Kahuku Medical Center

All Charges

Charge

Type

Setting

Price

CT SOFT TISSUE NECK W CON

Facility

$1,652.00

Service Code	HCPCS 70491
Hospital Charge Code	424704910
Hospital Revenue Code	351
Min. Negotiated Rate	$1,404.20
Max. Negotiated Rate	$1,602.44
Rate for Payer: Cash Price	$1,073.80
Rate for Payer: Health Management Network Commercial	$1,404.20
Rate for Payer: Kaiser Permanente Commercial	$1,486.80
Rate for Payer: MDX Hawaii PPO	$1,602.44

CT THORAX W CON

Facility

$2,478.00

Service Code	HCPCS 71260
Hospital Charge Code	424704911
Hospital Revenue Code	351
Min. Negotiated Rate	$2,106.30
Max. Negotiated Rate	$2,403.66
Rate for Payer: Cash Price	$1,610.70
Rate for Payer: Health Management Network Commercial	$2,106.30
Rate for Payer: Kaiser Permanente Commercial	$2,230.20
Rate for Payer: MDX Hawaii PPO	$2,403.66

CT THORAX W CON

Facility

$2,478.00

Service Code	HCPCS 71260
Hospital Charge Code	424704911
Hospital Revenue Code	351
Min. Negotiated Rate	$207.21
Max. Negotiated Rate	$2,403.66
Rate for Payer: AlohaCare Medicaid	$1,239.00
Rate for Payer: AlohaCare Medicare	$1,040.76
Rate for Payer: Cash Price	$1,610.70
Rate for Payer: Cash Price	$1,610.70
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$2,279.76
Rate for Payer: Devoted Health Medicare	$1,040.76
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$232.90
Rate for Payer: Hawaii Medical Service Association Commercial	$259.01
Rate for Payer: Hawaii Medical Service Association Medicare	$1,040.76
Rate for Payer: Hawaii Western Management Group Commercial	$207.21
Rate for Payer: Health Management Network Commercial	$2,106.30
Rate for Payer: Humana Medicare	$1,040.76
Rate for Payer: Kaiser Permanente Commercial	$2,230.20
Rate for Payer: Kaiser Permanente Medicaid	$1,263.78
Rate for Payer: Kaiser Permanente Medicare	$1,040.76
Rate for Payer: MDX Hawaii PPO	$2,403.66
Rate for Payer: Ohana Health Plan Medicaid	$1,040.76
Rate for Payer: Ohana Health Plan Medicare	$1,040.76
Rate for Payer: UnitedHealthcare Medicaid	$232.90
Rate for Payer: UnitedHealthcare Medicare	$1,040.76
Rate for Payer: University Health Alliance Commercial	$686.18

CT THORAX W CON

Facility

$1,302.00

Service Code	HCPCS 71260
Hospital Charge Code	424712600
Hospital Revenue Code	352
Min. Negotiated Rate	$207.21
Max. Negotiated Rate	$1,262.94
Rate for Payer: AlohaCare Medicaid	$651.00
Rate for Payer: AlohaCare Medicare	$546.84
Rate for Payer: Cash Price	$846.30
Rate for Payer: Cash Price	$846.30
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$1,197.84
Rate for Payer: Devoted Health Medicare	$546.84
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$232.90
Rate for Payer: Hawaii Medical Service Association Commercial	$259.01
Rate for Payer: Hawaii Medical Service Association Medicare	$546.84
Rate for Payer: Hawaii Western Management Group Commercial	$207.21
Rate for Payer: Health Management Network Commercial	$1,106.70
Rate for Payer: Humana Medicare	$546.84
Rate for Payer: Kaiser Permanente Commercial	$1,171.80
Rate for Payer: Kaiser Permanente Medicaid	$664.02
Rate for Payer: Kaiser Permanente Medicare	$546.84
Rate for Payer: MDX Hawaii PPO	$1,262.94
Rate for Payer: Ohana Health Plan Medicaid	$546.84
Rate for Payer: Ohana Health Plan Medicare	$546.84
Rate for Payer: UnitedHealthcare Medicaid	$232.90
Rate for Payer: UnitedHealthcare Medicare	$546.84
Rate for Payer: University Health Alliance Commercial	$686.18

CT THORAX W CON

Facility

$1,302.00

Service Code	HCPCS 71260
Hospital Charge Code	424712600
Hospital Revenue Code	352
Min. Negotiated Rate	$1,106.70
Max. Negotiated Rate	$1,262.94
Rate for Payer: Cash Price	$846.30
Rate for Payer: Health Management Network Commercial	$1,106.70
Rate for Payer: Kaiser Permanente Commercial	$1,171.80
Rate for Payer: MDX Hawaii PPO	$1,262.94

CT THORAX WO CON

Facility

$1,218.00

Service Code	HCPCS 71250
Hospital Charge Code	424712500
Hospital Revenue Code	352
Min. Negotiated Rate	$1,035.30
Max. Negotiated Rate	$1,181.46
Rate for Payer: Cash Price	$791.70
Rate for Payer: Health Management Network Commercial	$1,035.30
Rate for Payer: Kaiser Permanente Commercial	$1,096.20
Rate for Payer: MDX Hawaii PPO	$1,181.46

CT THORAX WO CON

Facility

$1,827.00

Service Code	HCPCS 71250
Hospital Charge Code	424704901
Hospital Revenue Code	351
Min. Negotiated Rate	$1,552.95
Max. Negotiated Rate	$1,772.19
Rate for Payer: Cash Price	$1,187.55
Rate for Payer: Health Management Network Commercial	$1,552.95
Rate for Payer: Kaiser Permanente Commercial	$1,644.30
Rate for Payer: MDX Hawaii PPO	$1,772.19

CT THORAX WO CON

Facility

$1,827.00

Service Code	HCPCS 71250
Hospital Charge Code	424704901
Hospital Revenue Code	351
Min. Negotiated Rate	$123.50
Max. Negotiated Rate	$1,772.19
Rate for Payer: AlohaCare Medicaid	$913.50
Rate for Payer: AlohaCare Medicare	$767.34
Rate for Payer: Cash Price	$1,187.55
Rate for Payer: Cash Price	$1,187.55
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$1,680.84
Rate for Payer: Devoted Health Medicare	$767.34
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$194.84
Rate for Payer: Hawaii Medical Service Association Commercial	$154.38
Rate for Payer: Hawaii Medical Service Association Medicare	$767.34
Rate for Payer: Hawaii Western Management Group Commercial	$123.50
Rate for Payer: Health Management Network Commercial	$1,552.95
Rate for Payer: Humana Medicare	$767.34
Rate for Payer: Kaiser Permanente Commercial	$1,644.30
Rate for Payer: Kaiser Permanente Medicaid	$931.77
Rate for Payer: Kaiser Permanente Medicare	$767.34
Rate for Payer: MDX Hawaii PPO	$1,772.19
Rate for Payer: Ohana Health Plan Medicaid	$767.34
Rate for Payer: Ohana Health Plan Medicare	$767.34
Rate for Payer: UnitedHealthcare Medicaid	$194.84
Rate for Payer: UnitedHealthcare Medicare	$767.34
Rate for Payer: University Health Alliance Commercial	$502.27

CT THORAX WO CON

Facility

$1,218.00

Service Code	HCPCS 71250
Hospital Charge Code	424712500
Hospital Revenue Code	352
Min. Negotiated Rate	$123.50
Max. Negotiated Rate	$1,181.46
Rate for Payer: AlohaCare Medicaid	$609.00
Rate for Payer: AlohaCare Medicare	$511.56
Rate for Payer: Cash Price	$791.70
Rate for Payer: Cash Price	$791.70
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$1,120.56
Rate for Payer: Devoted Health Medicare	$511.56
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$194.84
Rate for Payer: Hawaii Medical Service Association Commercial	$154.38
Rate for Payer: Hawaii Medical Service Association Medicare	$511.56
Rate for Payer: Hawaii Western Management Group Commercial	$123.50
Rate for Payer: Health Management Network Commercial	$1,035.30
Rate for Payer: Humana Medicare	$511.56
Rate for Payer: Kaiser Permanente Commercial	$1,096.20
Rate for Payer: Kaiser Permanente Medicaid	$621.18
Rate for Payer: Kaiser Permanente Medicare	$511.56
Rate for Payer: MDX Hawaii PPO	$1,181.46
Rate for Payer: Ohana Health Plan Medicaid	$511.56
Rate for Payer: Ohana Health Plan Medicare	$511.56
Rate for Payer: UnitedHealthcare Medicaid	$194.84
Rate for Payer: UnitedHealthcare Medicare	$511.56
Rate for Payer: University Health Alliance Commercial	$502.27

CT THORAX WO W CON FS

Facility

$2,950.00

Service Code	HCPCS 71270
Hospital Charge Code	424704921
Hospital Revenue Code	351
Min. Negotiated Rate	$2,507.50
Max. Negotiated Rate	$2,861.50
Rate for Payer: Cash Price	$1,917.50
Rate for Payer: Health Management Network Commercial	$2,507.50
Rate for Payer: Kaiser Permanente Commercial	$2,655.00
Rate for Payer: MDX Hawaii PPO	$2,861.50

CT THORAX WO W CON FS

Facility

$2,950.00

Service Code	HCPCS 71270
Hospital Charge Code	424704921
Hospital Revenue Code	351
Min. Negotiated Rate	$207.21
Max. Negotiated Rate	$2,861.50
Rate for Payer: AlohaCare Medicaid	$1,475.00
Rate for Payer: AlohaCare Medicare	$1,239.00
Rate for Payer: Cash Price	$1,917.50
Rate for Payer: Cash Price	$1,917.50
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$2,714.00
Rate for Payer: Devoted Health Medicare	$1,239.00
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$291.10
Rate for Payer: Hawaii Medical Service Association Commercial	$259.01
Rate for Payer: Hawaii Medical Service Association Medicare	$1,239.00
Rate for Payer: Hawaii Western Management Group Commercial	$207.21
Rate for Payer: Health Management Network Commercial	$2,507.50
Rate for Payer: Humana Medicare	$1,239.00
Rate for Payer: Kaiser Permanente Commercial	$2,655.00
Rate for Payer: Kaiser Permanente Medicaid	$1,504.50
Rate for Payer: Kaiser Permanente Medicare	$1,239.00
Rate for Payer: MDX Hawaii PPO	$2,861.50
Rate for Payer: Ohana Health Plan Medicaid	$1,239.00
Rate for Payer: Ohana Health Plan Medicare	$1,239.00
Rate for Payer: UnitedHealthcare Medicaid	$291.10
Rate for Payer: UnitedHealthcare Medicare	$1,239.00
Rate for Payer: University Health Alliance Commercial	$799.87

CT THORAX WO W CON FS

Facility

$1,302.00

Service Code	HCPCS 71270
Hospital Charge Code	424712700
Hospital Revenue Code	352
Min. Negotiated Rate	$1,106.70
Max. Negotiated Rate	$1,262.94
Rate for Payer: Cash Price	$846.30
Rate for Payer: Health Management Network Commercial	$1,106.70
Rate for Payer: Kaiser Permanente Commercial	$1,171.80
Rate for Payer: MDX Hawaii PPO	$1,262.94

CT THORAX WO W CON FS

Facility

$1,302.00

Service Code	HCPCS 71270
Hospital Charge Code	424712700
Hospital Revenue Code	352
Min. Negotiated Rate	$207.21
Max. Negotiated Rate	$1,262.94
Rate for Payer: AlohaCare Medicaid	$651.00
Rate for Payer: AlohaCare Medicare	$546.84
Rate for Payer: Cash Price	$846.30
Rate for Payer: Cash Price	$846.30
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$1,197.84
Rate for Payer: Devoted Health Medicare	$546.84
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$291.10
Rate for Payer: Hawaii Medical Service Association Commercial	$259.01
Rate for Payer: Hawaii Medical Service Association Medicare	$546.84
Rate for Payer: Hawaii Western Management Group Commercial	$207.21
Rate for Payer: Health Management Network Commercial	$1,106.70
Rate for Payer: Humana Medicare	$546.84
Rate for Payer: Kaiser Permanente Commercial	$1,171.80
Rate for Payer: Kaiser Permanente Medicaid	$664.02
Rate for Payer: Kaiser Permanente Medicare	$546.84
Rate for Payer: MDX Hawaii PPO	$1,262.94
Rate for Payer: Ohana Health Plan Medicaid	$546.84
Rate for Payer: Ohana Health Plan Medicare	$546.84
Rate for Payer: UnitedHealthcare Medicaid	$291.10
Rate for Payer: UnitedHealthcare Medicare	$546.84
Rate for Payer: University Health Alliance Commercial	$799.87

CT THOR SPINE W CON

Facility

$1,652.00

Service Code	HCPCS 72129
Hospital Charge Code	424721290
Hospital Revenue Code	352
Min. Negotiated Rate	$1,404.20
Max. Negotiated Rate	$1,602.44
Rate for Payer: Cash Price	$1,073.80
Rate for Payer: Health Management Network Commercial	$1,404.20
Rate for Payer: Kaiser Permanente Commercial	$1,486.80
Rate for Payer: MDX Hawaii PPO	$1,602.44

CT THOR SPINE W CON

Facility

$1,652.00

Service Code	HCPCS 72129
Hospital Charge Code	424721290
Hospital Revenue Code	352
Min. Negotiated Rate	$207.21
Max. Negotiated Rate	$1,602.44
Rate for Payer: AlohaCare Medicaid	$826.00
Rate for Payer: AlohaCare Medicare	$693.84
Rate for Payer: Cash Price	$1,073.80
Rate for Payer: Cash Price	$1,073.80
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$1,519.84
Rate for Payer: Devoted Health Medicare	$693.84
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$232.90
Rate for Payer: Hawaii Medical Service Association Commercial	$259.01
Rate for Payer: Hawaii Medical Service Association Medicare	$693.84
Rate for Payer: Hawaii Western Management Group Commercial	$207.21
Rate for Payer: Health Management Network Commercial	$1,404.20
Rate for Payer: Humana Medicare	$693.84
Rate for Payer: Kaiser Permanente Commercial	$1,486.80
Rate for Payer: Kaiser Permanente Medicaid	$842.52
Rate for Payer: Kaiser Permanente Medicare	$693.84
Rate for Payer: MDX Hawaii PPO	$1,602.44
Rate for Payer: Ohana Health Plan Medicaid	$693.84
Rate for Payer: Ohana Health Plan Medicare	$693.84
Rate for Payer: UnitedHealthcare Medicaid	$232.90
Rate for Payer: UnitedHealthcare Medicare	$693.84
Rate for Payer: University Health Alliance Commercial	$684.78

CT THOR SPINE WO CON

Facility

$1,218.00

Service Code	HCPCS 72128
Hospital Charge Code	424721280
Hospital Revenue Code	352
Min. Negotiated Rate	$123.50
Max. Negotiated Rate	$1,181.46
Rate for Payer: AlohaCare Medicaid	$609.00
Rate for Payer: AlohaCare Medicare	$511.56
Rate for Payer: Cash Price	$791.70
Rate for Payer: Cash Price	$791.70
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$1,120.56
Rate for Payer: Devoted Health Medicare	$511.56
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$194.84
Rate for Payer: Hawaii Medical Service Association Commercial	$154.38
Rate for Payer: Hawaii Medical Service Association Medicare	$511.56
Rate for Payer: Hawaii Western Management Group Commercial	$123.50
Rate for Payer: Health Management Network Commercial	$1,035.30
Rate for Payer: Humana Medicare	$511.56
Rate for Payer: Kaiser Permanente Commercial	$1,096.20
Rate for Payer: Kaiser Permanente Medicaid	$621.18
Rate for Payer: Kaiser Permanente Medicare	$511.56
Rate for Payer: MDX Hawaii PPO	$1,181.46
Rate for Payer: Ohana Health Plan Medicaid	$511.56
Rate for Payer: Ohana Health Plan Medicare	$511.56
Rate for Payer: UnitedHealthcare Medicaid	$194.84
Rate for Payer: UnitedHealthcare Medicare	$511.56
Rate for Payer: University Health Alliance Commercial	$502.27

CT THOR SPINE WO CON

Facility

$1,218.00

Service Code	HCPCS 72128
Hospital Charge Code	424721280
Hospital Revenue Code	352
Min. Negotiated Rate	$1,035.30
Max. Negotiated Rate	$1,181.46
Rate for Payer: Cash Price	$791.70
Rate for Payer: Health Management Network Commercial	$1,035.30
Rate for Payer: Kaiser Permanente Commercial	$1,096.20
Rate for Payer: MDX Hawaii PPO	$1,181.46

CT THOR SPINE WO W CON

Facility

$1,966.00

Service Code	HCPCS 72130
Hospital Charge Code	424721300
Hospital Revenue Code	352
Min. Negotiated Rate	$1,671.10
Max. Negotiated Rate	$1,907.02
Rate for Payer: Cash Price	$1,277.90
Rate for Payer: Health Management Network Commercial	$1,671.10
Rate for Payer: Kaiser Permanente Commercial	$1,769.40
Rate for Payer: MDX Hawaii PPO	$1,907.02

CT THOR SPINE WO W CON

Facility

$1,966.00

Service Code	HCPCS 72130
Hospital Charge Code	424721300
Hospital Revenue Code	352
Min. Negotiated Rate	$207.21
Max. Negotiated Rate	$1,907.02
Rate for Payer: AlohaCare Medicaid	$983.00
Rate for Payer: AlohaCare Medicare	$825.72
Rate for Payer: Cash Price	$1,277.90
Rate for Payer: Cash Price	$1,277.90
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$1,808.72
Rate for Payer: Devoted Health Medicare	$825.72
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$291.10
Rate for Payer: Hawaii Medical Service Association Commercial	$259.01
Rate for Payer: Hawaii Medical Service Association Medicare	$825.72
Rate for Payer: Hawaii Western Management Group Commercial	$207.21
Rate for Payer: Health Management Network Commercial	$1,671.10
Rate for Payer: Humana Medicare	$825.72
Rate for Payer: Kaiser Permanente Commercial	$1,769.40
Rate for Payer: Kaiser Permanente Medicaid	$1,002.66
Rate for Payer: Kaiser Permanente Medicare	$825.72
Rate for Payer: MDX Hawaii PPO	$1,907.02
Rate for Payer: Ohana Health Plan Medicaid	$825.72
Rate for Payer: Ohana Health Plan Medicare	$825.72
Rate for Payer: UnitedHealthcare Medicaid	$291.10
Rate for Payer: UnitedHealthcare Medicare	$825.72
Rate for Payer: University Health Alliance Commercial	$789.62

CT UPP XTR W CON

Facility

$2,686.00

Service Code	HCPCS 73201
Hospital Charge Code	424732010
Hospital Revenue Code	352
Min. Negotiated Rate	$2,283.10
Max. Negotiated Rate	$2,605.42
Rate for Payer: Cash Price	$1,745.90
Rate for Payer: Health Management Network Commercial	$2,283.10
Rate for Payer: Kaiser Permanente Commercial	$2,417.40
Rate for Payer: MDX Hawaii PPO	$2,605.42

CT UPP XTR W CON

Facility

$2,686.00

Service Code	HCPCS 73201
Hospital Charge Code	424732010
Hospital Revenue Code	352
Min. Negotiated Rate	$194.84
Max. Negotiated Rate	$2,605.42
Rate for Payer: AlohaCare Medicaid	$1,343.00
Rate for Payer: AlohaCare Medicare	$1,128.12
Rate for Payer: Cash Price	$1,745.90
Rate for Payer: Cash Price	$1,745.90
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$2,471.12
Rate for Payer: Devoted Health Medicare	$1,128.12
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$194.84
Rate for Payer: Hawaii Medical Service Association Commercial	$515.17
Rate for Payer: Hawaii Medical Service Association Medicare	$1,128.12
Rate for Payer: Hawaii Western Management Group Commercial	$412.14
Rate for Payer: Health Management Network Commercial	$2,283.10
Rate for Payer: Humana Medicare	$1,128.12
Rate for Payer: Kaiser Permanente Commercial	$2,417.40
Rate for Payer: Kaiser Permanente Medicaid	$1,369.86
Rate for Payer: Kaiser Permanente Medicare	$1,128.12
Rate for Payer: MDX Hawaii PPO	$2,605.42
Rate for Payer: Ohana Health Plan Medicaid	$1,128.12
Rate for Payer: Ohana Health Plan Medicare	$1,128.12
Rate for Payer: UnitedHealthcare Medicaid	$194.84
Rate for Payer: UnitedHealthcare Medicare	$1,128.12
Rate for Payer: University Health Alliance Commercial	$659.17

CT UPP XTR WO CON

Facility

$1,218.00

Service Code	HCPCS 73200
Hospital Charge Code	424732000
Hospital Revenue Code	352
Min. Negotiated Rate	$123.50
Max. Negotiated Rate	$1,181.46
Rate for Payer: AlohaCare Medicaid	$609.00
Rate for Payer: AlohaCare Medicare	$511.56
Rate for Payer: Cash Price	$791.70
Rate for Payer: Cash Price	$791.70
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$1,120.56
Rate for Payer: Devoted Health Medicare	$511.56
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$163.33
Rate for Payer: Hawaii Medical Service Association Commercial	$154.38
Rate for Payer: Hawaii Medical Service Association Medicare	$511.56
Rate for Payer: Hawaii Western Management Group Commercial	$123.50
Rate for Payer: Health Management Network Commercial	$1,035.30
Rate for Payer: Humana Medicare	$511.56
Rate for Payer: Kaiser Permanente Commercial	$1,096.20
Rate for Payer: Kaiser Permanente Medicaid	$621.18
Rate for Payer: Kaiser Permanente Medicare	$511.56
Rate for Payer: MDX Hawaii PPO	$1,181.46
Rate for Payer: Ohana Health Plan Medicaid	$511.56
Rate for Payer: Ohana Health Plan Medicare	$511.56
Rate for Payer: UnitedHealthcare Medicaid	$163.33
Rate for Payer: UnitedHealthcare Medicare	$511.56
Rate for Payer: University Health Alliance Commercial	$497.32

CT UPP XTR WO CON

Facility

$1,218.00

Service Code	HCPCS 73200
Hospital Charge Code	424732000
Hospital Revenue Code	352
Min. Negotiated Rate	$1,035.30
Max. Negotiated Rate	$1,181.46
Rate for Payer: Cash Price	$791.70
Rate for Payer: Health Management Network Commercial	$1,035.30
Rate for Payer: Kaiser Permanente Commercial	$1,096.20
Rate for Payer: MDX Hawaii PPO	$1,181.46

CT UPP XTR WO W CON FS

Facility

$1,966.00

Service Code	HCPCS 73202
Hospital Charge Code	424732020
Hospital Revenue Code	352
Min. Negotiated Rate	$1,671.10
Max. Negotiated Rate	$1,907.02
Rate for Payer: Cash Price	$1,277.90
Rate for Payer: Health Management Network Commercial	$1,671.10
Rate for Payer: Kaiser Permanente Commercial	$1,769.40
Rate for Payer: MDX Hawaii PPO	$1,907.02

CT UPP XTR WO W CON FS

Facility

$1,966.00

Service Code	HCPCS 73202
Hospital Charge Code	424732020
Hospital Revenue Code	352
Min. Negotiated Rate	$207.21
Max. Negotiated Rate	$1,907.02
Rate for Payer: AlohaCare Medicaid	$983.00
Rate for Payer: AlohaCare Medicare	$825.72
Rate for Payer: Cash Price	$1,277.90
Rate for Payer: Cash Price	$1,277.90
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$1,808.72
Rate for Payer: Devoted Health Medicare	$825.72
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$244.38
Rate for Payer: Hawaii Medical Service Association Commercial	$259.01
Rate for Payer: Hawaii Medical Service Association Medicare	$825.72
Rate for Payer: Hawaii Western Management Group Commercial	$207.21
Rate for Payer: Health Management Network Commercial	$1,671.10
Rate for Payer: Humana Medicare	$825.72
Rate for Payer: Kaiser Permanente Commercial	$1,769.40
Rate for Payer: Kaiser Permanente Medicaid	$1,002.66
Rate for Payer: Kaiser Permanente Medicare	$825.72
Rate for Payer: MDX Hawaii PPO	$1,907.02
Rate for Payer: Ohana Health Plan Medicaid	$825.72
Rate for Payer: Ohana Health Plan Medicare	$825.72
Rate for Payer: UnitedHealthcare Medicaid	$244.38
Rate for Payer: UnitedHealthcare Medicare	$825.72
Rate for Payer: University Health Alliance Commercial	$785.42

Know your out-of-pocket cost for care.

All Charges