Kau Hospital

All Charges

Charge

Type

Setting

Price

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

HC ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT

Facility

$1,175.00

Service Code	HCPCS 20604
Hospital Charge Code	3612060401
Hospital Revenue Code	450
Min. Negotiated Rate	$364.25
Max. Negotiated Rate	$1,600.00
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: Devoted Health Medicare	$399.50
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	$364.25
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,116.25
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	$937.50
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 Medicare	$364.25
Rate for Payer: University Health Alliance Commercial	$856.46

HC ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT

Facility

$1,175.00

Service Code	HCPCS 20604
Hospital Charge Code	3612060401
Hospital Revenue Code	450
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 ASPIRAT/INJECTION GANGLION CYST(S)

Facility

$1,175.00

Service Code	HCPCS 20612
Hospital Charge Code	3612061201
Hospital Revenue Code	450
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 ASPIRAT/INJECTION GANGLION CYST(S)

Facility

$1,175.00

Service Code	HCPCS 20612
Hospital Charge Code	3612061201
Hospital Revenue Code	450
Min. Negotiated Rate	$364.25
Max. Negotiated Rate	$1,600.00
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: Devoted Health Medicare	$399.50
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	$364.25
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,116.25
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	$937.50
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 Medicare	$364.25
Rate for Payer: University Health Alliance Commercial	$856.46

HC ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER

Facility

$8,152.00

Service Code	HCPCS 51102
Hospital Charge Code	3615110201
Hospital Revenue Code	450
Min. Negotiated Rate	$6,929.20
Max. Negotiated Rate	$7,907.44
Rate for Payer: Cash Price	$4,891.20
Rate for Payer: Health Management Network Commercial	$6,929.20
Rate for Payer: Kaiser Permanente Commercial	$7,336.80
Rate for Payer: MDX Hawaii PPO	$7,907.44

HC ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER

Facility

$8,152.00

Service Code	HCPCS 51102
Hospital Charge Code	3615110201
Hospital Revenue Code	450
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$7,907.44
Rate for Payer: AlohaCare Medicaid	$4,076.00
Rate for Payer: AlohaCare Medicare	$2,527.12
Rate for Payer: Cash Price	$4,891.20
Rate for Payer: Cash Price	$4,891.20
Rate for Payer: Devoted Health Medicare	$2,771.68
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	$2,527.12
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$7,744.40
Rate for Payer: Health Management Network Commercial	$6,929.20
Rate for Payer: Humana Medicare	$2,527.12
Rate for Payer: Kaiser Permanente Commercial	$7,336.80
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$2,527.12
Rate for Payer: MDX Hawaii PPO	$7,907.44
Rate for Payer: Ohana Health Plan Medicaid	$2,527.12
Rate for Payer: Ohana Health Plan Medicare	$2,527.12
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$2,527.12
Rate for Payer: University Health Alliance Commercial	$5,941.99

HC ASPIRATION OF BLADDER; BY NEEDLE

Facility

$948.00

Service Code	HCPCS 51100
Hospital Charge Code	4505110001
Hospital Revenue Code	450
Min. Negotiated Rate	$805.80
Max. Negotiated Rate	$919.56
Rate for Payer: Cash Price	$568.80
Rate for Payer: Health Management Network Commercial	$805.80
Rate for Payer: Kaiser Permanente Commercial	$853.20
Rate for Payer: MDX Hawaii PPO	$919.56

HC ASPIRATION OF BLADDER; BY NEEDLE

Facility

$948.00

Service Code	HCPCS 51100
Hospital Charge Code	4505110001
Hospital Revenue Code	450
Min. Negotiated Rate	$293.88
Max. Negotiated Rate	$1,600.00
Rate for Payer: AlohaCare Medicaid	$474.00
Rate for Payer: AlohaCare Medicare	$293.88
Rate for Payer: Cash Price	$568.80
Rate for Payer: Cash Price	$568.80
Rate for Payer: Devoted Health Medicare	$322.32
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	$293.88
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$900.60
Rate for Payer: Health Management Network Commercial	$805.80
Rate for Payer: Humana Medicare	$293.88
Rate for Payer: Kaiser Permanente Commercial	$853.20
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$293.88
Rate for Payer: MDX Hawaii PPO	$919.56
Rate for Payer: Ohana Health Plan Medicaid	$293.88
Rate for Payer: Ohana Health Plan Medicare	$293.88
Rate for Payer: UnitedHealthcare Medicare	$293.88
Rate for Payer: University Health Alliance Commercial	$691.00

HC ASPIRATION OF BLADDER; BY TROCAR OR INTRACATHETER

Facility

$3,965.00

Service Code	HCPCS 51101
Hospital Charge Code	4505110101
Hospital Revenue Code	450
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$3,846.05
Rate for Payer: AlohaCare Medicaid	$1,982.50
Rate for Payer: AlohaCare Medicare	$1,229.15
Rate for Payer: Cash Price	$2,379.00
Rate for Payer: Cash Price	$2,379.00
Rate for Payer: Devoted Health Medicare	$1,348.10
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	$1,229.15
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,766.75
Rate for Payer: Health Management Network Commercial	$3,370.25
Rate for Payer: Humana Medicare	$1,229.15
Rate for Payer: Kaiser Permanente Commercial	$3,568.50
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$1,229.15
Rate for Payer: MDX Hawaii PPO	$3,846.05
Rate for Payer: Ohana Health Plan Medicaid	$1,229.15
Rate for Payer: Ohana Health Plan Medicare	$1,229.15
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$1,229.15
Rate for Payer: University Health Alliance Commercial	$2,890.09

HC ASPIRATION OF BLADDER; BY TROCAR OR INTRACATHETER

Facility

$3,965.00

Service Code	HCPCS 51101
Hospital Charge Code	4505110101
Hospital Revenue Code	450
Min. Negotiated Rate	$3,370.25
Max. Negotiated Rate	$3,846.05
Rate for Payer: Cash Price	$2,379.00
Rate for Payer: Health Management Network Commercial	$3,370.25
Rate for Payer: Kaiser Permanente Commercial	$3,568.50
Rate for Payer: MDX Hawaii PPO	$3,846.05

HC ASSAY ALKAL PHOSPHATASE - ALKALINE PHOSPHATASE

Facility

$43.00

Service Code	HCPCS 84075
Hospital Charge Code	3018407501
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$41.71
Rate for Payer: AlohaCare Medicaid	$21.50
Rate for Payer: AlohaCare Medicare	$13.33
Rate for Payer: Cash Price	$25.80
Rate for Payer: Cash Price	$25.80
Rate for Payer: Devoted Health Medicare	$14.62
Rate for Payer: Hawaii Medical Service Association ABD	$7.15
Rate for Payer: Hawaii Medical Service Association Commercial	$6.47
Rate for Payer: Hawaii Medical Service Association Medicare	$13.33
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.51
Rate for Payer: Hawaii Western Management Group Commercial	$5.18
Rate for Payer: Health Management Network Commercial	$36.55
Rate for Payer: Humana Medicare	$13.33
Rate for Payer: Kaiser Permanente Commercial	$38.70
Rate for Payer: Kaiser Permanente Medicaid	$21.93
Rate for Payer: Kaiser Permanente Medicare	$13.33
Rate for Payer: MDX Hawaii PPO	$41.71
Rate for Payer: Ohana Health Plan Medicaid	$13.33
Rate for Payer: Ohana Health Plan Medicare	$13.33
Rate for Payer: UnitedHealthcare Medicaid	$7.15
Rate for Payer: UnitedHealthcare Medicare	$13.33
Rate for Payer: University Health Alliance Commercial	$13.38

HC ASSAY ALKAL PHOSPHATASE - ALKALINE PHOSPHATASE

Facility

$43.00

Service Code	HCPCS 84075
Hospital Charge Code	3018407501
Hospital Revenue Code	301
Min. Negotiated Rate	$36.55
Max. Negotiated Rate	$41.71
Rate for Payer: Cash Price	$25.80
Rate for Payer: Health Management Network Commercial	$36.55
Rate for Payer: Kaiser Permanente Commercial	$38.70
Rate for Payer: MDX Hawaii PPO	$41.71

HC ASSAY GROWTH HORMONE (HGH) - GROWTH HORMONE

Facility

$140.00

Service Code	HCPCS 83003
Hospital Charge Code	3018300301
Hospital Revenue Code	301
Min. Negotiated Rate	$16.67
Max. Negotiated Rate	$135.80
Rate for Payer: AlohaCare Medicaid	$70.00
Rate for Payer: AlohaCare Medicare	$43.40
Rate for Payer: Cash Price	$84.00
Rate for Payer: Cash Price	$84.00
Rate for Payer: Devoted Health Medicare	$47.60
Rate for Payer: Hawaii Medical Service Association ABD	$23.04
Rate for Payer: Hawaii Medical Service Association Commercial	$20.84
Rate for Payer: Hawaii Medical Service Association Medicare	$43.40
Rate for Payer: Hawaii Medical Service Association Non-ABD	$24.19
Rate for Payer: Hawaii Western Management Group Commercial	$16.67
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Humana Medicare	$43.40
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: Kaiser Permanente Medicaid	$71.40
Rate for Payer: Kaiser Permanente Medicare	$43.40
Rate for Payer: MDX Hawaii PPO	$135.80
Rate for Payer: Ohana Health Plan Medicaid	$43.40
Rate for Payer: Ohana Health Plan Medicare	$43.40
Rate for Payer: UnitedHealthcare Medicaid	$23.04
Rate for Payer: UnitedHealthcare Medicare	$43.40
Rate for Payer: University Health Alliance Commercial	$43.09

HC ASSAY GROWTH HORMONE (HGH) - GROWTH HORMONE

Facility

$140.00

Service Code	HCPCS 83003
Hospital Charge Code	3018300301
Hospital Revenue Code	301
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$135.80
Rate for Payer: Cash Price	$84.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: MDX Hawaii PPO	$135.80

HC ASSAY, NON-ENDOCRINE RECEPTOR - SOLUBLE TRANSFERR RECP SO

Facility

$307.00

Hospital Charge Code	3018423801
Hospital Revenue Code	301
Min. Negotiated Rate	$260.95
Max. Negotiated Rate	$297.79
Rate for Payer: Cash Price	$184.20
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

HC ASSAY, NON-ENDOCRINE RECEPTOR - SOLUBLE TRANSFERR RECP SO

Facility

$307.00

Hospital Charge Code	3018423801
Hospital Revenue Code	301
Min. Negotiated Rate	$95.17
Max. Negotiated Rate	$297.79
Rate for Payer: AlohaCare Medicaid	$153.50
Rate for Payer: AlohaCare Medicare	$95.17
Rate for Payer: Cash Price	$184.20
Rate for Payer: Devoted Health Medicare	$104.38
Rate for Payer: Hawaii Medical Service Association Medicare	$95.17
Rate for Payer: Hawaii Western Management Group Commercial	$291.65
Rate for Payer: Health Management Network Commercial	$260.95
Rate for Payer: Humana Medicare	$95.17
Rate for Payer: Kaiser Permanente Commercial	$276.30
Rate for Payer: Kaiser Permanente Medicaid	$156.57
Rate for Payer: Kaiser Permanente Medicare	$95.17
Rate for Payer: MDX Hawaii PPO	$297.79
Rate for Payer: Ohana Health Plan Medicaid	$95.17
Rate for Payer: Ohana Health Plan Medicare	$95.17
Rate for Payer: UnitedHealthcare Medicare	$95.17
Rate for Payer: University Health Alliance Commercial	$223.77

HC ASSAY OF AMYLASE - AMYLASE

Facility

$54.00

Service Code	HCPCS 82150
Hospital Charge Code	3018215005
Hospital Revenue Code	301
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$52.38
Rate for Payer: AlohaCare Medicaid	$27.00
Rate for Payer: AlohaCare Medicare	$16.74
Rate for Payer: Cash Price	$32.40
Rate for Payer: Cash Price	$32.40
Rate for Payer: Devoted Health Medicare	$18.36
Rate for Payer: Hawaii Medical Service Association ABD	$8.96
Rate for Payer: Hawaii Medical Service Association Commercial	$8.10
Rate for Payer: Hawaii Medical Service Association Medicare	$16.74
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9.41
Rate for Payer: Hawaii Western Management Group Commercial	$6.48
Rate for Payer: Health Management Network Commercial	$45.90
Rate for Payer: Humana Medicare	$16.74
Rate for Payer: Kaiser Permanente Commercial	$48.60
Rate for Payer: Kaiser Permanente Medicaid	$27.54
Rate for Payer: Kaiser Permanente Medicare	$16.74
Rate for Payer: MDX Hawaii PPO	$52.38
Rate for Payer: Ohana Health Plan Medicaid	$16.74
Rate for Payer: Ohana Health Plan Medicare	$16.74
Rate for Payer: UnitedHealthcare Medicaid	$8.96
Rate for Payer: UnitedHealthcare Medicare	$16.74
Rate for Payer: University Health Alliance Commercial	$16.76

HC ASSAY OF AMYLASE - AMYLASE

Facility

$54.00

Service Code	HCPCS 82150
Hospital Charge Code	3018215005
Hospital Revenue Code	301
Min. Negotiated Rate	$45.90
Max. Negotiated Rate	$52.38
Rate for Payer: Cash Price	$32.40
Rate for Payer: Health Management Network Commercial	$45.90
Rate for Payer: Kaiser Permanente Commercial	$48.60
Rate for Payer: MDX Hawaii PPO	$52.38

HC ASSAY OF APOLIPOPROTEIN - LIPOPROTEIN A (LPA)

Facility

$177.00

Service Code	HCPCS 82172
Hospital Charge Code	3018217201
Hospital Revenue Code	301
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$171.69
Rate for Payer: AlohaCare Medicaid	$88.50
Rate for Payer: AlohaCare Medicare	$54.87
Rate for Payer: Cash Price	$106.20
Rate for Payer: Cash Price	$106.20
Rate for Payer: Devoted Health Medicare	$60.18
Rate for Payer: Hawaii Medical Service Association ABD	$21.41
Rate for Payer: Hawaii Medical Service Association Commercial	$26.36
Rate for Payer: Hawaii Medical Service Association Medicare	$54.87
Rate for Payer: Hawaii Medical Service Association Non-ABD	$22.48
Rate for Payer: Hawaii Western Management Group Commercial	$21.09
Rate for Payer: Health Management Network Commercial	$150.45
Rate for Payer: Humana Medicare	$54.87
Rate for Payer: Kaiser Permanente Commercial	$159.30
Rate for Payer: Kaiser Permanente Medicaid	$90.27
Rate for Payer: Kaiser Permanente Medicare	$54.87
Rate for Payer: MDX Hawaii PPO	$171.69
Rate for Payer: Ohana Health Plan Medicaid	$54.87
Rate for Payer: Ohana Health Plan Medicare	$54.87
Rate for Payer: UnitedHealthcare Medicaid	$21.41
Rate for Payer: UnitedHealthcare Medicare	$54.87
Rate for Payer: University Health Alliance Commercial	$40.05

HC ASSAY OF APOLIPOPROTEIN - LIPOPROTEIN A (LPA)

Facility

$177.00

Service Code	HCPCS 82172
Hospital Charge Code	3018217201
Hospital Revenue Code	301
Min. Negotiated Rate	$150.45
Max. Negotiated Rate	$171.69
Rate for Payer: Cash Price	$106.20
Rate for Payer: Health Management Network Commercial	$150.45
Rate for Payer: Kaiser Permanente Commercial	$159.30
Rate for Payer: MDX Hawaii PPO	$171.69

HC ASSAY OF CK (CPK) - CK

Facility

$55.00

Service Code	HCPCS 82550
Hospital Charge Code	3018255001
Hospital Revenue Code	301
Min. Negotiated Rate	$46.75
Max. Negotiated Rate	$53.35
Rate for Payer: Cash Price	$33.00
Rate for Payer: Health Management Network Commercial	$46.75
Rate for Payer: Kaiser Permanente Commercial	$49.50
Rate for Payer: MDX Hawaii PPO	$53.35

HC ASSAY OF CK (CPK) - CK

Facility

$55.00

Service Code	HCPCS 82550
Hospital Charge Code	3018255001
Hospital Revenue Code	301
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$53.35
Rate for Payer: AlohaCare Medicaid	$27.50
Rate for Payer: AlohaCare Medicare	$17.05
Rate for Payer: Cash Price	$33.00
Rate for Payer: Cash Price	$33.00
Rate for Payer: Devoted Health Medicare	$18.70
Rate for Payer: Hawaii Medical Service Association ABD	$9.01
Rate for Payer: Hawaii Medical Service Association Commercial	$8.14
Rate for Payer: Hawaii Medical Service Association Medicare	$17.05
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9.46
Rate for Payer: Hawaii Western Management Group Commercial	$6.51
Rate for Payer: Health Management Network Commercial	$46.75
Rate for Payer: Humana Medicare	$17.05
Rate for Payer: Kaiser Permanente Commercial	$49.50
Rate for Payer: Kaiser Permanente Medicaid	$28.05
Rate for Payer: Kaiser Permanente Medicare	$17.05
Rate for Payer: MDX Hawaii PPO	$53.35
Rate for Payer: Ohana Health Plan Medicaid	$17.05
Rate for Payer: Ohana Health Plan Medicare	$17.05
Rate for Payer: UnitedHealthcare Medicaid	$9.01
Rate for Payer: UnitedHealthcare Medicare	$17.05
Rate for Payer: University Health Alliance Commercial	$16.84

HC ASSAY OF C-PEPTIDE - C-PEPTIDE

Facility

$175.00

Service Code	HCPCS 84681
Hospital Charge Code	3018468101
Hospital Revenue Code	301
Min. Negotiated Rate	$148.75
Max. Negotiated Rate	$169.75
Rate for Payer: Cash Price	$105.00
Rate for Payer: Health Management Network Commercial	$148.75
Rate for Payer: Kaiser Permanente Commercial	$157.50
Rate for Payer: MDX Hawaii PPO	$169.75

HC ASSAY OF C-PEPTIDE - C-PEPTIDE

Facility

$175.00

Service Code	HCPCS 84681
Hospital Charge Code	3018468101
Hospital Revenue Code	301
Min. Negotiated Rate	$20.81
Max. Negotiated Rate	$169.75
Rate for Payer: AlohaCare Medicaid	$87.50
Rate for Payer: AlohaCare Medicare	$54.25
Rate for Payer: Cash Price	$105.00
Rate for Payer: Cash Price	$105.00
Rate for Payer: Devoted Health Medicare	$59.50
Rate for Payer: Hawaii Medical Service Association ABD	$28.75
Rate for Payer: Hawaii Medical Service Association Commercial	$26.01
Rate for Payer: Hawaii Medical Service Association Medicare	$54.25
Rate for Payer: Hawaii Medical Service Association Non-ABD	$30.19
Rate for Payer: Hawaii Western Management Group Commercial	$20.81
Rate for Payer: Health Management Network Commercial	$148.75
Rate for Payer: Humana Medicare	$54.25
Rate for Payer: Kaiser Permanente Commercial	$157.50
Rate for Payer: Kaiser Permanente Medicaid	$89.25
Rate for Payer: Kaiser Permanente Medicare	$54.25
Rate for Payer: MDX Hawaii PPO	$169.75
Rate for Payer: Ohana Health Plan Medicaid	$54.25
Rate for Payer: Ohana Health Plan Medicare	$54.25
Rate for Payer: UnitedHealthcare Medicaid	$28.75
Rate for Payer: UnitedHealthcare Medicare	$54.25
Rate for Payer: University Health Alliance Commercial	$53.78

Know your out-of-pocket cost for care.

All Charges