Kohala Hospital

All Charges

Charge

Type

Setting

Price

1/2NS 1000 ML WITH KCL 20MEQ/L IV PREMIX

Facility

$27.60

Service Code	HCPCS J3480
Hospital Revenue Code	636
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$27.32
Rate for Payer: AlohaCare Medicaid	$13.80
Rate for Payer: AlohaCare Medicare	$24.84
Rate for Payer: Cash Price	$17.94
Rate for Payer: Cash Price	$17.94
Rate for Payer: Devoted Health Medicare	$27.32
Rate for Payer: Hawaii Medical Service Association ABD	$0.17
Rate for Payer: Hawaii Medical Service Association Medicare	$24.84
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.17
Rate for Payer: Hawaii Western Management Group Commercial	$26.22
Rate for Payer: Health Management Network Commercial	$23.46
Rate for Payer: Humana Medicare	$24.84
Rate for Payer: Kaiser Permanente Commercial	$24.84
Rate for Payer: Kaiser Permanente Medicaid	$14.08
Rate for Payer: Kaiser Permanente Medicare	$24.84
Rate for Payer: MDX Hawaii PPO	$26.77
Rate for Payer: Ohana Health Plan Medicaid	$24.84
Rate for Payer: Ohana Health Plan Medicare	$24.84
Rate for Payer: UnitedHealthcare Medicaid	$16.56
Rate for Payer: UnitedHealthcare Medicare	$24.84
Rate for Payer: University Health Alliance Commercial	$20.12

1/2NS 1000 ML WITH KCL 20MEQ/L IV PREMIX

Facility

$27.60

Service Code	HCPCS J3480
Hospital Revenue Code	250
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$26.77
Rate for Payer: Cash Price	$17.94
Rate for Payer: Health Management Network Commercial	$23.46
Rate for Payer: Kaiser Permanente Commercial	$24.84
Rate for Payer: MDX Hawaii PPO	$26.77

ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility

$10,760.71

Service Code	MSDRG 770
Min. Negotiated Rate	$10,760.71
Max. Negotiated Rate	$10,760.71
Rate for Payer: Hawaii Medical Service Association Commercial	$10,760.71

ABORTION WITHOUT D&C

Facility

$7,347.62

Service Code	MSDRG 779
Min. Negotiated Rate	$7,347.62
Max. Negotiated Rate	$7,347.62
Rate for Payer: Hawaii Medical Service Association Commercial	$7,347.62

ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN

Facility

$55.55

Service Code	HCPCS J0131
Hospital Revenue Code	250
Min. Negotiated Rate	$47.22
Max. Negotiated Rate	$53.88
Rate for Payer: Cash Price	$36.11
Rate for Payer: Health Management Network Commercial	$47.22
Rate for Payer: Kaiser Permanente Commercial	$49.99
Rate for Payer: MDX Hawaii PPO	$53.88

ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN

Facility

$55.55

Service Code	HCPCS J0131
Hospital Revenue Code	636
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$54.99
Rate for Payer: AlohaCare Medicaid	$27.77
Rate for Payer: AlohaCare Medicare	$49.99
Rate for Payer: Cash Price	$36.11
Rate for Payer: Cash Price	$36.11
Rate for Payer: Devoted Health Medicare	$54.99
Rate for Payer: Hawaii Medical Service Association ABD	$0.05
Rate for Payer: Hawaii Medical Service Association Medicare	$49.99
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.05
Rate for Payer: Hawaii Western Management Group Commercial	$52.77
Rate for Payer: Health Management Network Commercial	$47.22
Rate for Payer: Humana Medicare	$49.99
Rate for Payer: Kaiser Permanente Commercial	$49.99
Rate for Payer: Kaiser Permanente Medicaid	$28.33
Rate for Payer: Kaiser Permanente Medicare	$49.99
Rate for Payer: MDX Hawaii PPO	$53.88
Rate for Payer: Ohana Health Plan Medicaid	$49.99
Rate for Payer: Ohana Health Plan Medicare	$49.99
Rate for Payer: UnitedHealthcare Medicaid	$33.33
Rate for Payer: UnitedHealthcare Medicare	$49.99
Rate for Payer: University Health Alliance Commercial	$40.49

ACETAMINOPHEN 120 MG PR SUPP

Facility

$5.16

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$4.39
Max. Negotiated Rate	$5.01
Rate for Payer: Cash Price	$3.35
Rate for Payer: Cash Price	$1.11
Rate for Payer: Cash Price	$0.78
Rate for Payer: Health Management Network Commercial	$4.39
Rate for Payer: Health Management Network Commercial	$1.02
Rate for Payer: Health Management Network Commercial	$1.45
Rate for Payer: Kaiser Permanente Commercial	$1.54
Rate for Payer: Kaiser Permanente Commercial	$1.08
Rate for Payer: Kaiser Permanente Commercial	$4.64
Rate for Payer: MDX Hawaii PPO	$1.66
Rate for Payer: MDX Hawaii PPO	$1.16
Rate for Payer: MDX Hawaii PPO	$5.01

ACETAMINOPHEN 120 MG PR SUPP

Facility

$5.16

Service Code	HCPCS A9270
Hospital Revenue Code	637
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$5.11
Rate for Payer: AlohaCare Medicaid	$2.58
Rate for Payer: AlohaCare Medicaid	$0.60
Rate for Payer: AlohaCare Medicaid	$0.86
Rate for Payer: AlohaCare Medicare	$1.08
Rate for Payer: AlohaCare Medicare	$4.64
Rate for Payer: AlohaCare Medicare	$1.54
Rate for Payer: Cash Price	$1.11
Rate for Payer: Cash Price	$0.78
Rate for Payer: Cash Price	$3.35
Rate for Payer: Devoted Health Medicare	$1.69
Rate for Payer: Devoted Health Medicare	$1.19
Rate for Payer: Devoted Health Medicare	$5.11
Rate for Payer: Hawaii Medical Service Association Medicare	$1.08
Rate for Payer: Hawaii Medical Service Association Medicare	$1.54
Rate for Payer: Hawaii Medical Service Association Medicare	$4.64
Rate for Payer: Hawaii Western Management Group Commercial	$1.62
Rate for Payer: Hawaii Western Management Group Commercial	$4.90
Rate for Payer: Hawaii Western Management Group Commercial	$1.14
Rate for Payer: Health Management Network Commercial	$1.02
Rate for Payer: Health Management Network Commercial	$4.39
Rate for Payer: Health Management Network Commercial	$1.45
Rate for Payer: Humana Medicare	$1.08
Rate for Payer: Humana Medicare	$1.54
Rate for Payer: Humana Medicare	$4.64
Rate for Payer: Kaiser Permanente Commercial	$4.64
Rate for Payer: Kaiser Permanente Commercial	$1.08
Rate for Payer: Kaiser Permanente Commercial	$1.54
Rate for Payer: Kaiser Permanente Medicaid	$0.61
Rate for Payer: Kaiser Permanente Medicaid	$2.63
Rate for Payer: Kaiser Permanente Medicaid	$0.87
Rate for Payer: Kaiser Permanente Medicare	$1.08
Rate for Payer: Kaiser Permanente Medicare	$4.64
Rate for Payer: Kaiser Permanente Medicare	$1.54
Rate for Payer: MDX Hawaii PPO	$5.01
Rate for Payer: MDX Hawaii PPO	$1.66
Rate for Payer: MDX Hawaii PPO	$1.16
Rate for Payer: Ohana Health Plan Medicaid	$1.08
Rate for Payer: Ohana Health Plan Medicaid	$1.54
Rate for Payer: Ohana Health Plan Medicaid	$4.64
Rate for Payer: Ohana Health Plan Medicare	$1.08
Rate for Payer: Ohana Health Plan Medicare	$1.54
Rate for Payer: Ohana Health Plan Medicare	$4.64
Rate for Payer: UnitedHealthcare Medicare	$1.54
Rate for Payer: UnitedHealthcare Medicare	$4.64
Rate for Payer: UnitedHealthcare Medicare	$1.08
Rate for Payer: University Health Alliance Commercial	$3.76
Rate for Payer: University Health Alliance Commercial	$0.87
Rate for Payer: University Health Alliance Commercial	$1.25

ACETAMINOPHEN 160 MG/5 ML (5 ML) PO SUSP

Facility

$6.46

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$6.27
Rate for Payer: Cash Price	$4.20
Rate for Payer: Cash Price	$3.88
Rate for Payer: Health Management Network Commercial	$5.49
Rate for Payer: Health Management Network Commercial	$5.07
Rate for Payer: Kaiser Permanente Commercial	$5.81
Rate for Payer: Kaiser Permanente Commercial	$5.37
Rate for Payer: MDX Hawaii PPO	$5.79
Rate for Payer: MDX Hawaii PPO	$6.27

ACETAMINOPHEN 160 MG/5 ML (5 ML) PO SUSP

Facility

$5.97

Service Code	HCPCS A9270
Hospital Revenue Code	637
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$5.91
Rate for Payer: AlohaCare Medicaid	$2.98
Rate for Payer: AlohaCare Medicaid	$3.23
Rate for Payer: AlohaCare Medicare	$5.37
Rate for Payer: AlohaCare Medicare	$5.81
Rate for Payer: Cash Price	$4.20
Rate for Payer: Cash Price	$3.88
Rate for Payer: Devoted Health Medicare	$5.91
Rate for Payer: Devoted Health Medicare	$6.40
Rate for Payer: Hawaii Medical Service Association Medicare	$5.81
Rate for Payer: Hawaii Medical Service Association Medicare	$5.37
Rate for Payer: Hawaii Western Management Group Commercial	$6.14
Rate for Payer: Hawaii Western Management Group Commercial	$5.67
Rate for Payer: Health Management Network Commercial	$5.07
Rate for Payer: Health Management Network Commercial	$5.49
Rate for Payer: Humana Medicare	$5.81
Rate for Payer: Humana Medicare	$5.37
Rate for Payer: Kaiser Permanente Commercial	$5.37
Rate for Payer: Kaiser Permanente Commercial	$5.81
Rate for Payer: Kaiser Permanente Medicaid	$3.29
Rate for Payer: Kaiser Permanente Medicaid	$3.04
Rate for Payer: Kaiser Permanente Medicare	$5.81
Rate for Payer: Kaiser Permanente Medicare	$5.37
Rate for Payer: MDX Hawaii PPO	$6.27
Rate for Payer: MDX Hawaii PPO	$5.79
Rate for Payer: Ohana Health Plan Medicaid	$5.37
Rate for Payer: Ohana Health Plan Medicaid	$5.81
Rate for Payer: Ohana Health Plan Medicare	$5.37
Rate for Payer: Ohana Health Plan Medicare	$5.81
Rate for Payer: UnitedHealthcare Medicare	$5.37
Rate for Payer: UnitedHealthcare Medicare	$5.81
Rate for Payer: University Health Alliance Commercial	$4.71
Rate for Payer: University Health Alliance Commercial	$4.35

ACETAMINOPHEN 160 MG/5 ML PO SUSP

Facility

$28.32

Service Code	HCPCS A9270
Hospital Revenue Code	637
Min. Negotiated Rate	$14.16
Max. Negotiated Rate	$28.04
Rate for Payer: AlohaCare Medicaid	$14.16
Rate for Payer: AlohaCare Medicare	$25.49
Rate for Payer: Cash Price	$18.41
Rate for Payer: Devoted Health Medicare	$28.04
Rate for Payer: Hawaii Medical Service Association Medicare	$25.49
Rate for Payer: Hawaii Western Management Group Commercial	$26.90
Rate for Payer: Health Management Network Commercial	$24.07
Rate for Payer: Humana Medicare	$25.49
Rate for Payer: Kaiser Permanente Commercial	$25.49
Rate for Payer: Kaiser Permanente Medicaid	$14.44
Rate for Payer: Kaiser Permanente Medicare	$25.49
Rate for Payer: MDX Hawaii PPO	$27.47
Rate for Payer: Ohana Health Plan Medicaid	$25.49
Rate for Payer: Ohana Health Plan Medicare	$25.49
Rate for Payer: UnitedHealthcare Medicare	$25.49
Rate for Payer: University Health Alliance Commercial	$20.64

ACETAMINOPHEN 160 MG/5 ML PO SUSP

Facility

$28.32

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$24.07
Max. Negotiated Rate	$27.47
Rate for Payer: Cash Price	$18.41
Rate for Payer: Health Management Network Commercial	$24.07
Rate for Payer: Kaiser Permanente Commercial	$25.49
Rate for Payer: MDX Hawaii PPO	$27.47

ACETAMINOPHEN 325 MG PO TABLET

Facility

$1.20

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.16
Rate for Payer: Cash Price	$0.78
Rate for Payer: Health Management Network Commercial	$1.02
Rate for Payer: Kaiser Permanente Commercial	$1.08
Rate for Payer: MDX Hawaii PPO	$1.16

ACETAMINOPHEN 325 MG PO TABLET

Facility

$1.20

Service Code	HCPCS A9270
Hospital Revenue Code	637
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$1.19
Rate for Payer: AlohaCare Medicaid	$0.60
Rate for Payer: AlohaCare Medicare	$1.08
Rate for Payer: Cash Price	$0.78
Rate for Payer: Devoted Health Medicare	$1.19
Rate for Payer: Hawaii Medical Service Association Medicare	$1.08
Rate for Payer: Hawaii Western Management Group Commercial	$1.14
Rate for Payer: Health Management Network Commercial	$1.02
Rate for Payer: Humana Medicare	$1.08
Rate for Payer: Kaiser Permanente Commercial	$1.08
Rate for Payer: Kaiser Permanente Medicaid	$0.61
Rate for Payer: Kaiser Permanente Medicare	$1.08
Rate for Payer: MDX Hawaii PPO	$1.16
Rate for Payer: Ohana Health Plan Medicaid	$1.08
Rate for Payer: Ohana Health Plan Medicare	$1.08
Rate for Payer: UnitedHealthcare Medicare	$1.08
Rate for Payer: University Health Alliance Commercial	$0.87

ACETAMINOPHEN 325 MG PR SUPP

Facility

$5.62

Service Code	HCPCS A9270
Hospital Revenue Code	637
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$5.56
Rate for Payer: AlohaCare Medicaid	$2.81
Rate for Payer: AlohaCare Medicare	$5.06
Rate for Payer: Cash Price	$3.65
Rate for Payer: Devoted Health Medicare	$5.56
Rate for Payer: Hawaii Medical Service Association Medicare	$5.06
Rate for Payer: Hawaii Western Management Group Commercial	$5.34
Rate for Payer: Health Management Network Commercial	$4.78
Rate for Payer: Humana Medicare	$5.06
Rate for Payer: Kaiser Permanente Commercial	$5.06
Rate for Payer: Kaiser Permanente Medicaid	$2.87
Rate for Payer: Kaiser Permanente Medicare	$5.06
Rate for Payer: MDX Hawaii PPO	$5.45
Rate for Payer: Ohana Health Plan Medicaid	$5.06
Rate for Payer: Ohana Health Plan Medicare	$5.06
Rate for Payer: UnitedHealthcare Medicare	$5.06
Rate for Payer: University Health Alliance Commercial	$4.10

ACETAMINOPHEN 325 MG PR SUPP

Facility

$5.62

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$4.78
Max. Negotiated Rate	$5.45
Rate for Payer: Cash Price	$3.65
Rate for Payer: Health Management Network Commercial	$4.78
Rate for Payer: Kaiser Permanente Commercial	$5.06
Rate for Payer: MDX Hawaii PPO	$5.45

ACETAMINOPHEN 500 MG PO TABLET

Facility

$1.20

Service Code	HCPCS A9270
Hospital Revenue Code	637
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$1.19
Rate for Payer: AlohaCare Medicaid	$0.60
Rate for Payer: AlohaCare Medicare	$1.08
Rate for Payer: Cash Price	$0.78
Rate for Payer: Devoted Health Medicare	$1.19
Rate for Payer: Hawaii Medical Service Association Medicare	$1.08
Rate for Payer: Hawaii Western Management Group Commercial	$1.14
Rate for Payer: Health Management Network Commercial	$1.02
Rate for Payer: Humana Medicare	$1.08
Rate for Payer: Kaiser Permanente Commercial	$1.08
Rate for Payer: Kaiser Permanente Medicaid	$0.61
Rate for Payer: Kaiser Permanente Medicare	$1.08
Rate for Payer: MDX Hawaii PPO	$1.16
Rate for Payer: Ohana Health Plan Medicaid	$1.08
Rate for Payer: Ohana Health Plan Medicare	$1.08
Rate for Payer: UnitedHealthcare Medicare	$1.08
Rate for Payer: University Health Alliance Commercial	$0.87

ACETAMINOPHEN 500 MG PO TABLET

Facility

$1.20

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.16
Rate for Payer: Cash Price	$0.78
Rate for Payer: Health Management Network Commercial	$1.02
Rate for Payer: Kaiser Permanente Commercial	$1.08
Rate for Payer: MDX Hawaii PPO	$1.16

ACETAMINOPHEN 650 MG PR SUPP

Facility

$3.68

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$3.57
Rate for Payer: Cash Price	$2.39
Rate for Payer: Health Management Network Commercial	$3.13
Rate for Payer: Kaiser Permanente Commercial	$3.31
Rate for Payer: MDX Hawaii PPO	$3.57

ACETAMINOPHEN 650 MG PR SUPP

Facility

$3.68

Service Code	HCPCS A9270
Hospital Revenue Code	637
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$3.64
Rate for Payer: AlohaCare Medicaid	$1.84
Rate for Payer: AlohaCare Medicare	$3.31
Rate for Payer: Cash Price	$2.39
Rate for Payer: Devoted Health Medicare	$3.64
Rate for Payer: Hawaii Medical Service Association Medicare	$3.31
Rate for Payer: Hawaii Western Management Group Commercial	$3.50
Rate for Payer: Health Management Network Commercial	$3.13
Rate for Payer: Humana Medicare	$3.31
Rate for Payer: Kaiser Permanente Commercial	$3.31
Rate for Payer: Kaiser Permanente Medicaid	$1.88
Rate for Payer: Kaiser Permanente Medicare	$3.31
Rate for Payer: MDX Hawaii PPO	$3.57
Rate for Payer: Ohana Health Plan Medicaid	$3.31
Rate for Payer: Ohana Health Plan Medicare	$3.31
Rate for Payer: UnitedHealthcare Medicare	$3.31
Rate for Payer: University Health Alliance Commercial	$2.68

ACETAMINOPHEN-CODEINE 120-12 MG/5 ML PO SOLN

Facility

$2.21

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$2.14
Rate for Payer: Cash Price	$1.44
Rate for Payer: Health Management Network Commercial	$1.88
Rate for Payer: Kaiser Permanente Commercial	$1.99
Rate for Payer: MDX Hawaii PPO	$2.14

ACETAMINOPHEN-CODEINE 120-12 MG/5 ML PO SOLN

Facility

$2.21

Service Code	HCPCS A9270
Hospital Revenue Code	637
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$2.19
Rate for Payer: AlohaCare Medicaid	$1.10
Rate for Payer: AlohaCare Medicare	$1.99
Rate for Payer: Cash Price	$1.44
Rate for Payer: Devoted Health Medicare	$2.19
Rate for Payer: Hawaii Medical Service Association Medicare	$1.99
Rate for Payer: Hawaii Western Management Group Commercial	$2.10
Rate for Payer: Health Management Network Commercial	$1.88
Rate for Payer: Humana Medicare	$1.99
Rate for Payer: Kaiser Permanente Commercial	$1.99
Rate for Payer: Kaiser Permanente Medicaid	$1.13
Rate for Payer: Kaiser Permanente Medicare	$1.99
Rate for Payer: MDX Hawaii PPO	$2.14
Rate for Payer: Ohana Health Plan Medicaid	$1.99
Rate for Payer: Ohana Health Plan Medicare	$1.99
Rate for Payer: UnitedHealthcare Medicare	$1.99
Rate for Payer: University Health Alliance Commercial	$1.61

ACETAMINOPHEN-CODEINE 120 MG-12 MG /5 ML (5 ML) PO SOLN

Facility

$56.68

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$48.18
Max. Negotiated Rate	$54.98
Rate for Payer: Cash Price	$36.84
Rate for Payer: Health Management Network Commercial	$48.18
Rate for Payer: Kaiser Permanente Commercial	$51.01
Rate for Payer: MDX Hawaii PPO	$54.98

ACETAMINOPHEN-CODEINE 120 MG-12 MG /5 ML (5 ML) PO SOLN

Facility

$56.68

Service Code	HCPCS A9270
Hospital Revenue Code	637
Min. Negotiated Rate	$28.34
Max. Negotiated Rate	$56.11
Rate for Payer: AlohaCare Medicaid	$28.34
Rate for Payer: AlohaCare Medicare	$51.01
Rate for Payer: Cash Price	$36.84
Rate for Payer: Devoted Health Medicare	$56.11
Rate for Payer: Hawaii Medical Service Association Medicare	$51.01
Rate for Payer: Hawaii Western Management Group Commercial	$53.85
Rate for Payer: Health Management Network Commercial	$48.18
Rate for Payer: Humana Medicare	$51.01
Rate for Payer: Kaiser Permanente Commercial	$51.01
Rate for Payer: Kaiser Permanente Medicaid	$28.91
Rate for Payer: Kaiser Permanente Medicare	$51.01
Rate for Payer: MDX Hawaii PPO	$54.98
Rate for Payer: Ohana Health Plan Medicaid	$51.01
Rate for Payer: Ohana Health Plan Medicare	$51.01
Rate for Payer: UnitedHealthcare Medicare	$51.01
Rate for Payer: University Health Alliance Commercial	$41.31

ACETAMINOPHEN-CODEINE 300-30 MG PO TABLET

Facility

$7.88

Service Code	HCPCS A9270
Hospital Revenue Code	637
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$7.80
Rate for Payer: AlohaCare Medicaid	$3.94
Rate for Payer: AlohaCare Medicaid	$3.52
Rate for Payer: AlohaCare Medicare	$6.33
Rate for Payer: AlohaCare Medicare	$7.09
Rate for Payer: Cash Price	$4.57
Rate for Payer: Cash Price	$5.12
Rate for Payer: Devoted Health Medicare	$7.80
Rate for Payer: Devoted Health Medicare	$6.96
Rate for Payer: Hawaii Medical Service Association Medicare	$6.33
Rate for Payer: Hawaii Medical Service Association Medicare	$7.09
Rate for Payer: Hawaii Western Management Group Commercial	$6.68
Rate for Payer: Hawaii Western Management Group Commercial	$7.49
Rate for Payer: Health Management Network Commercial	$6.70
Rate for Payer: Health Management Network Commercial	$5.98
Rate for Payer: Humana Medicare	$7.09
Rate for Payer: Humana Medicare	$6.33
Rate for Payer: Kaiser Permanente Commercial	$6.33
Rate for Payer: Kaiser Permanente Commercial	$7.09
Rate for Payer: Kaiser Permanente Medicaid	$4.02
Rate for Payer: Kaiser Permanente Medicaid	$3.59
Rate for Payer: Kaiser Permanente Medicare	$6.33
Rate for Payer: Kaiser Permanente Medicare	$7.09
Rate for Payer: MDX Hawaii PPO	$6.82
Rate for Payer: MDX Hawaii PPO	$7.64
Rate for Payer: Ohana Health Plan Medicaid	$6.33
Rate for Payer: Ohana Health Plan Medicaid	$7.09
Rate for Payer: Ohana Health Plan Medicare	$6.33
Rate for Payer: Ohana Health Plan Medicare	$7.09
Rate for Payer: UnitedHealthcare Medicare	$7.09
Rate for Payer: UnitedHealthcare Medicare	$6.33
Rate for Payer: University Health Alliance Commercial	$5.74
Rate for Payer: University Health Alliance Commercial	$5.12

Know your out-of-pocket cost for care.

All Charges