Kona Community Hospital

All Charges

Charge

Type

Setting

Price

HCHG FUNGITELL (1-3)-B-D-GLUCAN

Facility

$83.00

Service Code	HCPCS 85130
Hospital Charge Code	H3011660
Hospital Revenue Code	301
Min. Negotiated Rate	$11.89
Max. Negotiated Rate	$80.51
Rate for Payer: AlohaCare Medicaid	$11.89
Rate for Payer: AlohaCare Medicare	$11.89
Rate for Payer: Cash Price	$53.95
Rate for Payer: Cash Price	$53.95
Rate for Payer: Devoted Health Medicare	$13.08
Rate for Payer: Hawaii Medical Service Association ABD	$16.44
Rate for Payer: Hawaii Medical Service Association Commercial	$14.86
Rate for Payer: Hawaii Medical Service Association Medicare	$11.89
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17.26
Rate for Payer: Hawaii Western Management Group Commercial	$11.89
Rate for Payer: Health Management Network Commercial	$70.55
Rate for Payer: Humana Medicare	$11.89
Rate for Payer: Kaiser Permanente Commercial	$52.29
Rate for Payer: Kaiser Permanente Medicaid	$42.33
Rate for Payer: Kaiser Permanente Medicare	$11.89
Rate for Payer: MDX Hawaii PPO	$80.51
Rate for Payer: Ohana Health Plan Medicaid	$13.08
Rate for Payer: Ohana Health Plan Medicare	$11.89
Rate for Payer: UnitedHealthcare Medicaid	$16.44
Rate for Payer: UnitedHealthcare Medicare	$11.89
Rate for Payer: University Health Alliance Commercial	$30.75

HCHG FUNGITELL (1-3)-B-D-GLUCAN

Facility

$83.00

Service Code	HCPCS 85130
Hospital Charge Code	H3011660
Hospital Revenue Code	301
Min. Negotiated Rate	$70.55
Max. Negotiated Rate	$80.51
Rate for Payer: Cash Price	$53.95
Rate for Payer: Health Management Network Commercial	$70.55
Rate for Payer: MDX Hawaii PPO	$80.51

HCHG FUNGITELL, SERUM - 90

Facility

$411.00

Service Code	HCPCS 87449
Hospital Charge Code	H3060776
Hospital Revenue Code	306
Min. Negotiated Rate	$11.98
Max. Negotiated Rate	$398.67
Rate for Payer: AlohaCare Medicaid	$11.98
Rate for Payer: AlohaCare Medicare	$11.98
Rate for Payer: Cash Price	$267.15
Rate for Payer: Cash Price	$267.15
Rate for Payer: Devoted Health Medicare	$13.18
Rate for Payer: Hawaii Medical Service Association ABD	$16.58
Rate for Payer: Hawaii Medical Service Association Commercial	$14.97
Rate for Payer: Hawaii Medical Service Association Medicare	$11.98
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17.41
Rate for Payer: Hawaii Western Management Group Commercial	$11.98
Rate for Payer: Health Management Network Commercial	$349.35
Rate for Payer: Humana Medicare	$11.98
Rate for Payer: Kaiser Permanente Commercial	$258.93
Rate for Payer: Kaiser Permanente Medicaid	$209.61
Rate for Payer: Kaiser Permanente Medicare	$11.98
Rate for Payer: MDX Hawaii PPO	$398.67
Rate for Payer: Ohana Health Plan Medicaid	$13.18
Rate for Payer: Ohana Health Plan Medicare	$11.98
Rate for Payer: UnitedHealthcare Medicaid	$16.58
Rate for Payer: UnitedHealthcare Medicare	$11.98
Rate for Payer: University Health Alliance Commercial	$31.01

HCHG FUNGITELL, SERUM - 90

Facility

$411.00

Service Code	HCPCS 87449
Hospital Charge Code	H3060776
Hospital Revenue Code	306
Min. Negotiated Rate	$349.35
Max. Negotiated Rate	$398.67
Rate for Payer: Cash Price	$267.15
Rate for Payer: Health Management Network Commercial	$349.35
Rate for Payer: MDX Hawaii PPO	$398.67

HCHG FUNGITELL SO

Facility

$411.00

Service Code	HCPCS 87449
Hospital Charge Code	K3010050
Hospital Revenue Code	301
Min. Negotiated Rate	$11.98
Max. Negotiated Rate	$398.67
Rate for Payer: AlohaCare Medicaid	$11.98
Rate for Payer: AlohaCare Medicare	$11.98
Rate for Payer: Cash Price	$267.15
Rate for Payer: Cash Price	$267.15
Rate for Payer: Devoted Health Medicare	$13.18
Rate for Payer: Hawaii Medical Service Association ABD	$16.58
Rate for Payer: Hawaii Medical Service Association Commercial	$14.97
Rate for Payer: Hawaii Medical Service Association Medicare	$11.98
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17.41
Rate for Payer: Hawaii Western Management Group Commercial	$11.98
Rate for Payer: Health Management Network Commercial	$349.35
Rate for Payer: Humana Medicare	$11.98
Rate for Payer: Kaiser Permanente Commercial	$258.93
Rate for Payer: Kaiser Permanente Medicaid	$209.61
Rate for Payer: Kaiser Permanente Medicare	$11.98
Rate for Payer: MDX Hawaii PPO	$398.67
Rate for Payer: Ohana Health Plan Medicaid	$13.18
Rate for Payer: Ohana Health Plan Medicare	$11.98
Rate for Payer: UnitedHealthcare Medicaid	$16.58
Rate for Payer: UnitedHealthcare Medicare	$11.98
Rate for Payer: University Health Alliance Commercial	$31.01

HCHG FUNGITELL SO

Facility

$411.00

Service Code	HCPCS 87449
Hospital Charge Code	K3010050
Hospital Revenue Code	301
Min. Negotiated Rate	$349.35
Max. Negotiated Rate	$398.67
Rate for Payer: Cash Price	$267.15
Rate for Payer: Health Management Network Commercial	$349.35
Rate for Payer: MDX Hawaii PPO	$398.67

HCHG FUNGUS CULTURE, HAIR/NAIL/SKIN

Facility

$95.00

Service Code	HCPCS 87101
Hospital Charge Code	H3060620
Hospital Revenue Code	306
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$92.15
Rate for Payer: AlohaCare Medicaid	$7.71
Rate for Payer: AlohaCare Medicare	$7.71
Rate for Payer: Cash Price	$61.75
Rate for Payer: Cash Price	$61.75
Rate for Payer: Devoted Health Medicare	$8.48
Rate for Payer: Hawaii Medical Service Association ABD	$10.66
Rate for Payer: Hawaii Medical Service Association Commercial	$9.64
Rate for Payer: Hawaii Medical Service Association Medicare	$7.71
Rate for Payer: Hawaii Medical Service Association Non-ABD	$11.19
Rate for Payer: Hawaii Western Management Group Commercial	$7.71
Rate for Payer: Health Management Network Commercial	$80.75
Rate for Payer: Humana Medicare	$7.71
Rate for Payer: Kaiser Permanente Commercial	$59.85
Rate for Payer: Kaiser Permanente Medicaid	$48.45
Rate for Payer: Kaiser Permanente Medicare	$7.71
Rate for Payer: MDX Hawaii PPO	$92.15
Rate for Payer: Ohana Health Plan Medicaid	$8.48
Rate for Payer: Ohana Health Plan Medicare	$7.71
Rate for Payer: UnitedHealthcare Medicaid	$10.66
Rate for Payer: UnitedHealthcare Medicare	$7.71
Rate for Payer: University Health Alliance Commercial	$19.92

HCHG FUNGUS CULTURE, HAIR/NAIL/SKIN

Facility

$95.00

Service Code	HCPCS 87101
Hospital Charge Code	H3060620
Hospital Revenue Code	306
Min. Negotiated Rate	$80.75
Max. Negotiated Rate	$92.15
Rate for Payer: Cash Price	$61.75
Rate for Payer: Health Management Network Commercial	$80.75
Rate for Payer: MDX Hawaii PPO	$92.15

HCHG FUNGUS STAIN BY CALCOFLUOR WHITE

Facility

$91.00

Service Code	HCPCS 87206
Hospital Charge Code	H3060658
Hospital Revenue Code	306
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$88.27
Rate for Payer: AlohaCare Medicaid	$5.39
Rate for Payer: AlohaCare Medicare	$5.39
Rate for Payer: Cash Price	$59.15
Rate for Payer: Cash Price	$59.15
Rate for Payer: Devoted Health Medicare	$5.93
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	$5.39
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	$77.35
Rate for Payer: Humana Medicare	$5.39
Rate for Payer: Kaiser Permanente Commercial	$57.33
Rate for Payer: Kaiser Permanente Medicaid	$46.41
Rate for Payer: Kaiser Permanente Medicare	$5.39
Rate for Payer: MDX Hawaii PPO	$88.27
Rate for Payer: Ohana Health Plan Medicaid	$5.93
Rate for Payer: Ohana Health Plan Medicare	$5.39
Rate for Payer: UnitedHealthcare Medicaid	$7.42
Rate for Payer: UnitedHealthcare Medicare	$5.39
Rate for Payer: University Health Alliance Commercial	$13.88

HCHG FUNGUS STAIN BY CALCOFLUOR WHITE

Facility

$91.00

Service Code	HCPCS 87206
Hospital Charge Code	H3060658
Hospital Revenue Code	306
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: MDX Hawaii PPO	$88.27

HCHG G6PD 90

Facility

$120.00

Service Code	HCPCS 82955
Hospital Charge Code	H3010626
Hospital Revenue Code	301
Min. Negotiated Rate	$9.70
Max. Negotiated Rate	$116.40
Rate for Payer: AlohaCare Medicaid	$9.70
Rate for Payer: AlohaCare Medicare	$9.70
Rate for Payer: Cash Price	$78.00
Rate for Payer: Cash Price	$78.00
Rate for Payer: Devoted Health Medicare	$10.67
Rate for Payer: Hawaii Medical Service Association ABD	$13.40
Rate for Payer: Hawaii Medical Service Association Commercial	$12.12
Rate for Payer: Hawaii Medical Service Association Medicare	$9.70
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14.07
Rate for Payer: Hawaii Western Management Group Commercial	$9.70
Rate for Payer: Health Management Network Commercial	$102.00
Rate for Payer: Humana Medicare	$9.70
Rate for Payer: Kaiser Permanente Commercial	$75.60
Rate for Payer: Kaiser Permanente Medicaid	$61.20
Rate for Payer: Kaiser Permanente Medicare	$9.70
Rate for Payer: MDX Hawaii PPO	$116.40
Rate for Payer: Ohana Health Plan Medicaid	$10.67
Rate for Payer: Ohana Health Plan Medicare	$9.70
Rate for Payer: UnitedHealthcare Medicaid	$13.40
Rate for Payer: UnitedHealthcare Medicare	$9.70
Rate for Payer: University Health Alliance Commercial	$25.07

HCHG G6PD 90

Facility

$120.00

Service Code	HCPCS 82955
Hospital Charge Code	H3010626
Hospital Revenue Code	301
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$116.40
Rate for Payer: Cash Price	$78.00
Rate for Payer: Health Management Network Commercial	$102.00
Rate for Payer: MDX Hawaii PPO	$116.40

HCHG GABAPENTIN

Facility

$169.00

Service Code	HCPCS 80171
Hospital Charge Code	H3010630
Hospital Revenue Code	301
Min. Negotiated Rate	$143.65
Max. Negotiated Rate	$163.93
Rate for Payer: Cash Price	$109.85
Rate for Payer: Health Management Network Commercial	$143.65
Rate for Payer: MDX Hawaii PPO	$163.93

HCHG GABAPENTIN

Facility

$169.00

Service Code	HCPCS 80171
Hospital Charge Code	H3010630
Hospital Revenue Code	301
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$163.93
Rate for Payer: AlohaCare Medicaid	$21.67
Rate for Payer: AlohaCare Medicare	$21.67
Rate for Payer: Cash Price	$109.85
Rate for Payer: Cash Price	$109.85
Rate for Payer: Devoted Health Medicare	$23.84
Rate for Payer: Hawaii Medical Service Association ABD	$11.11
Rate for Payer: Hawaii Medical Service Association Commercial	$27.09
Rate for Payer: Hawaii Medical Service Association Medicare	$21.67
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17.75
Rate for Payer: Hawaii Western Management Group Commercial	$21.67
Rate for Payer: Health Management Network Commercial	$143.65
Rate for Payer: Humana Medicare	$21.67
Rate for Payer: Kaiser Permanente Commercial	$106.47
Rate for Payer: Kaiser Permanente Medicaid	$86.19
Rate for Payer: Kaiser Permanente Medicare	$21.67
Rate for Payer: MDX Hawaii PPO	$163.93
Rate for Payer: Ohana Health Plan Medicaid	$23.84
Rate for Payer: Ohana Health Plan Medicare	$21.67
Rate for Payer: UnitedHealthcare Medicaid	$10.85
Rate for Payer: UnitedHealthcare Medicare	$21.67
Rate for Payer: University Health Alliance Commercial	$123.18

HCHG GAD 65 ANTIBODY SO

Facility

$135.00

Service Code	HCPCS 83519
Hospital Charge Code	K3020001
Hospital Revenue Code	302
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$130.95
Rate for Payer: Cash Price	$87.75
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: MDX Hawaii PPO	$130.95

HCHG GAD 65 ANTIBODY SO

Facility

$135.00

Service Code	HCPCS 83519
Hospital Charge Code	K3020001
Hospital Revenue Code	302
Min. Negotiated Rate	$18.40
Max. Negotiated Rate	$130.95
Rate for Payer: AlohaCare Medicaid	$18.40
Rate for Payer: AlohaCare Medicare	$18.40
Rate for Payer: Cash Price	$87.75
Rate for Payer: Cash Price	$87.75
Rate for Payer: Devoted Health Medicare	$20.24
Rate for Payer: Hawaii Medical Service Association ABD	$18.67
Rate for Payer: Hawaii Medical Service Association Commercial	$23.00
Rate for Payer: Hawaii Medical Service Association Medicare	$18.40
Rate for Payer: Hawaii Medical Service Association Non-ABD	$19.60
Rate for Payer: Hawaii Western Management Group Commercial	$18.40
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: Humana Medicare	$18.40
Rate for Payer: Kaiser Permanente Commercial	$85.05
Rate for Payer: Kaiser Permanente Medicaid	$68.85
Rate for Payer: Kaiser Permanente Medicare	$18.40
Rate for Payer: MDX Hawaii PPO	$130.95
Rate for Payer: Ohana Health Plan Medicaid	$20.24
Rate for Payer: Ohana Health Plan Medicare	$18.40
Rate for Payer: UnitedHealthcare Medicaid	$18.67
Rate for Payer: UnitedHealthcare Medicare	$18.40
Rate for Payer: University Health Alliance Commercial	$34.93

HCHG GAMMA GT

Facility

$97.00

Service Code	HCPCS 82977
Hospital Charge Code	H3010632
Hospital Revenue Code	301
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$94.09
Rate for Payer: AlohaCare Medicaid	$7.20
Rate for Payer: AlohaCare Medicare	$7.20
Rate for Payer: Cash Price	$63.05
Rate for Payer: Cash Price	$63.05
Rate for Payer: Devoted Health Medicare	$7.92
Rate for Payer: Hawaii Medical Service Association ABD	$9.95
Rate for Payer: Hawaii Medical Service Association Commercial	$9.00
Rate for Payer: Hawaii Medical Service Association Medicare	$7.20
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10.45
Rate for Payer: Hawaii Western Management Group Commercial	$7.20
Rate for Payer: Health Management Network Commercial	$82.45
Rate for Payer: Humana Medicare	$7.20
Rate for Payer: Kaiser Permanente Commercial	$61.11
Rate for Payer: Kaiser Permanente Medicaid	$49.47
Rate for Payer: Kaiser Permanente Medicare	$7.20
Rate for Payer: MDX Hawaii PPO	$94.09
Rate for Payer: Ohana Health Plan Medicaid	$7.92
Rate for Payer: Ohana Health Plan Medicare	$7.20
Rate for Payer: UnitedHealthcare Medicaid	$9.95
Rate for Payer: UnitedHealthcare Medicare	$7.20
Rate for Payer: University Health Alliance Commercial	$18.61

HCHG GAMMA GT

Facility

$97.00

Service Code	HCPCS 82977
Hospital Charge Code	H3010632
Hospital Revenue Code	301
Min. Negotiated Rate	$82.45
Max. Negotiated Rate	$94.09
Rate for Payer: Cash Price	$63.05
Rate for Payer: Health Management Network Commercial	$82.45
Rate for Payer: MDX Hawaii PPO	$94.09

HCHG GARNERELLA VAG, DIRECT PROBE

Facility

$248.00

Service Code	HCPCS 87510
Hospital Charge Code	H3060677
Hospital Revenue Code	306
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$240.56
Rate for Payer: AlohaCare Medicaid	$20.05
Rate for Payer: AlohaCare Medicare	$20.05
Rate for Payer: Cash Price	$161.20
Rate for Payer: Cash Price	$161.20
Rate for Payer: Devoted Health Medicare	$22.05
Rate for Payer: Hawaii Medical Service Association ABD	$27.71
Rate for Payer: Hawaii Medical Service Association Commercial	$25.06
Rate for Payer: Hawaii Medical Service Association Medicare	$20.05
Rate for Payer: Hawaii Medical Service Association Non-ABD	$29.10
Rate for Payer: Hawaii Western Management Group Commercial	$20.05
Rate for Payer: Health Management Network Commercial	$210.80
Rate for Payer: Humana Medicare	$20.05
Rate for Payer: Kaiser Permanente Commercial	$156.24
Rate for Payer: Kaiser Permanente Medicaid	$126.48
Rate for Payer: Kaiser Permanente Medicare	$20.05
Rate for Payer: MDX Hawaii PPO	$240.56
Rate for Payer: Ohana Health Plan Medicaid	$22.05
Rate for Payer: Ohana Health Plan Medicare	$20.05
Rate for Payer: UnitedHealthcare Medicaid	$27.71
Rate for Payer: UnitedHealthcare Medicare	$20.05
Rate for Payer: University Health Alliance Commercial	$51.84

HCHG GARNERELLA VAG, DIRECT PROBE

Facility

$248.00

Service Code	HCPCS 87510
Hospital Charge Code	H3060677
Hospital Revenue Code	306
Min. Negotiated Rate	$210.80
Max. Negotiated Rate	$240.56
Rate for Payer: Cash Price	$161.20
Rate for Payer: Health Management Network Commercial	$210.80
Rate for Payer: MDX Hawaii PPO	$240.56

HCHG GASTRIC EMPTYING

Facility

$2,256.00

Service Code	HCPCS 78264
Hospital Charge Code	H3410166
Hospital Revenue Code	341
Min. Negotiated Rate	$1,917.60
Max. Negotiated Rate	$2,188.32
Rate for Payer: Cash Price	$1,466.40
Rate for Payer: Health Management Network Commercial	$1,917.60
Rate for Payer: MDX Hawaii PPO	$2,188.32

HCHG GASTRIC EMPTYING

Facility

$2,256.00

Service Code	HCPCS 78264
Hospital Charge Code	H3410166
Hospital Revenue Code	341
Min. Negotiated Rate	$159.82
Max. Negotiated Rate	$2,188.32
Rate for Payer: AlohaCare Medicaid	$472.27
Rate for Payer: AlohaCare Medicare	$472.27
Rate for Payer: Cash Price	$1,466.40
Rate for Payer: Cash Price	$1,466.40
Rate for Payer: Devoted Health Medicare	$519.50
Rate for Payer: Hawaii Medical Service Association ABD	$164.93
Rate for Payer: Hawaii Medical Service Association Commercial	$590.34
Rate for Payer: Hawaii Medical Service Association Medicare	$472.27
Rate for Payer: Hawaii Medical Service Association Non-ABD	$159.82
Rate for Payer: Hawaii Western Management Group Commercial	$472.27
Rate for Payer: Health Management Network Commercial	$1,917.60
Rate for Payer: Humana Medicare	$472.27
Rate for Payer: Kaiser Permanente Commercial	$1,421.28
Rate for Payer: Kaiser Permanente Medicaid	$1,150.56
Rate for Payer: Kaiser Permanente Medicare	$472.27
Rate for Payer: MDX Hawaii PPO	$2,188.32
Rate for Payer: Ohana Health Plan Medicaid	$519.50
Rate for Payer: Ohana Health Plan Medicare	$472.27
Rate for Payer: UnitedHealthcare Medicaid	$164.93
Rate for Payer: UnitedHealthcare Medicare	$472.27
Rate for Payer: University Health Alliance Commercial	$524.51

HCHG GASTRIN 90

Facility

$217.00

Service Code	HCPCS 82941
Hospital Charge Code	H3010638
Hospital Revenue Code	301
Min. Negotiated Rate	$184.45
Max. Negotiated Rate	$210.49
Rate for Payer: Cash Price	$141.05
Rate for Payer: Health Management Network Commercial	$184.45
Rate for Payer: MDX Hawaii PPO	$210.49

HCHG GASTRIN 90

Facility

$217.00

Service Code	HCPCS 82941
Hospital Charge Code	H3010638
Hospital Revenue Code	301
Min. Negotiated Rate	$17.63
Max. Negotiated Rate	$210.49
Rate for Payer: AlohaCare Medicaid	$17.63
Rate for Payer: AlohaCare Medicare	$17.63
Rate for Payer: Cash Price	$141.05
Rate for Payer: Cash Price	$141.05
Rate for Payer: Devoted Health Medicare	$19.39
Rate for Payer: Hawaii Medical Service Association ABD	$24.38
Rate for Payer: Hawaii Medical Service Association Commercial	$22.04
Rate for Payer: Hawaii Medical Service Association Medicare	$17.63
Rate for Payer: Hawaii Medical Service Association Non-ABD	$25.60
Rate for Payer: Hawaii Western Management Group Commercial	$17.63
Rate for Payer: Health Management Network Commercial	$184.45
Rate for Payer: Humana Medicare	$17.63
Rate for Payer: Kaiser Permanente Commercial	$136.71
Rate for Payer: Kaiser Permanente Medicaid	$110.67
Rate for Payer: Kaiser Permanente Medicare	$17.63
Rate for Payer: MDX Hawaii PPO	$210.49
Rate for Payer: Ohana Health Plan Medicaid	$19.39
Rate for Payer: Ohana Health Plan Medicare	$17.63
Rate for Payer: UnitedHealthcare Medicaid	$24.38
Rate for Payer: UnitedHealthcare Medicare	$17.63
Rate for Payer: University Health Alliance Commercial	$45.58

HCHG GATED WALL EF/WM/EX SINGLE STUDY

Facility

$2,256.00

Service Code	HCPCS 78472
Hospital Charge Code	H3410172
Hospital Revenue Code	341
Min. Negotiated Rate	$181.81
Max. Negotiated Rate	$2,188.32
Rate for Payer: AlohaCare Medicaid	$472.27
Rate for Payer: AlohaCare Medicare	$472.27
Rate for Payer: Cash Price	$1,466.40
Rate for Payer: Cash Price	$1,466.40
Rate for Payer: Devoted Health Medicare	$519.50
Rate for Payer: Hawaii Medical Service Association ABD	$181.81
Rate for Payer: Hawaii Medical Service Association Commercial	$590.34
Rate for Payer: Hawaii Medical Service Association Medicare	$472.27
Rate for Payer: Hawaii Medical Service Association Non-ABD	$197.26
Rate for Payer: Hawaii Western Management Group Commercial	$472.27
Rate for Payer: Health Management Network Commercial	$1,917.60
Rate for Payer: Humana Medicare	$472.27
Rate for Payer: Kaiser Permanente Commercial	$1,421.28
Rate for Payer: Kaiser Permanente Medicaid	$1,150.56
Rate for Payer: Kaiser Permanente Medicare	$472.27
Rate for Payer: MDX Hawaii PPO	$2,188.32
Rate for Payer: Ohana Health Plan Medicaid	$519.50
Rate for Payer: Ohana Health Plan Medicare	$472.27
Rate for Payer: UnitedHealthcare Medicaid	$181.81
Rate for Payer: UnitedHealthcare Medicare	$472.27
Rate for Payer: University Health Alliance Commercial	$553.93

Know your out-of-pocket cost for care.

All Charges