Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code HCPCS 29260
Hospital Charge Code 440292600
Hospital Revenue Code 450
Min. Negotiated Rate $120.12
Max. Negotiated Rate $1,600.00
Rate for Payer: AlohaCare Medicaid $143.00
Rate for Payer: AlohaCare Medicare $120.12
Rate for Payer: Cash Price $185.90
Rate for Payer: Cash Price $185.90
Rate for Payer: Cash Price $185.90
Rate for Payer: Deseret Mutual Benefit Administrators Commercial $263.12
Rate for Payer: Devoted Health Medicare $120.12
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 $120.12
Rate for Payer: Hawaii Western Management Group Commercial $271.70
Rate for Payer: Health Management Network Commercial $243.10
Rate for Payer: Humana Medicare $120.12
Rate for Payer: Kaiser Permanente Commercial $257.40
Rate for Payer: Kaiser Permanente Medicaid $937.50
Rate for Payer: Kaiser Permanente Medicare $120.12
Rate for Payer: MDX Hawaii PPO $277.42
Rate for Payer: Ohana Health Plan Medicaid $120.12
Rate for Payer: Ohana Health Plan Medicare $120.12
Rate for Payer: UnitedHealthcare Medicare $120.12
Rate for Payer: University Health Alliance Commercial $208.47
Service Code HCPCS J1335
Hospital Revenue Code 636
Min. Negotiated Rate $510.00
Max. Negotiated Rate $582.00
Rate for Payer: Cash Price $390.00
Rate for Payer: Health Management Network Commercial $510.00
Rate for Payer: Kaiser Permanente Commercial $540.00
Rate for Payer: MDX Hawaii PPO $582.00
Service Code HCPCS J1335
Hospital Revenue Code 636
Min. Negotiated Rate $59.71
Max. Negotiated Rate $582.00
Rate for Payer: AlohaCare Medicaid $300.00
Rate for Payer: AlohaCare Medicare $252.00
Rate for Payer: Cash Price $390.00
Rate for Payer: Cash Price $390.00
Rate for Payer: Deseret Mutual Benefit Administrators Commercial $552.00
Rate for Payer: Devoted Health Medicare $252.00
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD $59.71
Rate for Payer: Hawaii Medical Service Association Medicare $252.00
Rate for Payer: Hawaii Western Management Group Commercial $570.00
Rate for Payer: Health Management Network Commercial $510.00
Rate for Payer: Humana Medicare $252.00
Rate for Payer: Kaiser Permanente Commercial $540.00
Rate for Payer: Kaiser Permanente Medicaid $306.00
Rate for Payer: Kaiser Permanente Medicare $252.00
Rate for Payer: MDX Hawaii PPO $582.00
Rate for Payer: Ohana Health Plan Medicaid $252.00
Rate for Payer: Ohana Health Plan Medicare $252.00
Rate for Payer: UnitedHealthcare Medicaid $360.00
Rate for Payer: UnitedHealthcare Medicare $252.00
Rate for Payer: University Health Alliance Commercial $437.34
Service Code HCPCS 37195
Hospital Charge Code 440371950
Hospital Revenue Code 450
Min. Negotiated Rate $394.80
Max. Negotiated Rate $1,600.00
Rate for Payer: AlohaCare Medicaid $470.00
Rate for Payer: AlohaCare Medicare $394.80
Rate for Payer: Cash Price $611.00
Rate for Payer: Cash Price $611.00
Rate for Payer: Cash Price $611.00
Rate for Payer: Deseret Mutual Benefit Administrators Commercial $864.80
Rate for Payer: Devoted Health Medicare $394.80
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 $394.80
Rate for Payer: Hawaii Western Management Group Commercial $893.00
Rate for Payer: Health Management Network Commercial $799.00
Rate for Payer: Humana Medicare $394.80
Rate for Payer: Kaiser Permanente Commercial $846.00
Rate for Payer: Kaiser Permanente Medicaid $937.50
Rate for Payer: Kaiser Permanente Medicare $394.80
Rate for Payer: MDX Hawaii PPO $911.80
Rate for Payer: Ohana Health Plan Medicaid $394.80
Rate for Payer: Ohana Health Plan Medicare $394.80
Rate for Payer: UnitedHealthcare Medicare $394.80
Rate for Payer: University Health Alliance Commercial $685.17
Service Code HCPCS 37195
Hospital Charge Code 440371950
Hospital Revenue Code 450
Min. Negotiated Rate $799.00
Max. Negotiated Rate $911.80
Rate for Payer: Cash Price $611.00
Rate for Payer: Health Management Network Commercial $799.00
Rate for Payer: Kaiser Permanente Commercial $846.00
Rate for Payer: MDX Hawaii PPO $911.80
Service Code HCPCS 24650
Hospital Charge Code 440246500
Hospital Revenue Code 450
Min. Negotiated Rate $372.54
Max. Negotiated Rate $1,600.00
Rate for Payer: AlohaCare Medicaid $443.50
Rate for Payer: AlohaCare Medicare $372.54
Rate for Payer: Cash Price $576.55
Rate for Payer: Cash Price $576.55
Rate for Payer: Cash Price $576.55
Rate for Payer: Deseret Mutual Benefit Administrators Commercial $816.04
Rate for Payer: Devoted Health Medicare $372.54
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 $372.54
Rate for Payer: Hawaii Western Management Group Commercial $842.65
Rate for Payer: Health Management Network Commercial $753.95
Rate for Payer: Humana Medicare $372.54
Rate for Payer: Kaiser Permanente Commercial $798.30
Rate for Payer: Kaiser Permanente Medicaid $937.50
Rate for Payer: Kaiser Permanente Medicare $372.54
Rate for Payer: MDX Hawaii PPO $860.39
Rate for Payer: Ohana Health Plan Medicaid $372.54
Rate for Payer: Ohana Health Plan Medicare $372.54
Rate for Payer: UnitedHealthcare Medicare $372.54
Rate for Payer: University Health Alliance Commercial $646.53
Service Code HCPCS 24650
Hospital Charge Code 440246500
Hospital Revenue Code 450
Min. Negotiated Rate $753.95
Max. Negotiated Rate $860.39
Rate for Payer: Cash Price $576.55
Rate for Payer: Health Management Network Commercial $753.95
Rate for Payer: Kaiser Permanente Commercial $798.30
Rate for Payer: MDX Hawaii PPO $860.39
Service Code HCPCS 25675
Hospital Charge Code 440256750
Hospital Revenue Code 450
Min. Negotiated Rate $372.54
Max. Negotiated Rate $1,600.00
Rate for Payer: AlohaCare Medicaid $443.50
Rate for Payer: AlohaCare Medicare $372.54
Rate for Payer: Cash Price $576.55
Rate for Payer: Cash Price $576.55
Rate for Payer: Cash Price $576.55
Rate for Payer: Deseret Mutual Benefit Administrators Commercial $816.04
Rate for Payer: Devoted Health Medicare $372.54
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 $372.54
Rate for Payer: Hawaii Western Management Group Commercial $842.65
Rate for Payer: Health Management Network Commercial $753.95
Rate for Payer: Humana Medicare $372.54
Rate for Payer: Kaiser Permanente Commercial $798.30
Rate for Payer: Kaiser Permanente Medicaid $937.50
Rate for Payer: Kaiser Permanente Medicare $372.54
Rate for Payer: MDX Hawaii PPO $860.39
Rate for Payer: Ohana Health Plan Medicaid $372.54
Rate for Payer: Ohana Health Plan Medicare $372.54
Rate for Payer: UnitedHealthcare Medicare $372.54
Rate for Payer: University Health Alliance Commercial $646.53
Service Code HCPCS 25675
Hospital Charge Code 440256750
Hospital Revenue Code 450
Min. Negotiated Rate $753.95
Max. Negotiated Rate $860.39
Rate for Payer: Cash Price $576.55
Rate for Payer: Health Management Network Commercial $753.95
Rate for Payer: Kaiser Permanente Commercial $798.30
Rate for Payer: MDX Hawaii PPO $860.39
Service Code HCPCS 27256
Hospital Charge Code 440272560
Hospital Revenue Code 450
Min. Negotiated Rate $232.68
Max. Negotiated Rate $1,600.00
Rate for Payer: AlohaCare Medicaid $277.00
Rate for Payer: AlohaCare Medicare $232.68
Rate for Payer: Cash Price $360.10
Rate for Payer: Cash Price $360.10
Rate for Payer: Cash Price $360.10
Rate for Payer: Deseret Mutual Benefit Administrators Commercial $509.68
Rate for Payer: Devoted Health Medicare $232.68
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 $232.68
Rate for Payer: Hawaii Western Management Group Commercial $526.30
Rate for Payer: Health Management Network Commercial $470.90
Rate for Payer: Humana Medicare $232.68
Rate for Payer: Kaiser Permanente Commercial $498.60
Rate for Payer: Kaiser Permanente Medicaid $937.50
Rate for Payer: Kaiser Permanente Medicare $232.68
Rate for Payer: MDX Hawaii PPO $537.38
Rate for Payer: Ohana Health Plan Medicaid $232.68
Rate for Payer: Ohana Health Plan Medicare $232.68
Rate for Payer: UnitedHealthcare Medicare $232.68
Rate for Payer: University Health Alliance Commercial $403.81
Service Code HCPCS 27256
Hospital Charge Code 440272560
Hospital Revenue Code 450
Min. Negotiated Rate $470.90
Max. Negotiated Rate $537.38
Rate for Payer: Cash Price $360.10
Rate for Payer: Health Management Network Commercial $470.90
Rate for Payer: Kaiser Permanente Commercial $498.60
Rate for Payer: MDX Hawaii PPO $537.38
Service Code NDC 24208091055
Hospital Revenue Code 250
Min. Negotiated Rate $5.76
Max. Negotiated Rate $13.30
Rate for Payer: AlohaCare Medicaid $6.86
Rate for Payer: AlohaCare Medicare $5.76
Rate for Payer: Cash Price $8.91
Rate for Payer: Deseret Mutual Benefit Administrators Commercial $12.61
Rate for Payer: Devoted Health Medicare $5.76
Rate for Payer: Hawaii Medical Service Association Medicare $5.76
Rate for Payer: Hawaii Western Management Group Commercial $13.02
Rate for Payer: Health Management Network Commercial $11.65
Rate for Payer: Humana Medicare $5.76
Rate for Payer: Kaiser Permanente Commercial $12.34
Rate for Payer: Kaiser Permanente Medicaid $6.99
Rate for Payer: Kaiser Permanente Medicare $5.76
Rate for Payer: MDX Hawaii PPO $13.30
Rate for Payer: Ohana Health Plan Medicaid $5.76
Rate for Payer: Ohana Health Plan Medicare $5.76
Rate for Payer: UnitedHealthcare Medicaid $8.23
Rate for Payer: UnitedHealthcare Medicare $5.76
Rate for Payer: University Health Alliance Commercial $9.99
Service Code NDC 24208091055
Hospital Revenue Code 250
Min. Negotiated Rate $11.65
Max. Negotiated Rate $13.30
Rate for Payer: Cash Price $8.91
Rate for Payer: Health Management Network Commercial $11.65
Rate for Payer: Kaiser Permanente Commercial $12.34
Rate for Payer: MDX Hawaii PPO $13.30
Service Code HCPCS 82668
Hospital Charge Code 422826685
Hospital Revenue Code 300
Min. Negotiated Rate $18.79
Max. Negotiated Rate $68.87
Rate for Payer: AlohaCare Medicaid $35.50
Rate for Payer: AlohaCare Medicare $29.82
Rate for Payer: Cash Price $46.15
Rate for Payer: Cash Price $46.15
Rate for Payer: Deseret Mutual Benefit Administrators Commercial $65.32
Rate for Payer: Devoted Health Medicare $29.82
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD $25.97
Rate for Payer: Hawaii Medical Service Association Commercial $23.49
Rate for Payer: Hawaii Medical Service Association Medicare $29.82
Rate for Payer: Hawaii Western Management Group Commercial $18.79
Rate for Payer: Health Management Network Commercial $60.35
Rate for Payer: Humana Medicare $29.82
Rate for Payer: Kaiser Permanente Commercial $63.90
Rate for Payer: Kaiser Permanente Medicaid $36.21
Rate for Payer: Kaiser Permanente Medicare $29.82
Rate for Payer: MDX Hawaii PPO $68.87
Rate for Payer: Ohana Health Plan Medicaid $29.82
Rate for Payer: Ohana Health Plan Medicare $29.82
Rate for Payer: UnitedHealthcare Medicaid $25.97
Rate for Payer: UnitedHealthcare Medicare $29.82
Rate for Payer: University Health Alliance Commercial $48.58
Service Code HCPCS 82668
Hospital Charge Code 422826685
Hospital Revenue Code 300
Min. Negotiated Rate $60.35
Max. Negotiated Rate $68.87
Rate for Payer: Cash Price $46.15
Rate for Payer: Health Management Network Commercial $60.35
Rate for Payer: Kaiser Permanente Commercial $63.90
Rate for Payer: MDX Hawaii PPO $68.87
Service Code HCPCS A9270
Hospital Revenue Code 637
Min. Negotiated Rate $14.89
Max. Negotiated Rate $16.99
Rate for Payer: Cash Price $11.39
Rate for Payer: Health Management Network Commercial $14.89
Rate for Payer: Kaiser Permanente Commercial $15.77
Rate for Payer: MDX Hawaii PPO $16.99
Service Code HCPCS A9270
Hospital Revenue Code 637
Min. Negotiated Rate $7.36
Max. Negotiated Rate $16.99
Rate for Payer: AlohaCare Medicaid $8.76
Rate for Payer: AlohaCare Medicare $7.36
Rate for Payer: Cash Price $11.39
Rate for Payer: Deseret Mutual Benefit Administrators Commercial $16.12
Rate for Payer: Devoted Health Medicare $7.36
Rate for Payer: Hawaii Medical Service Association Medicare $7.36
Rate for Payer: Hawaii Western Management Group Commercial $16.64
Rate for Payer: Health Management Network Commercial $14.89
Rate for Payer: Humana Medicare $7.36
Rate for Payer: Kaiser Permanente Commercial $15.77
Rate for Payer: Kaiser Permanente Medicaid $8.94
Rate for Payer: Kaiser Permanente Medicare $7.36
Rate for Payer: MDX Hawaii PPO $16.99
Rate for Payer: Ohana Health Plan Medicaid $7.36
Rate for Payer: Ohana Health Plan Medicare $7.36
Rate for Payer: UnitedHealthcare Medicare $7.36
Rate for Payer: University Health Alliance Commercial $12.77
Service Code NDC 65162070588
Hospital Revenue Code 250
Min. Negotiated Rate $2.69
Max. Negotiated Rate $3.07
Rate for Payer: Cash Price $2.06
Rate for Payer: Health Management Network Commercial $2.69
Rate for Payer: Kaiser Permanente Commercial $2.85
Rate for Payer: MDX Hawaii PPO $3.07
Service Code NDC 65162070588
Hospital Revenue Code 250
Min. Negotiated Rate $1.33
Max. Negotiated Rate $3.07
Rate for Payer: AlohaCare Medicaid $1.58
Rate for Payer: AlohaCare Medicare $1.33
Rate for Payer: Cash Price $2.06
Rate for Payer: Deseret Mutual Benefit Administrators Commercial $2.92
Rate for Payer: Devoted Health Medicare $1.33
Rate for Payer: Hawaii Medical Service Association Medicare $1.33
Rate for Payer: Hawaii Western Management Group Commercial $3.01
Rate for Payer: Health Management Network Commercial $2.69
Rate for Payer: Humana Medicare $1.33
Rate for Payer: Kaiser Permanente Commercial $2.85
Rate for Payer: Kaiser Permanente Medicaid $1.62
Rate for Payer: Kaiser Permanente Medicare $1.33
Rate for Payer: MDX Hawaii PPO $3.07
Rate for Payer: Ohana Health Plan Medicaid $1.33
Rate for Payer: Ohana Health Plan Medicare $1.33
Rate for Payer: UnitedHealthcare Medicaid $1.90
Rate for Payer: UnitedHealthcare Medicare $1.33
Rate for Payer: University Health Alliance Commercial $2.31
Service Code NDC 43547028010
Hospital Revenue Code 250
Min. Negotiated Rate $14.11
Max. Negotiated Rate $16.10
Rate for Payer: Cash Price $10.79
Rate for Payer: Health Management Network Commercial $14.11
Rate for Payer: Kaiser Permanente Commercial $14.94
Rate for Payer: MDX Hawaii PPO $16.10
Service Code NDC 43547028010
Hospital Revenue Code 250
Min. Negotiated Rate $6.97
Max. Negotiated Rate $16.10
Rate for Payer: AlohaCare Medicaid $8.30
Rate for Payer: AlohaCare Medicare $6.97
Rate for Payer: Cash Price $10.79
Rate for Payer: Deseret Mutual Benefit Administrators Commercial $15.27
Rate for Payer: Devoted Health Medicare $6.97
Rate for Payer: Hawaii Medical Service Association Medicare $6.97
Rate for Payer: Hawaii Western Management Group Commercial $15.77
Rate for Payer: Health Management Network Commercial $14.11
Rate for Payer: Humana Medicare $6.97
Rate for Payer: Kaiser Permanente Commercial $14.94
Rate for Payer: Kaiser Permanente Medicaid $8.47
Rate for Payer: Kaiser Permanente Medicare $6.97
Rate for Payer: MDX Hawaii PPO $16.10
Rate for Payer: Ohana Health Plan Medicaid $6.97
Rate for Payer: Ohana Health Plan Medicare $6.97
Rate for Payer: UnitedHealthcare Medicaid $9.96
Rate for Payer: UnitedHealthcare Medicare $6.97
Rate for Payer: University Health Alliance Commercial $12.10
Service Code NDC 16714073601
Hospital Revenue Code 250
Min. Negotiated Rate $14.84
Max. Negotiated Rate $34.28
Rate for Payer: AlohaCare Medicaid $17.67
Rate for Payer: AlohaCare Medicare $14.84
Rate for Payer: Cash Price $22.97
Rate for Payer: Deseret Mutual Benefit Administrators Commercial $32.51
Rate for Payer: Devoted Health Medicare $14.84
Rate for Payer: Hawaii Medical Service Association Medicare $14.84
Rate for Payer: Hawaii Western Management Group Commercial $33.57
Rate for Payer: Health Management Network Commercial $30.04
Rate for Payer: Humana Medicare $14.84
Rate for Payer: Kaiser Permanente Commercial $31.81
Rate for Payer: Kaiser Permanente Medicaid $18.02
Rate for Payer: Kaiser Permanente Medicare $14.84
Rate for Payer: MDX Hawaii PPO $34.28
Rate for Payer: Ohana Health Plan Medicaid $14.84
Rate for Payer: Ohana Health Plan Medicare $14.84
Rate for Payer: UnitedHealthcare Medicaid $21.20
Rate for Payer: UnitedHealthcare Medicare $14.84
Rate for Payer: University Health Alliance Commercial $25.76
Service Code NDC 16714073601
Hospital Revenue Code 250
Min. Negotiated Rate $30.04
Max. Negotiated Rate $34.28
Rate for Payer: Cash Price $22.97
Rate for Payer: Health Management Network Commercial $30.04
Rate for Payer: Kaiser Permanente Commercial $31.81
Rate for Payer: MDX Hawaii PPO $34.28
Service Code NDC 69097052934
Hospital Revenue Code 250
Min. Negotiated Rate $33.17
Max. Negotiated Rate $37.85
Rate for Payer: Cash Price $25.36
Rate for Payer: Health Management Network Commercial $33.17
Rate for Payer: Kaiser Permanente Commercial $35.12
Rate for Payer: MDX Hawaii PPO $37.85
Service Code NDC 69097052934
Hospital Revenue Code 250
Min. Negotiated Rate $16.39
Max. Negotiated Rate $37.85
Rate for Payer: AlohaCare Medicaid $19.51
Rate for Payer: AlohaCare Medicare $16.39
Rate for Payer: Cash Price $25.36
Rate for Payer: Deseret Mutual Benefit Administrators Commercial $35.90
Rate for Payer: Devoted Health Medicare $16.39
Rate for Payer: Hawaii Medical Service Association Medicare $16.39
Rate for Payer: Hawaii Western Management Group Commercial $37.07
Rate for Payer: Health Management Network Commercial $33.17
Rate for Payer: Humana Medicare $16.39
Rate for Payer: Kaiser Permanente Commercial $35.12
Rate for Payer: Kaiser Permanente Medicaid $19.90
Rate for Payer: Kaiser Permanente Medicare $16.39
Rate for Payer: MDX Hawaii PPO $37.85
Rate for Payer: Ohana Health Plan Medicaid $16.39
Rate for Payer: Ohana Health Plan Medicare $16.39
Rate for Payer: UnitedHealthcare Medicaid $23.41
Rate for Payer: UnitedHealthcare Medicare $16.39
Rate for Payer: University Health Alliance Commercial $28.44