Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

PERSONA FEM PS POR NRW SZ3 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$9,987.00
Max. Negotiated Rate	$19,374.78
Rate for Payer: AlohaCare Medicaid	$9,987.00
Rate for Payer: AlohaCare Medicare	$15,180.24
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Devoted Health Medicare	$16,778.16
Rate for Payer: Hawaii Medical Service Association Medicare	$15,180.24
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Humana Medicare	$15,180.24
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: Kaiser Permanente Medicare	$15,180.24
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: Ohana Health Plan Medicaid	$15,180.24
Rate for Payer: Ohana Health Plan Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$15,180.24
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ3 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ3 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$9,987.00
Max. Negotiated Rate	$19,374.78
Rate for Payer: AlohaCare Medicaid	$9,987.00
Rate for Payer: AlohaCare Medicare	$15,180.24
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Devoted Health Medicare	$16,778.16
Rate for Payer: Hawaii Medical Service Association Medicare	$15,180.24
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Humana Medicare	$15,180.24
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: Kaiser Permanente Medicare	$15,180.24
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: Ohana Health Plan Medicaid	$15,180.24
Rate for Payer: Ohana Health Plan Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$15,180.24
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ4 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ4 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$9,987.00
Max. Negotiated Rate	$19,374.78
Rate for Payer: AlohaCare Medicaid	$9,987.00
Rate for Payer: AlohaCare Medicare	$15,180.24
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Devoted Health Medicare	$16,778.16
Rate for Payer: Hawaii Medical Service Association Medicare	$15,180.24
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Humana Medicare	$15,180.24
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: Kaiser Permanente Medicare	$15,180.24
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: Ohana Health Plan Medicaid	$15,180.24
Rate for Payer: Ohana Health Plan Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$15,180.24
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ4 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ4 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$9,987.00
Max. Negotiated Rate	$19,374.78
Rate for Payer: AlohaCare Medicaid	$9,987.00
Rate for Payer: AlohaCare Medicare	$15,180.24
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Devoted Health Medicare	$16,778.16
Rate for Payer: Hawaii Medical Service Association Medicare	$15,180.24
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Humana Medicare	$15,180.24
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: Kaiser Permanente Medicare	$15,180.24
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: Ohana Health Plan Medicaid	$15,180.24
Rate for Payer: Ohana Health Plan Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$15,180.24
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ5 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$9,987.00
Max. Negotiated Rate	$19,374.78
Rate for Payer: AlohaCare Medicaid	$9,987.00
Rate for Payer: AlohaCare Medicare	$15,180.24
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Devoted Health Medicare	$16,778.16
Rate for Payer: Hawaii Medical Service Association Medicare	$15,180.24
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Humana Medicare	$15,180.24
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: Kaiser Permanente Medicare	$15,180.24
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: Ohana Health Plan Medicaid	$15,180.24
Rate for Payer: Ohana Health Plan Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$15,180.24
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ5 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ5 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$9,987.00
Max. Negotiated Rate	$19,374.78
Rate for Payer: AlohaCare Medicaid	$9,987.00
Rate for Payer: AlohaCare Medicare	$15,180.24
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Devoted Health Medicare	$16,778.16
Rate for Payer: Hawaii Medical Service Association Medicare	$15,180.24
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Humana Medicare	$15,180.24
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: Kaiser Permanente Medicare	$15,180.24
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: Ohana Health Plan Medicaid	$15,180.24
Rate for Payer: Ohana Health Plan Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$15,180.24
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ5 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ6 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ6 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$9,987.00
Max. Negotiated Rate	$19,374.78
Rate for Payer: AlohaCare Medicaid	$9,987.00
Rate for Payer: AlohaCare Medicare	$15,180.24
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Devoted Health Medicare	$16,778.16
Rate for Payer: Hawaii Medical Service Association Medicare	$15,180.24
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Humana Medicare	$15,180.24
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: Kaiser Permanente Medicare	$15,180.24
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: Ohana Health Plan Medicaid	$15,180.24
Rate for Payer: Ohana Health Plan Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$15,180.24
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ6 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ6 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$9,987.00
Max. Negotiated Rate	$19,374.78
Rate for Payer: AlohaCare Medicaid	$9,987.00
Rate for Payer: AlohaCare Medicare	$15,180.24
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Devoted Health Medicare	$16,778.16
Rate for Payer: Hawaii Medical Service Association Medicare	$15,180.24
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Humana Medicare	$15,180.24
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: Kaiser Permanente Medicare	$15,180.24
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: Ohana Health Plan Medicaid	$15,180.24
Rate for Payer: Ohana Health Plan Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$15,180.24
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ7 L

Facility

$7,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$3,700.00
Max. Negotiated Rate	$7,178.00
Rate for Payer: AlohaCare Medicaid	$3,700.00
Rate for Payer: AlohaCare Medicaid	$9,987.00
Rate for Payer: AlohaCare Medicare	$5,624.00
Rate for Payer: AlohaCare Medicare	$15,180.24
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Cash Price	$4,440.00
Rate for Payer: Devoted Health Medicare	$16,778.16
Rate for Payer: Devoted Health Medicare	$6,216.00
Rate for Payer: Hawaii Medical Service Association Medicare	$15,180.24
Rate for Payer: Hawaii Medical Service Association Medicare	$5,624.00
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Hawaii Western Management Group Commercial	$5,180.00
Rate for Payer: Health Management Network Commercial	$6,290.00
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Humana Medicare	$5,624.00
Rate for Payer: Humana Medicare	$15,180.24
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: Kaiser Permanente Commercial	$6,660.00
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: Kaiser Permanente Medicaid	$3,774.00
Rate for Payer: Kaiser Permanente Medicare	$5,624.00
Rate for Payer: Kaiser Permanente Medicare	$15,180.24
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: MDX Hawaii PPO	$7,178.00
Rate for Payer: Ohana Health Plan Medicaid	$5,624.00
Rate for Payer: Ohana Health Plan Medicaid	$15,180.24
Rate for Payer: Ohana Health Plan Medicare	$5,624.00
Rate for Payer: Ohana Health Plan Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$5,624.00
Rate for Payer: University Health Alliance Commercial	$4,144.00
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ7 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Cash Price	$4,440.00
Rate for Payer: Hawaii Western Management Group Commercial	$5,180.00
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$6,290.00
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$6,660.00
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: MDX Hawaii PPO	$7,178.00
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$4,144.00
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ7 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$9,987.00
Max. Negotiated Rate	$19,374.78
Rate for Payer: AlohaCare Medicaid	$9,987.00
Rate for Payer: AlohaCare Medicare	$15,180.24
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Devoted Health Medicare	$16,778.16
Rate for Payer: Hawaii Medical Service Association Medicare	$15,180.24
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Humana Medicare	$15,180.24
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: Kaiser Permanente Medicare	$15,180.24
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: Ohana Health Plan Medicaid	$15,180.24
Rate for Payer: Ohana Health Plan Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$15,180.24
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ7 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ8 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$9,987.00
Max. Negotiated Rate	$19,374.78
Rate for Payer: AlohaCare Medicaid	$9,987.00
Rate for Payer: AlohaCare Medicaid	$3,700.00
Rate for Payer: AlohaCare Medicare	$15,180.24
Rate for Payer: AlohaCare Medicare	$5,624.00
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Cash Price	$4,440.00
Rate for Payer: Devoted Health Medicare	$16,778.16
Rate for Payer: Devoted Health Medicare	$6,216.00
Rate for Payer: Hawaii Medical Service Association Medicare	$5,624.00
Rate for Payer: Hawaii Medical Service Association Medicare	$15,180.24
Rate for Payer: Hawaii Western Management Group Commercial	$5,180.00
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Health Management Network Commercial	$6,290.00
Rate for Payer: Humana Medicare	$15,180.24
Rate for Payer: Humana Medicare	$5,624.00
Rate for Payer: Kaiser Permanente Commercial	$6,660.00
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: Kaiser Permanente Medicaid	$3,774.00
Rate for Payer: Kaiser Permanente Medicare	$15,180.24
Rate for Payer: Kaiser Permanente Medicare	$5,624.00
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: MDX Hawaii PPO	$7,178.00
Rate for Payer: Ohana Health Plan Medicaid	$15,180.24
Rate for Payer: Ohana Health Plan Medicaid	$5,624.00
Rate for Payer: Ohana Health Plan Medicare	$5,624.00
Rate for Payer: Ohana Health Plan Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$5,624.00
Rate for Payer: University Health Alliance Commercial	$11,185.44
Rate for Payer: University Health Alliance Commercial	$4,144.00

PERSONA FEM PS POR NRW SZ8 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Cash Price	$4,440.00
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Hawaii Western Management Group Commercial	$5,180.00
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Health Management Network Commercial	$6,290.00
Rate for Payer: Kaiser Permanente Commercial	$6,660.00
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: MDX Hawaii PPO	$7,178.00
Rate for Payer: University Health Alliance Commercial	$4,144.00
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ8 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ8 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$9,987.00
Max. Negotiated Rate	$19,374.78
Rate for Payer: AlohaCare Medicaid	$9,987.00
Rate for Payer: AlohaCare Medicare	$15,180.24
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Devoted Health Medicare	$16,778.16
Rate for Payer: Hawaii Medical Service Association Medicare	$15,180.24
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Humana Medicare	$15,180.24
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: Kaiser Permanente Medicare	$15,180.24
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: Ohana Health Plan Medicaid	$15,180.24
Rate for Payer: Ohana Health Plan Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$15,180.24
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ9 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ9 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$9,987.00
Max. Negotiated Rate	$19,374.78
Rate for Payer: AlohaCare Medicaid	$9,987.00
Rate for Payer: AlohaCare Medicare	$15,180.24
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Devoted Health Medicare	$16,778.16
Rate for Payer: Hawaii Medical Service Association Medicare	$15,180.24
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Humana Medicare	$15,180.24
Rate for Payer: Kaiser Permanente Commercial	$17,976.60
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: Kaiser Permanente Medicare	$15,180.24
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: Ohana Health Plan Medicaid	$15,180.24
Rate for Payer: Ohana Health Plan Medicare	$15,180.24
Rate for Payer: UnitedHealthcare Medicare	$15,180.24
Rate for Payer: University Health Alliance Commercial	$11,185.44

Know your out-of-pocket cost for care.

All Charges