Kahuku Medical Center

All Charges

Charge

Type

Setting

Price

PULMONARY STRESS TEST Respiratory Therapy Charges

Facility

$407.00

Service Code	HCPCS 94620
Hospital Charge Code	429946200
Hospital Revenue Code	460
Min. Negotiated Rate	$345.95
Max. Negotiated Rate	$394.79
Rate for Payer: Cash Price	$264.55
Rate for Payer: Health Management Network Commercial	$345.95
Rate for Payer: Kaiser Permanente Commercial	$366.30
Rate for Payer: MDX Hawaii PPO	$394.79

PULMONARY STRESS TEST Respiratory Therapy Charges

Facility

$407.00

Service Code	HCPCS 94620
Hospital Charge Code	429946200
Hospital Revenue Code	460
Min. Negotiated Rate	$170.94
Max. Negotiated Rate	$394.79
Rate for Payer: AlohaCare Medicaid	$203.50
Rate for Payer: AlohaCare Medicare	$170.94
Rate for Payer: Cash Price	$264.55
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$374.44
Rate for Payer: Devoted Health Medicare	$170.94
Rate for Payer: Hawaii Medical Service Association Medicare	$170.94
Rate for Payer: Hawaii Western Management Group Commercial	$386.65
Rate for Payer: Health Management Network Commercial	$345.95
Rate for Payer: Humana Medicare	$170.94
Rate for Payer: Kaiser Permanente Commercial	$366.30
Rate for Payer: Kaiser Permanente Medicaid	$207.57
Rate for Payer: Kaiser Permanente Medicare	$170.94
Rate for Payer: MDX Hawaii PPO	$394.79
Rate for Payer: Ohana Health Plan Medicaid	$170.94
Rate for Payer: Ohana Health Plan Medicare	$170.94
Rate for Payer: UnitedHealthcare Medicare	$170.94
Rate for Payer: University Health Alliance Commercial	$296.66

PULSE OXIMETRY MULT Respiratory Therapy Charges

Facility

$773.00

Service Code	HCPCS 94761
Hospital Charge Code	440947610
Hospital Revenue Code	460
Min. Negotiated Rate	$4.77
Max. Negotiated Rate	$749.81
Rate for Payer: AlohaCare Medicaid	$386.50
Rate for Payer: AlohaCare Medicare	$324.66
Rate for Payer: Cash Price	$502.45
Rate for Payer: Cash Price	$502.45
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$711.16
Rate for Payer: Devoted Health Medicare	$324.66
Rate for Payer: Hawaii Medical Service Association Medicare	$324.66
Rate for Payer: Hawaii Western Management Group Commercial	$734.35
Rate for Payer: Health Management Network Commercial	$657.05
Rate for Payer: Humana Medicare	$324.66
Rate for Payer: Kaiser Permanente Commercial	$695.70
Rate for Payer: Kaiser Permanente Medicaid	$394.23
Rate for Payer: Kaiser Permanente Medicare	$324.66
Rate for Payer: MDX Hawaii PPO	$749.81
Rate for Payer: Ohana Health Plan Medicaid	$324.66
Rate for Payer: Ohana Health Plan Medicare	$324.66
Rate for Payer: UnitedHealthcare Medicaid	$4.77
Rate for Payer: UnitedHealthcare Medicare	$324.66
Rate for Payer: University Health Alliance Commercial	$563.44

PULSE OXIMETRY MULT Respiratory Therapy Charges

Facility

$773.00

Service Code	HCPCS 94761
Hospital Charge Code	440947610
Hospital Revenue Code	460
Min. Negotiated Rate	$657.05
Max. Negotiated Rate	$749.81
Rate for Payer: Cash Price	$502.45
Rate for Payer: Health Management Network Commercial	$657.05
Rate for Payer: Kaiser Permanente Commercial	$695.70
Rate for Payer: MDX Hawaii PPO	$749.81

PULSE OXIMETRY SGL Respiratory Therapy Charges

Facility

$184.00

Service Code	HCPCS 94760
Hospital Charge Code	440947600
Hospital Revenue Code	460
Min. Negotiated Rate	$156.40
Max. Negotiated Rate	$178.48
Rate for Payer: Cash Price	$119.60
Rate for Payer: Health Management Network Commercial	$156.40
Rate for Payer: Kaiser Permanente Commercial	$165.60
Rate for Payer: MDX Hawaii PPO	$178.48

PULSE OXIMETRY SGL Respiratory Therapy Charges

Facility

$184.00

Service Code	HCPCS 94760
Hospital Charge Code	440947600
Hospital Revenue Code	460
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$178.48
Rate for Payer: AlohaCare Medicaid	$92.00
Rate for Payer: AlohaCare Medicare	$77.28
Rate for Payer: Cash Price	$119.60
Rate for Payer: Cash Price	$119.60
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$169.28
Rate for Payer: Devoted Health Medicare	$77.28
Rate for Payer: Hawaii Medical Service Association Medicare	$77.28
Rate for Payer: Hawaii Western Management Group Commercial	$174.80
Rate for Payer: Health Management Network Commercial	$156.40
Rate for Payer: Humana Medicare	$77.28
Rate for Payer: Kaiser Permanente Commercial	$165.60
Rate for Payer: Kaiser Permanente Medicaid	$93.84
Rate for Payer: Kaiser Permanente Medicare	$77.28
Rate for Payer: MDX Hawaii PPO	$178.48
Rate for Payer: Ohana Health Plan Medicaid	$77.28
Rate for Payer: Ohana Health Plan Medicare	$77.28
Rate for Payer: UnitedHealthcare Medicaid	$2.29
Rate for Payer: UnitedHealthcare Medicare	$77.28
Rate for Payer: University Health Alliance Commercial	$134.12

PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION

Professional

Both

$230.00

Service Code	HCPCS 11105
Hospital Revenue Code	361
Min. Negotiated Rate	$20.99
Max. Negotiated Rate	$195.50
Rate for Payer: AlohaCare Medicaid	$25.66
Rate for Payer: AlohaCare Medicare	$20.99
Rate for Payer: Cash Price	$149.50
Rate for Payer: Cash Price	$149.50
Rate for Payer: Devoted Health Medicare	$20.99
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$25.66
Rate for Payer: Hawaii Medical Service Association Commercial	$39.98
Rate for Payer: Hawaii Medical Service Association Medicare	$20.99
Rate for Payer: Hawaii Western Management Group Commercial	$67.86
Rate for Payer: Health Management Network Commercial	$195.50
Rate for Payer: Kaiser Permanente Commercial	$25.19
Rate for Payer: Kaiser Permanente Medicaid	$25.19
Rate for Payer: Kaiser Permanente Medicare	$25.19
Rate for Payer: Ohana Health Plan Medicaid	$25.66
Rate for Payer: Ohana Health Plan Medicare	$20.99
Rate for Payer: UnitedHealthcare Medicaid	$25.66
Rate for Payer: UnitedHealthcare Medicare	$20.99
Rate for Payer: University Health Alliance Commercial	$29.74

PUNCH BIOPSY SKIN SINGLE LESION

Professional

Both

$529.00

Service Code	HCPCS 11104
Hospital Revenue Code	361
Min. Negotiated Rate	$37.91
Max. Negotiated Rate	$449.65
Rate for Payer: AlohaCare Medicaid	$47.09
Rate for Payer: AlohaCare Medicare	$37.91
Rate for Payer: Cash Price	$343.85
Rate for Payer: Cash Price	$343.85
Rate for Payer: Devoted Health Medicare	$37.91
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$47.09
Rate for Payer: Hawaii Medical Service Association Commercial	$75.38
Rate for Payer: Hawaii Medical Service Association Medicare	$37.91
Rate for Payer: Hawaii Western Management Group Commercial	$138.84
Rate for Payer: Health Management Network Commercial	$449.65
Rate for Payer: Kaiser Permanente Commercial	$45.49
Rate for Payer: Kaiser Permanente Medicaid	$45.49
Rate for Payer: Kaiser Permanente Medicare	$45.49
Rate for Payer: Ohana Health Plan Medicaid	$47.09
Rate for Payer: Ohana Health Plan Medicare	$37.91
Rate for Payer: UnitedHealthcare Medicaid	$47.09
Rate for Payer: UnitedHealthcare Medicare	$37.91
Rate for Payer: University Health Alliance Commercial	$54.29

PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST

Professional

Both

$5,725.00

Service Code	HCPCS 10160
Hospital Revenue Code	361
Min. Negotiated Rate	$47.58
Max. Negotiated Rate	$4,866.25
Rate for Payer: AlohaCare Medicaid	$101.97
Rate for Payer: AlohaCare Medicare	$95.49
Rate for Payer: Cash Price	$3,721.25
Rate for Payer: Cash Price	$3,721.25
Rate for Payer: Devoted Health Medicare	$95.49
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$101.97
Rate for Payer: Hawaii Medical Service Association Commercial	$153.51
Rate for Payer: Hawaii Medical Service Association Medicare	$95.49
Rate for Payer: Hawaii Western Management Group Commercial	$47.58
Rate for Payer: Health Management Network Commercial	$4,866.25
Rate for Payer: Kaiser Permanente Commercial	$114.59
Rate for Payer: Kaiser Permanente Medicaid	$114.59
Rate for Payer: Kaiser Permanente Medicare	$114.59
Rate for Payer: Ohana Health Plan Medicaid	$101.97
Rate for Payer: Ohana Health Plan Medicare	$95.49
Rate for Payer: UnitedHealthcare Medicaid	$101.97
Rate for Payer: UnitedHealthcare Medicare	$95.49
Rate for Payer: University Health Alliance Commercial	$110.81

PURE TONE AUDIOMETRY AIR ONLY

Professional

Both

$104.00

Service Code	HCPCS 92552
Hospital Revenue Code	440
Min. Negotiated Rate	$18.92
Max. Negotiated Rate	$88.40
Rate for Payer: AlohaCare Medicaid	$43.41
Rate for Payer: AlohaCare Medicare	$45.77
Rate for Payer: Cash Price	$67.60
Rate for Payer: Cash Price	$67.60
Rate for Payer: Devoted Health Medicare	$45.77
Rate for Payer: Hawaii Medical Service Association Medicare	$45.77
Rate for Payer: Hawaii Western Management Group Commercial	$18.92
Rate for Payer: Health Management Network Commercial	$88.40
Rate for Payer: Kaiser Permanente Commercial	$54.92
Rate for Payer: Kaiser Permanente Medicaid	$54.92
Rate for Payer: Kaiser Permanente Medicare	$54.92
Rate for Payer: Ohana Health Plan Medicaid	$43.41
Rate for Payer: Ohana Health Plan Medicare	$45.77
Rate for Payer: UnitedHealthcare Medicaid	$43.41
Rate for Payer: UnitedHealthcare Medicare	$45.77

pyrazinamide 500 mg Tab [KMC]

Facility

$4.84

Service Code	NDC 67253066010
Hospital Revenue Code	250
Min. Negotiated Rate	$4.11
Max. Negotiated Rate	$4.69
Rate for Payer: Cash Price	$3.15
Rate for Payer: Health Management Network Commercial	$4.11
Rate for Payer: Kaiser Permanente Commercial	$4.36
Rate for Payer: MDX Hawaii PPO	$4.69

pyrazinamide 500 mg Tab [KMC]

Facility

$4.84

Service Code	NDC 67253066010
Hospital Revenue Code	250
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$4.69
Rate for Payer: AlohaCare Medicaid	$2.42
Rate for Payer: AlohaCare Medicare	$2.03
Rate for Payer: Cash Price	$3.15
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$4.45
Rate for Payer: Devoted Health Medicare	$2.03
Rate for Payer: Hawaii Medical Service Association Medicare	$2.03
Rate for Payer: Hawaii Western Management Group Commercial	$4.60
Rate for Payer: Health Management Network Commercial	$4.11
Rate for Payer: Humana Medicare	$2.03
Rate for Payer: Kaiser Permanente Commercial	$4.36
Rate for Payer: Kaiser Permanente Medicaid	$2.47
Rate for Payer: Kaiser Permanente Medicare	$2.03
Rate for Payer: MDX Hawaii PPO	$4.69
Rate for Payer: Ohana Health Plan Medicaid	$2.03
Rate for Payer: Ohana Health Plan Medicare	$2.03
Rate for Payer: UnitedHealthcare Medicaid	$2.90
Rate for Payer: UnitedHealthcare Medicare	$2.03
Rate for Payer: University Health Alliance Commercial	$3.53

pyridostigmine 60 mg Tab [KMC]

Facility

$3.00

Service Code	NDC 68682030210
Hospital Revenue Code	250
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$2.91
Rate for Payer: AlohaCare Medicaid	$1.50
Rate for Payer: AlohaCare Medicare	$1.26
Rate for Payer: Cash Price	$1.95
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$2.76
Rate for Payer: Devoted Health Medicare	$1.26
Rate for Payer: Hawaii Medical Service Association Medicare	$1.26
Rate for Payer: Hawaii Western Management Group Commercial	$2.85
Rate for Payer: Health Management Network Commercial	$2.55
Rate for Payer: Humana Medicare	$1.26
Rate for Payer: Kaiser Permanente Commercial	$2.70
Rate for Payer: Kaiser Permanente Medicaid	$1.53
Rate for Payer: Kaiser Permanente Medicare	$1.26
Rate for Payer: MDX Hawaii PPO	$2.91
Rate for Payer: Ohana Health Plan Medicaid	$1.26
Rate for Payer: Ohana Health Plan Medicare	$1.26
Rate for Payer: UnitedHealthcare Medicaid	$1.80
Rate for Payer: UnitedHealthcare Medicare	$1.26
Rate for Payer: University Health Alliance Commercial	$2.19

pyridostigmine 60 mg Tab [KMC]

Facility

$3.00

Service Code	NDC 68682030210
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$1.95
Rate for Payer: Health Management Network Commercial	$2.55
Rate for Payer: Kaiser Permanente Commercial	$2.70
Rate for Payer: MDX Hawaii PPO	$2.91

pyridoxine 25 mg Tab [KMC]

Facility

$3.00

Service Code	NDC 00536440601
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$1.95
Rate for Payer: Health Management Network Commercial	$2.55
Rate for Payer: Kaiser Permanente Commercial	$2.70
Rate for Payer: MDX Hawaii PPO	$2.91

pyridoxine 25 mg Tab [KMC]

Facility

$3.00

Service Code	NDC 00536440601
Hospital Revenue Code	250
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$2.91
Rate for Payer: AlohaCare Medicaid	$1.50
Rate for Payer: AlohaCare Medicare	$1.26
Rate for Payer: Cash Price	$1.95
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$2.76
Rate for Payer: Devoted Health Medicare	$1.26
Rate for Payer: Hawaii Medical Service Association Medicare	$1.26
Rate for Payer: Hawaii Western Management Group Commercial	$2.85
Rate for Payer: Health Management Network Commercial	$2.55
Rate for Payer: Humana Medicare	$1.26
Rate for Payer: Kaiser Permanente Commercial	$2.70
Rate for Payer: Kaiser Permanente Medicaid	$1.53
Rate for Payer: Kaiser Permanente Medicare	$1.26
Rate for Payer: MDX Hawaii PPO	$2.91
Rate for Payer: Ohana Health Plan Medicaid	$1.26
Rate for Payer: Ohana Health Plan Medicare	$1.26
Rate for Payer: UnitedHealthcare Medicaid	$1.80
Rate for Payer: UnitedHealthcare Medicare	$1.26
Rate for Payer: University Health Alliance Commercial	$2.19

pyridoxine 50 mg Tab [KMC]

Facility

$3.00

Service Code	NDC 50268085815
Hospital Revenue Code	250
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$2.91
Rate for Payer: AlohaCare Medicaid	$1.50
Rate for Payer: AlohaCare Medicare	$1.26
Rate for Payer: Cash Price	$1.95
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$2.76
Rate for Payer: Devoted Health Medicare	$1.26
Rate for Payer: Hawaii Medical Service Association Medicare	$1.26
Rate for Payer: Hawaii Western Management Group Commercial	$2.85
Rate for Payer: Health Management Network Commercial	$2.55
Rate for Payer: Humana Medicare	$1.26
Rate for Payer: Kaiser Permanente Commercial	$2.70
Rate for Payer: Kaiser Permanente Medicaid	$1.53
Rate for Payer: Kaiser Permanente Medicare	$1.26
Rate for Payer: MDX Hawaii PPO	$2.91
Rate for Payer: Ohana Health Plan Medicaid	$1.26
Rate for Payer: Ohana Health Plan Medicare	$1.26
Rate for Payer: UnitedHealthcare Medicaid	$1.80
Rate for Payer: UnitedHealthcare Medicare	$1.26
Rate for Payer: University Health Alliance Commercial	$2.19

pyridoxine 50 mg Tab [KMC]

Facility

$3.00

Service Code	NDC 50268085815
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$1.95
Rate for Payer: Health Management Network Commercial	$2.55
Rate for Payer: Kaiser Permanente Commercial	$2.70
Rate for Payer: MDX Hawaii PPO	$2.91

QuantiFERON-TB Gold DLS

Facility

$347.00

Service Code	HCPCS 86480
Hospital Charge Code	24050452
Hospital Revenue Code	300
Min. Negotiated Rate	$294.95
Max. Negotiated Rate	$336.59
Rate for Payer: Cash Price	$225.55
Rate for Payer: Health Management Network Commercial	$294.95
Rate for Payer: Kaiser Permanente Commercial	$312.30
Rate for Payer: MDX Hawaii PPO	$336.59

QuantiFERON-TB Gold DLS

Facility

$347.00

Service Code	HCPCS 86480
Hospital Charge Code	24050452
Hospital Revenue Code	300
Min. Negotiated Rate	$51.95
Max. Negotiated Rate	$336.59
Rate for Payer: AlohaCare Medicaid	$173.50
Rate for Payer: AlohaCare Medicare	$145.74
Rate for Payer: Cash Price	$225.55
Rate for Payer: Cash Price	$225.55
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$319.24
Rate for Payer: Devoted Health Medicare	$145.74
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$51.95
Rate for Payer: Hawaii Medical Service Association Commercial	$77.47
Rate for Payer: Hawaii Medical Service Association Medicare	$145.74
Rate for Payer: Hawaii Western Management Group Commercial	$61.98
Rate for Payer: Health Management Network Commercial	$294.95
Rate for Payer: Humana Medicare	$145.74
Rate for Payer: Kaiser Permanente Commercial	$312.30
Rate for Payer: Kaiser Permanente Medicaid	$176.97
Rate for Payer: Kaiser Permanente Medicare	$145.74
Rate for Payer: MDX Hawaii PPO	$336.59
Rate for Payer: Ohana Health Plan Medicaid	$145.74
Rate for Payer: Ohana Health Plan Medicare	$145.74
Rate for Payer: UnitedHealthcare Medicaid	$51.95
Rate for Payer: UnitedHealthcare Medicare	$145.74
Rate for Payer: University Health Alliance Commercial	$160.19

QUEtiapine 100 mg Tab [KMC]

Facility

$27.44

Service Code	NDC 67877025001
Hospital Revenue Code	250
Min. Negotiated Rate	$11.52
Max. Negotiated Rate	$26.62
Rate for Payer: AlohaCare Medicaid	$13.72
Rate for Payer: AlohaCare Medicare	$11.52
Rate for Payer: Cash Price	$17.84
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$25.24
Rate for Payer: Devoted Health Medicare	$11.52
Rate for Payer: Hawaii Medical Service Association Medicare	$11.52
Rate for Payer: Hawaii Western Management Group Commercial	$26.07
Rate for Payer: Health Management Network Commercial	$23.32
Rate for Payer: Humana Medicare	$11.52
Rate for Payer: Kaiser Permanente Commercial	$24.70
Rate for Payer: Kaiser Permanente Medicaid	$13.99
Rate for Payer: Kaiser Permanente Medicare	$11.52
Rate for Payer: MDX Hawaii PPO	$26.62
Rate for Payer: Ohana Health Plan Medicaid	$11.52
Rate for Payer: Ohana Health Plan Medicare	$11.52
Rate for Payer: UnitedHealthcare Medicaid	$16.46
Rate for Payer: UnitedHealthcare Medicare	$11.52
Rate for Payer: University Health Alliance Commercial	$20.00

QUEtiapine 100 mg Tab [KMC]

Facility

$27.44

Service Code	NDC 67877025001
Hospital Revenue Code	250
Min. Negotiated Rate	$23.32
Max. Negotiated Rate	$26.62
Rate for Payer: Cash Price	$17.84
Rate for Payer: Health Management Network Commercial	$23.32
Rate for Payer: Kaiser Permanente Commercial	$24.70
Rate for Payer: MDX Hawaii PPO	$26.62

QUEtiapine 150 mg ER

Facility

$63.70

Service Code	NDC 52817016160
Hospital Revenue Code	250
Min. Negotiated Rate	$54.15
Max. Negotiated Rate	$61.79
Rate for Payer: Cash Price	$41.40
Rate for Payer: Health Management Network Commercial	$54.15
Rate for Payer: Kaiser Permanente Commercial	$57.33
Rate for Payer: MDX Hawaii PPO	$61.79

QUEtiapine 150 mg ER

Facility

$63.70

Service Code	NDC 52817016160
Hospital Revenue Code	250
Min. Negotiated Rate	$26.75
Max. Negotiated Rate	$61.79
Rate for Payer: AlohaCare Medicaid	$31.85
Rate for Payer: AlohaCare Medicare	$26.75
Rate for Payer: Cash Price	$41.40
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$58.60
Rate for Payer: Devoted Health Medicare	$26.75
Rate for Payer: Hawaii Medical Service Association Medicare	$26.75
Rate for Payer: Hawaii Western Management Group Commercial	$60.52
Rate for Payer: Health Management Network Commercial	$54.15
Rate for Payer: Humana Medicare	$26.75
Rate for Payer: Kaiser Permanente Commercial	$57.33
Rate for Payer: Kaiser Permanente Medicaid	$32.49
Rate for Payer: Kaiser Permanente Medicare	$26.75
Rate for Payer: MDX Hawaii PPO	$61.79
Rate for Payer: Ohana Health Plan Medicaid	$26.75
Rate for Payer: Ohana Health Plan Medicare	$26.75
Rate for Payer: UnitedHealthcare Medicaid	$38.22
Rate for Payer: UnitedHealthcare Medicare	$26.75
Rate for Payer: University Health Alliance Commercial	$46.43

QUEtiapine 200 mg ER Tab [KMC]

Facility

$70.11

Service Code	NDC 50228038260
Hospital Revenue Code	250
Min. Negotiated Rate	$29.45
Max. Negotiated Rate	$68.01
Rate for Payer: AlohaCare Medicaid	$35.05
Rate for Payer: AlohaCare Medicare	$29.45
Rate for Payer: Cash Price	$45.57
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$64.50
Rate for Payer: Devoted Health Medicare	$29.45
Rate for Payer: Hawaii Medical Service Association Medicare	$29.45
Rate for Payer: Hawaii Western Management Group Commercial	$66.60
Rate for Payer: Health Management Network Commercial	$59.59
Rate for Payer: Humana Medicare	$29.45
Rate for Payer: Kaiser Permanente Commercial	$63.10
Rate for Payer: Kaiser Permanente Medicaid	$35.76
Rate for Payer: Kaiser Permanente Medicare	$29.45
Rate for Payer: MDX Hawaii PPO	$68.01
Rate for Payer: Ohana Health Plan Medicaid	$29.45
Rate for Payer: Ohana Health Plan Medicare	$29.45
Rate for Payer: UnitedHealthcare Medicaid	$42.07
Rate for Payer: UnitedHealthcare Medicare	$29.45
Rate for Payer: University Health Alliance Commercial	$51.10

Know your out-of-pocket cost for care.

All Charges