Kau Hospital

All Charges

Charge

Type

Setting

Price

HC CTRL NOSEBLEED,POST,W/PACKS &/OR CAUT

Facility

$513.00

Service Code	HCPCS 30905
Hospital Charge Code	7613090501
Hospital Revenue Code	761
Min. Negotiated Rate	$98.64
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	$98.64
Rate for Payer: UnitedHealthcare Medicare	$159.03
Rate for Payer: University Health Alliance Commercial	$373.93

HC CTRL NOSEBLEED,POST,W/PACKS &/OR CAUT

Facility

$513.00

Service Code	HCPCS 30905
Hospital Charge Code	7613090501
Hospital Revenue Code	761
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 CULT ALL OTHER ISOL

Facility

$72.00

Service Code	HCPCS 87070
Hospital Charge Code	3068707009
Hospital Revenue Code	306
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$69.84
Rate for Payer: AlohaCare Medicaid	$36.00
Rate for Payer: AlohaCare Medicare	$22.32
Rate for Payer: Cash Price	$43.20
Rate for Payer: Cash Price	$43.20
Rate for Payer: Devoted Health Medicare	$24.48
Rate for Payer: Hawaii Medical Service Association ABD	$11.90
Rate for Payer: Hawaii Medical Service Association Commercial	$10.78
Rate for Payer: Hawaii Medical Service Association Medicare	$22.32
Rate for Payer: Hawaii Medical Service Association Non-ABD	$12.50
Rate for Payer: Hawaii Western Management Group Commercial	$8.62
Rate for Payer: Health Management Network Commercial	$61.20
Rate for Payer: Humana Medicare	$22.32
Rate for Payer: Kaiser Permanente Commercial	$64.80
Rate for Payer: Kaiser Permanente Medicaid	$36.72
Rate for Payer: Kaiser Permanente Medicare	$22.32
Rate for Payer: MDX Hawaii PPO	$69.84
Rate for Payer: Ohana Health Plan Medicaid	$22.32
Rate for Payer: Ohana Health Plan Medicare	$22.32
Rate for Payer: UnitedHealthcare Medicaid	$11.90
Rate for Payer: UnitedHealthcare Medicare	$22.32
Rate for Payer: University Health Alliance Commercial	$22.26

HC CULT ALL OTHER ISOL

Facility

$72.00

Service Code	HCPCS 87070
Hospital Charge Code	3068707009
Hospital Revenue Code	306
Min. Negotiated Rate	$61.20
Max. Negotiated Rate	$69.84
Rate for Payer: Cash Price	$43.20
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

HC CULT ANAEROBIC

Facility

$79.00

Service Code	HCPCS 87075
Hospital Charge Code	3068707501
Hospital Revenue Code	306
Min. Negotiated Rate	$9.47
Max. Negotiated Rate	$76.63
Rate for Payer: AlohaCare Medicaid	$39.50
Rate for Payer: AlohaCare Medicare	$24.49
Rate for Payer: Cash Price	$47.40
Rate for Payer: Cash Price	$47.40
Rate for Payer: Devoted Health Medicare	$26.86
Rate for Payer: Hawaii Medical Service Association ABD	$13.08
Rate for Payer: Hawaii Medical Service Association Commercial	$11.84
Rate for Payer: Hawaii Medical Service Association Medicare	$24.49
Rate for Payer: Hawaii Medical Service Association Non-ABD	$13.73
Rate for Payer: Hawaii Western Management Group Commercial	$9.47
Rate for Payer: Health Management Network Commercial	$67.15
Rate for Payer: Humana Medicare	$24.49
Rate for Payer: Kaiser Permanente Commercial	$71.10
Rate for Payer: Kaiser Permanente Medicaid	$40.29
Rate for Payer: Kaiser Permanente Medicare	$24.49
Rate for Payer: MDX Hawaii PPO	$76.63
Rate for Payer: Ohana Health Plan Medicaid	$24.49
Rate for Payer: Ohana Health Plan Medicare	$24.49
Rate for Payer: UnitedHealthcare Medicaid	$13.08
Rate for Payer: UnitedHealthcare Medicare	$24.49
Rate for Payer: University Health Alliance Commercial	$24.46

HC CULT ANAEROBIC

Facility

$79.00

Service Code	HCPCS 87075
Hospital Charge Code	3068707501
Hospital Revenue Code	306
Min. Negotiated Rate	$67.15
Max. Negotiated Rate	$76.63
Rate for Payer: Cash Price	$47.40
Rate for Payer: Health Management Network Commercial	$67.15
Rate for Payer: Kaiser Permanente Commercial	$71.10
Rate for Payer: MDX Hawaii PPO	$76.63

HC CULT ANAEROBIC ID EA

Facility

$68.00

Service Code	HCPCS 87076
Hospital Charge Code	3068707601
Hospital Revenue Code	306
Min. Negotiated Rate	$57.80
Max. Negotiated Rate	$65.96
Rate for Payer: Cash Price	$40.80
Rate for Payer: Health Management Network Commercial	$57.80
Rate for Payer: Kaiser Permanente Commercial	$61.20
Rate for Payer: MDX Hawaii PPO	$65.96

HC CULT ANAEROBIC ID EA

Facility

$68.00

Service Code	HCPCS 87076
Hospital Charge Code	3068707601
Hospital Revenue Code	306
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$65.96
Rate for Payer: AlohaCare Medicaid	$34.00
Rate for Payer: AlohaCare Medicare	$21.08
Rate for Payer: Cash Price	$40.80
Rate for Payer: Cash Price	$40.80
Rate for Payer: Devoted Health Medicare	$23.12
Rate for Payer: Hawaii Medical Service Association ABD	$11.16
Rate for Payer: Hawaii Medical Service Association Commercial	$10.10
Rate for Payer: Hawaii Medical Service Association Medicare	$21.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$13.95
Rate for Payer: Hawaii Western Management Group Commercial	$8.08
Rate for Payer: Health Management Network Commercial	$57.80
Rate for Payer: Humana Medicare	$21.08
Rate for Payer: Kaiser Permanente Commercial	$61.20
Rate for Payer: Kaiser Permanente Medicaid	$34.68
Rate for Payer: Kaiser Permanente Medicare	$21.08
Rate for Payer: MDX Hawaii PPO	$65.96
Rate for Payer: Ohana Health Plan Medicaid	$21.08
Rate for Payer: Ohana Health Plan Medicare	$21.08
Rate for Payer: UnitedHealthcare Medicaid	$11.16
Rate for Payer: UnitedHealthcare Medicare	$21.08
Rate for Payer: University Health Alliance Commercial	$20.89

HC CULT BLOOD

Facility

$87.00

Service Code	HCPCS 87040
Hospital Charge Code	3068704001
Hospital Revenue Code	306
Min. Negotiated Rate	$10.32
Max. Negotiated Rate	$84.39
Rate for Payer: AlohaCare Medicaid	$43.50
Rate for Payer: AlohaCare Medicare	$26.97
Rate for Payer: Cash Price	$52.20
Rate for Payer: Cash Price	$52.20
Rate for Payer: Devoted Health Medicare	$29.58
Rate for Payer: Hawaii Medical Service Association ABD	$14.27
Rate for Payer: Hawaii Medical Service Association Commercial	$12.90
Rate for Payer: Hawaii Medical Service Association Medicare	$26.97
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14.98
Rate for Payer: Hawaii Western Management Group Commercial	$10.32
Rate for Payer: Health Management Network Commercial	$73.95
Rate for Payer: Humana Medicare	$26.97
Rate for Payer: Kaiser Permanente Commercial	$78.30
Rate for Payer: Kaiser Permanente Medicaid	$44.37
Rate for Payer: Kaiser Permanente Medicare	$26.97
Rate for Payer: MDX Hawaii PPO	$84.39
Rate for Payer: Ohana Health Plan Medicaid	$26.97
Rate for Payer: Ohana Health Plan Medicare	$26.97
Rate for Payer: UnitedHealthcare Medicaid	$14.27
Rate for Payer: UnitedHealthcare Medicare	$26.97
Rate for Payer: University Health Alliance Commercial	$26.68

HC CULT BLOOD

Facility

$87.00

Service Code	HCPCS 87040
Hospital Charge Code	3068704001
Hospital Revenue Code	306
Min. Negotiated Rate	$73.95
Max. Negotiated Rate	$84.39
Rate for Payer: Cash Price	$52.20
Rate for Payer: Health Management Network Commercial	$73.95
Rate for Payer: Kaiser Permanente Commercial	$78.30
Rate for Payer: MDX Hawaii PPO	$84.39

HC CULT BLOOD #2

Facility

$87.00

Service Code	HCPCS 87040
Hospital Charge Code	3068704002
Hospital Revenue Code	306
Min. Negotiated Rate	$73.95
Max. Negotiated Rate	$84.39
Rate for Payer: Cash Price	$52.20
Rate for Payer: Health Management Network Commercial	$73.95
Rate for Payer: Kaiser Permanente Commercial	$78.30
Rate for Payer: MDX Hawaii PPO	$84.39

HC CULT BLOOD #2

Facility

$87.00

Service Code	HCPCS 87040
Hospital Charge Code	3068704002
Hospital Revenue Code	306
Min. Negotiated Rate	$10.32
Max. Negotiated Rate	$84.39
Rate for Payer: AlohaCare Medicaid	$43.50
Rate for Payer: AlohaCare Medicare	$26.97
Rate for Payer: Cash Price	$52.20
Rate for Payer: Cash Price	$52.20
Rate for Payer: Devoted Health Medicare	$29.58
Rate for Payer: Hawaii Medical Service Association ABD	$14.27
Rate for Payer: Hawaii Medical Service Association Commercial	$12.90
Rate for Payer: Hawaii Medical Service Association Medicare	$26.97
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14.98
Rate for Payer: Hawaii Western Management Group Commercial	$10.32
Rate for Payer: Health Management Network Commercial	$73.95
Rate for Payer: Humana Medicare	$26.97
Rate for Payer: Kaiser Permanente Commercial	$78.30
Rate for Payer: Kaiser Permanente Medicaid	$44.37
Rate for Payer: Kaiser Permanente Medicare	$26.97
Rate for Payer: MDX Hawaii PPO	$84.39
Rate for Payer: Ohana Health Plan Medicaid	$26.97
Rate for Payer: Ohana Health Plan Medicare	$26.97
Rate for Payer: UnitedHealthcare Medicaid	$14.27
Rate for Payer: UnitedHealthcare Medicare	$26.97
Rate for Payer: University Health Alliance Commercial	$26.68

HC CULT FLUID

Facility

$72.00

Service Code	HCPCS 87070
Hospital Charge Code	3068707004
Hospital Revenue Code	306
Min. Negotiated Rate	$61.20
Max. Negotiated Rate	$69.84
Rate for Payer: Cash Price	$43.20
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

HC CULT FLUID

Facility

$72.00

Service Code	HCPCS 87070
Hospital Charge Code	3068707004
Hospital Revenue Code	306
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$69.84
Rate for Payer: AlohaCare Medicaid	$36.00
Rate for Payer: AlohaCare Medicare	$22.32
Rate for Payer: Cash Price	$43.20
Rate for Payer: Cash Price	$43.20
Rate for Payer: Devoted Health Medicare	$24.48
Rate for Payer: Hawaii Medical Service Association ABD	$11.90
Rate for Payer: Hawaii Medical Service Association Commercial	$10.78
Rate for Payer: Hawaii Medical Service Association Medicare	$22.32
Rate for Payer: Hawaii Medical Service Association Non-ABD	$12.50
Rate for Payer: Hawaii Western Management Group Commercial	$8.62
Rate for Payer: Health Management Network Commercial	$61.20
Rate for Payer: Humana Medicare	$22.32
Rate for Payer: Kaiser Permanente Commercial	$64.80
Rate for Payer: Kaiser Permanente Medicaid	$36.72
Rate for Payer: Kaiser Permanente Medicare	$22.32
Rate for Payer: MDX Hawaii PPO	$69.84
Rate for Payer: Ohana Health Plan Medicaid	$22.32
Rate for Payer: Ohana Health Plan Medicare	$22.32
Rate for Payer: UnitedHealthcare Medicaid	$11.90
Rate for Payer: UnitedHealthcare Medicare	$22.32
Rate for Payer: University Health Alliance Commercial	$22.26

HC CULT FUNGUS ID YEAST EA

Facility

$87.00

Service Code	HCPCS 87106
Hospital Charge Code	3068710601
Hospital Revenue Code	306
Min. Negotiated Rate	$73.95
Max. Negotiated Rate	$84.39
Rate for Payer: Cash Price	$52.20
Rate for Payer: Health Management Network Commercial	$73.95
Rate for Payer: Kaiser Permanente Commercial	$78.30
Rate for Payer: MDX Hawaii PPO	$84.39

HC CULT FUNGUS ID YEAST EA

Facility

$87.00

Service Code	HCPCS 87106
Hospital Charge Code	3068710601
Hospital Revenue Code	306
Min. Negotiated Rate	$10.32
Max. Negotiated Rate	$84.39
Rate for Payer: AlohaCare Medicaid	$43.50
Rate for Payer: AlohaCare Medicare	$26.97
Rate for Payer: Cash Price	$52.20
Rate for Payer: Cash Price	$52.20
Rate for Payer: Devoted Health Medicare	$29.58
Rate for Payer: Hawaii Medical Service Association ABD	$14.27
Rate for Payer: Hawaii Medical Service Association Commercial	$12.90
Rate for Payer: Hawaii Medical Service Association Medicare	$26.97
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14.98
Rate for Payer: Hawaii Western Management Group Commercial	$10.32
Rate for Payer: Health Management Network Commercial	$73.95
Rate for Payer: Humana Medicare	$26.97
Rate for Payer: Kaiser Permanente Commercial	$78.30
Rate for Payer: Kaiser Permanente Medicaid	$44.37
Rate for Payer: Kaiser Permanente Medicare	$26.97
Rate for Payer: MDX Hawaii PPO	$84.39
Rate for Payer: Ohana Health Plan Medicaid	$26.97
Rate for Payer: Ohana Health Plan Medicare	$26.97
Rate for Payer: UnitedHealthcare Medicaid	$14.27
Rate for Payer: UnitedHealthcare Medicare	$26.97
Rate for Payer: University Health Alliance Commercial	$26.68

HC CULT SPUTUM

Facility

$72.00

Service Code	HCPCS 87070
Hospital Charge Code	3068707006
Hospital Revenue Code	306
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$69.84
Rate for Payer: AlohaCare Medicaid	$36.00
Rate for Payer: AlohaCare Medicare	$22.32
Rate for Payer: Cash Price	$43.20
Rate for Payer: Cash Price	$43.20
Rate for Payer: Devoted Health Medicare	$24.48
Rate for Payer: Hawaii Medical Service Association ABD	$11.90
Rate for Payer: Hawaii Medical Service Association Commercial	$10.78
Rate for Payer: Hawaii Medical Service Association Medicare	$22.32
Rate for Payer: Hawaii Medical Service Association Non-ABD	$12.50
Rate for Payer: Hawaii Western Management Group Commercial	$8.62
Rate for Payer: Health Management Network Commercial	$61.20
Rate for Payer: Humana Medicare	$22.32
Rate for Payer: Kaiser Permanente Commercial	$64.80
Rate for Payer: Kaiser Permanente Medicaid	$36.72
Rate for Payer: Kaiser Permanente Medicare	$22.32
Rate for Payer: MDX Hawaii PPO	$69.84
Rate for Payer: Ohana Health Plan Medicaid	$22.32
Rate for Payer: Ohana Health Plan Medicare	$22.32
Rate for Payer: UnitedHealthcare Medicaid	$11.90
Rate for Payer: UnitedHealthcare Medicare	$22.32
Rate for Payer: University Health Alliance Commercial	$22.26

HC CULT SPUTUM

Facility

$72.00

Service Code	HCPCS 87070
Hospital Charge Code	3068707006
Hospital Revenue Code	306
Min. Negotiated Rate	$61.20
Max. Negotiated Rate	$69.84
Rate for Payer: Cash Price	$43.20
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

HC CULT STOOL

Facility

$79.00

Service Code	HCPCS 87045
Hospital Charge Code	3068704501
Hospital Revenue Code	306
Min. Negotiated Rate	$9.44
Max. Negotiated Rate	$76.63
Rate for Payer: AlohaCare Medicaid	$39.50
Rate for Payer: AlohaCare Medicare	$24.49
Rate for Payer: Cash Price	$47.40
Rate for Payer: Cash Price	$47.40
Rate for Payer: Devoted Health Medicare	$26.86
Rate for Payer: Hawaii Medical Service Association ABD	$13.04
Rate for Payer: Hawaii Medical Service Association Commercial	$11.80
Rate for Payer: Hawaii Medical Service Association Medicare	$24.49
Rate for Payer: Hawaii Medical Service Association Non-ABD	$13.69
Rate for Payer: Hawaii Western Management Group Commercial	$9.44
Rate for Payer: Health Management Network Commercial	$67.15
Rate for Payer: Humana Medicare	$24.49
Rate for Payer: Kaiser Permanente Commercial	$71.10
Rate for Payer: Kaiser Permanente Medicaid	$40.29
Rate for Payer: Kaiser Permanente Medicare	$24.49
Rate for Payer: MDX Hawaii PPO	$76.63
Rate for Payer: Ohana Health Plan Medicaid	$24.49
Rate for Payer: Ohana Health Plan Medicare	$24.49
Rate for Payer: UnitedHealthcare Medicaid	$13.04
Rate for Payer: UnitedHealthcare Medicare	$24.49
Rate for Payer: University Health Alliance Commercial	$24.38

HC CULT STOOL

Facility

$79.00

Service Code	HCPCS 87045
Hospital Charge Code	3068704501
Hospital Revenue Code	306
Min. Negotiated Rate	$67.15
Max. Negotiated Rate	$76.63
Rate for Payer: Cash Price	$47.40
Rate for Payer: Health Management Network Commercial	$67.15
Rate for Payer: Kaiser Permanente Commercial	$71.10
Rate for Payer: MDX Hawaii PPO	$76.63

HC CULT THROAT

Facility

$72.00

Service Code	HCPCS 87070
Hospital Charge Code	3068707008
Hospital Revenue Code	306
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$69.84
Rate for Payer: AlohaCare Medicaid	$36.00
Rate for Payer: AlohaCare Medicare	$22.32
Rate for Payer: Cash Price	$43.20
Rate for Payer: Cash Price	$43.20
Rate for Payer: Devoted Health Medicare	$24.48
Rate for Payer: Hawaii Medical Service Association ABD	$11.90
Rate for Payer: Hawaii Medical Service Association Commercial	$10.78
Rate for Payer: Hawaii Medical Service Association Medicare	$22.32
Rate for Payer: Hawaii Medical Service Association Non-ABD	$12.50
Rate for Payer: Hawaii Western Management Group Commercial	$8.62
Rate for Payer: Health Management Network Commercial	$61.20
Rate for Payer: Humana Medicare	$22.32
Rate for Payer: Kaiser Permanente Commercial	$64.80
Rate for Payer: Kaiser Permanente Medicaid	$36.72
Rate for Payer: Kaiser Permanente Medicare	$22.32
Rate for Payer: MDX Hawaii PPO	$69.84
Rate for Payer: Ohana Health Plan Medicaid	$22.32
Rate for Payer: Ohana Health Plan Medicare	$22.32
Rate for Payer: UnitedHealthcare Medicaid	$11.90
Rate for Payer: UnitedHealthcare Medicare	$22.32
Rate for Payer: University Health Alliance Commercial	$22.26

HC CULT THROAT

Facility

$72.00

Service Code	HCPCS 87070
Hospital Charge Code	3068707008
Hospital Revenue Code	306
Min. Negotiated Rate	$61.20
Max. Negotiated Rate	$69.84
Rate for Payer: Cash Price	$43.20
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

HC CULTURE HERPES SO

Facility

$219.00

Service Code	HCPCS 87252
Hospital Charge Code	3068725201
Hospital Revenue Code	306
Min. Negotiated Rate	$186.15
Max. Negotiated Rate	$212.43
Rate for Payer: Cash Price	$131.40
Rate for Payer: Health Management Network Commercial	$186.15
Rate for Payer: Kaiser Permanente Commercial	$197.10
Rate for Payer: MDX Hawaii PPO	$212.43

HC CULTURE HERPES SO

Facility

$219.00

Service Code	HCPCS 87252
Hospital Charge Code	3068725201
Hospital Revenue Code	306
Min. Negotiated Rate	$26.07
Max. Negotiated Rate	$212.43
Rate for Payer: AlohaCare Medicaid	$109.50
Rate for Payer: AlohaCare Medicare	$67.89
Rate for Payer: Cash Price	$131.40
Rate for Payer: Cash Price	$131.40
Rate for Payer: Devoted Health Medicare	$74.46
Rate for Payer: Hawaii Medical Service Association ABD	$36.02
Rate for Payer: Hawaii Medical Service Association Commercial	$32.59
Rate for Payer: Hawaii Medical Service Association Medicare	$67.89
Rate for Payer: Hawaii Medical Service Association Non-ABD	$37.82
Rate for Payer: Hawaii Western Management Group Commercial	$26.07
Rate for Payer: Health Management Network Commercial	$186.15
Rate for Payer: Humana Medicare	$67.89
Rate for Payer: Kaiser Permanente Commercial	$197.10
Rate for Payer: Kaiser Permanente Medicaid	$111.69
Rate for Payer: Kaiser Permanente Medicare	$67.89
Rate for Payer: MDX Hawaii PPO	$212.43
Rate for Payer: Ohana Health Plan Medicaid	$67.89
Rate for Payer: Ohana Health Plan Medicare	$67.89
Rate for Payer: UnitedHealthcare Medicaid	$36.02
Rate for Payer: UnitedHealthcare Medicare	$67.89
Rate for Payer: University Health Alliance Commercial	$67.38

HC CULT URINE

Facility

$68.00

Service Code	HCPCS 87086
Hospital Charge Code	3068708601
Hospital Revenue Code	306
Min. Negotiated Rate	$57.80
Max. Negotiated Rate	$65.96
Rate for Payer: Cash Price	$40.80
Rate for Payer: Health Management Network Commercial	$57.80
Rate for Payer: Kaiser Permanente Commercial	$61.20
Rate for Payer: MDX Hawaii PPO	$65.96

Know your out-of-pocket cost for care.

All Charges