Kauai Veterans Memorial Hospital

All Charges

Charge

Type

Setting

Price

Bill Only Morph Ana Multiplex Each

Facility

$1,349.00

Service Code	HCPCS 88374 TC
Hospital Charge Code	8409287
Hospital Revenue Code	310
Min. Negotiated Rate	$28.79
Max. Negotiated Rate	$1,308.53
Rate for Payer: AlohaCare Medicaid	$674.50
Rate for Payer: AlohaCare Medicare	$674.50
Rate for Payer: Cash Price	$876.85
Rate for Payer: Cash Price	$876.85
Rate for Payer: Devoted Health Medicare	$741.95
Rate for Payer: Hawaii Medical Service Association ABD	$28.79
Rate for Payer: Hawaii Medical Service Association Medicare	$674.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$160.01
Rate for Payer: Hawaii Western Management Group Commercial	$1,281.55
Rate for Payer: Health Management Network Commercial	$1,146.65
Rate for Payer: Humana Medicare	$674.50
Rate for Payer: Kaiser Permanente Commercial	$1,214.10
Rate for Payer: Kaiser Permanente Medicaid	$687.99
Rate for Payer: Kaiser Permanente Medicare	$674.50
Rate for Payer: MDX Hawaii PPO	$1,308.53
Rate for Payer: Ohana Health Plan Medicaid	$674.50
Rate for Payer: Ohana Health Plan Medicare	$674.50
Rate for Payer: UnitedHealthcare Medicaid	$195.04
Rate for Payer: UnitedHealthcare Medicare	$674.50
Rate for Payer: University Health Alliance Commercial	$651.94

Bill Only Morph Ana Multiplex Each

Facility

$1,349.00

Service Code	HCPCS 88374 TC
Hospital Charge Code	8409287
Hospital Revenue Code	310
Min. Negotiated Rate	$1,146.65
Max. Negotiated Rate	$1,308.53
Rate for Payer: Cash Price	$876.85
Rate for Payer: Health Management Network Commercial	$1,146.65
Rate for Payer: Kaiser Permanente Commercial	$1,214.10
Rate for Payer: MDX Hawaii PPO	$1,308.53

Bill Only Morphometric Ana Nerve

Facility

$412.00

Service Code	HCPCS 88356 TC
Hospital Charge Code	8409283
Hospital Revenue Code	310
Min. Negotiated Rate	$350.20
Max. Negotiated Rate	$399.64
Rate for Payer: Cash Price	$267.80
Rate for Payer: Health Management Network Commercial	$350.20
Rate for Payer: Kaiser Permanente Commercial	$370.80
Rate for Payer: MDX Hawaii PPO	$399.64

Bill Only Morphometric Ana Nerve

Facility

$412.00

Service Code	HCPCS 88356 TC
Hospital Charge Code	8409283
Hospital Revenue Code	310
Min. Negotiated Rate	$96.16
Max. Negotiated Rate	$399.64
Rate for Payer: AlohaCare Medicaid	$206.00
Rate for Payer: AlohaCare Medicare	$206.00
Rate for Payer: Cash Price	$267.80
Rate for Payer: Cash Price	$267.80
Rate for Payer: Devoted Health Medicare	$226.60
Rate for Payer: Hawaii Medical Service Association ABD	$178.32
Rate for Payer: Hawaii Medical Service Association Medicare	$206.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$96.16
Rate for Payer: Hawaii Western Management Group Commercial	$391.40
Rate for Payer: Health Management Network Commercial	$350.20
Rate for Payer: Humana Medicare	$206.00
Rate for Payer: Kaiser Permanente Commercial	$370.80
Rate for Payer: Kaiser Permanente Medicaid	$210.12
Rate for Payer: Kaiser Permanente Medicare	$206.00
Rate for Payer: MDX Hawaii PPO	$399.64
Rate for Payer: Ohana Health Plan Medicaid	$206.00
Rate for Payer: Ohana Health Plan Medicare	$206.00
Rate for Payer: UnitedHealthcare Medicaid	$178.32
Rate for Payer: UnitedHealthcare Medicare	$206.00
Rate for Payer: University Health Alliance Commercial	$312.02

Bill Only MTB Complex Speciation

Facility

$365.00

Service Code	HCPCS 87150
Hospital Charge Code	8301474
Hospital Revenue Code	306
Min. Negotiated Rate	$35.09
Max. Negotiated Rate	$354.05
Rate for Payer: AlohaCare Medicaid	$182.50
Rate for Payer: AlohaCare Medicare	$182.50
Rate for Payer: Cash Price	$237.25
Rate for Payer: Cash Price	$237.25
Rate for Payer: Devoted Health Medicare	$200.75
Rate for Payer: Hawaii Medical Service Association ABD	$50.27
Rate for Payer: Hawaii Medical Service Association Commercial	$43.86
Rate for Payer: Hawaii Medical Service Association Medicare	$182.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$50.93
Rate for Payer: Hawaii Western Management Group Commercial	$35.09
Rate for Payer: Health Management Network Commercial	$310.25
Rate for Payer: Humana Medicare	$182.50
Rate for Payer: Kaiser Permanente Commercial	$328.50
Rate for Payer: Kaiser Permanente Medicaid	$186.15
Rate for Payer: Kaiser Permanente Medicare	$182.50
Rate for Payer: MDX Hawaii PPO	$354.05
Rate for Payer: Ohana Health Plan Medicaid	$182.50
Rate for Payer: Ohana Health Plan Medicare	$182.50
Rate for Payer: UnitedHealthcare Medicaid	$50.27
Rate for Payer: UnitedHealthcare Medicare	$182.50
Rate for Payer: University Health Alliance Commercial	$91.37

Bill Only MTB Complex Speciation

Facility

$365.00

Service Code	HCPCS 87150
Hospital Charge Code	8301474
Hospital Revenue Code	306
Min. Negotiated Rate	$310.25
Max. Negotiated Rate	$354.05
Rate for Payer: Cash Price	$237.25
Rate for Payer: Health Management Network Commercial	$310.25
Rate for Payer: Kaiser Permanente Commercial	$328.50
Rate for Payer: MDX Hawaii PPO	$354.05

Bill Only M tb Direct Probe Fee

Facility

$230.00

Service Code	HCPCS 87555
Hospital Charge Code	8301500
Hospital Revenue Code	306
Min. Negotiated Rate	$26.88
Max. Negotiated Rate	$223.10
Rate for Payer: AlohaCare Medicaid	$115.00
Rate for Payer: AlohaCare Medicare	$115.00
Rate for Payer: Cash Price	$149.50
Rate for Payer: Cash Price	$149.50
Rate for Payer: Devoted Health Medicare	$126.50
Rate for Payer: Hawaii Medical Service Association ABD	$27.71
Rate for Payer: Hawaii Medical Service Association Commercial	$33.60
Rate for Payer: Hawaii Medical Service Association Medicare	$115.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$29.10
Rate for Payer: Hawaii Western Management Group Commercial	$26.88
Rate for Payer: Health Management Network Commercial	$195.50
Rate for Payer: Humana Medicare	$115.00
Rate for Payer: Kaiser Permanente Commercial	$207.00
Rate for Payer: Kaiser Permanente Medicaid	$117.30
Rate for Payer: Kaiser Permanente Medicare	$115.00
Rate for Payer: MDX Hawaii PPO	$223.10
Rate for Payer: Ohana Health Plan Medicaid	$115.00
Rate for Payer: Ohana Health Plan Medicare	$115.00
Rate for Payer: UnitedHealthcare Medicaid	$27.71
Rate for Payer: UnitedHealthcare Medicare	$115.00
Rate for Payer: University Health Alliance Commercial	$51.84

Bill Only M tb Direct Probe Fee

Facility

$230.00

Service Code	HCPCS 87555
Hospital Charge Code	8301500
Hospital Revenue Code	306
Min. Negotiated Rate	$195.50
Max. Negotiated Rate	$223.10
Rate for Payer: Cash Price	$149.50
Rate for Payer: Health Management Network Commercial	$195.50
Rate for Payer: Kaiser Permanente Commercial	$207.00
Rate for Payer: MDX Hawaii PPO	$223.10

Bill Only Org ID Mchelonae Abc

Facility

$365.00

Service Code	HCPCS 87150
Hospital Charge Code	8301472
Hospital Revenue Code	306
Min. Negotiated Rate	$35.09
Max. Negotiated Rate	$354.05
Rate for Payer: AlohaCare Medicaid	$182.50
Rate for Payer: AlohaCare Medicare	$182.50
Rate for Payer: Cash Price	$237.25
Rate for Payer: Cash Price	$237.25
Rate for Payer: Devoted Health Medicare	$200.75
Rate for Payer: Hawaii Medical Service Association ABD	$50.27
Rate for Payer: Hawaii Medical Service Association Commercial	$43.86
Rate for Payer: Hawaii Medical Service Association Medicare	$182.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$50.93
Rate for Payer: Hawaii Western Management Group Commercial	$35.09
Rate for Payer: Health Management Network Commercial	$310.25
Rate for Payer: Humana Medicare	$182.50
Rate for Payer: Kaiser Permanente Commercial	$328.50
Rate for Payer: Kaiser Permanente Medicaid	$186.15
Rate for Payer: Kaiser Permanente Medicare	$182.50
Rate for Payer: MDX Hawaii PPO	$354.05
Rate for Payer: Ohana Health Plan Medicaid	$182.50
Rate for Payer: Ohana Health Plan Medicare	$182.50
Rate for Payer: UnitedHealthcare Medicaid	$50.27
Rate for Payer: UnitedHealthcare Medicare	$182.50
Rate for Payer: University Health Alliance Commercial	$91.37

Bill Only Org ID Mchelonae Abc

Facility

$365.00

Service Code	HCPCS 87150
Hospital Charge Code	8301472
Hospital Revenue Code	306
Min. Negotiated Rate	$310.25
Max. Negotiated Rate	$354.05
Rate for Payer: Cash Price	$237.25
Rate for Payer: Health Management Network Commercial	$310.25
Rate for Payer: Kaiser Permanente Commercial	$328.50
Rate for Payer: MDX Hawaii PPO	$354.05

Bill Only ORG IDX2

Facility

$119.00

Service Code	HCPCS 87077
Hospital Charge Code	8301493
Hospital Revenue Code	306
Min. Negotiated Rate	$101.15
Max. Negotiated Rate	$115.43
Rate for Payer: Cash Price	$77.35
Rate for Payer: Health Management Network Commercial	$101.15
Rate for Payer: Kaiser Permanente Commercial	$107.10
Rate for Payer: MDX Hawaii PPO	$115.43

Bill Only ORG IDX2

Facility

$119.00

Service Code	HCPCS 87077
Hospital Charge Code	8301493
Hospital Revenue Code	306
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$115.43
Rate for Payer: AlohaCare Medicaid	$59.50
Rate for Payer: AlohaCare Medicare	$59.50
Rate for Payer: Cash Price	$77.35
Rate for Payer: Cash Price	$77.35
Rate for Payer: Devoted Health Medicare	$65.45
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	$59.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$11.72
Rate for Payer: Hawaii Western Management Group Commercial	$8.08
Rate for Payer: Health Management Network Commercial	$101.15
Rate for Payer: Humana Medicare	$59.50
Rate for Payer: Kaiser Permanente Commercial	$107.10
Rate for Payer: Kaiser Permanente Medicaid	$60.69
Rate for Payer: Kaiser Permanente Medicare	$59.50
Rate for Payer: MDX Hawaii PPO	$115.43
Rate for Payer: Ohana Health Plan Medicaid	$59.50
Rate for Payer: Ohana Health Plan Medicare	$59.50
Rate for Payer: UnitedHealthcare Medicaid	$11.16
Rate for Payer: UnitedHealthcare Medicare	$59.50
Rate for Payer: University Health Alliance Commercial	$20.89

Bill Only ORG IDX3

Facility

$119.00

Service Code	HCPCS 87077
Hospital Charge Code	8301494
Hospital Revenue Code	306
Min. Negotiated Rate	$101.15
Max. Negotiated Rate	$115.43
Rate for Payer: Cash Price	$77.35
Rate for Payer: Health Management Network Commercial	$101.15
Rate for Payer: Kaiser Permanente Commercial	$107.10
Rate for Payer: MDX Hawaii PPO	$115.43

Bill Only ORG IDX3

Facility

$119.00

Service Code	HCPCS 87077
Hospital Charge Code	8301494
Hospital Revenue Code	306
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$115.43
Rate for Payer: AlohaCare Medicaid	$59.50
Rate for Payer: AlohaCare Medicare	$59.50
Rate for Payer: Cash Price	$77.35
Rate for Payer: Cash Price	$77.35
Rate for Payer: Devoted Health Medicare	$65.45
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	$59.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$11.72
Rate for Payer: Hawaii Western Management Group Commercial	$8.08
Rate for Payer: Health Management Network Commercial	$101.15
Rate for Payer: Humana Medicare	$59.50
Rate for Payer: Kaiser Permanente Commercial	$107.10
Rate for Payer: Kaiser Permanente Medicaid	$60.69
Rate for Payer: Kaiser Permanente Medicare	$59.50
Rate for Payer: MDX Hawaii PPO	$115.43
Rate for Payer: Ohana Health Plan Medicaid	$59.50
Rate for Payer: Ohana Health Plan Medicare	$59.50
Rate for Payer: UnitedHealthcare Medicaid	$11.16
Rate for Payer: UnitedHealthcare Medicare	$59.50
Rate for Payer: University Health Alliance Commercial	$20.89

Bill Only ORG IDX4

Facility

$119.00

Service Code	HCPCS 87077
Hospital Charge Code	8301495
Hospital Revenue Code	306
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$115.43
Rate for Payer: AlohaCare Medicaid	$59.50
Rate for Payer: AlohaCare Medicare	$59.50
Rate for Payer: Cash Price	$77.35
Rate for Payer: Cash Price	$77.35
Rate for Payer: Devoted Health Medicare	$65.45
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	$59.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$11.72
Rate for Payer: Hawaii Western Management Group Commercial	$8.08
Rate for Payer: Health Management Network Commercial	$101.15
Rate for Payer: Humana Medicare	$59.50
Rate for Payer: Kaiser Permanente Commercial	$107.10
Rate for Payer: Kaiser Permanente Medicaid	$60.69
Rate for Payer: Kaiser Permanente Medicare	$59.50
Rate for Payer: MDX Hawaii PPO	$115.43
Rate for Payer: Ohana Health Plan Medicaid	$59.50
Rate for Payer: Ohana Health Plan Medicare	$59.50
Rate for Payer: UnitedHealthcare Medicaid	$11.16
Rate for Payer: UnitedHealthcare Medicare	$59.50
Rate for Payer: University Health Alliance Commercial	$20.89

Bill Only ORG IDX4

Facility

$119.00

Service Code	HCPCS 87077
Hospital Charge Code	8301495
Hospital Revenue Code	306
Min. Negotiated Rate	$101.15
Max. Negotiated Rate	$115.43
Rate for Payer: Cash Price	$77.35
Rate for Payer: Health Management Network Commercial	$101.15
Rate for Payer: Kaiser Permanente Commercial	$107.10
Rate for Payer: MDX Hawaii PPO	$115.43

Bill Only Pap Smear Gyn

Facility

$136.00

Service Code	HCPCS 88164
Hospital Charge Code	8409271
Hospital Revenue Code	311
Min. Negotiated Rate	$14.60
Max. Negotiated Rate	$131.92
Rate for Payer: AlohaCare Medicaid	$68.00
Rate for Payer: AlohaCare Medicare	$68.00
Rate for Payer: Cash Price	$88.40
Rate for Payer: Cash Price	$88.40
Rate for Payer: Devoted Health Medicare	$74.80
Rate for Payer: Hawaii Medical Service Association ABD	$14.60
Rate for Payer: Hawaii Medical Service Association Commercial	$23.18
Rate for Payer: Hawaii Medical Service Association Medicare	$68.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$15.23
Rate for Payer: Hawaii Western Management Group Commercial	$18.54
Rate for Payer: Health Management Network Commercial	$115.60
Rate for Payer: Humana Medicare	$68.00
Rate for Payer: Kaiser Permanente Commercial	$122.40
Rate for Payer: Kaiser Permanente Medicaid	$69.36
Rate for Payer: Kaiser Permanente Medicare	$68.00
Rate for Payer: MDX Hawaii PPO	$131.92
Rate for Payer: Ohana Health Plan Medicaid	$68.00
Rate for Payer: Ohana Health Plan Medicare	$68.00
Rate for Payer: UnitedHealthcare Medicaid	$14.60
Rate for Payer: UnitedHealthcare Medicare	$68.00
Rate for Payer: University Health Alliance Commercial	$27.31

Bill Only Pap Smear Gyn

Facility

$136.00

Service Code	HCPCS 88164
Hospital Charge Code	8409271
Hospital Revenue Code	311
Min. Negotiated Rate	$115.60
Max. Negotiated Rate	$131.92
Rate for Payer: Cash Price	$88.40
Rate for Payer: Health Management Network Commercial	$115.60
Rate for Payer: Kaiser Permanente Commercial	$122.40
Rate for Payer: MDX Hawaii PPO	$131.92

Bill Only Phlebotomy

Facility

$66.00

Service Code	HCPCS 36415
Hospital Charge Code	8301488
Hospital Revenue Code	300
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$64.02
Rate for Payer: AlohaCare Medicaid	$33.00
Rate for Payer: AlohaCare Medicare	$33.00
Rate for Payer: Cash Price	$42.90
Rate for Payer: Cash Price	$42.90
Rate for Payer: Devoted Health Medicare	$36.30
Rate for Payer: Hawaii Medical Service Association Commercial	$11.68
Rate for Payer: Hawaii Medical Service Association Medicare	$33.00
Rate for Payer: Hawaii Western Management Group Commercial	$62.70
Rate for Payer: Health Management Network Commercial	$56.10
Rate for Payer: Humana Medicare	$33.00
Rate for Payer: Kaiser Permanente Commercial	$59.40
Rate for Payer: Kaiser Permanente Medicaid	$33.66
Rate for Payer: Kaiser Permanente Medicare	$33.00
Rate for Payer: MDX Hawaii PPO	$64.02
Rate for Payer: Ohana Health Plan Medicaid	$33.00
Rate for Payer: Ohana Health Plan Medicare	$33.00
Rate for Payer: UnitedHealthcare Medicaid	$3.00
Rate for Payer: UnitedHealthcare Medicare	$33.00
Rate for Payer: University Health Alliance Commercial	$48.11

Bill Only Phlebotomy

Facility

$66.00

Service Code	HCPCS 36415
Hospital Charge Code	8301488
Hospital Revenue Code	300
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$64.02
Rate for Payer: Cash Price	$42.90
Rate for Payer: Health Management Network Commercial	$56.10
Rate for Payer: Kaiser Permanente Commercial	$59.40
Rate for Payer: MDX Hawaii PPO	$64.02

Bill Only PLT Neut

Facility

$166.00

Service Code	HCPCS 85597
Hospital Charge Code	8301503
Hospital Revenue Code	305
Min. Negotiated Rate	$141.10
Max. Negotiated Rate	$161.02
Rate for Payer: Cash Price	$107.90
Rate for Payer: Health Management Network Commercial	$141.10
Rate for Payer: Kaiser Permanente Commercial	$149.40
Rate for Payer: MDX Hawaii PPO	$161.02

Bill Only PLT Neut

Facility

$166.00

Service Code	HCPCS 85597
Hospital Charge Code	8301503
Hospital Revenue Code	305
Min. Negotiated Rate	$17.98
Max. Negotiated Rate	$161.02
Rate for Payer: AlohaCare Medicaid	$83.00
Rate for Payer: AlohaCare Medicare	$83.00
Rate for Payer: Cash Price	$107.90
Rate for Payer: Cash Price	$107.90
Rate for Payer: Devoted Health Medicare	$91.30
Rate for Payer: Hawaii Medical Service Association ABD	$24.84
Rate for Payer: Hawaii Medical Service Association Commercial	$22.48
Rate for Payer: Hawaii Medical Service Association Medicare	$83.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$26.08
Rate for Payer: Hawaii Western Management Group Commercial	$17.98
Rate for Payer: Health Management Network Commercial	$141.10
Rate for Payer: Humana Medicare	$83.00
Rate for Payer: Kaiser Permanente Commercial	$149.40
Rate for Payer: Kaiser Permanente Medicaid	$84.66
Rate for Payer: Kaiser Permanente Medicare	$83.00
Rate for Payer: MDX Hawaii PPO	$161.02
Rate for Payer: Ohana Health Plan Medicaid	$83.00
Rate for Payer: Ohana Health Plan Medicare	$83.00
Rate for Payer: UnitedHealthcare Medicaid	$24.84
Rate for Payer: UnitedHealthcare Medicare	$83.00
Rate for Payer: University Health Alliance Commercial	$46.47

Bill Only PTT Mix

Facility

$69.00

Service Code	HCPCS 85732
Hospital Charge Code	8301504
Hospital Revenue Code	305
Min. Negotiated Rate	$6.47
Max. Negotiated Rate	$66.93
Rate for Payer: AlohaCare Medicaid	$34.50
Rate for Payer: AlohaCare Medicare	$34.50
Rate for Payer: Cash Price	$44.85
Rate for Payer: Cash Price	$44.85
Rate for Payer: Devoted Health Medicare	$37.95
Rate for Payer: Hawaii Medical Service Association ABD	$8.95
Rate for Payer: Hawaii Medical Service Association Commercial	$8.09
Rate for Payer: Hawaii Medical Service Association Medicare	$34.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9.40
Rate for Payer: Hawaii Western Management Group Commercial	$6.47
Rate for Payer: Health Management Network Commercial	$58.65
Rate for Payer: Humana Medicare	$34.50
Rate for Payer: Kaiser Permanente Commercial	$62.10
Rate for Payer: Kaiser Permanente Medicaid	$35.19
Rate for Payer: Kaiser Permanente Medicare	$34.50
Rate for Payer: MDX Hawaii PPO	$66.93
Rate for Payer: Ohana Health Plan Medicaid	$34.50
Rate for Payer: Ohana Health Plan Medicare	$34.50
Rate for Payer: UnitedHealthcare Medicaid	$8.95
Rate for Payer: UnitedHealthcare Medicare	$34.50
Rate for Payer: University Health Alliance Commercial	$16.72

Bill Only PTT Mix

Facility

$69.00

Service Code	HCPCS 85732
Hospital Charge Code	8301504
Hospital Revenue Code	305
Min. Negotiated Rate	$58.65
Max. Negotiated Rate	$66.93
Rate for Payer: Cash Price	$44.85
Rate for Payer: Health Management Network Commercial	$58.65
Rate for Payer: Kaiser Permanente Commercial	$62.10
Rate for Payer: MDX Hawaii PPO	$66.93

Bill Only Reptilase Time

Facility

$96.00

Service Code	HCPCS 85635
Hospital Charge Code	8301485
Hospital Revenue Code	305
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$93.12
Rate for Payer: AlohaCare Medicaid	$48.00
Rate for Payer: AlohaCare Medicare	$48.00
Rate for Payer: Cash Price	$62.40
Rate for Payer: Cash Price	$62.40
Rate for Payer: Devoted Health Medicare	$52.80
Rate for Payer: Hawaii Medical Service Association ABD	$8.26
Rate for Payer: Hawaii Medical Service Association Commercial	$12.31
Rate for Payer: Hawaii Medical Service Association Medicare	$48.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$13.61
Rate for Payer: Hawaii Western Management Group Commercial	$9.85
Rate for Payer: Health Management Network Commercial	$81.60
Rate for Payer: Humana Medicare	$48.00
Rate for Payer: Kaiser Permanente Commercial	$86.40
Rate for Payer: Kaiser Permanente Medicaid	$48.96
Rate for Payer: Kaiser Permanente Medicare	$48.00
Rate for Payer: MDX Hawaii PPO	$93.12
Rate for Payer: Ohana Health Plan Medicaid	$48.00
Rate for Payer: Ohana Health Plan Medicare	$48.00
Rate for Payer: UnitedHealthcare Medicaid	$8.26
Rate for Payer: UnitedHealthcare Medicare	$48.00
Rate for Payer: University Health Alliance Commercial	$25.46

Know your out-of-pocket cost for care.

All Charges