Kau Hospital

All Charges

Charge

Type

Setting

Price

HC APPLY FOREARM SPLINT,STATIC

Facility

$513.00

Service Code	HCPCS 29125
Hospital Charge Code	7002912501
Hospital Revenue Code	700
Min. Negotiated Rate	$24.61
Max. Negotiated Rate	$497.61
Rate for Payer: AlohaCare Medicaid	$256.50
Rate for Payer: AlohaCare Medicare	$159.03
Rate for Payer: Cash Price	$307.80
Rate for Payer: Cash Price	$307.80
Rate for Payer: Devoted Health Medicare	$174.42
Rate for Payer: Hawaii Medical Service Association Commercial	$169.91
Rate for Payer: Hawaii Medical Service Association Medicare	$159.03
Rate for Payer: Hawaii Western Management Group Commercial	$487.35
Rate for Payer: Health Management Network Commercial	$436.05
Rate for Payer: Humana Medicare	$159.03
Rate for Payer: Kaiser Permanente Commercial	$461.70
Rate for Payer: Kaiser Permanente Medicaid	$261.63
Rate for Payer: Kaiser Permanente Medicare	$159.03
Rate for Payer: MDX Hawaii PPO	$497.61
Rate for Payer: Ohana Health Plan Medicaid	$159.03
Rate for Payer: Ohana Health Plan Medicare	$159.03
Rate for Payer: UnitedHealthcare Medicaid	$24.61
Rate for Payer: UnitedHealthcare Medicare	$159.03
Rate for Payer: University Health Alliance Commercial	$373.93

HC APPLY FOREARM SPLINT,STATIC

Facility

$513.00

Service Code	HCPCS 29125
Hospital Charge Code	7002912501
Hospital Revenue Code	700
Min. Negotiated Rate	$436.05
Max. Negotiated Rate	$497.61
Rate for Payer: Cash Price	$307.80
Rate for Payer: Health Management Network Commercial	$436.05
Rate for Payer: Kaiser Permanente Commercial	$461.70
Rate for Payer: MDX Hawaii PPO	$497.61

HC APPLY LONG ARM CAST

Facility

$1,057.00

Service Code	HCPCS 29065
Hospital Charge Code	7002906501
Hospital Revenue Code	450
Min. Negotiated Rate	$327.67
Max. Negotiated Rate	$1,600.00
Rate for Payer: AlohaCare Medicaid	$528.50
Rate for Payer: AlohaCare Medicare	$327.67
Rate for Payer: Cash Price	$634.20
Rate for Payer: Cash Price	$634.20
Rate for Payer: Devoted Health Medicare	$359.38
Rate for Payer: Hawaii Medical Service Association ABD	$469.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$327.67
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,004.15
Rate for Payer: Health Management Network Commercial	$898.45
Rate for Payer: Humana Medicare	$327.67
Rate for Payer: Kaiser Permanente Commercial	$951.30
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$327.67
Rate for Payer: MDX Hawaii PPO	$1,025.29
Rate for Payer: Ohana Health Plan Medicaid	$327.67
Rate for Payer: Ohana Health Plan Medicare	$327.67
Rate for Payer: UnitedHealthcare Medicare	$327.67
Rate for Payer: University Health Alliance Commercial	$770.45

HC APPLY LONG ARM CAST

Facility

$1,057.00

Service Code	HCPCS 29065
Hospital Charge Code	7002906501
Hospital Revenue Code	450
Min. Negotiated Rate	$898.45
Max. Negotiated Rate	$1,025.29
Rate for Payer: Cash Price	$634.20
Rate for Payer: Health Management Network Commercial	$898.45
Rate for Payer: Kaiser Permanente Commercial	$951.30
Rate for Payer: MDX Hawaii PPO	$1,025.29

HC APPLY LONG ARM SPLINT

Facility

$628.00

Service Code	HCPCS 29105
Hospital Charge Code	4502910501
Hospital Revenue Code	450
Min. Negotiated Rate	$194.68
Max. Negotiated Rate	$1,600.00
Rate for Payer: AlohaCare Medicaid	$314.00
Rate for Payer: AlohaCare Medicare	$194.68
Rate for Payer: Cash Price	$376.80
Rate for Payer: Cash Price	$376.80
Rate for Payer: Devoted Health Medicare	$213.52
Rate for Payer: Hawaii Medical Service Association ABD	$469.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$194.68
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$596.60
Rate for Payer: Health Management Network Commercial	$533.80
Rate for Payer: Humana Medicare	$194.68
Rate for Payer: Kaiser Permanente Commercial	$565.20
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$194.68
Rate for Payer: MDX Hawaii PPO	$609.16
Rate for Payer: Ohana Health Plan Medicaid	$194.68
Rate for Payer: Ohana Health Plan Medicare	$194.68
Rate for Payer: UnitedHealthcare Medicare	$194.68
Rate for Payer: University Health Alliance Commercial	$457.75

HC APPLY LONG ARM SPLINT

Facility

$628.00

Service Code	HCPCS 29105
Hospital Charge Code	4502910501
Hospital Revenue Code	450
Min. Negotiated Rate	$533.80
Max. Negotiated Rate	$609.16
Rate for Payer: Cash Price	$376.80
Rate for Payer: Health Management Network Commercial	$533.80
Rate for Payer: Kaiser Permanente Commercial	$565.20
Rate for Payer: MDX Hawaii PPO	$609.16

HC APPLY LONG LEG CAST

Facility

$1,057.00

Service Code	HCPCS 29345
Hospital Charge Code	7002934501
Hospital Revenue Code	450
Min. Negotiated Rate	$327.67
Max. Negotiated Rate	$1,600.00
Rate for Payer: AlohaCare Medicaid	$528.50
Rate for Payer: AlohaCare Medicare	$327.67
Rate for Payer: Cash Price	$634.20
Rate for Payer: Cash Price	$634.20
Rate for Payer: Devoted Health Medicare	$359.38
Rate for Payer: Hawaii Medical Service Association ABD	$469.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$327.67
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,004.15
Rate for Payer: Health Management Network Commercial	$898.45
Rate for Payer: Humana Medicare	$327.67
Rate for Payer: Kaiser Permanente Commercial	$951.30
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$327.67
Rate for Payer: MDX Hawaii PPO	$1,025.29
Rate for Payer: Ohana Health Plan Medicaid	$327.67
Rate for Payer: Ohana Health Plan Medicare	$327.67
Rate for Payer: UnitedHealthcare Medicare	$327.67
Rate for Payer: University Health Alliance Commercial	$770.45

HC APPLY LONG LEG CAST

Facility

$1,057.00

Service Code	HCPCS 29345
Hospital Charge Code	7002934501
Hospital Revenue Code	450
Min. Negotiated Rate	$898.45
Max. Negotiated Rate	$1,025.29
Rate for Payer: Cash Price	$634.20
Rate for Payer: Health Management Network Commercial	$898.45
Rate for Payer: Kaiser Permanente Commercial	$951.30
Rate for Payer: MDX Hawaii PPO	$1,025.29

HC APPLY LONG LEG CAST,WALKER

Facility

$1,035.00

Service Code	HCPCS 29355
Hospital Charge Code	7002935501
Hospital Revenue Code	450
Min. Negotiated Rate	$879.75
Max. Negotiated Rate	$1,003.95
Rate for Payer: Cash Price	$621.00
Rate for Payer: Health Management Network Commercial	$879.75
Rate for Payer: Kaiser Permanente Commercial	$931.50
Rate for Payer: MDX Hawaii PPO	$1,003.95

HC APPLY LONG LEG CAST,WALKER

Facility

$1,035.00

Service Code	HCPCS 29355
Hospital Charge Code	7002935501
Hospital Revenue Code	450
Min. Negotiated Rate	$320.85
Max. Negotiated Rate	$1,600.00
Rate for Payer: AlohaCare Medicaid	$517.50
Rate for Payer: AlohaCare Medicare	$320.85
Rate for Payer: Cash Price	$621.00
Rate for Payer: Cash Price	$621.00
Rate for Payer: Devoted Health Medicare	$351.90
Rate for Payer: Hawaii Medical Service Association ABD	$469.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$320.85
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$983.25
Rate for Payer: Health Management Network Commercial	$879.75
Rate for Payer: Humana Medicare	$320.85
Rate for Payer: Kaiser Permanente Commercial	$931.50
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$320.85
Rate for Payer: MDX Hawaii PPO	$1,003.95
Rate for Payer: Ohana Health Plan Medicaid	$320.85
Rate for Payer: Ohana Health Plan Medicare	$320.85
Rate for Payer: UnitedHealthcare Medicare	$320.85
Rate for Payer: University Health Alliance Commercial	$754.41

HC APPLY LONG LEG SPLINT

Facility

$628.00

Service Code	HCPCS 29505
Hospital Charge Code	4502950501
Hospital Revenue Code	450
Min. Negotiated Rate	$533.80
Max. Negotiated Rate	$609.16
Rate for Payer: Cash Price	$376.80
Rate for Payer: Health Management Network Commercial	$533.80
Rate for Payer: Kaiser Permanente Commercial	$565.20
Rate for Payer: MDX Hawaii PPO	$609.16

HC APPLY LONG LEG SPLINT

Facility

$628.00

Service Code	HCPCS 29505
Hospital Charge Code	4502950501
Hospital Revenue Code	450
Min. Negotiated Rate	$194.68
Max. Negotiated Rate	$1,600.00
Rate for Payer: AlohaCare Medicaid	$314.00
Rate for Payer: AlohaCare Medicare	$194.68
Rate for Payer: Cash Price	$376.80
Rate for Payer: Cash Price	$376.80
Rate for Payer: Devoted Health Medicare	$213.52
Rate for Payer: Hawaii Medical Service Association ABD	$469.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$194.68
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$596.60
Rate for Payer: Health Management Network Commercial	$533.80
Rate for Payer: Humana Medicare	$194.68
Rate for Payer: Kaiser Permanente Commercial	$565.20
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$194.68
Rate for Payer: MDX Hawaii PPO	$609.16
Rate for Payer: Ohana Health Plan Medicaid	$194.68
Rate for Payer: Ohana Health Plan Medicare	$194.68
Rate for Payer: UnitedHealthcare Medicare	$194.68
Rate for Payer: University Health Alliance Commercial	$457.75

HC APPLY LOWER LEG SPLINT

Facility

$628.00

Service Code	HCPCS 29515
Hospital Charge Code	7002951501
Hospital Revenue Code	700
Min. Negotiated Rate	$533.80
Max. Negotiated Rate	$609.16
Rate for Payer: Cash Price	$376.80
Rate for Payer: Health Management Network Commercial	$533.80
Rate for Payer: Kaiser Permanente Commercial	$565.20
Rate for Payer: MDX Hawaii PPO	$609.16

HC APPLY LOWER LEG SPLINT

Facility

$628.00

Service Code	HCPCS 29515
Hospital Charge Code	7002951501
Hospital Revenue Code	700
Min. Negotiated Rate	$29.94
Max. Negotiated Rate	$609.16
Rate for Payer: AlohaCare Medicaid	$314.00
Rate for Payer: AlohaCare Medicare	$194.68
Rate for Payer: Cash Price	$376.80
Rate for Payer: Cash Price	$376.80
Rate for Payer: Devoted Health Medicare	$213.52
Rate for Payer: Hawaii Medical Service Association Commercial	$207.53
Rate for Payer: Hawaii Medical Service Association Medicare	$194.68
Rate for Payer: Hawaii Western Management Group Commercial	$596.60
Rate for Payer: Health Management Network Commercial	$533.80
Rate for Payer: Humana Medicare	$194.68
Rate for Payer: Kaiser Permanente Commercial	$565.20
Rate for Payer: Kaiser Permanente Medicaid	$320.28
Rate for Payer: Kaiser Permanente Medicare	$194.68
Rate for Payer: MDX Hawaii PPO	$609.16
Rate for Payer: Ohana Health Plan Medicaid	$194.68
Rate for Payer: Ohana Health Plan Medicare	$194.68
Rate for Payer: UnitedHealthcare Medicaid	$29.94
Rate for Payer: UnitedHealthcare Medicare	$194.68
Rate for Payer: University Health Alliance Commercial	$457.75

HC APPLY SHORT LEG CAST

Facility

$1,057.00

Service Code	HCPCS 29405
Hospital Charge Code	7002940501
Hospital Revenue Code	450
Min. Negotiated Rate	$898.45
Max. Negotiated Rate	$1,025.29
Rate for Payer: Cash Price	$634.20
Rate for Payer: Health Management Network Commercial	$898.45
Rate for Payer: Kaiser Permanente Commercial	$951.30
Rate for Payer: MDX Hawaii PPO	$1,025.29

HC APPLY SHORT LEG CAST

Facility

$1,057.00

Service Code	HCPCS 29405
Hospital Charge Code	7002940501
Hospital Revenue Code	450
Min. Negotiated Rate	$327.67
Max. Negotiated Rate	$1,600.00
Rate for Payer: AlohaCare Medicaid	$528.50
Rate for Payer: AlohaCare Medicare	$327.67
Rate for Payer: Cash Price	$634.20
Rate for Payer: Cash Price	$634.20
Rate for Payer: Devoted Health Medicare	$359.38
Rate for Payer: Hawaii Medical Service Association ABD	$469.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$327.67
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,004.15
Rate for Payer: Health Management Network Commercial	$898.45
Rate for Payer: Humana Medicare	$327.67
Rate for Payer: Kaiser Permanente Commercial	$951.30
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$327.67
Rate for Payer: MDX Hawaii PPO	$1,025.29
Rate for Payer: Ohana Health Plan Medicaid	$327.67
Rate for Payer: Ohana Health Plan Medicare	$327.67
Rate for Payer: UnitedHealthcare Medicare	$327.67
Rate for Payer: University Health Alliance Commercial	$770.45

HC APPLY SHORT LEG CAST,WALKER

Facility

$1,057.00

Service Code	HCPCS 29425
Hospital Charge Code	7002942501
Hospital Revenue Code	450
Min. Negotiated Rate	$327.67
Max. Negotiated Rate	$1,600.00
Rate for Payer: AlohaCare Medicaid	$528.50
Rate for Payer: AlohaCare Medicare	$327.67
Rate for Payer: Cash Price	$634.20
Rate for Payer: Cash Price	$634.20
Rate for Payer: Devoted Health Medicare	$359.38
Rate for Payer: Hawaii Medical Service Association ABD	$469.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$327.67
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,004.15
Rate for Payer: Health Management Network Commercial	$898.45
Rate for Payer: Humana Medicare	$327.67
Rate for Payer: Kaiser Permanente Commercial	$951.30
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$327.67
Rate for Payer: MDX Hawaii PPO	$1,025.29
Rate for Payer: Ohana Health Plan Medicaid	$327.67
Rate for Payer: Ohana Health Plan Medicare	$327.67
Rate for Payer: UnitedHealthcare Medicare	$327.67
Rate for Payer: University Health Alliance Commercial	$770.45

HC APPLY SHORT LEG CAST,WALKER

Facility

$1,057.00

Service Code	HCPCS 29425
Hospital Charge Code	7002942501
Hospital Revenue Code	450
Min. Negotiated Rate	$898.45
Max. Negotiated Rate	$1,025.29
Rate for Payer: Cash Price	$634.20
Rate for Payer: Health Management Network Commercial	$898.45
Rate for Payer: Kaiser Permanente Commercial	$951.30
Rate for Payer: MDX Hawaii PPO	$1,025.29

HC ARTERIAL CATHETERIZATION OR CANNULATION FOR SAMPLING, MONITORING OR TRANSFUSION; CUTDOWN

Facility

$254.00

Service Code	HCPCS 36625
Hospital Charge Code	4503662501
Hospital Revenue Code	450
Min. Negotiated Rate	$215.90
Max. Negotiated Rate	$246.38
Rate for Payer: Cash Price	$152.40
Rate for Payer: Health Management Network Commercial	$215.90
Rate for Payer: Kaiser Permanente Commercial	$228.60
Rate for Payer: MDX Hawaii PPO	$246.38

HC ARTERIAL CATHETERIZATION OR CANNULATION FOR SAMPLING, MONITORING OR TRANSFUSION; CUTDOWN

Facility

$254.00

Service Code	HCPCS 36625
Hospital Charge Code	4503662501
Hospital Revenue Code	450
Min. Negotiated Rate	$78.74
Max. Negotiated Rate	$1,600.00
Rate for Payer: AlohaCare Medicaid	$127.00
Rate for Payer: AlohaCare Medicare	$78.74
Rate for Payer: Cash Price	$152.40
Rate for Payer: Cash Price	$152.40
Rate for Payer: Devoted Health Medicare	$86.36
Rate for Payer: Hawaii Medical Service Association ABD	$469.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$78.74
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$241.30
Rate for Payer: Health Management Network Commercial	$215.90
Rate for Payer: Humana Medicare	$78.74
Rate for Payer: Kaiser Permanente Commercial	$228.60
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$78.74
Rate for Payer: MDX Hawaii PPO	$246.38
Rate for Payer: Ohana Health Plan Medicaid	$78.74
Rate for Payer: Ohana Health Plan Medicare	$78.74
Rate for Payer: UnitedHealthcare Medicare	$78.74
Rate for Payer: University Health Alliance Commercial	$185.14

HC ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US

Facility

$2,756.00

Service Code	HCPCS 20606
Hospital Charge Code	7612060601
Hospital Revenue Code	761
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$2,673.32
Rate for Payer: AlohaCare Medicaid	$1,378.00
Rate for Payer: AlohaCare Medicare	$854.36
Rate for Payer: Cash Price	$1,653.60
Rate for Payer: Cash Price	$1,653.60
Rate for Payer: Cash Price	$1,653.60
Rate for Payer: Devoted Health Medicare	$937.04
Rate for Payer: Hawaii Medical Service Association Commercial	$901.46
Rate for Payer: Hawaii Medical Service Association Medicare	$854.36
Rate for Payer: Hawaii Western Management Group Commercial	$2,618.20
Rate for Payer: Health Management Network Commercial	$2,342.60
Rate for Payer: Humana Medicare	$854.36
Rate for Payer: Kaiser Permanente Commercial	$2,480.40
Rate for Payer: Kaiser Permanente Medicaid	$1,405.56
Rate for Payer: Kaiser Permanente Medicare	$854.36
Rate for Payer: MDX Hawaii PPO	$2,673.32
Rate for Payer: Ohana Health Plan Medicaid	$854.36
Rate for Payer: Ohana Health Plan Medicare	$854.36
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$854.36
Rate for Payer: University Health Alliance Commercial	$2,008.85

HC ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US

Facility

$2,756.00

Service Code	HCPCS 20606
Hospital Charge Code	7612060601
Hospital Revenue Code	761
Min. Negotiated Rate	$2,342.60
Max. Negotiated Rate	$2,673.32
Rate for Payer: Cash Price	$1,653.60
Rate for Payer: Health Management Network Commercial	$2,342.60
Rate for Payer: Kaiser Permanente Commercial	$2,480.40
Rate for Payer: MDX Hawaii PPO	$2,673.32

HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US

Facility

$1,175.00

Service Code	HCPCS 20610
Hospital Charge Code	3612061001
Hospital Revenue Code	361
Min. Negotiated Rate	$48.79
Max. Negotiated Rate	$4,035.20
Rate for Payer: AlohaCare Medicaid	$587.50
Rate for Payer: AlohaCare Medicare	$364.25
Rate for Payer: Cash Price	$705.00
Rate for Payer: Cash Price	$705.00
Rate for Payer: Cash Price	$705.00
Rate for Payer: Devoted Health Medicare	$399.50
Rate for Payer: Hawaii Medical Service Association Commercial	$392.00
Rate for Payer: Hawaii Medical Service Association Medicare	$364.25
Rate for Payer: Health Management Network Commercial	$998.75
Rate for Payer: Humana Medicare	$364.25
Rate for Payer: Kaiser Permanente Commercial	$1,057.50
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$364.25
Rate for Payer: MDX Hawaii PPO	$1,139.75
Rate for Payer: Ohana Health Plan Medicaid	$364.25
Rate for Payer: Ohana Health Plan Medicare	$364.25
Rate for Payer: UnitedHealthcare Medicaid	$48.79
Rate for Payer: UnitedHealthcare Medicare	$364.25
Rate for Payer: University Health Alliance Commercial	$4,035.20

HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US

Facility

$1,175.00

Service Code	HCPCS 20610
Hospital Charge Code	3612061001
Hospital Revenue Code	361
Min. Negotiated Rate	$998.75
Max. Negotiated Rate	$1,139.75
Rate for Payer: Cash Price	$705.00
Rate for Payer: Health Management Network Commercial	$998.75
Rate for Payer: Kaiser Permanente Commercial	$1,057.50
Rate for Payer: MDX Hawaii PPO	$1,139.75

HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US

Facility

$1,175.00

Service Code	HCPCS 20611
Hospital Charge Code	7612061101
Hospital Revenue Code	761
Min. Negotiated Rate	$998.75
Max. Negotiated Rate	$1,139.75
Rate for Payer: Cash Price	$705.00
Rate for Payer: Health Management Network Commercial	$998.75
Rate for Payer: Kaiser Permanente Commercial	$1,057.50
Rate for Payer: MDX Hawaii PPO	$1,139.75

Know your out-of-pocket cost for care.

All Charges