Kauai Veterans Memorial Hospital

All Charges

Charge

Type

Setting

Price

STRAIGHT PLATE, 2.7MM, 10 HOLE

Facility

$1,883.00

Service Code	HCPCS C1713
Hospital Charge Code	13004969
Hospital Revenue Code	278
Min. Negotiated Rate	$1,054.48
Max. Negotiated Rate	$1,826.51
Rate for Payer: Cash Price	$1,223.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,318.10
Rate for Payer: Health Management Network Commercial	$1,600.55
Rate for Payer: Kaiser Permanente Commercial	$1,694.70
Rate for Payer: MDX Hawaii PPO	$1,826.51
Rate for Payer: University Health Alliance Commercial	$1,054.48

STRAIGHT PLATE, 2.7MM,10 HOLE,REINFORCED

Facility

$1,883.00

Service Code	HCPCS C1713
Hospital Charge Code	13000621
Hospital Revenue Code	278
Min. Negotiated Rate	$1,054.48
Max. Negotiated Rate	$1,826.51
Rate for Payer: Cash Price	$1,223.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,318.10
Rate for Payer: Health Management Network Commercial	$1,600.55
Rate for Payer: Kaiser Permanente Commercial	$1,694.70
Rate for Payer: MDX Hawaii PPO	$1,826.51
Rate for Payer: University Health Alliance Commercial	$1,054.48

STRAIGHT PLATE, 2.7MM,10 HOLE,REINFORCED

Facility

$1,883.00

Service Code	HCPCS C1713
Hospital Charge Code	13000621
Hospital Revenue Code	278
Min. Negotiated Rate	$941.50
Max. Negotiated Rate	$1,826.51
Rate for Payer: AlohaCare Medicaid	$941.50
Rate for Payer: AlohaCare Medicare	$941.50
Rate for Payer: Cash Price	$1,223.95
Rate for Payer: Devoted Health Medicare	$1,035.65
Rate for Payer: Hawaii Medical Service Association Medicare	$941.50
Rate for Payer: Hawaii Western Management Group Commercial	$1,318.10
Rate for Payer: Health Management Network Commercial	$1,600.55
Rate for Payer: Humana Medicare	$941.50
Rate for Payer: Kaiser Permanente Commercial	$1,694.70
Rate for Payer: Kaiser Permanente Medicaid	$960.33
Rate for Payer: Kaiser Permanente Medicare	$941.50
Rate for Payer: MDX Hawaii PPO	$1,826.51
Rate for Payer: Ohana Health Plan Medicaid	$941.50
Rate for Payer: Ohana Health Plan Medicare	$941.50
Rate for Payer: UnitedHealthcare Medicare	$941.50
Rate for Payer: University Health Alliance Commercial	$1,054.48

STRAIGHT PLATE, 2.7MM, 20 HOLE

Facility

$2,355.00

Service Code	HCPCS C1713
Hospital Charge Code	13004970
Hospital Revenue Code	278
Min. Negotiated Rate	$1,318.80
Max. Negotiated Rate	$2,284.35
Rate for Payer: Cash Price	$1,530.75
Rate for Payer: Hawaii Western Management Group Commercial	$1,648.50
Rate for Payer: Health Management Network Commercial	$2,001.75
Rate for Payer: Kaiser Permanente Commercial	$2,119.50
Rate for Payer: MDX Hawaii PPO	$2,284.35
Rate for Payer: University Health Alliance Commercial	$1,318.80

STRAIGHT PLATE, 2.7MM, 20 HOLE

Facility

$2,355.00

Service Code	HCPCS C1713
Hospital Charge Code	13004970
Hospital Revenue Code	278
Min. Negotiated Rate	$1,177.50
Max. Negotiated Rate	$2,284.35
Rate for Payer: AlohaCare Medicaid	$1,177.50
Rate for Payer: AlohaCare Medicare	$1,177.50
Rate for Payer: Cash Price	$1,530.75
Rate for Payer: Devoted Health Medicare	$1,295.25
Rate for Payer: Hawaii Medical Service Association Medicare	$1,177.50
Rate for Payer: Hawaii Western Management Group Commercial	$1,648.50
Rate for Payer: Health Management Network Commercial	$2,001.75
Rate for Payer: Humana Medicare	$1,177.50
Rate for Payer: Kaiser Permanente Commercial	$2,119.50
Rate for Payer: Kaiser Permanente Medicaid	$1,201.05
Rate for Payer: Kaiser Permanente Medicare	$1,177.50
Rate for Payer: MDX Hawaii PPO	$2,284.35
Rate for Payer: Ohana Health Plan Medicaid	$1,177.50
Rate for Payer: Ohana Health Plan Medicare	$1,177.50
Rate for Payer: UnitedHealthcare Medicare	$1,177.50
Rate for Payer: University Health Alliance Commercial	$1,318.80

STRAIGHT PLATE, 2.7MM, 4 HOLE

Facility

$1,883.00

Service Code	HCPCS C1713
Hospital Charge Code	13004976
Hospital Revenue Code	278
Min. Negotiated Rate	$941.50
Max. Negotiated Rate	$1,826.51
Rate for Payer: AlohaCare Medicaid	$941.50
Rate for Payer: AlohaCare Medicare	$941.50
Rate for Payer: Cash Price	$1,223.95
Rate for Payer: Devoted Health Medicare	$1,035.65
Rate for Payer: Hawaii Medical Service Association Medicare	$941.50
Rate for Payer: Hawaii Western Management Group Commercial	$1,318.10
Rate for Payer: Health Management Network Commercial	$1,600.55
Rate for Payer: Humana Medicare	$941.50
Rate for Payer: Kaiser Permanente Commercial	$1,694.70
Rate for Payer: Kaiser Permanente Medicaid	$960.33
Rate for Payer: Kaiser Permanente Medicare	$941.50
Rate for Payer: MDX Hawaii PPO	$1,826.51
Rate for Payer: Ohana Health Plan Medicaid	$941.50
Rate for Payer: Ohana Health Plan Medicare	$941.50
Rate for Payer: UnitedHealthcare Medicare	$941.50
Rate for Payer: University Health Alliance Commercial	$1,054.48

STRAIGHT PLATE, 2.7MM, 4 HOLE

Facility

$1,883.00

Service Code	HCPCS C1713
Hospital Charge Code	13004976
Hospital Revenue Code	278
Min. Negotiated Rate	$1,054.48
Max. Negotiated Rate	$1,826.51
Rate for Payer: Cash Price	$1,223.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,318.10
Rate for Payer: Health Management Network Commercial	$1,600.55
Rate for Payer: Kaiser Permanente Commercial	$1,694.70
Rate for Payer: MDX Hawaii PPO	$1,826.51
Rate for Payer: University Health Alliance Commercial	$1,054.48

STRAIGHT PLATE, 2.7MM, 4 HOLE,REINFORCED

Facility

$1,883.00

Service Code	HCPCS C1713
Hospital Charge Code	13004967
Hospital Revenue Code	278
Min. Negotiated Rate	$941.50
Max. Negotiated Rate	$1,826.51
Rate for Payer: AlohaCare Medicaid	$941.50
Rate for Payer: AlohaCare Medicare	$941.50
Rate for Payer: Cash Price	$1,223.95
Rate for Payer: Devoted Health Medicare	$1,035.65
Rate for Payer: Hawaii Medical Service Association Medicare	$941.50
Rate for Payer: Hawaii Western Management Group Commercial	$1,318.10
Rate for Payer: Health Management Network Commercial	$1,600.55
Rate for Payer: Humana Medicare	$941.50
Rate for Payer: Kaiser Permanente Commercial	$1,694.70
Rate for Payer: Kaiser Permanente Medicaid	$960.33
Rate for Payer: Kaiser Permanente Medicare	$941.50
Rate for Payer: MDX Hawaii PPO	$1,826.51
Rate for Payer: Ohana Health Plan Medicaid	$941.50
Rate for Payer: Ohana Health Plan Medicare	$941.50
Rate for Payer: UnitedHealthcare Medicare	$941.50
Rate for Payer: University Health Alliance Commercial	$1,054.48

STRAIGHT PLATE, 2.7MM, 4 HOLE,REINFORCED

Facility

$1,883.00

Service Code	HCPCS C1713
Hospital Charge Code	13004967
Hospital Revenue Code	278
Min. Negotiated Rate	$1,054.48
Max. Negotiated Rate	$1,826.51
Rate for Payer: Cash Price	$1,223.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,318.10
Rate for Payer: Health Management Network Commercial	$1,600.55
Rate for Payer: Kaiser Permanente Commercial	$1,694.70
Rate for Payer: MDX Hawaii PPO	$1,826.51
Rate for Payer: University Health Alliance Commercial	$1,054.48

STRAIGHT PLATE, 2.7MM, 6 HOLE

Facility

$1,883.00

Service Code	HCPCS C1713
Hospital Charge Code	13004971
Hospital Revenue Code	278
Min. Negotiated Rate	$1,054.48
Max. Negotiated Rate	$1,826.51
Rate for Payer: Cash Price	$1,223.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,318.10
Rate for Payer: Health Management Network Commercial	$1,600.55
Rate for Payer: Kaiser Permanente Commercial	$1,694.70
Rate for Payer: MDX Hawaii PPO	$1,826.51
Rate for Payer: University Health Alliance Commercial	$1,054.48

STRAIGHT PLATE, 2.7MM, 6 HOLE

Facility

$1,883.00

Service Code	HCPCS C1713
Hospital Charge Code	13004971
Hospital Revenue Code	278
Min. Negotiated Rate	$941.50
Max. Negotiated Rate	$1,826.51
Rate for Payer: AlohaCare Medicaid	$941.50
Rate for Payer: AlohaCare Medicare	$941.50
Rate for Payer: Cash Price	$1,223.95
Rate for Payer: Devoted Health Medicare	$1,035.65
Rate for Payer: Hawaii Medical Service Association Medicare	$941.50
Rate for Payer: Hawaii Western Management Group Commercial	$1,318.10
Rate for Payer: Health Management Network Commercial	$1,600.55
Rate for Payer: Humana Medicare	$941.50
Rate for Payer: Kaiser Permanente Commercial	$1,694.70
Rate for Payer: Kaiser Permanente Medicaid	$960.33
Rate for Payer: Kaiser Permanente Medicare	$941.50
Rate for Payer: MDX Hawaii PPO	$1,826.51
Rate for Payer: Ohana Health Plan Medicaid	$941.50
Rate for Payer: Ohana Health Plan Medicare	$941.50
Rate for Payer: UnitedHealthcare Medicare	$941.50
Rate for Payer: University Health Alliance Commercial	$1,054.48

STRAIGHT PLATE, 2.7MM, 6 HOLE,REINFORCED

Facility

$1,883.00

Service Code	HCPCS C1713
Hospital Charge Code	13000615
Hospital Revenue Code	278
Min. Negotiated Rate	$1,054.48
Max. Negotiated Rate	$1,826.51
Rate for Payer: Cash Price	$1,223.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,318.10
Rate for Payer: Health Management Network Commercial	$1,600.55
Rate for Payer: Kaiser Permanente Commercial	$1,694.70
Rate for Payer: MDX Hawaii PPO	$1,826.51
Rate for Payer: University Health Alliance Commercial	$1,054.48

STRAIGHT PLATE, 2.7MM, 6 HOLE,REINFORCED

Facility

$1,883.00

Service Code	HCPCS C1713
Hospital Charge Code	13000615
Hospital Revenue Code	278
Min. Negotiated Rate	$941.50
Max. Negotiated Rate	$1,826.51
Rate for Payer: AlohaCare Medicaid	$941.50
Rate for Payer: AlohaCare Medicare	$941.50
Rate for Payer: Cash Price	$1,223.95
Rate for Payer: Devoted Health Medicare	$1,035.65
Rate for Payer: Hawaii Medical Service Association Medicare	$941.50
Rate for Payer: Hawaii Western Management Group Commercial	$1,318.10
Rate for Payer: Health Management Network Commercial	$1,600.55
Rate for Payer: Humana Medicare	$941.50
Rate for Payer: Kaiser Permanente Commercial	$1,694.70
Rate for Payer: Kaiser Permanente Medicaid	$960.33
Rate for Payer: Kaiser Permanente Medicare	$941.50
Rate for Payer: MDX Hawaii PPO	$1,826.51
Rate for Payer: Ohana Health Plan Medicaid	$941.50
Rate for Payer: Ohana Health Plan Medicare	$941.50
Rate for Payer: UnitedHealthcare Medicare	$941.50
Rate for Payer: University Health Alliance Commercial	$1,054.48

STRAIGHT PLATE, 2.7MM, 8 HOLE

Facility

$2,510.00

Service Code	HCPCS C1713
Hospital Charge Code	13000617
Hospital Revenue Code	278
Min. Negotiated Rate	$1,405.60
Max. Negotiated Rate	$2,434.70
Rate for Payer: Cash Price	$1,631.50
Rate for Payer: Hawaii Western Management Group Commercial	$1,757.00
Rate for Payer: Health Management Network Commercial	$2,133.50
Rate for Payer: Kaiser Permanente Commercial	$2,259.00
Rate for Payer: MDX Hawaii PPO	$2,434.70
Rate for Payer: University Health Alliance Commercial	$1,405.60

STRAIGHT PLATE, 2.7MM, 8 HOLE

Facility

$2,510.00

Service Code	HCPCS C1713
Hospital Charge Code	13000617
Hospital Revenue Code	278
Min. Negotiated Rate	$1,255.00
Max. Negotiated Rate	$2,434.70
Rate for Payer: AlohaCare Medicaid	$1,255.00
Rate for Payer: AlohaCare Medicare	$1,255.00
Rate for Payer: Cash Price	$1,631.50
Rate for Payer: Devoted Health Medicare	$1,380.50
Rate for Payer: Hawaii Medical Service Association Medicare	$1,255.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,757.00
Rate for Payer: Health Management Network Commercial	$2,133.50
Rate for Payer: Humana Medicare	$1,255.00
Rate for Payer: Kaiser Permanente Commercial	$2,259.00
Rate for Payer: Kaiser Permanente Medicaid	$1,280.10
Rate for Payer: Kaiser Permanente Medicare	$1,255.00
Rate for Payer: MDX Hawaii PPO	$2,434.70
Rate for Payer: Ohana Health Plan Medicaid	$1,255.00
Rate for Payer: Ohana Health Plan Medicare	$1,255.00
Rate for Payer: UnitedHealthcare Medicare	$1,255.00
Rate for Payer: University Health Alliance Commercial	$1,405.60

STRAIGHT PLATE, 2.7MM, 8 HOLE,REINFORCED

Facility

$1,883.00

Service Code	HCPCS C1713
Hospital Charge Code	13000616
Hospital Revenue Code	278
Min. Negotiated Rate	$941.50
Max. Negotiated Rate	$1,826.51
Rate for Payer: AlohaCare Medicaid	$941.50
Rate for Payer: AlohaCare Medicare	$941.50
Rate for Payer: Cash Price	$1,223.95
Rate for Payer: Devoted Health Medicare	$1,035.65
Rate for Payer: Hawaii Medical Service Association Medicare	$941.50
Rate for Payer: Hawaii Western Management Group Commercial	$1,318.10
Rate for Payer: Health Management Network Commercial	$1,600.55
Rate for Payer: Humana Medicare	$941.50
Rate for Payer: Kaiser Permanente Commercial	$1,694.70
Rate for Payer: Kaiser Permanente Medicaid	$960.33
Rate for Payer: Kaiser Permanente Medicare	$941.50
Rate for Payer: MDX Hawaii PPO	$1,826.51
Rate for Payer: Ohana Health Plan Medicaid	$941.50
Rate for Payer: Ohana Health Plan Medicare	$941.50
Rate for Payer: UnitedHealthcare Medicare	$941.50
Rate for Payer: University Health Alliance Commercial	$1,054.48

STRAIGHT PLATE, 2.7MM, 8 HOLE,REINFORCED

Facility

$1,883.00

Service Code	HCPCS C1713
Hospital Charge Code	13000616
Hospital Revenue Code	278
Min. Negotiated Rate	$1,054.48
Max. Negotiated Rate	$1,826.51
Rate for Payer: Cash Price	$1,223.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,318.10
Rate for Payer: Health Management Network Commercial	$1,600.55
Rate for Payer: Kaiser Permanente Commercial	$1,694.70
Rate for Payer: MDX Hawaii PPO	$1,826.51
Rate for Payer: University Health Alliance Commercial	$1,054.48

Strep Group A by NAAT FSI

Facility

$231.00

Service Code	HCPCS 87651 QW
Hospital Charge Code	9793384
Hospital Revenue Code	306
Min. Negotiated Rate	$196.35
Max. Negotiated Rate	$224.07
Rate for Payer: Cash Price	$150.15
Rate for Payer: Health Management Network Commercial	$196.35
Rate for Payer: Kaiser Permanente Commercial	$207.90
Rate for Payer: MDX Hawaii PPO	$224.07

Strep Group A by NAAT FSI

Facility

$231.00

Service Code	HCPCS 87651 QW
Hospital Charge Code	9793384
Hospital Revenue Code	306
Min. Negotiated Rate	$29.42
Max. Negotiated Rate	$224.07
Rate for Payer: AlohaCare Medicaid	$115.50
Rate for Payer: AlohaCare Medicare	$115.50
Rate for Payer: Cash Price	$150.15
Rate for Payer: Cash Price	$150.15
Rate for Payer: Devoted Health Medicare	$127.05
Rate for Payer: Hawaii Medical Service Association ABD	$29.42
Rate for Payer: Hawaii Medical Service Association Commercial	$43.86
Rate for Payer: Hawaii Medical Service Association Medicare	$115.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$48.48
Rate for Payer: Hawaii Western Management Group Commercial	$35.09
Rate for Payer: Health Management Network Commercial	$196.35
Rate for Payer: Humana Medicare	$115.50
Rate for Payer: Kaiser Permanente Commercial	$207.90
Rate for Payer: Kaiser Permanente Medicaid	$117.81
Rate for Payer: Kaiser Permanente Medicare	$115.50
Rate for Payer: MDX Hawaii PPO	$224.07
Rate for Payer: Ohana Health Plan Medicaid	$115.50
Rate for Payer: Ohana Health Plan Medicare	$115.50
Rate for Payer: UnitedHealthcare Medicaid	$29.42
Rate for Payer: UnitedHealthcare Medicare	$115.50
Rate for Payer: University Health Alliance Commercial	$90.72

Streptococcus pneumoniae Antigen, CSF FSI

Facility

$139.00

Service Code	HCPCS 87899
Hospital Charge Code	8228920
Hospital Revenue Code	306
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$134.83
Rate for Payer: AlohaCare Medicaid	$69.50
Rate for Payer: AlohaCare Medicare	$69.50
Rate for Payer: Cash Price	$90.35
Rate for Payer: Cash Price	$90.35
Rate for Payer: Devoted Health Medicare	$76.45
Rate for Payer: Hawaii Medical Service Association ABD	$16.58
Rate for Payer: Hawaii Medical Service Association Commercial	$20.09
Rate for Payer: Hawaii Medical Service Association Medicare	$69.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17.41
Rate for Payer: Hawaii Western Management Group Commercial	$16.07
Rate for Payer: Health Management Network Commercial	$118.15
Rate for Payer: Humana Medicare	$69.50
Rate for Payer: Kaiser Permanente Commercial	$125.10
Rate for Payer: Kaiser Permanente Medicaid	$70.89
Rate for Payer: Kaiser Permanente Medicare	$69.50
Rate for Payer: MDX Hawaii PPO	$134.83
Rate for Payer: Ohana Health Plan Medicaid	$69.50
Rate for Payer: Ohana Health Plan Medicare	$69.50
Rate for Payer: UnitedHealthcare Medicaid	$16.58
Rate for Payer: UnitedHealthcare Medicare	$69.50
Rate for Payer: University Health Alliance Commercial	$31.01

Streptococcus pneumoniae Antigen, CSF FSI

Facility

$139.00

Service Code	HCPCS 87899
Hospital Charge Code	8228920
Hospital Revenue Code	306
Min. Negotiated Rate	$118.15
Max. Negotiated Rate	$134.83
Rate for Payer: Cash Price	$90.35
Rate for Payer: Health Management Network Commercial	$118.15
Rate for Payer: Kaiser Permanente Commercial	$125.10
Rate for Payer: MDX Hawaii PPO	$134.83

Streptozyme FSI

Facility

$81.00

Service Code	HCPCS 86063
Hospital Charge Code	8228921
Hospital Revenue Code	302
Min. Negotiated Rate	$68.85
Max. Negotiated Rate	$78.57
Rate for Payer: Cash Price	$52.65
Rate for Payer: Health Management Network Commercial	$68.85
Rate for Payer: Kaiser Permanente Commercial	$72.90
Rate for Payer: MDX Hawaii PPO	$78.57

Streptozyme FSI

Facility

$81.00

Service Code	HCPCS 86063
Hospital Charge Code	8228921
Hospital Revenue Code	302
Min. Negotiated Rate	$5.77
Max. Negotiated Rate	$78.57
Rate for Payer: AlohaCare Medicaid	$40.50
Rate for Payer: AlohaCare Medicare	$40.50
Rate for Payer: Cash Price	$52.65
Rate for Payer: Cash Price	$52.65
Rate for Payer: Devoted Health Medicare	$44.55
Rate for Payer: Hawaii Medical Service Association ABD	$7.98
Rate for Payer: Hawaii Medical Service Association Commercial	$7.21
Rate for Payer: Hawaii Medical Service Association Medicare	$40.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8.38
Rate for Payer: Hawaii Western Management Group Commercial	$5.77
Rate for Payer: Health Management Network Commercial	$68.85
Rate for Payer: Humana Medicare	$40.50
Rate for Payer: Kaiser Permanente Commercial	$72.90
Rate for Payer: Kaiser Permanente Medicaid	$41.31
Rate for Payer: Kaiser Permanente Medicare	$40.50
Rate for Payer: MDX Hawaii PPO	$78.57
Rate for Payer: Ohana Health Plan Medicaid	$40.50
Rate for Payer: Ohana Health Plan Medicare	$40.50
Rate for Payer: UnitedHealthcare Medicaid	$7.98
Rate for Payer: UnitedHealthcare Medicare	$40.50
Rate for Payer: University Health Alliance Commercial	$14.93

strong iodine 5% (Lugol's) soln 20 mL [HHSC]

Facility

$16.01

Service Code	NDC 38779059805
Hospital Charge Code	2500425
Hospital Revenue Code	250
Min. Negotiated Rate	$8.01
Max. Negotiated Rate	$15.53
Rate for Payer: AlohaCare Medicaid	$8.01
Rate for Payer: AlohaCare Medicare	$8.01
Rate for Payer: Cash Price	$10.41
Rate for Payer: Devoted Health Medicare	$8.81
Rate for Payer: Hawaii Medical Service Association Medicare	$8.01
Rate for Payer: Hawaii Western Management Group Commercial	$15.21
Rate for Payer: Health Management Network Commercial	$13.61
Rate for Payer: Humana Medicare	$8.01
Rate for Payer: Kaiser Permanente Commercial	$14.41
Rate for Payer: Kaiser Permanente Medicaid	$8.17
Rate for Payer: Kaiser Permanente Medicare	$8.01
Rate for Payer: MDX Hawaii PPO	$15.53
Rate for Payer: Ohana Health Plan Medicaid	$8.01
Rate for Payer: Ohana Health Plan Medicare	$8.01
Rate for Payer: UnitedHealthcare Medicaid	$9.61
Rate for Payer: UnitedHealthcare Medicare	$8.01
Rate for Payer: University Health Alliance Commercial	$11.67

strong iodine 5% (Lugol's) soln 20 mL [HHSC]

Facility

$17.57

Service Code	NDC 00395277516
Hospital Charge Code	2500425
Hospital Revenue Code	250
Min. Negotiated Rate	$8.79
Max. Negotiated Rate	$17.04
Rate for Payer: AlohaCare Medicaid	$8.79
Rate for Payer: AlohaCare Medicare	$8.79
Rate for Payer: Cash Price	$11.42
Rate for Payer: Devoted Health Medicare	$9.66
Rate for Payer: Hawaii Medical Service Association Medicare	$8.79
Rate for Payer: Hawaii Western Management Group Commercial	$16.69
Rate for Payer: Health Management Network Commercial	$14.93
Rate for Payer: Humana Medicare	$8.79
Rate for Payer: Kaiser Permanente Commercial	$15.81
Rate for Payer: Kaiser Permanente Medicaid	$8.96
Rate for Payer: Kaiser Permanente Medicare	$8.79
Rate for Payer: MDX Hawaii PPO	$17.04
Rate for Payer: Ohana Health Plan Medicaid	$8.79
Rate for Payer: Ohana Health Plan Medicare	$8.79
Rate for Payer: UnitedHealthcare Medicaid	$10.54
Rate for Payer: UnitedHealthcare Medicare	$8.79
Rate for Payer: University Health Alliance Commercial	$12.81

Know your out-of-pocket cost for care.

All Charges