Kahuku Medical Center

All Charges

Charge

Type

Setting

Price

Creatinine

Facility

$72.00

Service Code	HCPCS 82565
Hospital Charge Code	422825650
Hospital Revenue Code	301
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$69.84
Rate for Payer: AlohaCare Medicaid	$36.00
Rate for Payer: AlohaCare Medicare	$30.24
Rate for Payer: Cash Price	$46.80
Rate for Payer: Cash Price	$46.80
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$66.24
Rate for Payer: Devoted Health Medicare	$30.24
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$7.07
Rate for Payer: Hawaii Medical Service Association Commercial	$6.40
Rate for Payer: Hawaii Medical Service Association Medicare	$30.24
Rate for Payer: Hawaii Western Management Group Commercial	$5.12
Rate for Payer: Health Management Network Commercial	$61.20
Rate for Payer: Humana Medicare	$30.24
Rate for Payer: Kaiser Permanente Commercial	$64.80
Rate for Payer: Kaiser Permanente Medicaid	$36.72
Rate for Payer: Kaiser Permanente Medicare	$30.24
Rate for Payer: MDX Hawaii PPO	$69.84
Rate for Payer: Ohana Health Plan Medicaid	$30.24
Rate for Payer: Ohana Health Plan Medicare	$30.24
Rate for Payer: UnitedHealthcare Medicaid	$7.07
Rate for Payer: UnitedHealthcare Medicare	$30.24
Rate for Payer: University Health Alliance Commercial	$13.25

Creatinine

Facility

$72.00

Service Code	HCPCS 82565
Hospital Charge Code	422825650
Hospital Revenue Code	301
Min. Negotiated Rate	$61.20
Max. Negotiated Rate	$69.84
Rate for Payer: Cash Price	$46.80
Rate for Payer: Health Management Network Commercial	$61.20
Rate for Payer: Kaiser Permanente Commercial	$64.80
Rate for Payer: MDX Hawaii PPO	$69.84

Creatinine, 24 Hr Urine DLS

Facility

$95.00

Service Code	HCPCS 82570
Hospital Charge Code	422825705
Hospital Revenue Code	301
Min. Negotiated Rate	$80.75
Max. Negotiated Rate	$92.15
Rate for Payer: Cash Price	$61.75
Rate for Payer: Health Management Network Commercial	$80.75
Rate for Payer: Kaiser Permanente Commercial	$85.50
Rate for Payer: MDX Hawaii PPO	$92.15

Creatinine, 24 Hr Urine DLS

Facility

$95.00

Service Code	HCPCS 82570
Hospital Charge Code	422825705
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$92.15
Rate for Payer: AlohaCare Medicaid	$47.50
Rate for Payer: AlohaCare Medicare	$39.90
Rate for Payer: Cash Price	$61.75
Rate for Payer: Cash Price	$61.75
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$87.40
Rate for Payer: Devoted Health Medicare	$39.90
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$7.15
Rate for Payer: Hawaii Medical Service Association Commercial	$6.47
Rate for Payer: Hawaii Medical Service Association Medicare	$39.90
Rate for Payer: Hawaii Western Management Group Commercial	$5.18
Rate for Payer: Health Management Network Commercial	$80.75
Rate for Payer: Humana Medicare	$39.90
Rate for Payer: Kaiser Permanente Commercial	$85.50
Rate for Payer: Kaiser Permanente Medicaid	$48.45
Rate for Payer: Kaiser Permanente Medicare	$39.90
Rate for Payer: MDX Hawaii PPO	$92.15
Rate for Payer: Ohana Health Plan Medicaid	$39.90
Rate for Payer: Ohana Health Plan Medicare	$39.90
Rate for Payer: UnitedHealthcare Medicaid	$7.15
Rate for Payer: UnitedHealthcare Medicare	$39.90
Rate for Payer: University Health Alliance Commercial	$13.38

Creatinine Clearance, 24 Hr Urine DLS

Facility

$159.00

Service Code	HCPCS 82575
Hospital Charge Code	422825755
Hospital Revenue Code	301
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$154.23
Rate for Payer: AlohaCare Medicaid	$79.50
Rate for Payer: AlohaCare Medicare	$66.78
Rate for Payer: Cash Price	$103.35
Rate for Payer: Cash Price	$103.35
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$146.28
Rate for Payer: Devoted Health Medicare	$66.78
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$13.06
Rate for Payer: Hawaii Medical Service Association Commercial	$11.82
Rate for Payer: Hawaii Medical Service Association Medicare	$66.78
Rate for Payer: Hawaii Western Management Group Commercial	$9.46
Rate for Payer: Health Management Network Commercial	$135.15
Rate for Payer: Humana Medicare	$66.78
Rate for Payer: Kaiser Permanente Commercial	$143.10
Rate for Payer: Kaiser Permanente Medicaid	$81.09
Rate for Payer: Kaiser Permanente Medicare	$66.78
Rate for Payer: MDX Hawaii PPO	$154.23
Rate for Payer: Ohana Health Plan Medicaid	$66.78
Rate for Payer: Ohana Health Plan Medicare	$66.78
Rate for Payer: UnitedHealthcare Medicaid	$13.06
Rate for Payer: UnitedHealthcare Medicare	$66.78
Rate for Payer: University Health Alliance Commercial	$24.42

Creatinine Clearance, 24 Hr Urine DLS

Facility

$159.00

Service Code	HCPCS 82575
Hospital Charge Code	422825755
Hospital Revenue Code	301
Min. Negotiated Rate	$135.15
Max. Negotiated Rate	$154.23
Rate for Payer: Cash Price	$103.35
Rate for Payer: Health Management Network Commercial	$135.15
Rate for Payer: Kaiser Permanente Commercial	$143.10
Rate for Payer: MDX Hawaii PPO	$154.23

Creatinine DLS

Facility

$72.00

Service Code	HCPCS 82565
Hospital Charge Code	422825655
Hospital Revenue Code	301
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$69.84
Rate for Payer: AlohaCare Medicaid	$36.00
Rate for Payer: AlohaCare Medicare	$30.24
Rate for Payer: Cash Price	$46.80
Rate for Payer: Cash Price	$46.80
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$66.24
Rate for Payer: Devoted Health Medicare	$30.24
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$7.07
Rate for Payer: Hawaii Medical Service Association Commercial	$6.40
Rate for Payer: Hawaii Medical Service Association Medicare	$30.24
Rate for Payer: Hawaii Western Management Group Commercial	$5.12
Rate for Payer: Health Management Network Commercial	$61.20
Rate for Payer: Humana Medicare	$30.24
Rate for Payer: Kaiser Permanente Commercial	$64.80
Rate for Payer: Kaiser Permanente Medicaid	$36.72
Rate for Payer: Kaiser Permanente Medicare	$30.24
Rate for Payer: MDX Hawaii PPO	$69.84
Rate for Payer: Ohana Health Plan Medicaid	$30.24
Rate for Payer: Ohana Health Plan Medicare	$30.24
Rate for Payer: UnitedHealthcare Medicaid	$7.07
Rate for Payer: UnitedHealthcare Medicare	$30.24
Rate for Payer: University Health Alliance Commercial	$13.25

Creatinine DLS

Facility

$72.00

Service Code	HCPCS 82565
Hospital Charge Code	422825655
Hospital Revenue Code	301
Min. Negotiated Rate	$61.20
Max. Negotiated Rate	$69.84
Rate for Payer: Cash Price	$46.80
Rate for Payer: Health Management Network Commercial	$61.20
Rate for Payer: Kaiser Permanente Commercial	$64.80
Rate for Payer: MDX Hawaii PPO	$69.84

Creatinine, Random Urine DLS

Facility

$51.00

Service Code	HCPCS 82570
Hospital Charge Code	422842705
Hospital Revenue Code	301
Min. Negotiated Rate	$43.35
Max. Negotiated Rate	$49.47
Rate for Payer: Cash Price	$33.15
Rate for Payer: Health Management Network Commercial	$43.35
Rate for Payer: Kaiser Permanente Commercial	$45.90
Rate for Payer: MDX Hawaii PPO	$49.47

Creatinine, Random Urine DLS

Facility

$51.00

Service Code	HCPCS 82570
Hospital Charge Code	422842705
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$49.47
Rate for Payer: AlohaCare Medicaid	$25.50
Rate for Payer: AlohaCare Medicare	$21.42
Rate for Payer: Cash Price	$33.15
Rate for Payer: Cash Price	$33.15
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$46.92
Rate for Payer: Devoted Health Medicare	$21.42
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$7.15
Rate for Payer: Hawaii Medical Service Association Commercial	$6.47
Rate for Payer: Hawaii Medical Service Association Medicare	$21.42
Rate for Payer: Hawaii Western Management Group Commercial	$5.18
Rate for Payer: Health Management Network Commercial	$43.35
Rate for Payer: Humana Medicare	$21.42
Rate for Payer: Kaiser Permanente Commercial	$45.90
Rate for Payer: Kaiser Permanente Medicaid	$26.01
Rate for Payer: Kaiser Permanente Medicare	$21.42
Rate for Payer: MDX Hawaii PPO	$49.47
Rate for Payer: Ohana Health Plan Medicaid	$21.42
Rate for Payer: Ohana Health Plan Medicare	$21.42
Rate for Payer: UnitedHealthcare Medicaid	$7.15
Rate for Payer: UnitedHealthcare Medicare	$21.42
Rate for Payer: University Health Alliance Commercial	$13.38

C REP TRUNK, 1.1-2.5CM Charges

Facility

$2,091.00

Service Code	HCPCS 13100
Hospital Charge Code	440131000
Hospital Revenue Code	450
Min. Negotiated Rate	$417.00
Max. Negotiated Rate	$2,028.27
Rate for Payer: AlohaCare Medicaid	$1,045.50
Rate for Payer: AlohaCare Medicare	$878.22
Rate for Payer: Cash Price	$1,359.15
Rate for Payer: Cash Price	$1,359.15
Rate for Payer: Cash Price	$1,359.15
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$1,923.72
Rate for Payer: Devoted Health Medicare	$878.22
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$417.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$878.22
Rate for Payer: Hawaii Western Management Group Commercial	$1,986.45
Rate for Payer: Health Management Network Commercial	$1,777.35
Rate for Payer: Humana Medicare	$878.22
Rate for Payer: Kaiser Permanente Commercial	$1,881.90
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$878.22
Rate for Payer: MDX Hawaii PPO	$2,028.27
Rate for Payer: Ohana Health Plan Medicaid	$878.22
Rate for Payer: Ohana Health Plan Medicare	$878.22
Rate for Payer: UnitedHealthcare Medicare	$878.22
Rate for Payer: University Health Alliance Commercial	$1,524.13

C REP TRUNK, 1.1-2.5CM Charges

Facility

$2,091.00

Service Code	HCPCS 13100
Hospital Charge Code	440131000
Hospital Revenue Code	450
Min. Negotiated Rate	$1,777.35
Max. Negotiated Rate	$2,028.27
Rate for Payer: Cash Price	$1,359.15
Rate for Payer: Health Management Network Commercial	$1,777.35
Rate for Payer: Kaiser Permanente Commercial	$1,881.90
Rate for Payer: MDX Hawaii PPO	$2,028.27

CREP TRUNK 2.6-7.5CM Charge

Facility

$2,091.00

Service Code	HCPCS 13101
Hospital Charge Code	440131010
Hospital Revenue Code	450
Min. Negotiated Rate	$417.00
Max. Negotiated Rate	$2,028.27
Rate for Payer: AlohaCare Medicaid	$1,045.50
Rate for Payer: AlohaCare Medicare	$878.22
Rate for Payer: Cash Price	$1,359.15
Rate for Payer: Cash Price	$1,359.15
Rate for Payer: Cash Price	$1,359.15
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$1,923.72
Rate for Payer: Devoted Health Medicare	$878.22
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$417.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$878.22
Rate for Payer: Hawaii Western Management Group Commercial	$1,986.45
Rate for Payer: Health Management Network Commercial	$1,777.35
Rate for Payer: Humana Medicare	$878.22
Rate for Payer: Kaiser Permanente Commercial	$1,881.90
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$878.22
Rate for Payer: MDX Hawaii PPO	$2,028.27
Rate for Payer: Ohana Health Plan Medicaid	$878.22
Rate for Payer: Ohana Health Plan Medicare	$878.22
Rate for Payer: UnitedHealthcare Medicare	$878.22
Rate for Payer: University Health Alliance Commercial	$1,524.13

CREP TRUNK 2.6-7.5CM Charge

Facility

$2,091.00

Service Code	HCPCS 13101
Hospital Charge Code	440131010
Hospital Revenue Code	450
Min. Negotiated Rate	$1,777.35
Max. Negotiated Rate	$2,028.27
Rate for Payer: Cash Price	$1,359.15
Rate for Payer: Health Management Network Commercial	$1,777.35
Rate for Payer: Kaiser Permanente Commercial	$1,881.90
Rate for Payer: MDX Hawaii PPO	$2,028.27

C REP TRUNK EA ADDTL 5CM/<

Facility

$1,115.00

Service Code	HCPCS 13102
Hospital Charge Code	440131020
Hospital Revenue Code	450
Min. Negotiated Rate	$417.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: AlohaCare Medicaid	$557.50
Rate for Payer: AlohaCare Medicare	$468.30
Rate for Payer: Cash Price	$724.75
Rate for Payer: Cash Price	$724.75
Rate for Payer: Cash Price	$724.75
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$1,025.80
Rate for Payer: Devoted Health Medicare	$468.30
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$417.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$468.30
Rate for Payer: Hawaii Western Management Group Commercial	$1,059.25
Rate for Payer: Health Management Network Commercial	$947.75
Rate for Payer: Humana Medicare	$468.30
Rate for Payer: Kaiser Permanente Commercial	$1,003.50
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$468.30
Rate for Payer: MDX Hawaii PPO	$1,081.55
Rate for Payer: Ohana Health Plan Medicaid	$468.30
Rate for Payer: Ohana Health Plan Medicare	$468.30
Rate for Payer: UnitedHealthcare Medicare	$468.30
Rate for Payer: University Health Alliance Commercial	$812.72

C REP TRUNK EA ADDTL 5CM/<

Facility

$1,115.00

Service Code	HCPCS 13102
Hospital Charge Code	440131020
Hospital Revenue Code	450
Min. Negotiated Rate	$947.75
Max. Negotiated Rate	$1,081.55
Rate for Payer: Cash Price	$724.75
Rate for Payer: Health Management Network Commercial	$947.75
Rate for Payer: Kaiser Permanente Commercial	$1,003.50
Rate for Payer: MDX Hawaii PPO	$1,081.55

CRICOTHYROTOMY CATHETER SET

Facility

$1,042.00

Hospital Charge Code	8434
Hospital Revenue Code	270
Min. Negotiated Rate	$885.70
Max. Negotiated Rate	$1,010.74
Rate for Payer: Cash Price	$677.30
Rate for Payer: Health Management Network Commercial	$885.70
Rate for Payer: Kaiser Permanente Commercial	$937.80
Rate for Payer: MDX Hawaii PPO	$1,010.74

CRICOTHYROTOMY CATHETER SET

Facility

$1,042.00

Hospital Charge Code	8434
Hospital Revenue Code	270
Min. Negotiated Rate	$437.64
Max. Negotiated Rate	$1,010.74
Rate for Payer: AlohaCare Medicaid	$521.00
Rate for Payer: AlohaCare Medicare	$437.64
Rate for Payer: Cash Price	$677.30
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$958.64
Rate for Payer: Devoted Health Medicare	$437.64
Rate for Payer: Hawaii Medical Service Association Medicare	$437.64
Rate for Payer: Hawaii Western Management Group Commercial	$989.90
Rate for Payer: Health Management Network Commercial	$885.70
Rate for Payer: Humana Medicare	$437.64
Rate for Payer: Kaiser Permanente Commercial	$937.80
Rate for Payer: Kaiser Permanente Medicaid	$531.42
Rate for Payer: Kaiser Permanente Medicare	$437.64
Rate for Payer: MDX Hawaii PPO	$1,010.74
Rate for Payer: Ohana Health Plan Medicaid	$437.64
Rate for Payer: Ohana Health Plan Medicare	$437.64
Rate for Payer: UnitedHealthcare Medicare	$437.64
Rate for Payer: University Health Alliance Commercial	$759.51

CRILE-WOOD NEEDLE HOLDER 6"

Facility

$4.00

Hospital Charge Code	8573
Hospital Revenue Code	270
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$3.88
Rate for Payer: AlohaCare Medicaid	$2.00
Rate for Payer: AlohaCare Medicare	$1.68
Rate for Payer: Cash Price	$2.60
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$3.68
Rate for Payer: Devoted Health Medicare	$1.68
Rate for Payer: Hawaii Medical Service Association Medicare	$1.68
Rate for Payer: Hawaii Western Management Group Commercial	$3.80
Rate for Payer: Health Management Network Commercial	$3.40
Rate for Payer: Humana Medicare	$1.68
Rate for Payer: Kaiser Permanente Commercial	$3.60
Rate for Payer: Kaiser Permanente Medicaid	$2.04
Rate for Payer: Kaiser Permanente Medicare	$1.68
Rate for Payer: MDX Hawaii PPO	$3.88
Rate for Payer: Ohana Health Plan Medicaid	$1.68
Rate for Payer: Ohana Health Plan Medicare	$1.68
Rate for Payer: UnitedHealthcare Medicare	$1.68
Rate for Payer: University Health Alliance Commercial	$2.92

CRILE-WOOD NEEDLE HOLDER 6"

Facility

$4.00

Hospital Charge Code	8573
Hospital Revenue Code	270
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$2.60
Rate for Payer: Health Management Network Commercial	$3.40
Rate for Payer: Kaiser Permanente Commercial	$3.60
Rate for Payer: MDX Hawaii PPO	$3.88

Crossmatch IS

Facility

$60.00

Service Code	HCPCS 86920
Hospital Charge Code	42286920
Hospital Revenue Code	390
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$251.59
Rate for Payer: AlohaCare Medicaid	$30.00
Rate for Payer: AlohaCare Medicare	$25.20
Rate for Payer: Cash Price	$39.00
Rate for Payer: Cash Price	$39.00
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$55.20
Rate for Payer: Devoted Health Medicare	$25.20
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$20.80
Rate for Payer: Hawaii Medical Service Association Commercial	$251.59
Rate for Payer: Hawaii Medical Service Association Medicare	$25.20
Rate for Payer: Hawaii Western Management Group Commercial	$201.27
Rate for Payer: Health Management Network Commercial	$51.00
Rate for Payer: Humana Medicare	$25.20
Rate for Payer: Kaiser Permanente Commercial	$54.00
Rate for Payer: Kaiser Permanente Medicaid	$30.60
Rate for Payer: Kaiser Permanente Medicare	$25.20
Rate for Payer: MDX Hawaii PPO	$58.20
Rate for Payer: Ohana Health Plan Medicaid	$25.20
Rate for Payer: Ohana Health Plan Medicare	$25.20
Rate for Payer: UnitedHealthcare Medicaid	$20.80
Rate for Payer: UnitedHealthcare Medicare	$25.20
Rate for Payer: University Health Alliance Commercial	$42.35

Crossmatch IS

Facility

$60.00

Service Code	HCPCS 86920
Hospital Charge Code	42286920
Hospital Revenue Code	390
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$58.20
Rate for Payer: Cash Price	$39.00
Rate for Payer: Health Management Network Commercial	$51.00
Rate for Payer: Kaiser Permanente Commercial	$54.00
Rate for Payer: MDX Hawaii PPO	$58.20

CRP (High Sensitivity) DLS

Facility

$66.00

Service Code	HCPCS 86141
Hospital Charge Code	422861415
Hospital Revenue Code	301
Min. Negotiated Rate	$12.95
Max. Negotiated Rate	$64.02
Rate for Payer: AlohaCare Medicaid	$33.00
Rate for Payer: AlohaCare Medicare	$27.72
Rate for Payer: Cash Price	$42.90
Rate for Payer: Cash Price	$42.90
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$60.72
Rate for Payer: Devoted Health Medicare	$27.72
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$17.20
Rate for Payer: Hawaii Medical Service Association Commercial	$16.19
Rate for Payer: Hawaii Medical Service Association Medicare	$27.72
Rate for Payer: Hawaii Western Management Group Commercial	$12.95
Rate for Payer: Health Management Network Commercial	$56.10
Rate for Payer: Humana Medicare	$27.72
Rate for Payer: Kaiser Permanente Commercial	$59.40
Rate for Payer: Kaiser Permanente Medicaid	$33.66
Rate for Payer: Kaiser Permanente Medicare	$27.72
Rate for Payer: MDX Hawaii PPO	$64.02
Rate for Payer: Ohana Health Plan Medicaid	$27.72
Rate for Payer: Ohana Health Plan Medicare	$27.72
Rate for Payer: UnitedHealthcare Medicaid	$17.20
Rate for Payer: UnitedHealthcare Medicare	$27.72
Rate for Payer: University Health Alliance Commercial	$33.47

CRP (High Sensitivity) DLS

Facility

$66.00

Service Code	HCPCS 86141
Hospital Charge Code	422861415
Hospital Revenue Code	301
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$64.02
Rate for Payer: Cash Price	$42.90
Rate for Payer: Health Management Network Commercial	$56.10
Rate for Payer: Kaiser Permanente Commercial	$59.40
Rate for Payer: MDX Hawaii PPO	$64.02

CRUTCHES LG

Facility

$56.00

Hospital Charge Code	8404
Hospital Revenue Code	270
Min. Negotiated Rate	$23.52
Max. Negotiated Rate	$54.32
Rate for Payer: AlohaCare Medicaid	$28.00
Rate for Payer: AlohaCare Medicare	$23.52
Rate for Payer: Cash Price	$36.40
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$51.52
Rate for Payer: Devoted Health Medicare	$23.52
Rate for Payer: Hawaii Medical Service Association Medicare	$23.52
Rate for Payer: Hawaii Western Management Group Commercial	$53.20
Rate for Payer: Health Management Network Commercial	$47.60
Rate for Payer: Humana Medicare	$23.52
Rate for Payer: Kaiser Permanente Commercial	$50.40
Rate for Payer: Kaiser Permanente Medicaid	$28.56
Rate for Payer: Kaiser Permanente Medicare	$23.52
Rate for Payer: MDX Hawaii PPO	$54.32
Rate for Payer: Ohana Health Plan Medicaid	$23.52
Rate for Payer: Ohana Health Plan Medicare	$23.52
Rate for Payer: UnitedHealthcare Medicare	$23.52
Rate for Payer: University Health Alliance Commercial	$40.82

Know your out-of-pocket cost for care.

All Charges