Kahuku Medical Center

All Charges

Charge

Type

Setting

Price

Hepatitis A Ab, IgM DLS

Facility

$110.00

Service Code	HCPCS 86709
Hospital Charge Code	422867095
Hospital Revenue Code	301
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$106.70
Rate for Payer: Cash Price	$71.50
Rate for Payer: Health Management Network Commercial	$93.50
Rate for Payer: Kaiser Permanente Commercial	$99.00
Rate for Payer: MDX Hawaii PPO	$106.70

Hepatitis A Ab, IgM DLS

Facility

$110.00

Service Code	HCPCS 86709
Hospital Charge Code	422867095
Hospital Revenue Code	301
Min. Negotiated Rate	$11.26
Max. Negotiated Rate	$106.70
Rate for Payer: AlohaCare Medicaid	$55.00
Rate for Payer: AlohaCare Medicare	$46.20
Rate for Payer: Cash Price	$71.50
Rate for Payer: Cash Price	$71.50
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$101.20
Rate for Payer: Devoted Health Medicare	$46.20
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$15.55
Rate for Payer: Hawaii Medical Service Association Commercial	$14.07
Rate for Payer: Hawaii Medical Service Association Medicare	$46.20
Rate for Payer: Hawaii Western Management Group Commercial	$11.26
Rate for Payer: Health Management Network Commercial	$93.50
Rate for Payer: Humana Medicare	$46.20
Rate for Payer: Kaiser Permanente Commercial	$99.00
Rate for Payer: Kaiser Permanente Medicaid	$56.10
Rate for Payer: Kaiser Permanente Medicare	$46.20
Rate for Payer: MDX Hawaii PPO	$106.70
Rate for Payer: Ohana Health Plan Medicaid	$46.20
Rate for Payer: Ohana Health Plan Medicare	$46.20
Rate for Payer: UnitedHealthcare Medicaid	$15.55
Rate for Payer: UnitedHealthcare Medicare	$46.20
Rate for Payer: University Health Alliance Commercial	$29.10

Hepatitis A Ab, Total DLS

Facility

$84.00

Service Code	HCPCS 86708
Hospital Charge Code	422867085
Hospital Revenue Code	302
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$81.48
Rate for Payer: AlohaCare Medicaid	$42.00
Rate for Payer: AlohaCare Medicare	$35.28
Rate for Payer: Cash Price	$54.60
Rate for Payer: Cash Price	$54.60
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$77.28
Rate for Payer: Devoted Health Medicare	$35.28
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$17.12
Rate for Payer: Hawaii Medical Service Association Commercial	$15.49
Rate for Payer: Hawaii Medical Service Association Medicare	$35.28
Rate for Payer: Hawaii Western Management Group Commercial	$12.39
Rate for Payer: Health Management Network Commercial	$71.40
Rate for Payer: Humana Medicare	$35.28
Rate for Payer: Kaiser Permanente Commercial	$75.60
Rate for Payer: Kaiser Permanente Medicaid	$42.84
Rate for Payer: Kaiser Permanente Medicare	$35.28
Rate for Payer: MDX Hawaii PPO	$81.48
Rate for Payer: Ohana Health Plan Medicaid	$35.28
Rate for Payer: Ohana Health Plan Medicare	$35.28
Rate for Payer: UnitedHealthcare Medicaid	$17.12
Rate for Payer: UnitedHealthcare Medicare	$35.28
Rate for Payer: University Health Alliance Commercial	$32.02

Hepatitis A Ab, Total DLS

Facility

$84.00

Service Code	HCPCS 86708
Hospital Charge Code	422867085
Hospital Revenue Code	302
Min. Negotiated Rate	$71.40
Max. Negotiated Rate	$81.48
Rate for Payer: Cash Price	$54.60
Rate for Payer: Health Management Network Commercial	$71.40
Rate for Payer: Kaiser Permanente Commercial	$75.60
Rate for Payer: MDX Hawaii PPO	$81.48

hepatitis A-hepatitis B vaccine 720 units-20 mcg/mL

Facility

$477.59

Service Code	NDC 58160081552
Hospital Revenue Code	250
Min. Negotiated Rate	$405.95
Max. Negotiated Rate	$463.26
Rate for Payer: Cash Price	$310.43
Rate for Payer: Health Management Network Commercial	$405.95
Rate for Payer: Kaiser Permanente Commercial	$429.83
Rate for Payer: MDX Hawaii PPO	$463.26

hepatitis A-hepatitis B vaccine 720 units-20 mcg/mL

Facility

$477.59

Service Code	NDC 58160081552
Hospital Revenue Code	250
Min. Negotiated Rate	$200.59
Max. Negotiated Rate	$463.26
Rate for Payer: AlohaCare Medicaid	$238.79
Rate for Payer: AlohaCare Medicare	$200.59
Rate for Payer: Cash Price	$310.43
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$439.38
Rate for Payer: Devoted Health Medicare	$200.59
Rate for Payer: Hawaii Medical Service Association Medicare	$200.59
Rate for Payer: Hawaii Western Management Group Commercial	$453.71
Rate for Payer: Health Management Network Commercial	$405.95
Rate for Payer: Humana Medicare	$200.59
Rate for Payer: Kaiser Permanente Commercial	$429.83
Rate for Payer: Kaiser Permanente Medicaid	$243.57
Rate for Payer: Kaiser Permanente Medicare	$200.59
Rate for Payer: MDX Hawaii PPO	$463.26
Rate for Payer: Ohana Health Plan Medicaid	$200.59
Rate for Payer: Ohana Health Plan Medicare	$200.59
Rate for Payer: UnitedHealthcare Medicaid	$286.55
Rate for Payer: UnitedHealthcare Medicare	$200.59
Rate for Payer: University Health Alliance Commercial	$348.12

hepatitis B adult vaccine 10 mcg/mL Sus [KMC]

Facility

$290.24

Service Code	HCPCS J1571
Hospital Revenue Code	636
Min. Negotiated Rate	$71.66
Max. Negotiated Rate	$281.53
Rate for Payer: AlohaCare Medicaid	$145.12
Rate for Payer: AlohaCare Medicare	$121.90
Rate for Payer: Cash Price	$188.66
Rate for Payer: Cash Price	$188.66
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$267.02
Rate for Payer: Devoted Health Medicare	$121.90
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$71.66
Rate for Payer: Hawaii Medical Service Association Commercial	$87.79
Rate for Payer: Hawaii Medical Service Association Medicare	$121.90
Rate for Payer: Hawaii Western Management Group Commercial	$275.73
Rate for Payer: Health Management Network Commercial	$246.70
Rate for Payer: Humana Medicare	$121.90
Rate for Payer: Kaiser Permanente Commercial	$261.22
Rate for Payer: Kaiser Permanente Medicaid	$148.02
Rate for Payer: Kaiser Permanente Medicare	$121.90
Rate for Payer: MDX Hawaii PPO	$281.53
Rate for Payer: Ohana Health Plan Medicaid	$121.90
Rate for Payer: Ohana Health Plan Medicare	$121.90
Rate for Payer: UnitedHealthcare Medicaid	$174.14
Rate for Payer: UnitedHealthcare Medicare	$121.90
Rate for Payer: University Health Alliance Commercial	$211.56

hepatitis B adult vaccine 10 mcg/mL Sus [KMC]

Facility

$290.24

Service Code	HCPCS J1571
Hospital Revenue Code	636
Min. Negotiated Rate	$246.70
Max. Negotiated Rate	$281.53
Rate for Payer: Cash Price	$188.66
Rate for Payer: Health Management Network Commercial	$246.70
Rate for Payer: Kaiser Permanente Commercial	$261.22
Rate for Payer: MDX Hawaii PPO	$281.53

hepatitis B adult vaccine 20 mcg/mL Sus [KMC]

Facility

$308.06

Service Code	NDC 58160082152
Hospital Revenue Code	250
Min. Negotiated Rate	$261.85
Max. Negotiated Rate	$298.82
Rate for Payer: Cash Price	$200.24
Rate for Payer: Health Management Network Commercial	$261.85
Rate for Payer: Kaiser Permanente Commercial	$277.25
Rate for Payer: MDX Hawaii PPO	$298.82

hepatitis B adult vaccine 20 mcg/mL Sus [KMC]

Facility

$308.06

Service Code	NDC 58160082152
Hospital Revenue Code	250
Min. Negotiated Rate	$129.39
Max. Negotiated Rate	$298.82
Rate for Payer: AlohaCare Medicaid	$154.03
Rate for Payer: AlohaCare Medicare	$129.39
Rate for Payer: Cash Price	$200.24
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$283.42
Rate for Payer: Devoted Health Medicare	$129.39
Rate for Payer: Hawaii Medical Service Association Medicare	$129.39
Rate for Payer: Hawaii Western Management Group Commercial	$292.66
Rate for Payer: Health Management Network Commercial	$261.85
Rate for Payer: Humana Medicare	$129.39
Rate for Payer: Kaiser Permanente Commercial	$277.25
Rate for Payer: Kaiser Permanente Medicaid	$157.11
Rate for Payer: Kaiser Permanente Medicare	$129.39
Rate for Payer: MDX Hawaii PPO	$298.82
Rate for Payer: Ohana Health Plan Medicaid	$129.39
Rate for Payer: Ohana Health Plan Medicare	$129.39
Rate for Payer: UnitedHealthcare Medicaid	$184.84
Rate for Payer: UnitedHealthcare Medicare	$129.39
Rate for Payer: University Health Alliance Commercial	$224.54

Hepatitis B Core Antibody, IgM DLS

Facility

$97.00

Service Code	HCPCS 86705
Hospital Charge Code	422867055
Hospital Revenue Code	301
Min. Negotiated Rate	$11.77
Max. Negotiated Rate	$94.09
Rate for Payer: AlohaCare Medicaid	$48.50
Rate for Payer: AlohaCare Medicare	$40.74
Rate for Payer: Cash Price	$63.05
Rate for Payer: Cash Price	$63.05
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$89.24
Rate for Payer: Devoted Health Medicare	$40.74
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$16.27
Rate for Payer: Hawaii Medical Service Association Commercial	$14.71
Rate for Payer: Hawaii Medical Service Association Medicare	$40.74
Rate for Payer: Hawaii Western Management Group Commercial	$11.77
Rate for Payer: Health Management Network Commercial	$82.45
Rate for Payer: Humana Medicare	$40.74
Rate for Payer: Kaiser Permanente Commercial	$87.30
Rate for Payer: Kaiser Permanente Medicaid	$49.47
Rate for Payer: Kaiser Permanente Medicare	$40.74
Rate for Payer: MDX Hawaii PPO	$94.09
Rate for Payer: Ohana Health Plan Medicaid	$40.74
Rate for Payer: Ohana Health Plan Medicare	$40.74
Rate for Payer: UnitedHealthcare Medicaid	$16.27
Rate for Payer: UnitedHealthcare Medicare	$40.74
Rate for Payer: University Health Alliance Commercial	$30.41

Hepatitis B Core Antibody, IgM DLS

Facility

$97.00

Service Code	HCPCS 86705
Hospital Charge Code	422867055
Hospital Revenue Code	301
Min. Negotiated Rate	$82.45
Max. Negotiated Rate	$94.09
Rate for Payer: Cash Price	$63.05
Rate for Payer: Health Management Network Commercial	$82.45
Rate for Payer: Kaiser Permanente Commercial	$87.30
Rate for Payer: MDX Hawaii PPO	$94.09

Hepatitis B Core Antibody, Total DLS

Facility

$97.00

Service Code	HCPCS 86704
Hospital Charge Code	422867045
Hospital Revenue Code	301
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$94.09
Rate for Payer: AlohaCare Medicaid	$48.50
Rate for Payer: AlohaCare Medicare	$40.74
Rate for Payer: Cash Price	$63.05
Rate for Payer: Cash Price	$63.05
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$89.24
Rate for Payer: Devoted Health Medicare	$40.74
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$16.66
Rate for Payer: Hawaii Medical Service Association Commercial	$15.06
Rate for Payer: Hawaii Medical Service Association Medicare	$40.74
Rate for Payer: Hawaii Western Management Group Commercial	$12.05
Rate for Payer: Health Management Network Commercial	$82.45
Rate for Payer: Humana Medicare	$40.74
Rate for Payer: Kaiser Permanente Commercial	$87.30
Rate for Payer: Kaiser Permanente Medicaid	$49.47
Rate for Payer: Kaiser Permanente Medicare	$40.74
Rate for Payer: MDX Hawaii PPO	$94.09
Rate for Payer: Ohana Health Plan Medicaid	$40.74
Rate for Payer: Ohana Health Plan Medicare	$40.74
Rate for Payer: UnitedHealthcare Medicaid	$16.66
Rate for Payer: UnitedHealthcare Medicare	$40.74
Rate for Payer: University Health Alliance Commercial	$31.15

Hepatitis B Core Antibody, Total DLS

Facility

$97.00

Service Code	HCPCS 86704
Hospital Charge Code	422867045
Hospital Revenue Code	301
Min. Negotiated Rate	$82.45
Max. Negotiated Rate	$94.09
Rate for Payer: Cash Price	$63.05
Rate for Payer: Health Management Network Commercial	$82.45
Rate for Payer: Kaiser Permanente Commercial	$87.30
Rate for Payer: MDX Hawaii PPO	$94.09

Hepatitis B DNA, Quant., TaqMan DLS

Facility

$546.00

Service Code	HCPCS 87517
Hospital Charge Code	422875175
Hospital Revenue Code	301
Min. Negotiated Rate	$42.84
Max. Negotiated Rate	$529.62
Rate for Payer: AlohaCare Medicaid	$273.00
Rate for Payer: AlohaCare Medicare	$229.32
Rate for Payer: Cash Price	$354.90
Rate for Payer: Cash Price	$354.90
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$502.32
Rate for Payer: Devoted Health Medicare	$229.32
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$59.20
Rate for Payer: Hawaii Medical Service Association Commercial	$53.55
Rate for Payer: Hawaii Medical Service Association Medicare	$229.32
Rate for Payer: Hawaii Western Management Group Commercial	$42.84
Rate for Payer: Health Management Network Commercial	$464.10
Rate for Payer: Humana Medicare	$229.32
Rate for Payer: Kaiser Permanente Commercial	$491.40
Rate for Payer: Kaiser Permanente Medicaid	$278.46
Rate for Payer: Kaiser Permanente Medicare	$229.32
Rate for Payer: MDX Hawaii PPO	$529.62
Rate for Payer: Ohana Health Plan Medicaid	$229.32
Rate for Payer: Ohana Health Plan Medicare	$229.32
Rate for Payer: UnitedHealthcare Medicaid	$59.20
Rate for Payer: UnitedHealthcare Medicare	$229.32
Rate for Payer: University Health Alliance Commercial	$110.72

Hepatitis B DNA, Quant., TaqMan DLS

Facility

$546.00

Service Code	HCPCS 87517
Hospital Charge Code	422875175
Hospital Revenue Code	301
Min. Negotiated Rate	$464.10
Max. Negotiated Rate	$529.62
Rate for Payer: Cash Price	$354.90
Rate for Payer: Health Management Network Commercial	$464.10
Rate for Payer: Kaiser Permanente Commercial	$491.40
Rate for Payer: MDX Hawaii PPO	$529.62

Hepatitis B Surface Antibody DLS

Facility

$103.00

Service Code	HCPCS 86706
Hospital Charge Code	422867065
Hospital Revenue Code	301
Min. Negotiated Rate	$10.74
Max. Negotiated Rate	$99.91
Rate for Payer: AlohaCare Medicaid	$51.50
Rate for Payer: AlohaCare Medicare	$43.26
Rate for Payer: Cash Price	$66.95
Rate for Payer: Cash Price	$66.95
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$94.76
Rate for Payer: Devoted Health Medicare	$43.26
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$14.84
Rate for Payer: Hawaii Medical Service Association Commercial	$13.43
Rate for Payer: Hawaii Medical Service Association Medicare	$43.26
Rate for Payer: Hawaii Western Management Group Commercial	$10.74
Rate for Payer: Health Management Network Commercial	$87.55
Rate for Payer: Humana Medicare	$43.26
Rate for Payer: Kaiser Permanente Commercial	$92.70
Rate for Payer: Kaiser Permanente Medicaid	$52.53
Rate for Payer: Kaiser Permanente Medicare	$43.26
Rate for Payer: MDX Hawaii PPO	$99.91
Rate for Payer: Ohana Health Plan Medicaid	$43.26
Rate for Payer: Ohana Health Plan Medicare	$43.26
Rate for Payer: UnitedHealthcare Medicaid	$14.84
Rate for Payer: UnitedHealthcare Medicare	$43.26
Rate for Payer: University Health Alliance Commercial	$27.77

Hepatitis B Surface Antibody DLS

Facility

$103.00

Service Code	HCPCS 86706
Hospital Charge Code	422867065
Hospital Revenue Code	301
Min. Negotiated Rate	$87.55
Max. Negotiated Rate	$99.91
Rate for Payer: Cash Price	$66.95
Rate for Payer: Health Management Network Commercial	$87.55
Rate for Payer: Kaiser Permanente Commercial	$92.70
Rate for Payer: MDX Hawaii PPO	$99.91

Hepatitis B Surface Antigen DLS

Facility

$97.00

Service Code	HCPCS 87340
Hospital Charge Code	422873405
Hospital Revenue Code	301
Min. Negotiated Rate	$10.33
Max. Negotiated Rate	$94.09
Rate for Payer: AlohaCare Medicaid	$48.50
Rate for Payer: AlohaCare Medicare	$40.74
Rate for Payer: Cash Price	$63.05
Rate for Payer: Cash Price	$63.05
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$89.24
Rate for Payer: Devoted Health Medicare	$40.74
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$14.27
Rate for Payer: Hawaii Medical Service Association Commercial	$12.91
Rate for Payer: Hawaii Medical Service Association Medicare	$40.74
Rate for Payer: Hawaii Western Management Group Commercial	$10.33
Rate for Payer: Health Management Network Commercial	$82.45
Rate for Payer: Humana Medicare	$40.74
Rate for Payer: Kaiser Permanente Commercial	$87.30
Rate for Payer: Kaiser Permanente Medicaid	$49.47
Rate for Payer: Kaiser Permanente Medicare	$40.74
Rate for Payer: MDX Hawaii PPO	$94.09
Rate for Payer: Ohana Health Plan Medicaid	$40.74
Rate for Payer: Ohana Health Plan Medicare	$40.74
Rate for Payer: UnitedHealthcare Medicaid	$14.27
Rate for Payer: UnitedHealthcare Medicare	$40.74
Rate for Payer: University Health Alliance Commercial	$26.70

Hepatitis B Surface Antigen DLS

Facility

$97.00

Service Code	HCPCS 87340
Hospital Charge Code	422873405
Hospital Revenue Code	301
Min. Negotiated Rate	$82.45
Max. Negotiated Rate	$94.09
Rate for Payer: Cash Price	$63.05
Rate for Payer: Health Management Network Commercial	$82.45
Rate for Payer: Kaiser Permanente Commercial	$87.30
Rate for Payer: MDX Hawaii PPO	$94.09

Hepatitis C Antibody DLS

Facility

$203.00

Service Code	HCPCS 86803
Hospital Charge Code	422868035
Hospital Revenue Code	301
Min. Negotiated Rate	$14.27
Max. Negotiated Rate	$196.91
Rate for Payer: AlohaCare Medicaid	$101.50
Rate for Payer: AlohaCare Medicare	$85.26
Rate for Payer: Cash Price	$131.95
Rate for Payer: Cash Price	$131.95
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$186.76
Rate for Payer: Devoted Health Medicare	$85.26
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$19.73
Rate for Payer: Hawaii Medical Service Association Commercial	$17.84
Rate for Payer: Hawaii Medical Service Association Medicare	$85.26
Rate for Payer: Hawaii Western Management Group Commercial	$14.27
Rate for Payer: Health Management Network Commercial	$172.55
Rate for Payer: Humana Medicare	$85.26
Rate for Payer: Kaiser Permanente Commercial	$182.70
Rate for Payer: Kaiser Permanente Medicaid	$103.53
Rate for Payer: Kaiser Permanente Medicare	$85.26
Rate for Payer: MDX Hawaii PPO	$196.91
Rate for Payer: Ohana Health Plan Medicaid	$85.26
Rate for Payer: Ohana Health Plan Medicare	$85.26
Rate for Payer: UnitedHealthcare Medicaid	$19.73
Rate for Payer: UnitedHealthcare Medicare	$85.26
Rate for Payer: University Health Alliance Commercial	$36.89

Hepatitis C Antibody DLS

Facility

$203.00

Service Code	HCPCS 86803
Hospital Charge Code	422868035
Hospital Revenue Code	301
Min. Negotiated Rate	$172.55
Max. Negotiated Rate	$196.91
Rate for Payer: Cash Price	$131.95
Rate for Payer: Health Management Network Commercial	$172.55
Rate for Payer: Kaiser Permanente Commercial	$182.70
Rate for Payer: MDX Hawaii PPO	$196.91

Hepatitis C RNA, Quant., TaqMan DLS

Facility

$490.00

Service Code	HCPCS 87522
Hospital Charge Code	422875225
Hospital Revenue Code	306
Min. Negotiated Rate	$416.50
Max. Negotiated Rate	$475.30
Rate for Payer: Cash Price	$318.50
Rate for Payer: Health Management Network Commercial	$416.50
Rate for Payer: Kaiser Permanente Commercial	$441.00
Rate for Payer: MDX Hawaii PPO	$475.30

Hepatitis C RNA, Quant., TaqMan DLS

Facility

$490.00

Service Code	HCPCS 87522
Hospital Charge Code	422875225
Hospital Revenue Code	306
Min. Negotiated Rate	$42.84
Max. Negotiated Rate	$475.30
Rate for Payer: AlohaCare Medicaid	$245.00
Rate for Payer: AlohaCare Medicare	$205.80
Rate for Payer: Cash Price	$318.50
Rate for Payer: Cash Price	$318.50
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$450.80
Rate for Payer: Devoted Health Medicare	$205.80
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$59.20
Rate for Payer: Hawaii Medical Service Association Commercial	$53.55
Rate for Payer: Hawaii Medical Service Association Medicare	$205.80
Rate for Payer: Hawaii Western Management Group Commercial	$42.84
Rate for Payer: Health Management Network Commercial	$416.50
Rate for Payer: Humana Medicare	$205.80
Rate for Payer: Kaiser Permanente Commercial	$441.00
Rate for Payer: Kaiser Permanente Medicaid	$249.90
Rate for Payer: Kaiser Permanente Medicare	$205.80
Rate for Payer: MDX Hawaii PPO	$475.30
Rate for Payer: Ohana Health Plan Medicaid	$205.80
Rate for Payer: Ohana Health Plan Medicare	$205.80
Rate for Payer: UnitedHealthcare Medicaid	$59.20
Rate for Payer: UnitedHealthcare Medicare	$205.80
Rate for Payer: University Health Alliance Commercial	$110.72

HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC

Facility

$65,464.92

Service Code	MSDRG 421
Min. Negotiated Rate	$65,464.92
Max. Negotiated Rate	$65,464.92
Rate for Payer: Hawaii Medical Service Association Commercial	$65,464.92

Know your out-of-pocket cost for care.

All Charges