,385.30

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	$164.50
Rate for Payer: AlohaCare Medicare	$250.04
Rate for Payer: Cash Price	$197.40
Rate for Payer: Cash Price	$197.40
Rate for Payer: Devoted Health Medicare	$276.36
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	$250.04
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	$250.04
Rate for Payer: Kaiser Permanente Commercial	$296.10
Rate for Payer: Kaiser Permanente Medicaid	$167.79
Rate for Payer: Kaiser Permanente Medicare	$250.04
Rate for Payer: MDX Hawaii PPO	$319.13
Rate for Payer: Ohana Health Plan Medicaid	$250.04
Rate for Payer: Ohana Health Plan Medicare	$250.04
Rate for Payer: UnitedHealthcare Medicaid	$28.46
Rate for Payer: UnitedHealthcare Medicare	$250.04
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: Kaiser Permanente Commercial	$296.10
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: Kaiser Permanente Commercial	$3,750.30
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	$2,083.50
Max. Negotiated Rate	$4,041.99
Rate for Payer: AlohaCare Medicaid	$2,083.50
Rate for Payer: AlohaCare Medicare	$3,166.92
Rate for Payer: Cash Price	$2,500.20
Rate for Payer: Devoted Health Medicare	$3,500.28
Rate for Payer: Hawaii Medical Service Association Medicare	$3,166.92
Rate for Payer: Hawaii Western Management Group Commercial	$3,958.65
Rate for Payer: Health Management Network Commercial	$3,541.95
Rate for Payer: Humana Medicare	$3,166.92
Rate for Payer: Kaiser Permanente Commercial	$3,750.30
Rate for Payer: Kaiser Permanente Medicaid	$2,125.17
Rate for Payer: Kaiser Permanente Medicare	$3,166.92
Rate for Payer: MDX Hawaii PPO	$4,041.99
Rate for Payer: Ohana Health Plan Medicaid	$3,166.92
Rate for Payer: Ohana Health Plan Medicare	$3,166.92
Rate for Payer: UnitedHealthcare Medicare	$3,166.92
Rate for Payer: University Health Alliance Commercial	$3,037.33

HC N.GONORRHOEAE, DNA, AMP PROB - GC DNA PCR

Facility

$294.00

Service Code	HCPCS 87591
Hospital Charge Code	3068759101
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: Kaiser Permanente Commercial	$264.60
Rate for Payer: MDX Hawaii PPO	$285.18

HC N.GONORRHOEAE, DNA, AMP PROB - GC DNA PCR

Facility

$294.00

Service Code	HCPCS 87591
Hospital Charge Code	3068759101
Hospital Revenue Code	306
Min. Negotiated Rate	$35.09
Max. Negotiated Rate	$285.18
Rate for Payer: AlohaCare Medicaid	$147.00
Rate for Payer: AlohaCare Medicare	$223.44
Rate for Payer: Cash Price	$176.40
Rate for Payer: Cash Price	$176.40
Rate for Payer: Devoted Health Medicare	$246.96
Rate for Payer: Hawaii Medical Service Association ABD	$48.50
Rate for Payer: Hawaii Medical Service Association Commercial	$43.86
Rate for Payer: Hawaii Medical Service Association Medicare	$223.44
Rate for Payer: Hawaii Medical Service Association Non-ABD	$50.93
Rate for Payer: Hawaii Western Management Group Commercial	$35.09
Rate for Payer: Health Management Network Commercial	$249.90
Rate for Payer: Humana Medicare	$223.44
Rate for Payer: Kaiser Permanente Commercial	$264.60
Rate for Payer: Kaiser Permanente Medicaid	$149.94
Rate for Payer: Kaiser Permanente Medicare	$223.44
Rate for Payer: MDX Hawaii PPO	$285.18
Rate for Payer: Ohana Health Plan Medicaid	$223.44
Rate for Payer: Ohana Health Plan Medicare	$223.44
Rate for Payer: UnitedHealthcare Medicaid	$48.50
Rate for Payer: UnitedHealthcare Medicare	$223.44
Rate for Payer: University Health Alliance Commercial	$90.72

HC OBSERVATION CARVE-OUT - GASTROINTESTINAL

Facility

$174.00

Service Code	HCPCS G0378
Hospital Charge Code	762G037803
Hospital Revenue Code	762
Min. Negotiated Rate	$147.90
Max. Negotiated Rate	$168.78
Rate for Payer: Cash Price	$104.40
Rate for Payer: Health Management Network Commercial	$147.90
Rate for Payer: Kaiser Permanente Commercial	$156.60
Rate for Payer: MDX Hawaii PPO	$168.78

HC OBSERVATION CARVE-OUT - GASTROINTESTINAL

Facility

$174.00

Service Code	HCPCS G0378
Hospital Charge Code	762G037803
Hospital Revenue Code	762
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: AlohaCare Medicaid	$87.00
Rate for Payer: AlohaCare Medicare	$132.24
Rate for Payer: Cash Price	$104.40
Rate for Payer: Cash Price	$104.40
Rate for Payer: Devoted Health Medicare	$146.16
Rate for Payer: Hawaii Medical Service Association Commercial	$1,200.00
Rate for Payer: Hawaii Medical Service Association Medicare	$132.24
Rate for Payer: Hawaii Western Management Group Commercial	$165.30
Rate for Payer: Health Management Network Commercial	$147.90
Rate for Payer: Humana Medicare	$132.24
Rate for Payer: Kaiser Permanente Commercial	$156.60
Rate for Payer: Kaiser Permanente Medicaid	$88.74
Rate for Payer: Kaiser Permanente Medicare	$132.24
Rate for Payer: MDX Hawaii PPO	$168.78
Rate for Payer: Ohana Health Plan Medicaid	$132.24
Rate for Payer: Ohana Health Plan Medicare	$132.24
Rate for Payer: UnitedHealthcare Medicare	$132.24
Rate for Payer: University Health Alliance Commercial	$126.83

HC OBSERVATION CARVE-OUT - IV INFUSION ADMIN

Facility

$174.00

Service Code	HCPCS G0378
Hospital Charge Code	762G037808
Hospital Revenue Code	762
Min. Negotiated Rate	$147.90
Max. Negotiated Rate	$168.78
Rate for Payer: Cash Price	$104.40
Rate for Payer: Health Management Network Commercial	$147.90
Rate for Payer: Kaiser Permanente Commercial	$156.60
Rate for Payer: MDX Hawaii PPO	$168.78

HC OBSERVATION CARVE-OUT - IV INFUSION ADMIN

Facility

$174.00

Service Code	HCPCS G0378
Hospital Charge Code	762G037808
Hospital Revenue Code	762
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: AlohaCare Medicaid	$87.00
Rate for Payer: AlohaCare Medicare	$132.24
Rate for Payer: Cash Price	$104.40
Rate for Payer: Cash Price	$104.40
Rate for Payer: Devoted Health Medicare	$146.16
Rate for Payer: Hawaii Medical Service Association Commercial	$1,200.00
Rate for Payer: Hawaii Medical Service Association Medicare	$132.24
Rate for Payer: Hawaii Western Management Group Commercial	$165.30
Rate for Payer: Health Management Network Commercial	$147.90
Rate for Payer: Humana Medicare	$132.24
Rate for Payer: Kaiser Permanente Commercial	$156.60
Rate for Payer: Kaiser Permanente Medicaid	$88.74
Rate for Payer: Kaiser Permanente Medicare	$132.24
Rate for Payer: MDX Hawaii PPO	$168.78
Rate for Payer: Ohana Health Plan Medicaid	$132.24
Rate for Payer: Ohana Health Plan Medicare	$132.24
Rate for Payer: UnitedHealthcare Medicare	$132.24
Rate for Payer: University Health Alliance Commercial	$126.83

HC OBSERVATION CARVE-OUT - RADIOLOGY

Facility

$174.00

Service Code	HCPCS G0378
Hospital Charge Code	762G037802
Hospital Revenue Code	762
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: AlohaCare Medicaid	$87.00
Rate for Payer: AlohaCare Medicare	$132.24
Rate for Payer: Cash Price	$104.40
Rate for Payer: Cash Price	$104.40
Rate for Payer: Devoted Health Medicare	$146.16
Rate for Payer: Hawaii Medical Service Association Commercial	$1,200.00
Rate for Payer: Hawaii Medical Service Association Medicare	$132.24
Rate for Payer: Hawaii Western Management Group Commercial	$165.30
Rate for Payer: Health Management Network Commercial	$147.90
Rate for Payer: Humana Medicare	$132.24
Rate for Payer: Kaiser Permanente Commercial	$156.60
Rate for Payer: Kaiser Permanente Medicaid	$88.74
Rate for Payer: Kaiser Permanente Medicare	$132.24
Rate for Payer: MDX Hawaii PPO	$168.78
Rate for Payer: Ohana Health Plan Medicaid	$132.24
Rate for Payer: Ohana Health Plan Medicare	$132.24
Rate for Payer: UnitedHealthcare Medicare	$132.24
Rate for Payer: University Health Alliance Commercial	$126.83

HC OBSERVATION CARVE-OUT - RADIOLOGY

Facility

$174.00

Service Code	HCPCS G0378
Hospital Charge Code	762G037802
Hospital Revenue Code	762
Min. Negotiated Rate	$147.90
Max. Negotiated Rate	$168.78
Rate for Payer: Cash Price	$104.40
Rate for Payer: Health Management Network Commercial	$147.90
Rate for Payer: Kaiser Permanente Commercial	$156.60
Rate for Payer: MDX Hawaii PPO	$168.78

HC OBSERVATION CARVE-OUT - RESPIRATORY

Facility

$174.00

Service Code	HCPCS G0378
Hospital Charge Code	762G037805
Hospital Revenue Code	762
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: AlohaCare Medicaid	$87.00
Rate for Payer: AlohaCare Medicare	$132.24
Rate for Payer: Cash Price	$104.40
Rate for Payer: Cash Price	$104.40
Rate for Payer: Devoted Health Medicare	$146.16
Rate for Payer: Hawaii Medical Service Association Commercial	$1,200.00
Rate for Payer: Hawaii Medical Service Association Medicare	$132.24
Rate for Payer: Hawaii Western Management Group Commercial	$165.30
Rate for Payer: Health Management Network Commercial	$147.90
Rate for Payer: Humana Medicare	$132.24
Rate for Payer: Kaiser Permanente Commercial	$156.60
Rate for Payer: Kaiser Permanente Medicaid	$88.74
Rate for Payer: Kaiser Permanente Medicare	$132.24
Rate for Payer: MDX Hawaii PPO	$168.78
Rate for Payer: Ohana Health Plan Medicaid	$132.24
Rate for Payer: Ohana Health Plan Medicare	$132.24
Rate for Payer: UnitedHealthcare Medicare	$132.24
Rate for Payer: University Health Alliance Commercial	$126.83

HC OBSERVATION CARVE-OUT - RESPIRATORY

Facility

$174.00

Service Code	HCPCS G0378
Hospital Charge Code	762G037805
Hospital Revenue Code	762
Min. Negotiated Rate	$147.90
Max. Negotiated Rate	$168.78
Rate for Payer: Cash Price	$104.40
Rate for Payer: Health Management Network Commercial	$147.90
Rate for Payer: Kaiser Permanente Commercial	$156.60
Rate for Payer: MDX Hawaii PPO	$168.78

HC OBSERVATION CARVE-OUT - SURGICAL

Facility

$174.00

Service Code	HCPCS G0378
Hospital Charge Code	762G037806
Hospital Revenue Code	762
Min. Negotiated Rate	$147.90
Max. Negotiated Rate	$168.78
Rate for Payer: Cash Price	$104.40
Rate for Payer: Health Management Network Commercial	$147.90
Rate for Payer: Kaiser Permanente Commercial	$156.60
Rate for Payer: MDX Hawaii PPO	$168.78

HC OBSERVATION CARVE-OUT - SURGICAL

Facility

$174.00

Service Code	HCPCS G0378
Hospital Charge Code	762G037806
Hospital Revenue Code	762
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: AlohaCare Medicaid	$87.00
Rate for Payer: AlohaCare Medicare	$132.24
Rate for Payer: Cash Price	$104.40
Rate for Payer: Cash Price	$104.40
Rate for Payer: Devoted Health Medicare	$146.16
Rate for Payer: Hawaii Medical Service Association Commercial	$1,200.00
Rate for Payer: Hawaii Medical Service Association Medicare	$132.24
Rate for Payer: Hawaii Western Management Group Commercial	$165.30
Rate for Payer: Health Management Network Commercial	$147.90
Rate for Payer: Humana Medicare	$132.24
Rate for Payer: Kaiser Permanente Commercial	$156.60
Rate for Payer: Kaiser Permanente Medicaid	$88.74
Rate for Payer: Kaiser Permanente Medicare	$132.24
Rate for Payer: MDX Hawaii PPO	$168.78
Rate for Payer: Ohana Health Plan Medicaid	$132.24
Rate for Payer: Ohana Health Plan Medicare	$132.24
Rate for Payer: UnitedHealthcare Medicare	$132.24
Rate for Payer: University Health Alliance Commercial	$126.83

Know your out-of-pocket cost for care.

All Charges