Kahuku Medical Center

All Charges

Charge

Type

Setting

Price

CHEST PA LAT LORDOT

Facility

$369.00

Service Code	HCPCS 71047
Hospital Charge Code	424710210
Hospital Revenue Code	324
Min. Negotiated Rate	$313.65
Max. Negotiated Rate	$357.93
Rate for Payer: Cash Price	$239.85
Rate for Payer: Health Management Network Commercial	$313.65
Rate for Payer: Kaiser Permanente Commercial	$332.10
Rate for Payer: MDX Hawaii PPO	$357.93

CHEST PA LAT LORDOT

Facility

$369.00

Service Code	HCPCS 71047
Hospital Charge Code	424710210
Hospital Revenue Code	324
Min. Negotiated Rate	$24.39
Max. Negotiated Rate	$357.93
Rate for Payer: AlohaCare Medicaid	$184.50
Rate for Payer: AlohaCare Medicare	$154.98
Rate for Payer: Cash Price	$239.85
Rate for Payer: Cash Price	$239.85
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$339.48
Rate for Payer: Devoted Health Medicare	$154.98
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$24.39
Rate for Payer: Hawaii Medical Service Association Commercial	$128.51
Rate for Payer: Hawaii Medical Service Association Medicare	$154.98
Rate for Payer: Hawaii Western Management Group Commercial	$102.81
Rate for Payer: Health Management Network Commercial	$313.65
Rate for Payer: Humana Medicare	$154.98
Rate for Payer: Kaiser Permanente Commercial	$332.10
Rate for Payer: Kaiser Permanente Medicaid	$188.19
Rate for Payer: Kaiser Permanente Medicare	$154.98
Rate for Payer: MDX Hawaii PPO	$357.93
Rate for Payer: Ohana Health Plan Medicaid	$154.98
Rate for Payer: Ohana Health Plan Medicare	$154.98
Rate for Payer: UnitedHealthcare Medicaid	$28.11
Rate for Payer: UnitedHealthcare Medicare	$154.98
Rate for Payer: University Health Alliance Commercial	$80.64

Chest Physiotherapy

Facility

$92.00

Service Code	HCPCS 94667
Hospital Charge Code	429946670
Hospital Revenue Code	410
Min. Negotiated Rate	$20.34
Max. Negotiated Rate	$196.47
Rate for Payer: AlohaCare Medicaid	$46.00
Rate for Payer: AlohaCare Medicare	$38.64
Rate for Payer: Cash Price	$59.80
Rate for Payer: Cash Price	$59.80
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$84.64
Rate for Payer: Devoted Health Medicare	$38.64
Rate for Payer: Hawaii Medical Service Association Commercial	$196.47
Rate for Payer: Hawaii Medical Service Association Medicare	$38.64
Rate for Payer: Hawaii Western Management Group Commercial	$87.40
Rate for Payer: Health Management Network Commercial	$78.20
Rate for Payer: Humana Medicare	$38.64
Rate for Payer: Kaiser Permanente Commercial	$82.80
Rate for Payer: Kaiser Permanente Medicaid	$46.92
Rate for Payer: Kaiser Permanente Medicare	$38.64
Rate for Payer: MDX Hawaii PPO	$89.24
Rate for Payer: Ohana Health Plan Medicaid	$38.64
Rate for Payer: Ohana Health Plan Medicare	$38.64
Rate for Payer: UnitedHealthcare Medicaid	$20.34
Rate for Payer: UnitedHealthcare Medicare	$38.64
Rate for Payer: University Health Alliance Commercial	$67.06

Chest Physiotherapy

Facility

$92.00

Service Code	HCPCS 94667
Hospital Charge Code	429946670
Hospital Revenue Code	410
Min. Negotiated Rate	$78.20
Max. Negotiated Rate	$89.24
Rate for Payer: Cash Price	$59.80
Rate for Payer: Health Management Network Commercial	$78.20
Rate for Payer: Kaiser Permanente Commercial	$82.80
Rate for Payer: MDX Hawaii PPO	$89.24

Chest Physiotherapy Subsequent

Facility

$92.00

Service Code	HCPCS 94667
Hospital Charge Code	429946671
Hospital Revenue Code	410
Min. Negotiated Rate	$78.20
Max. Negotiated Rate	$89.24
Rate for Payer: Cash Price	$59.80
Rate for Payer: Health Management Network Commercial	$78.20
Rate for Payer: Kaiser Permanente Commercial	$82.80
Rate for Payer: MDX Hawaii PPO	$89.24

Chest Physiotherapy Subsequent

Facility

$92.00

Service Code	HCPCS 94667
Hospital Charge Code	429946671
Hospital Revenue Code	410
Min. Negotiated Rate	$20.34
Max. Negotiated Rate	$196.47
Rate for Payer: AlohaCare Medicaid	$46.00
Rate for Payer: AlohaCare Medicare	$38.64
Rate for Payer: Cash Price	$59.80
Rate for Payer: Cash Price	$59.80
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$84.64
Rate for Payer: Devoted Health Medicare	$38.64
Rate for Payer: Hawaii Medical Service Association Commercial	$196.47
Rate for Payer: Hawaii Medical Service Association Medicare	$38.64
Rate for Payer: Hawaii Western Management Group Commercial	$87.40
Rate for Payer: Health Management Network Commercial	$78.20
Rate for Payer: Humana Medicare	$38.64
Rate for Payer: Kaiser Permanente Commercial	$82.80
Rate for Payer: Kaiser Permanente Medicaid	$46.92
Rate for Payer: Kaiser Permanente Medicare	$38.64
Rate for Payer: MDX Hawaii PPO	$89.24
Rate for Payer: Ohana Health Plan Medicaid	$38.64
Rate for Payer: Ohana Health Plan Medicare	$38.64
Rate for Payer: UnitedHealthcare Medicaid	$20.34
Rate for Payer: UnitedHealthcare Medicare	$38.64
Rate for Payer: University Health Alliance Commercial	$67.06

CHEST SGL VW FRONTAL

Facility

$369.00

Service Code	HCPCS 71045
Hospital Charge Code	424710450
Hospital Revenue Code	324
Min. Negotiated Rate	$313.65
Max. Negotiated Rate	$357.93
Rate for Payer: Cash Price	$239.85
Rate for Payer: Health Management Network Commercial	$313.65
Rate for Payer: Kaiser Permanente Commercial	$332.10
Rate for Payer: MDX Hawaii PPO	$357.93

CHEST SGL VW FRONTAL

Facility

$369.00

Service Code	HCPCS 71045
Hospital Charge Code	424710450
Hospital Revenue Code	324
Min. Negotiated Rate	$15.78
Max. Negotiated Rate	$357.93
Rate for Payer: AlohaCare Medicaid	$184.50
Rate for Payer: AlohaCare Medicare	$154.98
Rate for Payer: Cash Price	$239.85
Rate for Payer: Cash Price	$239.85
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$339.48
Rate for Payer: Devoted Health Medicare	$154.98
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$15.78
Rate for Payer: Hawaii Medical Service Association Commercial	$128.51
Rate for Payer: Hawaii Medical Service Association Medicare	$154.98
Rate for Payer: Hawaii Western Management Group Commercial	$102.81
Rate for Payer: Health Management Network Commercial	$313.65
Rate for Payer: Humana Medicare	$154.98
Rate for Payer: Kaiser Permanente Commercial	$332.10
Rate for Payer: Kaiser Permanente Medicaid	$188.19
Rate for Payer: Kaiser Permanente Medicare	$154.98
Rate for Payer: MDX Hawaii PPO	$357.93
Rate for Payer: Ohana Health Plan Medicaid	$154.98
Rate for Payer: Ohana Health Plan Medicare	$154.98
Rate for Payer: UnitedHealthcare Medicaid	$16.90
Rate for Payer: UnitedHealthcare Medicare	$154.98
Rate for Payer: University Health Alliance Commercial	$40.29

CHEST SPECIAL VWS

Facility

$369.00

Service Code	HCPCS 71035
Hospital Charge Code	424710350
Hospital Revenue Code	324
Min. Negotiated Rate	$67.30
Max. Negotiated Rate	$357.93
Rate for Payer: AlohaCare Medicaid	$184.50
Rate for Payer: AlohaCare Medicare	$154.98
Rate for Payer: Cash Price	$239.85
Rate for Payer: Cash Price	$239.85
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$339.48
Rate for Payer: Devoted Health Medicare	$154.98
Rate for Payer: Hawaii Medical Service Association Medicare	$154.98
Rate for Payer: Hawaii Western Management Group Commercial	$350.55
Rate for Payer: Health Management Network Commercial	$313.65
Rate for Payer: Humana Medicare	$154.98
Rate for Payer: Kaiser Permanente Commercial	$332.10
Rate for Payer: Kaiser Permanente Medicaid	$188.19
Rate for Payer: Kaiser Permanente Medicare	$154.98
Rate for Payer: MDX Hawaii PPO	$357.93
Rate for Payer: Ohana Health Plan Medicaid	$154.98
Rate for Payer: Ohana Health Plan Medicare	$154.98
Rate for Payer: UnitedHealthcare Medicare	$154.98
Rate for Payer: University Health Alliance Commercial	$67.30

CHEST SPECIAL VWS

Facility

$369.00

Service Code	HCPCS 71035
Hospital Charge Code	424710350
Hospital Revenue Code	324
Min. Negotiated Rate	$313.65
Max. Negotiated Rate	$357.93
Rate for Payer: Cash Price	$239.85
Rate for Payer: Health Management Network Commercial	$313.65
Rate for Payer: Kaiser Permanente Commercial	$332.10
Rate for Payer: MDX Hawaii PPO	$357.93

CHEST TUBE INSERTION Charge

Facility

$1,859.00

Service Code	HCPCS 32551
Hospital Charge Code	317325510
Hospital Revenue Code	361
Min. Negotiated Rate	$1,580.15
Max. Negotiated Rate	$1,803.23
Rate for Payer: Cash Price	$1,208.35
Rate for Payer: Health Management Network Commercial	$1,580.15
Rate for Payer: Kaiser Permanente Commercial	$1,673.10
Rate for Payer: MDX Hawaii PPO	$1,803.23

CHEST TUBE INSERTION Charge

Facility

$1,859.00

Service Code	HCPCS 32551
Hospital Charge Code	317325510
Hospital Revenue Code	361
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$2,837.00
Rate for Payer: AlohaCare Medicaid	$929.50
Rate for Payer: AlohaCare Medicare	$780.78
Rate for Payer: Cash Price	$1,208.35
Rate for Payer: Cash Price	$1,208.35
Rate for Payer: Cash Price	$1,208.35
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$1,710.28
Rate for Payer: Devoted Health Medicare	$780.78
Rate for Payer: Hawaii Medical Service Association Commercial	$2,324.53
Rate for Payer: Hawaii Medical Service Association Medicare	$780.78
Rate for Payer: Health Management Network Commercial	$1,580.15
Rate for Payer: Humana Medicare	$780.78
Rate for Payer: Kaiser Permanente Commercial	$1,673.10
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$780.78
Rate for Payer: MDX Hawaii PPO	$1,803.23
Rate for Payer: Ohana Health Plan Medicaid	$780.78
Rate for Payer: Ohana Health Plan Medicare	$780.78
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$780.78
Rate for Payer: University Health Alliance Commercial	$1,355.03

CHEST WALL MANIP SUBSEQ Respiratory Therapy Charges

Facility

$153.00

Service Code	HCPCS 94668
Hospital Charge Code	429946680
Hospital Revenue Code	410
Min. Negotiated Rate	$130.05
Max. Negotiated Rate	$148.41
Rate for Payer: Cash Price	$99.45
Rate for Payer: Health Management Network Commercial	$130.05
Rate for Payer: Kaiser Permanente Commercial	$137.70
Rate for Payer: MDX Hawaii PPO	$148.41

CHEST WALL MANIP SUBSEQ Respiratory Therapy Charges

Facility

$153.00

Service Code	HCPCS 94668
Hospital Charge Code	429946680
Hospital Revenue Code	410
Min. Negotiated Rate	$16.41
Max. Negotiated Rate	$196.47
Rate for Payer: AlohaCare Medicaid	$76.50
Rate for Payer: AlohaCare Medicare	$64.26
Rate for Payer: Cash Price	$99.45
Rate for Payer: Cash Price	$99.45
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$140.76
Rate for Payer: Devoted Health Medicare	$64.26
Rate for Payer: Hawaii Medical Service Association Commercial	$196.47
Rate for Payer: Hawaii Medical Service Association Medicare	$64.26
Rate for Payer: Hawaii Western Management Group Commercial	$145.35
Rate for Payer: Health Management Network Commercial	$130.05
Rate for Payer: Humana Medicare	$64.26
Rate for Payer: Kaiser Permanente Commercial	$137.70
Rate for Payer: Kaiser Permanente Medicaid	$78.03
Rate for Payer: Kaiser Permanente Medicare	$64.26
Rate for Payer: MDX Hawaii PPO	$148.41
Rate for Payer: Ohana Health Plan Medicaid	$64.26
Rate for Payer: Ohana Health Plan Medicare	$64.26
Rate for Payer: UnitedHealthcare Medicaid	$16.41
Rate for Payer: UnitedHealthcare Medicare	$64.26
Rate for Payer: University Health Alliance Commercial	$111.52

CHEST W OBLIQUE PROJECTION

Facility

$422.00

Service Code	HCPCS 71047
Hospital Charge Code	424710470
Hospital Revenue Code	324
Min. Negotiated Rate	$24.39
Max. Negotiated Rate	$409.34
Rate for Payer: AlohaCare Medicaid	$211.00
Rate for Payer: AlohaCare Medicare	$177.24
Rate for Payer: Cash Price	$274.30
Rate for Payer: Cash Price	$274.30
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$388.24
Rate for Payer: Devoted Health Medicare	$177.24
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$24.39
Rate for Payer: Hawaii Medical Service Association Commercial	$128.51
Rate for Payer: Hawaii Medical Service Association Medicare	$177.24
Rate for Payer: Hawaii Western Management Group Commercial	$102.81
Rate for Payer: Health Management Network Commercial	$358.70
Rate for Payer: Humana Medicare	$177.24
Rate for Payer: Kaiser Permanente Commercial	$379.80
Rate for Payer: Kaiser Permanente Medicaid	$215.22
Rate for Payer: Kaiser Permanente Medicare	$177.24
Rate for Payer: MDX Hawaii PPO	$409.34
Rate for Payer: Ohana Health Plan Medicaid	$177.24
Rate for Payer: Ohana Health Plan Medicare	$177.24
Rate for Payer: UnitedHealthcare Medicaid	$28.11
Rate for Payer: UnitedHealthcare Medicare	$177.24
Rate for Payer: University Health Alliance Commercial	$80.64

CHEST W OBLIQUE PROJECTION

Facility

$422.00

Service Code	HCPCS 71047
Hospital Charge Code	424710470
Hospital Revenue Code	324
Min. Negotiated Rate	$358.70
Max. Negotiated Rate	$409.34
Rate for Payer: Cash Price	$274.30
Rate for Payer: Health Management Network Commercial	$358.70
Rate for Payer: Kaiser Permanente Commercial	$379.80
Rate for Payer: MDX Hawaii PPO	$409.34

CHEST W OBLIQUE PROJECTIONS

Facility

$497.00

Service Code	HCPCS 71046
Hospital Charge Code	424710460
Hospital Revenue Code	324
Min. Negotiated Rate	$20.40
Max. Negotiated Rate	$482.09
Rate for Payer: AlohaCare Medicaid	$248.50
Rate for Payer: AlohaCare Medicare	$208.74
Rate for Payer: Cash Price	$323.05
Rate for Payer: Cash Price	$323.05
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$457.24
Rate for Payer: Devoted Health Medicare	$208.74
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$20.40
Rate for Payer: Hawaii Medical Service Association Commercial	$128.51
Rate for Payer: Hawaii Medical Service Association Medicare	$208.74
Rate for Payer: Hawaii Western Management Group Commercial	$102.81
Rate for Payer: Health Management Network Commercial	$422.45
Rate for Payer: Humana Medicare	$208.74
Rate for Payer: Kaiser Permanente Commercial	$447.30
Rate for Payer: Kaiser Permanente Medicaid	$253.47
Rate for Payer: Kaiser Permanente Medicare	$208.74
Rate for Payer: MDX Hawaii PPO	$482.09
Rate for Payer: Ohana Health Plan Medicaid	$208.74
Rate for Payer: Ohana Health Plan Medicare	$208.74
Rate for Payer: UnitedHealthcare Medicaid	$22.29
Rate for Payer: UnitedHealthcare Medicare	$208.74
Rate for Payer: University Health Alliance Commercial	$62.81

CHEST W OBLIQUE PROJECTIONS

Facility

$497.00

Service Code	HCPCS 71046
Hospital Charge Code	424710460
Hospital Revenue Code	324
Min. Negotiated Rate	$422.45
Max. Negotiated Rate	$482.09
Rate for Payer: Cash Price	$323.05
Rate for Payer: Health Management Network Commercial	$422.45
Rate for Payer: Kaiser Permanente Commercial	$447.30
Rate for Payer: MDX Hawaii PPO	$482.09

Childhood (Food/Inhalant) Profile DLS

Facility

$307.00

Service Code	HCPCS 86003
Hospital Charge Code	422860035
Hospital Revenue Code	300
Min. Negotiated Rate	$5.22
Max. Negotiated Rate	$297.79
Rate for Payer: AlohaCare Medicaid	$153.50
Rate for Payer: AlohaCare Medicare	$128.94
Rate for Payer: Cash Price	$199.55
Rate for Payer: Cash Price	$199.55
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$282.44
Rate for Payer: Devoted Health Medicare	$128.94
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$7.22
Rate for Payer: Hawaii Medical Service Association Commercial	$6.53
Rate for Payer: Hawaii Medical Service Association Medicare	$128.94
Rate for Payer: Hawaii Western Management Group Commercial	$5.22
Rate for Payer: Health Management Network Commercial	$260.95
Rate for Payer: Humana Medicare	$128.94
Rate for Payer: Kaiser Permanente Commercial	$276.30
Rate for Payer: Kaiser Permanente Medicaid	$156.57
Rate for Payer: Kaiser Permanente Medicare	$128.94
Rate for Payer: MDX Hawaii PPO	$297.79
Rate for Payer: Ohana Health Plan Medicaid	$128.94
Rate for Payer: Ohana Health Plan Medicare	$128.94
Rate for Payer: UnitedHealthcare Medicaid	$7.22
Rate for Payer: UnitedHealthcare Medicare	$128.94
Rate for Payer: University Health Alliance Commercial	$13.51

Childhood (Food/Inhalant) Profile DLS

Facility

$307.00

Service Code	HCPCS 86003
Hospital Charge Code	422860035
Hospital Revenue Code	300
Min. Negotiated Rate	$260.95
Max. Negotiated Rate	$297.79
Rate for Payer: Cash Price	$199.55
Rate for Payer: Health Management Network Commercial	$260.95
Rate for Payer: Kaiser Permanente Commercial	$276.30
Rate for Payer: MDX Hawaii PPO	$297.79

Chlamydia/GC, PCR DLS

Facility

$166.00

Service Code	HCPCS 87491
Hospital Charge Code	422874915
Hospital Revenue Code	306
Min. Negotiated Rate	$141.10
Max. Negotiated Rate	$161.02
Rate for Payer: Cash Price	$107.90
Rate for Payer: Health Management Network Commercial	$141.10
Rate for Payer: Kaiser Permanente Commercial	$149.40
Rate for Payer: MDX Hawaii PPO	$161.02

Chlamydia/GC, PCR DLS

Facility

$166.00

Service Code	HCPCS 87491
Hospital Charge Code	422874915
Hospital Revenue Code	306
Min. Negotiated Rate	$35.09
Max. Negotiated Rate	$161.02
Rate for Payer: AlohaCare Medicaid	$83.00
Rate for Payer: AlohaCare Medicare	$69.72
Rate for Payer: Cash Price	$107.90
Rate for Payer: Cash Price	$107.90
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$152.72
Rate for Payer: Devoted Health Medicare	$69.72
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$48.50
Rate for Payer: Hawaii Medical Service Association Commercial	$43.86
Rate for Payer: Hawaii Medical Service Association Medicare	$69.72
Rate for Payer: Hawaii Western Management Group Commercial	$35.09
Rate for Payer: Health Management Network Commercial	$141.10
Rate for Payer: Humana Medicare	$69.72
Rate for Payer: Kaiser Permanente Commercial	$149.40
Rate for Payer: Kaiser Permanente Medicaid	$84.66
Rate for Payer: Kaiser Permanente Medicare	$69.72
Rate for Payer: MDX Hawaii PPO	$161.02
Rate for Payer: Ohana Health Plan Medicaid	$69.72
Rate for Payer: Ohana Health Plan Medicare	$69.72
Rate for Payer: UnitedHealthcare Medicaid	$48.50
Rate for Payer: UnitedHealthcare Medicare	$69.72
Rate for Payer: University Health Alliance Commercial	$90.72

Chlamydia, PCR DLS

Facility

$166.00

Service Code	HCPCS 87491
Hospital Charge Code	422874915
Hospital Revenue Code	306
Min. Negotiated Rate	$141.10
Max. Negotiated Rate	$161.02
Rate for Payer: Cash Price	$107.90
Rate for Payer: Health Management Network Commercial	$141.10
Rate for Payer: Kaiser Permanente Commercial	$149.40
Rate for Payer: MDX Hawaii PPO	$161.02

Chlamydia, PCR DLS

Facility

$166.00

Service Code	HCPCS 87491
Hospital Charge Code	422874915
Hospital Revenue Code	306
Min. Negotiated Rate	$35.09
Max. Negotiated Rate	$161.02
Rate for Payer: AlohaCare Medicaid	$83.00
Rate for Payer: AlohaCare Medicare	$69.72
Rate for Payer: Cash Price	$107.90
Rate for Payer: Cash Price	$107.90
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$152.72
Rate for Payer: Devoted Health Medicare	$69.72
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$48.50
Rate for Payer: Hawaii Medical Service Association Commercial	$43.86
Rate for Payer: Hawaii Medical Service Association Medicare	$69.72
Rate for Payer: Hawaii Western Management Group Commercial	$35.09
Rate for Payer: Health Management Network Commercial	$141.10
Rate for Payer: Humana Medicare	$69.72
Rate for Payer: Kaiser Permanente Commercial	$149.40
Rate for Payer: Kaiser Permanente Medicaid	$84.66
Rate for Payer: Kaiser Permanente Medicare	$69.72
Rate for Payer: MDX Hawaii PPO	$161.02
Rate for Payer: Ohana Health Plan Medicaid	$69.72
Rate for Payer: Ohana Health Plan Medicare	$69.72
Rate for Payer: UnitedHealthcare Medicaid	$48.50
Rate for Payer: UnitedHealthcare Medicare	$69.72
Rate for Payer: University Health Alliance Commercial	$90.72

CHLORAHEXIDINE 2% GLUCONATE CLOTH

Facility

$2.00

Hospital Charge Code	8565
Hospital Revenue Code	270
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$1.94
Rate for Payer: Cash Price	$1.30
Rate for Payer: Health Management Network Commercial	$1.70
Rate for Payer: Kaiser Permanente Commercial	$1.80
Rate for Payer: MDX Hawaii PPO	$1.94

Know your out-of-pocket cost for care.

All Charges