Kohala Hospital

All Charges

Charge

Type

Setting

Price

HCHG SPINAL PUNC LUMBAR DX

Facility

$3,543.00

Service Code	HCPCS 62270
Hospital Charge Code	H4500682
Hospital Revenue Code	450
Min. Negotiated Rate	$3,011.55
Max. Negotiated Rate	$3,436.71
Rate for Payer: Cash Price	$2,302.95
Rate for Payer: Health Management Network Commercial	$3,011.55
Rate for Payer: Kaiser Permanente Commercial	$3,188.70
Rate for Payer: MDX Hawaii PPO	$3,436.71

HCHG SPINAL PUNC LUMBAR DX

Facility

$3,543.00

Service Code	HCPCS 62270
Hospital Charge Code	H4500682
Hospital Revenue Code	450
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$4,035.20
Rate for Payer: AlohaCare Medicaid	$1,771.50
Rate for Payer: AlohaCare Medicare	$3,188.70
Rate for Payer: Cash Price	$2,302.95
Rate for Payer: Cash Price	$2,302.95
Rate for Payer: Devoted Health Medicare	$3,507.57
Rate for Payer: Hawaii Medical Service Association ABD	$469.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$3,188.70
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,365.85
Rate for Payer: Health Management Network Commercial	$3,011.55
Rate for Payer: Humana Medicare	$3,188.70
Rate for Payer: Kaiser Permanente Commercial	$3,188.70
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$3,188.70
Rate for Payer: MDX Hawaii PPO	$3,436.71
Rate for Payer: Ohana Health Plan Medicaid	$3,188.70
Rate for Payer: Ohana Health Plan Medicare	$3,188.70
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$3,188.70
Rate for Payer: University Health Alliance Commercial	$4,035.20

HCHG SPINE THORACOLUMBAR, 2 VIEWS

Facility

$493.00

Service Code	HCPCS 72080
Hospital Charge Code	H3200734
Hospital Revenue Code	320
Min. Negotiated Rate	$419.05
Max. Negotiated Rate	$478.21
Rate for Payer: Cash Price	$320.45
Rate for Payer: Health Management Network Commercial	$419.05
Rate for Payer: Kaiser Permanente Commercial	$443.70
Rate for Payer: MDX Hawaii PPO	$478.21

HCHG SPINE THORACOLUMBAR, 2 VIEWS

Facility

$493.00

Service Code	HCPCS 72080
Hospital Charge Code	H3200734
Hospital Revenue Code	320
Min. Negotiated Rate	$21.96
Max. Negotiated Rate	$488.07
Rate for Payer: AlohaCare Medicaid	$246.50
Rate for Payer: AlohaCare Medicare	$443.70
Rate for Payer: Cash Price	$320.45
Rate for Payer: Cash Price	$320.45
Rate for Payer: Devoted Health Medicare	$488.07
Rate for Payer: Hawaii Medical Service Association ABD	$21.96
Rate for Payer: Hawaii Medical Service Association Commercial	$111.14
Rate for Payer: Hawaii Medical Service Association Medicare	$443.70
Rate for Payer: Hawaii Medical Service Association Non-ABD	$24.13
Rate for Payer: Hawaii Western Management Group Commercial	$88.91
Rate for Payer: Health Management Network Commercial	$419.05
Rate for Payer: Humana Medicare	$443.70
Rate for Payer: Kaiser Permanente Commercial	$443.70
Rate for Payer: Kaiser Permanente Medicaid	$251.43
Rate for Payer: Kaiser Permanente Medicare	$443.70
Rate for Payer: MDX Hawaii PPO	$478.21
Rate for Payer: Ohana Health Plan Medicaid	$443.70
Rate for Payer: Ohana Health Plan Medicare	$443.70
Rate for Payer: UnitedHealthcare Medicaid	$21.96
Rate for Payer: UnitedHealthcare Medicare	$443.70
Rate for Payer: University Health Alliance Commercial	$72.83

HCHG SP INITIAL COGNITIVE 15 MINUTES

Facility

$162.00

Service Code	HCPCS 97129
Hospital Charge Code	H4400359
Hospital Revenue Code	440
Min. Negotiated Rate	$137.70
Max. Negotiated Rate	$157.14
Rate for Payer: Cash Price	$105.30
Rate for Payer: Health Management Network Commercial	$137.70
Rate for Payer: Kaiser Permanente Commercial	$145.80
Rate for Payer: MDX Hawaii PPO	$157.14

HCHG SP INITIAL COGNITIVE 15 MINUTES

Facility

$162.00

Service Code	HCPCS 97129
Hospital Charge Code	H4400359
Hospital Revenue Code	440
Min. Negotiated Rate	$22.57
Max. Negotiated Rate	$160.38
Rate for Payer: AlohaCare Medicaid	$81.00
Rate for Payer: AlohaCare Medicare	$145.80
Rate for Payer: Cash Price	$105.30
Rate for Payer: Cash Price	$105.30
Rate for Payer: Devoted Health Medicare	$160.38
Rate for Payer: Hawaii Medical Service Association Medicare	$145.80
Rate for Payer: Hawaii Western Management Group Commercial	$153.90
Rate for Payer: Health Management Network Commercial	$137.70
Rate for Payer: Humana Medicare	$145.80
Rate for Payer: Kaiser Permanente Commercial	$145.80
Rate for Payer: Kaiser Permanente Medicaid	$82.62
Rate for Payer: Kaiser Permanente Medicare	$145.80
Rate for Payer: MDX Hawaii PPO	$157.14
Rate for Payer: Ohana Health Plan Medicaid	$145.80
Rate for Payer: Ohana Health Plan Medicare	$145.80
Rate for Payer: UnitedHealthcare Medicaid	$22.57
Rate for Payer: UnitedHealthcare Medicare	$145.80
Rate for Payer: University Health Alliance Commercial	$118.08

HCHG SP SPEECH GEN DEVICE TX

Facility

$588.00

Service Code	HCPCS 92609
Hospital Charge Code	H4720102
Hospital Revenue Code	440
Min. Negotiated Rate	$47.70
Max. Negotiated Rate	$582.12
Rate for Payer: AlohaCare Medicaid	$294.00
Rate for Payer: AlohaCare Medicare	$529.20
Rate for Payer: Cash Price	$382.20
Rate for Payer: Cash Price	$382.20
Rate for Payer: Devoted Health Medicare	$582.12
Rate for Payer: Hawaii Medical Service Association Medicare	$529.20
Rate for Payer: Hawaii Western Management Group Commercial	$558.60
Rate for Payer: Health Management Network Commercial	$499.80
Rate for Payer: Humana Medicare	$529.20
Rate for Payer: Kaiser Permanente Commercial	$529.20
Rate for Payer: Kaiser Permanente Medicaid	$299.88
Rate for Payer: Kaiser Permanente Medicare	$529.20
Rate for Payer: MDX Hawaii PPO	$570.36
Rate for Payer: Ohana Health Plan Medicaid	$529.20
Rate for Payer: Ohana Health Plan Medicare	$529.20
Rate for Payer: UnitedHealthcare Medicaid	$47.70
Rate for Payer: UnitedHealthcare Medicare	$529.20
Rate for Payer: University Health Alliance Commercial	$428.59

HCHG SP SPEECH GEN DEVICE TX

Facility

$588.00

Service Code	HCPCS 92609
Hospital Charge Code	H4720102
Hospital Revenue Code	440
Min. Negotiated Rate	$499.80
Max. Negotiated Rate	$570.36
Rate for Payer: Cash Price	$382.20
Rate for Payer: Health Management Network Commercial	$499.80
Rate for Payer: Kaiser Permanente Commercial	$529.20
Rate for Payer: MDX Hawaii PPO	$570.36

HCHG SP SPEECH-LANG-VOICE TREAT

Facility

$483.00

Service Code	HCPCS 92507
Hospital Charge Code	H4400140
Hospital Revenue Code	440
Min. Negotiated Rate	$21.05
Max. Negotiated Rate	$478.17
Rate for Payer: AlohaCare Medicaid	$241.50
Rate for Payer: AlohaCare Medicare	$434.70
Rate for Payer: Cash Price	$313.95
Rate for Payer: Cash Price	$313.95
Rate for Payer: Devoted Health Medicare	$478.17
Rate for Payer: Hawaii Medical Service Association Medicare	$434.70
Rate for Payer: Hawaii Western Management Group Commercial	$458.85
Rate for Payer: Health Management Network Commercial	$410.55
Rate for Payer: Humana Medicare	$434.70
Rate for Payer: Kaiser Permanente Commercial	$434.70
Rate for Payer: Kaiser Permanente Medicaid	$246.33
Rate for Payer: Kaiser Permanente Medicare	$434.70
Rate for Payer: MDX Hawaii PPO	$468.51
Rate for Payer: Ohana Health Plan Medicaid	$434.70
Rate for Payer: Ohana Health Plan Medicare	$434.70
Rate for Payer: UnitedHealthcare Medicaid	$21.05
Rate for Payer: UnitedHealthcare Medicare	$434.70
Rate for Payer: University Health Alliance Commercial	$352.06

HCHG SP SPEECH-LANG-VOICE TREAT

Facility

$483.00

Service Code	HCPCS 92507
Hospital Charge Code	H4400140
Hospital Revenue Code	440
Min. Negotiated Rate	$410.55
Max. Negotiated Rate	$468.51
Rate for Payer: Cash Price	$313.95
Rate for Payer: Health Management Network Commercial	$410.55
Rate for Payer: Kaiser Permanente Commercial	$434.70
Rate for Payer: MDX Hawaii PPO	$468.51

HCHG SP SWALLOW TREAT

Facility

$533.00

Service Code	HCPCS 92526
Hospital Charge Code	H4400148
Hospital Revenue Code	440
Min. Negotiated Rate	$453.05
Max. Negotiated Rate	$517.01
Rate for Payer: Cash Price	$346.45
Rate for Payer: Health Management Network Commercial	$453.05
Rate for Payer: Kaiser Permanente Commercial	$479.70
Rate for Payer: MDX Hawaii PPO	$517.01

HCHG SP SWALLOW TREAT

Facility

$533.00

Service Code	HCPCS 92526
Hospital Charge Code	H4400148
Hospital Revenue Code	440
Min. Negotiated Rate	$22.46
Max. Negotiated Rate	$527.67
Rate for Payer: AlohaCare Medicaid	$266.50
Rate for Payer: AlohaCare Medicare	$479.70
Rate for Payer: Cash Price	$346.45
Rate for Payer: Cash Price	$346.45
Rate for Payer: Devoted Health Medicare	$527.67
Rate for Payer: Hawaii Medical Service Association Medicare	$479.70
Rate for Payer: Hawaii Western Management Group Commercial	$506.35
Rate for Payer: Health Management Network Commercial	$453.05
Rate for Payer: Humana Medicare	$479.70
Rate for Payer: Kaiser Permanente Commercial	$479.70
Rate for Payer: Kaiser Permanente Medicaid	$271.83
Rate for Payer: Kaiser Permanente Medicare	$479.70
Rate for Payer: MDX Hawaii PPO	$517.01
Rate for Payer: Ohana Health Plan Medicaid	$479.70
Rate for Payer: Ohana Health Plan Medicare	$479.70
Rate for Payer: UnitedHealthcare Medicaid	$22.46
Rate for Payer: UnitedHealthcare Medicare	$479.70
Rate for Payer: University Health Alliance Commercial	$388.50

HCHG SPUTUM GRAM STAIN

Facility

$71.00

Service Code	HCPCS 87205
Hospital Charge Code	H3060468
Hospital Revenue Code	306
Min. Negotiated Rate	$60.35
Max. Negotiated Rate	$68.87
Rate for Payer: Cash Price	$46.15
Rate for Payer: Health Management Network Commercial	$60.35
Rate for Payer: Kaiser Permanente Commercial	$63.90
Rate for Payer: MDX Hawaii PPO	$68.87

HCHG SPUTUM GRAM STAIN

Facility

$71.00

Service Code	HCPCS 87205
Hospital Charge Code	H3060468
Hospital Revenue Code	306
Min. Negotiated Rate	$4.27
Max. Negotiated Rate	$70.29
Rate for Payer: AlohaCare Medicaid	$35.50
Rate for Payer: AlohaCare Medicare	$63.90
Rate for Payer: Cash Price	$46.15
Rate for Payer: Cash Price	$46.15
Rate for Payer: Devoted Health Medicare	$70.29
Rate for Payer: Hawaii Medical Service Association ABD	$5.90
Rate for Payer: Hawaii Medical Service Association Commercial	$5.34
Rate for Payer: Hawaii Medical Service Association Medicare	$63.90
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6.20
Rate for Payer: Hawaii Western Management Group Commercial	$4.27
Rate for Payer: Health Management Network Commercial	$60.35
Rate for Payer: Humana Medicare	$63.90
Rate for Payer: Kaiser Permanente Commercial	$63.90
Rate for Payer: Kaiser Permanente Medicaid	$36.21
Rate for Payer: Kaiser Permanente Medicare	$63.90
Rate for Payer: MDX Hawaii PPO	$68.87
Rate for Payer: Ohana Health Plan Medicaid	$63.90
Rate for Payer: Ohana Health Plan Medicare	$63.90
Rate for Payer: UnitedHealthcare Medicaid	$5.90
Rate for Payer: UnitedHealthcare Medicare	$63.90
Rate for Payer: University Health Alliance Commercial	$11.03

HCHG STERNUM MIN 2 VIEWS

Facility

$485.00

Service Code	HCPCS 71120
Hospital Charge Code	H3200780
Hospital Revenue Code	320
Min. Negotiated Rate	$412.25
Max. Negotiated Rate	$470.45
Rate for Payer: Cash Price	$315.25
Rate for Payer: Health Management Network Commercial	$412.25
Rate for Payer: Kaiser Permanente Commercial	$436.50
Rate for Payer: MDX Hawaii PPO	$470.45

HCHG STERNUM MIN 2 VIEWS

Facility

$485.00

Service Code	HCPCS 71120
Hospital Charge Code	H3200780
Hospital Revenue Code	320
Min. Negotiated Rate	$21.34
Max. Negotiated Rate	$480.15
Rate for Payer: AlohaCare Medicaid	$242.50
Rate for Payer: AlohaCare Medicare	$436.50
Rate for Payer: Cash Price	$315.25
Rate for Payer: Cash Price	$315.25
Rate for Payer: Devoted Health Medicare	$480.15
Rate for Payer: Hawaii Medical Service Association ABD	$21.34
Rate for Payer: Hawaii Medical Service Association Commercial	$111.14
Rate for Payer: Hawaii Medical Service Association Medicare	$436.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$23.43
Rate for Payer: Hawaii Western Management Group Commercial	$88.91
Rate for Payer: Health Management Network Commercial	$412.25
Rate for Payer: Humana Medicare	$436.50
Rate for Payer: Kaiser Permanente Commercial	$436.50
Rate for Payer: Kaiser Permanente Medicaid	$247.35
Rate for Payer: Kaiser Permanente Medicare	$436.50
Rate for Payer: MDX Hawaii PPO	$470.45
Rate for Payer: Ohana Health Plan Medicaid	$436.50
Rate for Payer: Ohana Health Plan Medicare	$436.50
Rate for Payer: UnitedHealthcare Medicaid	$21.34
Rate for Payer: UnitedHealthcare Medicare	$436.50
Rate for Payer: University Health Alliance Commercial	$69.73

HCHG STONE CALCULI ANALYS 90 INFRARED

Facility

$99.00

Service Code	HCPCS 82365
Hospital Charge Code	H3011180
Hospital Revenue Code	301
Min. Negotiated Rate	$84.15
Max. Negotiated Rate	$96.03
Rate for Payer: Cash Price	$64.35
Rate for Payer: Health Management Network Commercial	$84.15
Rate for Payer: Kaiser Permanente Commercial	$89.10
Rate for Payer: MDX Hawaii PPO	$96.03

HCHG STONE CALCULI ANALYS 90 INFRARED

Facility

$99.00

Service Code	HCPCS 82365
Hospital Charge Code	H3011180
Hospital Revenue Code	301
Min. Negotiated Rate	$11.44
Max. Negotiated Rate	$98.01
Rate for Payer: AlohaCare Medicaid	$49.50
Rate for Payer: AlohaCare Medicare	$89.10
Rate for Payer: Cash Price	$64.35
Rate for Payer: Cash Price	$64.35
Rate for Payer: Devoted Health Medicare	$98.01
Rate for Payer: Hawaii Medical Service Association ABD	$11.44
Rate for Payer: Hawaii Medical Service Association Commercial	$16.12
Rate for Payer: Hawaii Medical Service Association Medicare	$89.10
Rate for Payer: Hawaii Medical Service Association Non-ABD	$12.01
Rate for Payer: Hawaii Western Management Group Commercial	$12.90
Rate for Payer: Health Management Network Commercial	$84.15
Rate for Payer: Humana Medicare	$89.10
Rate for Payer: Kaiser Permanente Commercial	$89.10
Rate for Payer: Kaiser Permanente Medicaid	$50.49
Rate for Payer: Kaiser Permanente Medicare	$89.10
Rate for Payer: MDX Hawaii PPO	$96.03
Rate for Payer: Ohana Health Plan Medicaid	$89.10
Rate for Payer: Ohana Health Plan Medicare	$89.10
Rate for Payer: UnitedHealthcare Medicaid	$11.44
Rate for Payer: UnitedHealthcare Medicare	$89.10
Rate for Payer: University Health Alliance Commercial	$21.40

HCHG STOOL CULTR AEROBIC BACT EA

Facility

$156.00

Service Code	HCPCS 87046
Hospital Charge Code	H3000122
Hospital Revenue Code	306
Min. Negotiated Rate	$7.91
Max. Negotiated Rate	$154.44
Rate for Payer: AlohaCare Medicaid	$78.00
Rate for Payer: AlohaCare Medicare	$140.40
Rate for Payer: Cash Price	$101.40
Rate for Payer: Cash Price	$101.40
Rate for Payer: Devoted Health Medicare	$154.44
Rate for Payer: Hawaii Medical Service Association ABD	$7.91
Rate for Payer: Hawaii Medical Service Association Commercial	$11.80
Rate for Payer: Hawaii Medical Service Association Medicare	$140.40
Rate for Payer: Hawaii Medical Service Association Non-ABD	$12.65
Rate for Payer: Hawaii Western Management Group Commercial	$9.44
Rate for Payer: Health Management Network Commercial	$132.60
Rate for Payer: Humana Medicare	$140.40
Rate for Payer: Kaiser Permanente Commercial	$140.40
Rate for Payer: Kaiser Permanente Medicaid	$79.56
Rate for Payer: Kaiser Permanente Medicare	$140.40
Rate for Payer: MDX Hawaii PPO	$151.32
Rate for Payer: Ohana Health Plan Medicaid	$140.40
Rate for Payer: Ohana Health Plan Medicare	$140.40
Rate for Payer: UnitedHealthcare Medicaid	$7.91
Rate for Payer: UnitedHealthcare Medicare	$140.40
Rate for Payer: University Health Alliance Commercial	$24.38

HCHG STOOL CULTR AEROBIC BACT EA

Facility

$156.00

Service Code	HCPCS 87046
Hospital Charge Code	H3000122
Hospital Revenue Code	306
Min. Negotiated Rate	$132.60
Max. Negotiated Rate	$151.32
Rate for Payer: Cash Price	$101.40
Rate for Payer: Health Management Network Commercial	$132.60
Rate for Payer: Kaiser Permanente Commercial	$140.40
Rate for Payer: MDX Hawaii PPO	$151.32

HCHG STOOL GI PATHOGEN PANEL, PCR - 90

Facility

$1,766.00

Service Code	HCPCS 87507
Hospital Charge Code	H3060800
Hospital Revenue Code	306
Min. Negotiated Rate	$1,501.10
Max. Negotiated Rate	$1,713.02
Rate for Payer: Cash Price	$1,147.90
Rate for Payer: Health Management Network Commercial	$1,501.10
Rate for Payer: Kaiser Permanente Commercial	$1,589.40
Rate for Payer: MDX Hawaii PPO	$1,713.02

HCHG STOOL GI PATHOGEN PANEL, PCR - 90

Facility

$1,766.00

Service Code	HCPCS 87507
Hospital Charge Code	H3060800
Hospital Revenue Code	306
Min. Negotiated Rate	$312.59
Max. Negotiated Rate	$1,748.34
Rate for Payer: AlohaCare Medicaid	$883.00
Rate for Payer: AlohaCare Medicare	$1,589.40
Rate for Payer: Cash Price	$1,147.90
Rate for Payer: Cash Price	$1,147.90
Rate for Payer: Devoted Health Medicare	$1,748.34
Rate for Payer: Hawaii Medical Service Association Commercial	$520.98
Rate for Payer: Hawaii Medical Service Association Medicare	$1,589.40
Rate for Payer: Hawaii Medical Service Association Non-ABD	$599.94
Rate for Payer: Hawaii Western Management Group Commercial	$416.78
Rate for Payer: Health Management Network Commercial	$1,501.10
Rate for Payer: Humana Medicare	$1,589.40
Rate for Payer: Kaiser Permanente Commercial	$1,589.40
Rate for Payer: Kaiser Permanente Medicaid	$900.66
Rate for Payer: Kaiser Permanente Medicare	$1,589.40
Rate for Payer: MDX Hawaii PPO	$1,713.02
Rate for Payer: Ohana Health Plan Medicaid	$1,589.40
Rate for Payer: Ohana Health Plan Medicare	$1,589.40
Rate for Payer: UnitedHealthcare Medicaid	$312.59
Rate for Payer: UnitedHealthcare Medicare	$1,589.40
Rate for Payer: University Health Alliance Commercial	$1,287.24

HCHG STRAPPING ANKLE

Facility

$1,001.00

Service Code	HCPCS 29540
Hospital Charge Code	H4500694
Hospital Revenue Code	450
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: AlohaCare Medicaid	$500.50
Rate for Payer: AlohaCare Medicare	$900.90
Rate for Payer: Cash Price	$650.65
Rate for Payer: Cash Price	$650.65
Rate for Payer: Devoted Health Medicare	$990.99
Rate for Payer: Hawaii Medical Service Association ABD	$469.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$900.90
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$950.95
Rate for Payer: Health Management Network Commercial	$850.85
Rate for Payer: Humana Medicare	$900.90
Rate for Payer: Kaiser Permanente Commercial	$900.90
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$900.90
Rate for Payer: MDX Hawaii PPO	$970.97
Rate for Payer: Ohana Health Plan Medicaid	$900.90
Rate for Payer: Ohana Health Plan Medicare	$900.90
Rate for Payer: UnitedHealthcare Medicare	$900.90
Rate for Payer: University Health Alliance Commercial	$729.63

HCHG STRAPPING ANKLE

Facility

$1,001.00

Service Code	HCPCS 29540
Hospital Charge Code	H4500694
Hospital Revenue Code	450
Min. Negotiated Rate	$850.85
Max. Negotiated Rate	$970.97
Rate for Payer: Cash Price	$650.65
Rate for Payer: Health Management Network Commercial	$850.85
Rate for Payer: Kaiser Permanente Commercial	$900.90
Rate for Payer: MDX Hawaii PPO	$970.97

HCHG STRAPPING ELBOW OR WRIST

Facility

$448.00

Service Code	HCPCS 29260
Hospital Charge Code	H4500696
Hospital Revenue Code	450
Min. Negotiated Rate	$224.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: AlohaCare Medicaid	$224.00
Rate for Payer: AlohaCare Medicare	$403.20
Rate for Payer: Cash Price	$291.20
Rate for Payer: Cash Price	$291.20
Rate for Payer: Devoted Health Medicare	$443.52
Rate for Payer: Hawaii Medical Service Association ABD	$469.00
Rate for Payer: Hawaii Medical Service Association Commercial	$1,600.00
Rate for Payer: Hawaii Medical Service Association Medicare	$403.20
Rate for Payer: Hawaii Medical Service Association Non-ABD	$450.00
Rate for Payer: Hawaii Western Management Group Commercial	$425.60
Rate for Payer: Health Management Network Commercial	$380.80
Rate for Payer: Humana Medicare	$403.20
Rate for Payer: Kaiser Permanente Commercial	$403.20
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$403.20
Rate for Payer: MDX Hawaii PPO	$434.56
Rate for Payer: Ohana Health Plan Medicaid	$403.20
Rate for Payer: Ohana Health Plan Medicare	$403.20
Rate for Payer: UnitedHealthcare Medicare	$403.20
Rate for Payer: University Health Alliance Commercial	$326.55

Know your out-of-pocket cost for care.

All Charges