Kohala Hospital

All Charges

Charge

Type

Setting

Price

HCHG AFP MATERNAL SERUM

Facility

$237.00

Service Code	HCPCS 82105
Hospital Charge Code	H3010138
Hospital Revenue Code	301
Min. Negotiated Rate	$201.45
Max. Negotiated Rate	$229.89
Rate for Payer: Cash Price	$154.05
Rate for Payer: Health Management Network Commercial	$201.45
Rate for Payer: Kaiser Permanente Commercial	$213.30
Rate for Payer: MDX Hawaii PPO	$229.89

HCHG AFP NON-MATERNAL

Facility

$249.00

Service Code	HCPCS 82105
Hospital Charge Code	H3010140
Hospital Revenue Code	301
Min. Negotiated Rate	$16.77
Max. Negotiated Rate	$246.51
Rate for Payer: AlohaCare Medicaid	$124.50
Rate for Payer: AlohaCare Medicare	$224.10
Rate for Payer: Cash Price	$161.85
Rate for Payer: Cash Price	$161.85
Rate for Payer: Devoted Health Medicare	$246.51
Rate for Payer: Hawaii Medical Service Association ABD	$23.18
Rate for Payer: Hawaii Medical Service Association Commercial	$20.96
Rate for Payer: Hawaii Medical Service Association Medicare	$224.10
Rate for Payer: Hawaii Medical Service Association Non-ABD	$24.34
Rate for Payer: Hawaii Western Management Group Commercial	$16.77
Rate for Payer: Health Management Network Commercial	$211.65
Rate for Payer: Humana Medicare	$224.10
Rate for Payer: Kaiser Permanente Commercial	$224.10
Rate for Payer: Kaiser Permanente Medicaid	$126.99
Rate for Payer: Kaiser Permanente Medicare	$224.10
Rate for Payer: MDX Hawaii PPO	$241.53
Rate for Payer: Ohana Health Plan Medicaid	$224.10
Rate for Payer: Ohana Health Plan Medicare	$224.10
Rate for Payer: UnitedHealthcare Medicaid	$23.18
Rate for Payer: UnitedHealthcare Medicare	$224.10
Rate for Payer: University Health Alliance Commercial	$43.36

HCHG AFP NON-MATERNAL

Facility

$249.00

Service Code	HCPCS 82105
Hospital Charge Code	H3010140
Hospital Revenue Code	301
Min. Negotiated Rate	$211.65
Max. Negotiated Rate	$241.53
Rate for Payer: Cash Price	$161.85
Rate for Payer: Health Management Network Commercial	$211.65
Rate for Payer: Kaiser Permanente Commercial	$224.10
Rate for Payer: MDX Hawaii PPO	$241.53

HCHG AHG TEST (C3) DIRECT

Facility

$94.00

Service Code	HCPCS 86880
Hospital Charge Code	H3020172
Hospital Revenue Code	302
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$93.06
Rate for Payer: AlohaCare Medicaid	$47.00
Rate for Payer: AlohaCare Medicare	$84.60
Rate for Payer: Cash Price	$61.10
Rate for Payer: Cash Price	$61.10
Rate for Payer: Devoted Health Medicare	$93.06
Rate for Payer: Hawaii Medical Service Association ABD	$7.42
Rate for Payer: Hawaii Medical Service Association Commercial	$6.74
Rate for Payer: Hawaii Medical Service Association Medicare	$84.60
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.79
Rate for Payer: Hawaii Western Management Group Commercial	$5.39
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: Humana Medicare	$84.60
Rate for Payer: Kaiser Permanente Commercial	$84.60
Rate for Payer: Kaiser Permanente Medicaid	$47.94
Rate for Payer: Kaiser Permanente Medicare	$84.60
Rate for Payer: MDX Hawaii PPO	$91.18
Rate for Payer: Ohana Health Plan Medicaid	$84.60
Rate for Payer: Ohana Health Plan Medicare	$84.60
Rate for Payer: UnitedHealthcare Medicaid	$7.42
Rate for Payer: UnitedHealthcare Medicare	$84.60
Rate for Payer: University Health Alliance Commercial	$13.88

HCHG AHG TEST (C3) DIRECT

Facility

$94.00

Service Code	HCPCS 86880
Hospital Charge Code	H3020172
Hospital Revenue Code	302
Min. Negotiated Rate	$79.90
Max. Negotiated Rate	$91.18
Rate for Payer: Cash Price	$61.10
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: Kaiser Permanente Commercial	$84.60
Rate for Payer: MDX Hawaii PPO	$91.18

HCHG AHG TEST (IGG) DIRECT

Facility

$94.00

Service Code	HCPCS 86880
Hospital Charge Code	H3020174
Hospital Revenue Code	302
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$93.06
Rate for Payer: AlohaCare Medicaid	$47.00
Rate for Payer: AlohaCare Medicare	$84.60
Rate for Payer: Cash Price	$61.10
Rate for Payer: Cash Price	$61.10
Rate for Payer: Devoted Health Medicare	$93.06
Rate for Payer: Hawaii Medical Service Association ABD	$7.42
Rate for Payer: Hawaii Medical Service Association Commercial	$6.74
Rate for Payer: Hawaii Medical Service Association Medicare	$84.60
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.79
Rate for Payer: Hawaii Western Management Group Commercial	$5.39
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: Humana Medicare	$84.60
Rate for Payer: Kaiser Permanente Commercial	$84.60
Rate for Payer: Kaiser Permanente Medicaid	$47.94
Rate for Payer: Kaiser Permanente Medicare	$84.60
Rate for Payer: MDX Hawaii PPO	$91.18
Rate for Payer: Ohana Health Plan Medicaid	$84.60
Rate for Payer: Ohana Health Plan Medicare	$84.60
Rate for Payer: UnitedHealthcare Medicaid	$7.42
Rate for Payer: UnitedHealthcare Medicare	$84.60
Rate for Payer: University Health Alliance Commercial	$13.88

HCHG AHG TEST (IGG) DIRECT

Facility

$94.00

Service Code	HCPCS 86880
Hospital Charge Code	H3020174
Hospital Revenue Code	302
Min. Negotiated Rate	$79.90
Max. Negotiated Rate	$91.18
Rate for Payer: Cash Price	$61.10
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: Kaiser Permanente Commercial	$84.60
Rate for Payer: MDX Hawaii PPO	$91.18

HCHG AIRWAY INHALATION TREATMENT

Facility

$1,256.00

Service Code	HCPCS 94640
Hospital Charge Code	H4500996
Hospital Revenue Code	410
Min. Negotiated Rate	$1,067.60
Max. Negotiated Rate	$1,218.32
Rate for Payer: Cash Price	$816.40
Rate for Payer: Health Management Network Commercial	$1,067.60
Rate for Payer: Kaiser Permanente Commercial	$1,130.40
Rate for Payer: MDX Hawaii PPO	$1,218.32

HCHG AIRWAY INHALATION TREATMENT

Facility

$1,256.00

Service Code	HCPCS 94640
Hospital Charge Code	H4500996
Hospital Revenue Code	410
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$1,243.44
Rate for Payer: AlohaCare Medicaid	$628.00
Rate for Payer: AlohaCare Medicare	$1,130.40
Rate for Payer: Cash Price	$816.40
Rate for Payer: Cash Price	$816.40
Rate for Payer: Devoted Health Medicare	$1,243.44
Rate for Payer: Hawaii Medical Service Association Commercial	$279.65
Rate for Payer: Hawaii Medical Service Association Medicare	$1,130.40
Rate for Payer: Hawaii Western Management Group Commercial	$1,193.20
Rate for Payer: Health Management Network Commercial	$1,067.60
Rate for Payer: Humana Medicare	$1,130.40
Rate for Payer: Kaiser Permanente Commercial	$1,130.40
Rate for Payer: Kaiser Permanente Medicaid	$640.56
Rate for Payer: Kaiser Permanente Medicare	$1,130.40
Rate for Payer: MDX Hawaii PPO	$1,218.32
Rate for Payer: Ohana Health Plan Medicaid	$1,130.40
Rate for Payer: Ohana Health Plan Medicare	$1,130.40
Rate for Payer: UnitedHealthcare Medicaid	$13.32
Rate for Payer: UnitedHealthcare Medicare	$1,130.40
Rate for Payer: University Health Alliance Commercial	$915.50

HCHG ALBUMIN BODY FLUID

Facility

$91.00

Service Code	HCPCS 82042
Hospital Charge Code	H3010144
Hospital Revenue Code	301
Min. Negotiated Rate	$77.35
Max. Negotiated Rate	$88.27
Rate for Payer: Cash Price	$59.15
Rate for Payer: Health Management Network Commercial	$77.35
Rate for Payer: Kaiser Permanente Commercial	$81.90
Rate for Payer: MDX Hawaii PPO	$88.27

HCHG ALBUMIN BODY FLUID

Facility

$91.00

Service Code	HCPCS 82042
Hospital Charge Code	H3010144
Hospital Revenue Code	301
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$90.09
Rate for Payer: AlohaCare Medicaid	$45.50
Rate for Payer: AlohaCare Medicare	$81.90
Rate for Payer: Cash Price	$59.15
Rate for Payer: Cash Price	$59.15
Rate for Payer: Devoted Health Medicare	$90.09
Rate for Payer: Hawaii Medical Service Association ABD	$7.15
Rate for Payer: Hawaii Medical Service Association Commercial	$9.72
Rate for Payer: Hawaii Medical Service Association Medicare	$81.90
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.51
Rate for Payer: Hawaii Western Management Group Commercial	$7.78
Rate for Payer: Health Management Network Commercial	$77.35
Rate for Payer: Humana Medicare	$81.90
Rate for Payer: Kaiser Permanente Commercial	$81.90
Rate for Payer: Kaiser Permanente Medicaid	$46.41
Rate for Payer: Kaiser Permanente Medicare	$81.90
Rate for Payer: MDX Hawaii PPO	$88.27
Rate for Payer: Ohana Health Plan Medicaid	$81.90
Rate for Payer: Ohana Health Plan Medicare	$81.90
Rate for Payer: UnitedHealthcare Medicaid	$7.15
Rate for Payer: UnitedHealthcare Medicare	$81.90
Rate for Payer: University Health Alliance Commercial	$13.38

HCHG ALBUMIN CSF X 90

Facility

$91.00

Service Code	HCPCS 82042
Hospital Charge Code	H3010146
Hospital Revenue Code	301
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$90.09
Rate for Payer: AlohaCare Medicaid	$45.50
Rate for Payer: AlohaCare Medicare	$81.90
Rate for Payer: Cash Price	$59.15
Rate for Payer: Cash Price	$59.15
Rate for Payer: Devoted Health Medicare	$90.09
Rate for Payer: Hawaii Medical Service Association ABD	$7.15
Rate for Payer: Hawaii Medical Service Association Commercial	$9.72
Rate for Payer: Hawaii Medical Service Association Medicare	$81.90
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.51
Rate for Payer: Hawaii Western Management Group Commercial	$7.78
Rate for Payer: Health Management Network Commercial	$77.35
Rate for Payer: Humana Medicare	$81.90
Rate for Payer: Kaiser Permanente Commercial	$81.90
Rate for Payer: Kaiser Permanente Medicaid	$46.41
Rate for Payer: Kaiser Permanente Medicare	$81.90
Rate for Payer: MDX Hawaii PPO	$88.27
Rate for Payer: Ohana Health Plan Medicaid	$81.90
Rate for Payer: Ohana Health Plan Medicare	$81.90
Rate for Payer: UnitedHealthcare Medicaid	$7.15
Rate for Payer: UnitedHealthcare Medicare	$81.90
Rate for Payer: University Health Alliance Commercial	$13.38

HCHG ALBUMIN CSF X 90

Facility

$91.00

Service Code	HCPCS 82042
Hospital Charge Code	H3010146
Hospital Revenue Code	301
Min. Negotiated Rate	$77.35
Max. Negotiated Rate	$88.27
Rate for Payer: Cash Price	$59.15
Rate for Payer: Health Management Network Commercial	$77.35
Rate for Payer: Kaiser Permanente Commercial	$81.90
Rate for Payer: MDX Hawaii PPO	$88.27

HCHG ALBUMIN, RANDOM URINE - 90

Facility

$87.00

Service Code	HCPCS 82043
Hospital Charge Code	H3011828
Hospital Revenue Code	301
Min. Negotiated Rate	$73.95
Max. Negotiated Rate	$84.39
Rate for Payer: Cash Price	$56.55
Rate for Payer: Health Management Network Commercial	$73.95
Rate for Payer: Kaiser Permanente Commercial	$78.30
Rate for Payer: MDX Hawaii PPO	$84.39

HCHG ALBUMIN, RANDOM URINE - 90

Facility

$87.00

Service Code	HCPCS 82043
Hospital Charge Code	H3011828
Hospital Revenue Code	301
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$86.13
Rate for Payer: AlohaCare Medicaid	$43.50
Rate for Payer: AlohaCare Medicare	$78.30
Rate for Payer: Cash Price	$56.55
Rate for Payer: Cash Price	$56.55
Rate for Payer: Devoted Health Medicare	$86.13
Rate for Payer: Hawaii Medical Service Association ABD	$8.00
Rate for Payer: Hawaii Medical Service Association Commercial	$7.22
Rate for Payer: Hawaii Medical Service Association Medicare	$78.30
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8.40
Rate for Payer: Hawaii Western Management Group Commercial	$5.78
Rate for Payer: Health Management Network Commercial	$73.95
Rate for Payer: Humana Medicare	$78.30
Rate for Payer: Kaiser Permanente Commercial	$78.30
Rate for Payer: Kaiser Permanente Medicaid	$44.37
Rate for Payer: Kaiser Permanente Medicare	$78.30
Rate for Payer: MDX Hawaii PPO	$84.39
Rate for Payer: Ohana Health Plan Medicaid	$78.30
Rate for Payer: Ohana Health Plan Medicare	$78.30
Rate for Payer: UnitedHealthcare Medicaid	$8.00
Rate for Payer: UnitedHealthcare Medicare	$78.30
Rate for Payer: University Health Alliance Commercial	$14.97

HCHG ALBUMIN SERUM/PLASMA/WHOLE BLOOD

Facility

$38.00

Service Code	HCPCS 82040
Hospital Charge Code	H3010142
Hospital Revenue Code	301
Min. Negotiated Rate	$32.30
Max. Negotiated Rate	$36.86
Rate for Payer: Cash Price	$24.70
Rate for Payer: Health Management Network Commercial	$32.30
Rate for Payer: Kaiser Permanente Commercial	$34.20
Rate for Payer: MDX Hawaii PPO	$36.86

HCHG ALBUMIN SERUM/PLASMA/WHOLE BLOOD

Facility

$38.00

Service Code	HCPCS 82040
Hospital Charge Code	H3010142
Hospital Revenue Code	301
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$37.62
Rate for Payer: AlohaCare Medicaid	$19.00
Rate for Payer: AlohaCare Medicare	$34.20
Rate for Payer: Cash Price	$24.70
Rate for Payer: Cash Price	$24.70
Rate for Payer: Devoted Health Medicare	$37.62
Rate for Payer: Hawaii Medical Service Association ABD	$6.85
Rate for Payer: Hawaii Medical Service Association Commercial	$6.19
Rate for Payer: Hawaii Medical Service Association Medicare	$34.20
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.19
Rate for Payer: Hawaii Western Management Group Commercial	$4.95
Rate for Payer: Health Management Network Commercial	$32.30
Rate for Payer: Humana Medicare	$34.20
Rate for Payer: Kaiser Permanente Commercial	$34.20
Rate for Payer: Kaiser Permanente Medicaid	$19.38
Rate for Payer: Kaiser Permanente Medicare	$34.20
Rate for Payer: MDX Hawaii PPO	$36.86
Rate for Payer: Ohana Health Plan Medicaid	$34.20
Rate for Payer: Ohana Health Plan Medicare	$34.20
Rate for Payer: UnitedHealthcare Medicaid	$6.85
Rate for Payer: UnitedHealthcare Medicare	$34.20
Rate for Payer: University Health Alliance Commercial	$12.80

HCHG ALCOHOL BLOOD

Facility

$699.00

Service Code	HCPCS 80307
Hospital Charge Code	K3010020
Hospital Revenue Code	301
Min. Negotiated Rate	$47.89
Max. Negotiated Rate	$692.01
Rate for Payer: AlohaCare Medicaid	$349.50
Rate for Payer: AlohaCare Medicare	$629.10
Rate for Payer: Cash Price	$454.35
Rate for Payer: Cash Price	$454.35
Rate for Payer: Devoted Health Medicare	$692.01
Rate for Payer: Hawaii Medical Service Association ABD	$59.38
Rate for Payer: Hawaii Medical Service Association Commercial	$77.67
Rate for Payer: Hawaii Medical Service Association Medicare	$629.10
Rate for Payer: Hawaii Medical Service Association Non-ABD	$59.38
Rate for Payer: Hawaii Western Management Group Commercial	$62.14
Rate for Payer: Health Management Network Commercial	$594.15
Rate for Payer: Humana Medicare	$629.10
Rate for Payer: Kaiser Permanente Commercial	$629.10
Rate for Payer: Kaiser Permanente Medicaid	$356.49
Rate for Payer: Kaiser Permanente Medicare	$629.10
Rate for Payer: MDX Hawaii PPO	$678.03
Rate for Payer: Ohana Health Plan Medicaid	$629.10
Rate for Payer: Ohana Health Plan Medicare	$629.10
Rate for Payer: UnitedHealthcare Medicaid	$47.89
Rate for Payer: UnitedHealthcare Medicare	$629.10
Rate for Payer: University Health Alliance Commercial	$147.65

HCHG ALCOHOL BLOOD

Facility

$699.00

Service Code	HCPCS 80307
Hospital Charge Code	K3010020
Hospital Revenue Code	301
Min. Negotiated Rate	$594.15
Max. Negotiated Rate	$678.03
Rate for Payer: Cash Price	$454.35
Rate for Payer: Health Management Network Commercial	$594.15
Rate for Payer: Kaiser Permanente Commercial	$629.10
Rate for Payer: MDX Hawaii PPO	$678.03

HCHG ALCOHOL (ETHANOL) ANY SPECIMEN EXPECT BREATH 90

Facility

$189.00

Service Code	HCPCS 80320
Hospital Charge Code	H3011562
Hospital Revenue Code	301
Min. Negotiated Rate	$160.65
Max. Negotiated Rate	$183.33
Rate for Payer: Cash Price	$122.85
Rate for Payer: Health Management Network Commercial	$160.65
Rate for Payer: Kaiser Permanente Commercial	$170.10
Rate for Payer: MDX Hawaii PPO	$183.33

HCHG ALCOHOL (ETHANOL) ANY SPECIMEN EXPECT BREATH 90

Facility

$189.00

Service Code	HCPCS 80320
Hospital Charge Code	H3011562
Hospital Revenue Code	301
Min. Negotiated Rate	$14.93
Max. Negotiated Rate	$187.11
Rate for Payer: AlohaCare Medicaid	$94.50
Rate for Payer: AlohaCare Medicare	$170.10
Rate for Payer: Cash Price	$122.85
Rate for Payer: Cash Price	$122.85
Rate for Payer: Devoted Health Medicare	$187.11
Rate for Payer: Hawaii Medical Service Association ABD	$14.93
Rate for Payer: Hawaii Medical Service Association Medicare	$170.10
Rate for Payer: Hawaii Medical Service Association Non-ABD	$15.68
Rate for Payer: Hawaii Western Management Group Commercial	$179.55
Rate for Payer: Health Management Network Commercial	$160.65
Rate for Payer: Humana Medicare	$170.10
Rate for Payer: Kaiser Permanente Commercial	$170.10
Rate for Payer: Kaiser Permanente Medicaid	$96.39
Rate for Payer: Kaiser Permanente Medicare	$170.10
Rate for Payer: MDX Hawaii PPO	$183.33
Rate for Payer: Ohana Health Plan Medicaid	$170.10
Rate for Payer: Ohana Health Plan Medicare	$170.10
Rate for Payer: UnitedHealthcare Medicare	$170.10
Rate for Payer: University Health Alliance Commercial	$137.76

HCHG ALDOLASE 90

Facility

$75.00

Service Code	HCPCS 82085
Hospital Charge Code	H3010152
Hospital Revenue Code	301
Min. Negotiated Rate	$9.71
Max. Negotiated Rate	$74.25
Rate for Payer: AlohaCare Medicaid	$37.50
Rate for Payer: AlohaCare Medicare	$67.50
Rate for Payer: Cash Price	$48.75
Rate for Payer: Cash Price	$48.75
Rate for Payer: Devoted Health Medicare	$74.25
Rate for Payer: Hawaii Medical Service Association ABD	$13.42
Rate for Payer: Hawaii Medical Service Association Commercial	$12.14
Rate for Payer: Hawaii Medical Service Association Medicare	$67.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14.09
Rate for Payer: Hawaii Western Management Group Commercial	$9.71
Rate for Payer: Health Management Network Commercial	$63.75
Rate for Payer: Humana Medicare	$67.50
Rate for Payer: Kaiser Permanente Commercial	$67.50
Rate for Payer: Kaiser Permanente Medicaid	$38.25
Rate for Payer: Kaiser Permanente Medicare	$67.50
Rate for Payer: MDX Hawaii PPO	$72.75
Rate for Payer: Ohana Health Plan Medicaid	$67.50
Rate for Payer: Ohana Health Plan Medicare	$67.50
Rate for Payer: UnitedHealthcare Medicaid	$13.42
Rate for Payer: UnitedHealthcare Medicare	$67.50
Rate for Payer: University Health Alliance Commercial	$25.09

HCHG ALDOLASE 90

Facility

$75.00

Service Code	HCPCS 82085
Hospital Charge Code	H3010152
Hospital Revenue Code	301
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$72.75
Rate for Payer: Cash Price	$48.75
Rate for Payer: Health Management Network Commercial	$63.75
Rate for Payer: Kaiser Permanente Commercial	$67.50
Rate for Payer: MDX Hawaii PPO	$72.75

HCHG ALDOSTERONE

Facility

$502.00

Service Code	HCPCS 82088
Hospital Charge Code	H3011734
Hospital Revenue Code	301
Min. Negotiated Rate	$426.70
Max. Negotiated Rate	$486.94
Rate for Payer: Cash Price	$326.30
Rate for Payer: Health Management Network Commercial	$426.70
Rate for Payer: Kaiser Permanente Commercial	$451.80
Rate for Payer: MDX Hawaii PPO	$486.94

HCHG ALDOSTERONE

Facility

$502.00

Service Code	HCPCS 82088
Hospital Charge Code	H3011734
Hospital Revenue Code	301
Min. Negotiated Rate	$40.75
Max. Negotiated Rate	$496.98
Rate for Payer: AlohaCare Medicaid	$251.00
Rate for Payer: AlohaCare Medicare	$451.80
Rate for Payer: Cash Price	$326.30
Rate for Payer: Cash Price	$326.30
Rate for Payer: Devoted Health Medicare	$496.98
Rate for Payer: Hawaii Medical Service Association ABD	$56.32
Rate for Payer: Hawaii Medical Service Association Commercial	$50.94
Rate for Payer: Hawaii Medical Service Association Medicare	$451.80
Rate for Payer: Hawaii Medical Service Association Non-ABD	$59.14
Rate for Payer: Hawaii Western Management Group Commercial	$40.75
Rate for Payer: Health Management Network Commercial	$426.70
Rate for Payer: Humana Medicare	$451.80
Rate for Payer: Kaiser Permanente Commercial	$451.80
Rate for Payer: Kaiser Permanente Medicaid	$256.02
Rate for Payer: Kaiser Permanente Medicare	$451.80
Rate for Payer: MDX Hawaii PPO	$486.94
Rate for Payer: Ohana Health Plan Medicaid	$451.80
Rate for Payer: Ohana Health Plan Medicare	$451.80
Rate for Payer: UnitedHealthcare Medicaid	$56.32
Rate for Payer: UnitedHealthcare Medicare	$451.80
Rate for Payer: University Health Alliance Commercial	$105.34

Know your out-of-pocket cost for care.

All Charges