Kauai Veterans Memorial Hospital

All Charges

Charge

Type

Setting

Price

Creatinine Arterial POCT

Facility

$63.00

Service Code	HCPCS 82565
Hospital Charge Code	9364667
Hospital Revenue Code	301
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$61.11
Rate for Payer: AlohaCare Medicaid	$31.50
Rate for Payer: AlohaCare Medicare	$31.50
Rate for Payer: Cash Price	$40.95
Rate for Payer: Cash Price	$40.95
Rate for Payer: Devoted Health Medicare	$34.65
Rate for Payer: Hawaii Medical Service Association ABD	$7.07
Rate for Payer: Hawaii Medical Service Association Commercial	$6.40
Rate for Payer: Hawaii Medical Service Association Medicare	$31.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.42
Rate for Payer: Hawaii Western Management Group Commercial	$5.12
Rate for Payer: Health Management Network Commercial	$53.55
Rate for Payer: Humana Medicare	$31.50
Rate for Payer: Kaiser Permanente Commercial	$56.70
Rate for Payer: Kaiser Permanente Medicaid	$32.13
Rate for Payer: Kaiser Permanente Medicare	$31.50
Rate for Payer: MDX Hawaii PPO	$61.11
Rate for Payer: Ohana Health Plan Medicaid	$31.50
Rate for Payer: Ohana Health Plan Medicare	$31.50
Rate for Payer: UnitedHealthcare Medicaid	$7.07
Rate for Payer: UnitedHealthcare Medicare	$31.50
Rate for Payer: University Health Alliance Commercial	$13.25

Creatinine Arterial POCT

Facility

$63.00

Service Code	HCPCS 82565
Hospital Charge Code	9364667
Hospital Revenue Code	301
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$61.11
Rate for Payer: Cash Price	$40.95
Rate for Payer: Health Management Network Commercial	$53.55
Rate for Payer: Kaiser Permanente Commercial	$56.70
Rate for Payer: MDX Hawaii PPO	$61.11

Creatinine Clearance FSI

Facility

$110.00

Service Code	HCPCS 82575
Hospital Charge Code	8117895
Hospital Revenue Code	301
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$106.70
Rate for Payer: AlohaCare Medicaid	$55.00
Rate for Payer: AlohaCare Medicare	$55.00
Rate for Payer: Cash Price	$71.50
Rate for Payer: Cash Price	$71.50
Rate for Payer: Devoted Health Medicare	$60.50
Rate for Payer: Hawaii Medical Service Association ABD	$13.06
Rate for Payer: Hawaii Medical Service Association Commercial	$11.82
Rate for Payer: Hawaii Medical Service Association Medicare	$55.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$13.71
Rate for Payer: Hawaii Western Management Group Commercial	$9.46
Rate for Payer: Health Management Network Commercial	$93.50
Rate for Payer: Humana Medicare	$55.00
Rate for Payer: Kaiser Permanente Commercial	$99.00
Rate for Payer: Kaiser Permanente Medicaid	$56.10
Rate for Payer: Kaiser Permanente Medicare	$55.00
Rate for Payer: MDX Hawaii PPO	$106.70
Rate for Payer: Ohana Health Plan Medicaid	$55.00
Rate for Payer: Ohana Health Plan Medicare	$55.00
Rate for Payer: UnitedHealthcare Medicaid	$13.06
Rate for Payer: UnitedHealthcare Medicare	$55.00
Rate for Payer: University Health Alliance Commercial	$24.42

Creatinine Clearance FSI

Facility

$110.00

Service Code	HCPCS 82575
Hospital Charge Code	8117895
Hospital Revenue Code	301
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$106.70
Rate for Payer: Cash Price	$71.50
Rate for Payer: Health Management Network Commercial	$93.50
Rate for Payer: Kaiser Permanente Commercial	$99.00
Rate for Payer: MDX Hawaii PPO	$106.70

Creatinine FSI

Facility

$88.00

Service Code	HCPCS 87075
Hospital Charge Code	8117896
Hospital Revenue Code	306
Min. Negotiated Rate	$9.47
Max. Negotiated Rate	$85.36
Rate for Payer: AlohaCare Medicaid	$44.00
Rate for Payer: AlohaCare Medicare	$44.00
Rate for Payer: Cash Price	$57.20
Rate for Payer: Cash Price	$57.20
Rate for Payer: Devoted Health Medicare	$48.40
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	$44.00
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	$74.80
Rate for Payer: Humana Medicare	$44.00
Rate for Payer: Kaiser Permanente Commercial	$79.20
Rate for Payer: Kaiser Permanente Medicaid	$44.88
Rate for Payer: Kaiser Permanente Medicare	$44.00
Rate for Payer: MDX Hawaii PPO	$85.36
Rate for Payer: Ohana Health Plan Medicaid	$44.00
Rate for Payer: Ohana Health Plan Medicare	$44.00
Rate for Payer: UnitedHealthcare Medicaid	$13.08
Rate for Payer: UnitedHealthcare Medicare	$44.00
Rate for Payer: University Health Alliance Commercial	$24.46

Creatinine FSI

Facility

$88.00

Service Code	HCPCS 87075
Hospital Charge Code	8117896
Hospital Revenue Code	306
Min. Negotiated Rate	$74.80
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$57.20
Rate for Payer: Health Management Network Commercial	$74.80
Rate for Payer: Kaiser Permanente Commercial	$79.20
Rate for Payer: MDX Hawaii PPO	$85.36

Creatinine iSTAT

Facility

$58.00

Service Code	HCPCS 82565 QW
Hospital Charge Code	8293265
Hospital Revenue Code	301
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$56.26
Rate for Payer: MDX Hawaii PPO	$56.26
Rate for Payer: AlohaCare Medicaid	$29.00
Rate for Payer: AlohaCare Medicare	$29.00
Rate for Payer: Cash Price	$37.70
Rate for Payer: Cash Price	$37.70
Rate for Payer: Devoted Health Medicare	$31.90
Rate for Payer: Hawaii Medical Service Association ABD	$7.07
Rate for Payer: Hawaii Medical Service Association Commercial	$6.40
Rate for Payer: Hawaii Medical Service Association Medicare	$29.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.42
Rate for Payer: Hawaii Western Management Group Commercial	$5.12
Rate for Payer: Health Management Network Commercial	$49.30
Rate for Payer: Humana Medicare	$29.00
Rate for Payer: Kaiser Permanente Commercial	$52.20
Rate for Payer: Kaiser Permanente Medicaid	$29.58
Rate for Payer: Kaiser Permanente Medicare	$29.00
Rate for Payer: Ohana Health Plan Medicaid	$29.00
Rate for Payer: Ohana Health Plan Medicare	$29.00
Rate for Payer: UnitedHealthcare Medicaid	$7.07
Rate for Payer: UnitedHealthcare Medicare	$29.00
Rate for Payer: University Health Alliance Commercial	$13.25

Creatinine iSTAT

Facility

$58.00

Service Code	HCPCS 82565 QW
Hospital Charge Code	8293265
Hospital Revenue Code	301
Min. Negotiated Rate	$49.30
Max. Negotiated Rate	$56.26
Rate for Payer: Cash Price	$37.70
Rate for Payer: Health Management Network Commercial	$49.30
Rate for Payer: Kaiser Permanente Commercial	$52.20
Rate for Payer: MDX Hawaii PPO	$56.26

Creatinine Kinase

Facility

$57.00

Service Code	HCPCS 82550
Hospital Charge Code	12499888
Hospital Revenue Code	301
Min. Negotiated Rate	$48.45
Max. Negotiated Rate	$55.29
Rate for Payer: Cash Price	$37.05
Rate for Payer: Health Management Network Commercial	$48.45
Rate for Payer: Kaiser Permanente Commercial	$51.30
Rate for Payer: MDX Hawaii PPO	$55.29

Creatinine Kinase

Facility

$57.00

Service Code	HCPCS 82550
Hospital Charge Code	12499888
Hospital Revenue Code	301
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$55.29
Rate for Payer: AlohaCare Medicaid	$28.50
Rate for Payer: AlohaCare Medicare	$28.50
Rate for Payer: Cash Price	$37.05
Rate for Payer: Cash Price	$37.05
Rate for Payer: Devoted Health Medicare	$31.35
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	$28.50
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	$48.45
Rate for Payer: Humana Medicare	$28.50
Rate for Payer: Kaiser Permanente Commercial	$51.30
Rate for Payer: Kaiser Permanente Medicaid	$29.07
Rate for Payer: Kaiser Permanente Medicare	$28.50
Rate for Payer: MDX Hawaii PPO	$55.29
Rate for Payer: Ohana Health Plan Medicaid	$28.50
Rate for Payer: Ohana Health Plan Medicare	$28.50
Rate for Payer: UnitedHealthcare Medicaid	$9.01
Rate for Payer: UnitedHealthcare Medicare	$28.50
Rate for Payer: University Health Alliance Commercial	$16.84

Creatinine, Urine Random FSI

Facility

$269.00

Service Code	HCPCS 82570
Hospital Charge Code	8228863
Hospital Revenue Code	301
Min. Negotiated Rate	$228.65
Max. Negotiated Rate	$260.93
Rate for Payer: Cash Price	$174.85
Rate for Payer: Health Management Network Commercial	$228.65
Rate for Payer: Kaiser Permanente Commercial	$242.10
Rate for Payer: MDX Hawaii PPO	$260.93

Creatinine, Urine Random FSI

Facility

$269.00

Service Code	HCPCS 82570
Hospital Charge Code	8228863
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$260.93
Rate for Payer: AlohaCare Medicaid	$134.50
Rate for Payer: AlohaCare Medicare	$134.50
Rate for Payer: Cash Price	$174.85
Rate for Payer: Cash Price	$174.85
Rate for Payer: Devoted Health Medicare	$147.95
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	$134.50
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	$228.65
Rate for Payer: Humana Medicare	$134.50
Rate for Payer: Kaiser Permanente Commercial	$242.10
Rate for Payer: Kaiser Permanente Medicaid	$137.19
Rate for Payer: Kaiser Permanente Medicare	$134.50
Rate for Payer: MDX Hawaii PPO	$260.93
Rate for Payer: Ohana Health Plan Medicaid	$134.50
Rate for Payer: Ohana Health Plan Medicare	$134.50
Rate for Payer: UnitedHealthcare Medicaid	$7.15
Rate for Payer: UnitedHealthcare Medicare	$134.50
Rate for Payer: University Health Alliance Commercial	$13.38

Creatinine Urine Timed FSI

Facility

$269.00

Service Code	HCPCS 82570
Hospital Charge Code	8117897
Hospital Revenue Code	301
Min. Negotiated Rate	$228.65
Max. Negotiated Rate	$260.93
Rate for Payer: Cash Price	$174.85
Rate for Payer: Health Management Network Commercial	$228.65
Rate for Payer: Kaiser Permanente Commercial	$242.10
Rate for Payer: MDX Hawaii PPO	$260.93

Creatinine Urine Timed FSI

Facility

$269.00

Service Code	HCPCS 82570
Hospital Charge Code	8117897
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$260.93
Rate for Payer: AlohaCare Medicaid	$134.50
Rate for Payer: AlohaCare Medicare	$134.50
Rate for Payer: Cash Price	$174.85
Rate for Payer: Cash Price	$174.85
Rate for Payer: Devoted Health Medicare	$147.95
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	$134.50
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	$228.65
Rate for Payer: Humana Medicare	$134.50
Rate for Payer: Kaiser Permanente Commercial	$242.10
Rate for Payer: Kaiser Permanente Medicaid	$137.19
Rate for Payer: Kaiser Permanente Medicare	$134.50
Rate for Payer: MDX Hawaii PPO	$260.93
Rate for Payer: Ohana Health Plan Medicaid	$134.50
Rate for Payer: Ohana Health Plan Medicare	$134.50
Rate for Payer: UnitedHealthcare Medicaid	$7.15
Rate for Payer: UnitedHealthcare Medicare	$134.50
Rate for Payer: University Health Alliance Commercial	$13.38

Creatinine Venous POCT

Facility

$63.00

Service Code	HCPCS 82565
Hospital Charge Code	9364666
Hospital Revenue Code	301
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$61.11
Rate for Payer: Cash Price	$40.95
Rate for Payer: Health Management Network Commercial	$53.55
Rate for Payer: Kaiser Permanente Commercial	$56.70
Rate for Payer: MDX Hawaii PPO	$61.11

Creatinine Venous POCT

Facility

$63.00

Service Code	HCPCS 82565
Hospital Charge Code	9364666
Hospital Revenue Code	301
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$61.11
Rate for Payer: AlohaCare Medicaid	$31.50
Rate for Payer: AlohaCare Medicare	$31.50
Rate for Payer: Cash Price	$40.95
Rate for Payer: Cash Price	$40.95
Rate for Payer: Devoted Health Medicare	$34.65
Rate for Payer: Hawaii Medical Service Association ABD	$7.07
Rate for Payer: Hawaii Medical Service Association Commercial	$6.40
Rate for Payer: Hawaii Medical Service Association Medicare	$31.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.42
Rate for Payer: Hawaii Western Management Group Commercial	$5.12
Rate for Payer: Health Management Network Commercial	$53.55
Rate for Payer: Humana Medicare	$31.50
Rate for Payer: Kaiser Permanente Commercial	$56.70
Rate for Payer: Kaiser Permanente Medicaid	$32.13
Rate for Payer: Kaiser Permanente Medicare	$31.50
Rate for Payer: MDX Hawaii PPO	$61.11
Rate for Payer: Ohana Health Plan Medicaid	$31.50
Rate for Payer: Ohana Health Plan Medicare	$31.50
Rate for Payer: UnitedHealthcare Medicaid	$7.07
Rate for Payer: UnitedHealthcare Medicare	$31.50
Rate for Payer: University Health Alliance Commercial	$13.25

Critical Care Ill/Injured Patient Addl 30 Min 99292

Facility

$1,296.00

Service Code	HCPCS 99292
Hospital Charge Code	2389456
Hospital Revenue Code	450
Min. Negotiated Rate	$1,101.60
Max. Negotiated Rate	$1,257.12
Rate for Payer: Cash Price	$842.40
Rate for Payer: Health Management Network Commercial	$1,101.60
Rate for Payer: Kaiser Permanente Commercial	$1,166.40
Rate for Payer: MDX Hawaii PPO	$1,257.12

Critical Care Ill/Injured Patient Addl 30 Min 99292

Facility

$1,296.00

Service Code	HCPCS 99292
Hospital Charge Code	2389456
Hospital Revenue Code	450
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: AlohaCare Medicaid	$525.09
Rate for Payer: AlohaCare Medicare	$648.00
Rate for Payer: Cash Price	$842.40
Rate for Payer: Cash Price	$842.40
Rate for Payer: Cash Price	$842.40
Rate for Payer: Devoted Health Medicare	$712.80
Rate for Payer: Hawaii Medical Service Association ABD	$588.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$648.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$520.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,231.20
Rate for Payer: Health Management Network Commercial	$1,101.60
Rate for Payer: Humana Medicare	$648.00
Rate for Payer: Kaiser Permanente Commercial	$1,166.40
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$648.00
Rate for Payer: MDX Hawaii PPO	$1,257.12
Rate for Payer: Ohana Health Plan Medicaid	$648.00
Rate for Payer: Ohana Health Plan Medicare	$648.00
Rate for Payer: UnitedHealthcare Medicare	$648.00
Rate for Payer: University Health Alliance Commercial	$944.65

CRP C Reactive Protein, Highly Sensitive FSI

Facility

$148.00

Service Code	HCPCS 86141
Hospital Charge Code	8117898
Hospital Revenue Code	302
Min. Negotiated Rate	$125.80
Max. Negotiated Rate	$143.56
Rate for Payer: Cash Price	$96.20
Rate for Payer: Health Management Network Commercial	$125.80
Rate for Payer: Kaiser Permanente Commercial	$133.20
Rate for Payer: MDX Hawaii PPO	$143.56

CRP C Reactive Protein, Highly Sensitive FSI

Facility

$148.00

Service Code	HCPCS 86141
Hospital Charge Code	8117898
Hospital Revenue Code	302
Min. Negotiated Rate	$12.95
Max. Negotiated Rate	$143.56
Rate for Payer: AlohaCare Medicaid	$74.00
Rate for Payer: AlohaCare Medicare	$74.00
Rate for Payer: Cash Price	$96.20
Rate for Payer: Cash Price	$96.20
Rate for Payer: Devoted Health Medicare	$81.40
Rate for Payer: Hawaii Medical Service Association ABD	$17.20
Rate for Payer: Hawaii Medical Service Association Commercial	$16.19
Rate for Payer: Hawaii Medical Service Association Medicare	$74.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$18.06
Rate for Payer: Hawaii Western Management Group Commercial	$12.95
Rate for Payer: Health Management Network Commercial	$125.80
Rate for Payer: Humana Medicare	$74.00
Rate for Payer: Kaiser Permanente Commercial	$133.20
Rate for Payer: Kaiser Permanente Medicaid	$75.48
Rate for Payer: Kaiser Permanente Medicare	$74.00
Rate for Payer: MDX Hawaii PPO	$143.56
Rate for Payer: Ohana Health Plan Medicaid	$74.00
Rate for Payer: Ohana Health Plan Medicare	$74.00
Rate for Payer: UnitedHealthcare Medicaid	$17.20
Rate for Payer: UnitedHealthcare Medicare	$74.00
Rate for Payer: University Health Alliance Commercial	$33.47

Cryoglobulin Evaluation FSI

Facility

$77.00

Service Code	HCPCS 82595
Hospital Charge Code	8117899
Hospital Revenue Code	301
Min. Negotiated Rate	$6.47
Max. Negotiated Rate	$74.69
Rate for Payer: AlohaCare Medicaid	$38.50
Rate for Payer: AlohaCare Medicare	$38.50
Rate for Payer: Cash Price	$50.05
Rate for Payer: Cash Price	$50.05
Rate for Payer: Devoted Health Medicare	$42.35
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	$38.50
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	$65.45
Rate for Payer: Humana Medicare	$38.50
Rate for Payer: Kaiser Permanente Commercial	$69.30
Rate for Payer: Kaiser Permanente Medicaid	$39.27
Rate for Payer: Kaiser Permanente Medicare	$38.50
Rate for Payer: MDX Hawaii PPO	$74.69
Rate for Payer: Ohana Health Plan Medicaid	$38.50
Rate for Payer: Ohana Health Plan Medicare	$38.50
Rate for Payer: UnitedHealthcare Medicaid	$8.95
Rate for Payer: UnitedHealthcare Medicare	$38.50
Rate for Payer: University Health Alliance Commercial	$16.72

Cryoglobulin Evaluation FSI

Facility

$77.00

Service Code	HCPCS 82595
Hospital Charge Code	8117899
Hospital Revenue Code	301
Min. Negotiated Rate	$65.45
Max. Negotiated Rate	$74.69
Rate for Payer: Cash Price	$50.05
Rate for Payer: Health Management Network Commercial	$65.45
Rate for Payer: Kaiser Permanente Commercial	$69.30
Rate for Payer: MDX Hawaii PPO	$74.69

Crystals, Fluid REF

Facility

$124.00

Service Code	HCPCS 89060
Hospital Charge Code	8159877
Hospital Revenue Code	309
Min. Negotiated Rate	$7.33
Max. Negotiated Rate	$120.28
Rate for Payer: AlohaCare Medicaid	$62.00
Rate for Payer: AlohaCare Medicare	$62.00
Rate for Payer: Cash Price	$80.60
Rate for Payer: Cash Price	$80.60
Rate for Payer: Devoted Health Medicare	$68.20
Rate for Payer: Hawaii Medical Service Association ABD	$9.88
Rate for Payer: Hawaii Medical Service Association Commercial	$9.16
Rate for Payer: Hawaii Medical Service Association Medicare	$62.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10.37
Rate for Payer: Hawaii Western Management Group Commercial	$7.33
Rate for Payer: Health Management Network Commercial	$105.40
Rate for Payer: Humana Medicare	$62.00
Rate for Payer: Kaiser Permanente Commercial	$111.60
Rate for Payer: Kaiser Permanente Medicaid	$63.24
Rate for Payer: Kaiser Permanente Medicare	$62.00
Rate for Payer: MDX Hawaii PPO	$120.28
Rate for Payer: Ohana Health Plan Medicaid	$62.00
Rate for Payer: Ohana Health Plan Medicare	$62.00
Rate for Payer: UnitedHealthcare Medicaid	$9.88
Rate for Payer: UnitedHealthcare Medicare	$62.00
Rate for Payer: University Health Alliance Commercial	$18.48

Crystals, Fluid REF

Facility

$124.00

Service Code	HCPCS 89060
Hospital Charge Code	8159877
Hospital Revenue Code	309
Min. Negotiated Rate	$105.40
Max. Negotiated Rate	$120.28
Rate for Payer: Cash Price	$80.60
Rate for Payer: Health Management Network Commercial	$105.40
Rate for Payer: Kaiser Permanente Commercial	$111.60
Rate for Payer: MDX Hawaii PPO	$120.28

CT Abdomen and Pelvis w/ Contrast

Facility

$3,518.00

Service Code	HCPCS 74177
Hospital Charge Code	2424647
Hospital Revenue Code	352
Min. Negotiated Rate	$180.62
Max. Negotiated Rate	$3,412.46
Rate for Payer: AlohaCare Medicaid	$1,759.00
Rate for Payer: AlohaCare Medicare	$1,759.00
Rate for Payer: Cash Price	$2,286.70
Rate for Payer: Cash Price	$2,286.70
Rate for Payer: Devoted Health Medicare	$1,934.90
Rate for Payer: Hawaii Medical Service Association ABD	$180.62
Rate for Payer: Hawaii Medical Service Association Commercial	$445.54
Rate for Payer: Hawaii Medical Service Association Medicare	$1,759.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$490.36
Rate for Payer: Hawaii Western Management Group Commercial	$356.43
Rate for Payer: Health Management Network Commercial	$2,990.30
Rate for Payer: Humana Medicare	$1,759.00
Rate for Payer: Kaiser Permanente Commercial	$3,166.20
Rate for Payer: Kaiser Permanente Medicaid	$1,794.18
Rate for Payer: Kaiser Permanente Medicare	$1,759.00
Rate for Payer: MDX Hawaii PPO	$3,412.46
Rate for Payer: Ohana Health Plan Medicaid	$1,759.00
Rate for Payer: Ohana Health Plan Medicare	$1,759.00
Rate for Payer: UnitedHealthcare Medicaid	$180.62
Rate for Payer: UnitedHealthcare Medicare	$1,759.00
Rate for Payer: University Health Alliance Commercial	$727.57

Know your out-of-pocket cost for care.

All Charges