Kona Community Hospital

All Charges

Charge

Type

Setting

Price

HCHG TOBRAMYCIN LEVEL RIA

Facility

$198.00

Service Code	HCPCS 80200
Hospital Charge Code	H3011234
Hospital Revenue Code	301
Min. Negotiated Rate	$16.13
Max. Negotiated Rate	$192.06
Rate for Payer: AlohaCare Medicaid	$16.13
Rate for Payer: AlohaCare Medicare	$16.13
Rate for Payer: Cash Price	$128.70
Rate for Payer: Cash Price	$128.70
Rate for Payer: Devoted Health Medicare	$17.74
Rate for Payer: Hawaii Medical Service Association ABD	$22.27
Rate for Payer: Hawaii Medical Service Association Commercial	$20.16
Rate for Payer: Hawaii Medical Service Association Medicare	$16.13
Rate for Payer: Hawaii Medical Service Association Non-ABD	$23.38
Rate for Payer: Hawaii Western Management Group Commercial	$16.13
Rate for Payer: Health Management Network Commercial	$168.30
Rate for Payer: Humana Medicare	$16.13
Rate for Payer: Kaiser Permanente Commercial	$124.74
Rate for Payer: Kaiser Permanente Medicaid	$100.98
Rate for Payer: Kaiser Permanente Medicare	$16.13
Rate for Payer: MDX Hawaii PPO	$192.06
Rate for Payer: Ohana Health Plan Medicaid	$17.74
Rate for Payer: Ohana Health Plan Medicare	$16.13
Rate for Payer: UnitedHealthcare Medicaid	$22.27
Rate for Payer: UnitedHealthcare Medicare	$16.13
Rate for Payer: University Health Alliance Commercial	$41.66

HCHG TOBRAMYCIN LEVEL RIA

Facility

$198.00

Service Code	HCPCS 80200
Hospital Charge Code	H3011234
Hospital Revenue Code	301
Min. Negotiated Rate	$168.30
Max. Negotiated Rate	$192.06
Rate for Payer: Cash Price	$128.70
Rate for Payer: Health Management Network Commercial	$168.30
Rate for Payer: MDX Hawaii PPO	$192.06

HCHG TOES MIN 2 VIEWS

Facility

$426.00

Service Code	HCPCS 73660
Hospital Charge Code	H3200798
Hospital Revenue Code	320
Min. Negotiated Rate	$362.10
Max. Negotiated Rate	$413.22
Rate for Payer: Cash Price	$276.90
Rate for Payer: Health Management Network Commercial	$362.10
Rate for Payer: MDX Hawaii PPO	$413.22

HCHG TOES MIN 2 VIEWS

Facility

$426.00

Service Code	HCPCS 73660
Hospital Charge Code	H3200798
Hospital Revenue Code	320
Min. Negotiated Rate	$13.91
Max. Negotiated Rate	$413.22
Rate for Payer: AlohaCare Medicaid	$102.81
Rate for Payer: AlohaCare Medicare	$102.81
Rate for Payer: Cash Price	$276.90
Rate for Payer: Cash Price	$276.90
Rate for Payer: Devoted Health Medicare	$113.09
Rate for Payer: Hawaii Medical Service Association ABD	$13.91
Rate for Payer: Hawaii Medical Service Association Commercial	$128.51
Rate for Payer: Hawaii Medical Service Association Medicare	$102.81
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14.94
Rate for Payer: Hawaii Western Management Group Commercial	$102.81
Rate for Payer: Health Management Network Commercial	$362.10
Rate for Payer: Humana Medicare	$102.81
Rate for Payer: Kaiser Permanente Commercial	$268.38
Rate for Payer: Kaiser Permanente Medicaid	$217.26
Rate for Payer: Kaiser Permanente Medicare	$102.81
Rate for Payer: MDX Hawaii PPO	$413.22
Rate for Payer: Ohana Health Plan Medicaid	$113.09
Rate for Payer: Ohana Health Plan Medicare	$102.81
Rate for Payer: UnitedHealthcare Medicaid	$13.91
Rate for Payer: UnitedHealthcare Medicare	$102.81
Rate for Payer: University Health Alliance Commercial	$53.35

HCHG TOPIRAMATE

Facility

$147.00

Service Code	HCPCS 80201
Hospital Charge Code	H3020905
Hospital Revenue Code	301
Min. Negotiated Rate	$11.92
Max. Negotiated Rate	$142.59
Rate for Payer: AlohaCare Medicaid	$11.92
Rate for Payer: AlohaCare Medicare	$11.92
Rate for Payer: Cash Price	$95.55
Rate for Payer: Cash Price	$95.55
Rate for Payer: Devoted Health Medicare	$13.11
Rate for Payer: Hawaii Medical Service Association ABD	$16.48
Rate for Payer: Hawaii Medical Service Association Commercial	$14.90
Rate for Payer: Hawaii Medical Service Association Medicare	$11.92
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17.30
Rate for Payer: Hawaii Western Management Group Commercial	$11.92
Rate for Payer: Health Management Network Commercial	$124.95
Rate for Payer: Humana Medicare	$11.92
Rate for Payer: Kaiser Permanente Commercial	$92.61
Rate for Payer: Kaiser Permanente Medicaid	$74.97
Rate for Payer: Kaiser Permanente Medicare	$11.92
Rate for Payer: MDX Hawaii PPO	$142.59
Rate for Payer: Ohana Health Plan Medicaid	$13.11
Rate for Payer: Ohana Health Plan Medicare	$11.92
Rate for Payer: UnitedHealthcare Medicaid	$16.48
Rate for Payer: UnitedHealthcare Medicare	$11.92
Rate for Payer: University Health Alliance Commercial	$30.82

HCHG TOPIRAMATE

Facility

$147.00

Service Code	HCPCS 80201
Hospital Charge Code	H3020905
Hospital Revenue Code	301
Min. Negotiated Rate	$124.95
Max. Negotiated Rate	$142.59
Rate for Payer: Cash Price	$95.55
Rate for Payer: Health Management Network Commercial	$124.95
Rate for Payer: MDX Hawaii PPO	$142.59

HCHG TOT B CELLS

Facility

$389.00

Service Code	HCPCS 86355
Hospital Charge Code	H3110268
Hospital Revenue Code	302
Min. Negotiated Rate	$330.65
Max. Negotiated Rate	$377.33
Rate for Payer: Cash Price	$252.85
Rate for Payer: Health Management Network Commercial	$330.65
Rate for Payer: MDX Hawaii PPO	$377.33

HCHG TOT B CELLS

Facility

$389.00

Service Code	HCPCS 86355
Hospital Charge Code	H3110268
Hospital Revenue Code	302
Min. Negotiated Rate	$36.89
Max. Negotiated Rate	$377.33
Rate for Payer: AlohaCare Medicaid	$37.73
Rate for Payer: AlohaCare Medicare	$37.73
Rate for Payer: Cash Price	$252.85
Rate for Payer: Cash Price	$252.85
Rate for Payer: Devoted Health Medicare	$41.50
Rate for Payer: Hawaii Medical Service Association ABD	$36.89
Rate for Payer: Hawaii Medical Service Association Commercial	$47.16
Rate for Payer: Hawaii Medical Service Association Medicare	$37.73
Rate for Payer: Hawaii Medical Service Association Non-ABD	$52.10
Rate for Payer: Hawaii Western Management Group Commercial	$37.73
Rate for Payer: Health Management Network Commercial	$330.65
Rate for Payer: Humana Medicare	$37.73
Rate for Payer: Kaiser Permanente Commercial	$245.07
Rate for Payer: Kaiser Permanente Medicaid	$198.39
Rate for Payer: Kaiser Permanente Medicare	$37.73
Rate for Payer: MDX Hawaii PPO	$377.33
Rate for Payer: Ohana Health Plan Medicaid	$41.50
Rate for Payer: Ohana Health Plan Medicare	$37.73
Rate for Payer: UnitedHealthcare Medicaid	$36.89
Rate for Payer: UnitedHealthcare Medicare	$37.73
Rate for Payer: University Health Alliance Commercial	$97.50

HCHG TOT PROTEIN URINE

Facility

$63.00

Service Code	HCPCS 84156
Hospital Charge Code	H3011307
Hospital Revenue Code	301
Min. Negotiated Rate	$3.67
Max. Negotiated Rate	$61.11
Rate for Payer: AlohaCare Medicaid	$3.67
Rate for Payer: AlohaCare Medicare	$3.67
Rate for Payer: Cash Price	$40.95
Rate for Payer: Cash Price	$40.95
Rate for Payer: Devoted Health Medicare	$4.04
Rate for Payer: Hawaii Medical Service Association ABD	$3.69
Rate for Payer: Hawaii Medical Service Association Commercial	$4.59
Rate for Payer: Hawaii Medical Service Association Medicare	$3.67
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5.06
Rate for Payer: Hawaii Western Management Group Commercial	$3.67
Rate for Payer: Health Management Network Commercial	$53.55
Rate for Payer: Humana Medicare	$3.67
Rate for Payer: Kaiser Permanente Commercial	$39.69
Rate for Payer: Kaiser Permanente Medicaid	$32.13
Rate for Payer: Kaiser Permanente Medicare	$3.67
Rate for Payer: MDX Hawaii PPO	$61.11
Rate for Payer: Ohana Health Plan Medicaid	$4.04
Rate for Payer: Ohana Health Plan Medicare	$3.67
Rate for Payer: UnitedHealthcare Medicaid	$3.69
Rate for Payer: UnitedHealthcare Medicare	$3.67
Rate for Payer: University Health Alliance Commercial	$9.47

HCHG TOT PROTEIN URINE

Facility

$63.00

Service Code	HCPCS 84156
Hospital Charge Code	H3011307
Hospital Revenue Code	301
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$61.11
Rate for Payer: Cash Price	$40.95
Rate for Payer: Health Management Network Commercial	$53.55
Rate for Payer: MDX Hawaii PPO	$61.11

HCHG TOXIN REFLEX NAAT

Facility

$204.00

Service Code	HCPCS 87449
Hospital Charge Code	H3060683
Hospital Revenue Code	306
Min. Negotiated Rate	$11.98
Max. Negotiated Rate	$197.88
Rate for Payer: AlohaCare Medicaid	$11.98
Rate for Payer: AlohaCare Medicare	$11.98
Rate for Payer: Cash Price	$132.60
Rate for Payer: Cash Price	$132.60
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	$173.40
Rate for Payer: Humana Medicare	$11.98
Rate for Payer: Kaiser Permanente Commercial	$128.52
Rate for Payer: Kaiser Permanente Medicaid	$104.04
Rate for Payer: Kaiser Permanente Medicare	$11.98
Rate for Payer: MDX Hawaii PPO	$197.88
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 TOXIN REFLEX NAAT

Facility

$204.00

Service Code	HCPCS 87449
Hospital Charge Code	H3060683
Hospital Revenue Code	306
Min. Negotiated Rate	$173.40
Max. Negotiated Rate	$197.88
Rate for Payer: Cash Price	$132.60
Rate for Payer: Health Management Network Commercial	$173.40
Rate for Payer: MDX Hawaii PPO	$197.88

HCHG TOXOPLASMA AB IGA SO

Facility

$237.00

Service Code	HCPCS 86777
Hospital Charge Code	K3020016
Hospital Revenue Code	302
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: MDX Hawaii PPO	$229.89

HCHG TOXOPLASMA AB IGA SO

Facility

$237.00

Service Code	HCPCS 86777
Hospital Charge Code	K3020016
Hospital Revenue Code	302
Min. Negotiated Rate	$14.39
Max. Negotiated Rate	$229.89
Rate for Payer: AlohaCare Medicaid	$14.39
Rate for Payer: AlohaCare Medicare	$14.39
Rate for Payer: Cash Price	$154.05
Rate for Payer: Cash Price	$154.05
Rate for Payer: Devoted Health Medicare	$15.83
Rate for Payer: Hawaii Medical Service Association ABD	$19.89
Rate for Payer: Hawaii Medical Service Association Commercial	$17.99
Rate for Payer: Hawaii Medical Service Association Medicare	$14.39
Rate for Payer: Hawaii Medical Service Association Non-ABD	$20.88
Rate for Payer: Hawaii Western Management Group Commercial	$14.39
Rate for Payer: Health Management Network Commercial	$201.45
Rate for Payer: Humana Medicare	$14.39
Rate for Payer: Kaiser Permanente Commercial	$149.31
Rate for Payer: Kaiser Permanente Medicaid	$120.87
Rate for Payer: Kaiser Permanente Medicare	$14.39
Rate for Payer: MDX Hawaii PPO	$229.89
Rate for Payer: Ohana Health Plan Medicaid	$15.83
Rate for Payer: Ohana Health Plan Medicare	$14.39
Rate for Payer: UnitedHealthcare Medicaid	$19.89
Rate for Payer: UnitedHealthcare Medicare	$14.39
Rate for Payer: University Health Alliance Commercial	$37.20

HCHG TOXOPLASMA AB IGE SO

Facility

$237.00

Service Code	HCPCS 86777
Hospital Charge Code	K3020015
Hospital Revenue Code	302
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: MDX Hawaii PPO	$229.89

HCHG TOXOPLASMA AB IGE SO

Facility

$237.00

Service Code	HCPCS 86777
Hospital Charge Code	K3020015
Hospital Revenue Code	302
Min. Negotiated Rate	$14.39
Max. Negotiated Rate	$229.89
Rate for Payer: AlohaCare Medicaid	$14.39
Rate for Payer: AlohaCare Medicare	$14.39
Rate for Payer: Cash Price	$154.05
Rate for Payer: Cash Price	$154.05
Rate for Payer: Devoted Health Medicare	$15.83
Rate for Payer: Hawaii Medical Service Association ABD	$19.89
Rate for Payer: Hawaii Medical Service Association Commercial	$17.99
Rate for Payer: Hawaii Medical Service Association Medicare	$14.39
Rate for Payer: Hawaii Medical Service Association Non-ABD	$20.88
Rate for Payer: Hawaii Western Management Group Commercial	$14.39
Rate for Payer: Health Management Network Commercial	$201.45
Rate for Payer: Humana Medicare	$14.39
Rate for Payer: Kaiser Permanente Commercial	$149.31
Rate for Payer: Kaiser Permanente Medicaid	$120.87
Rate for Payer: Kaiser Permanente Medicare	$14.39
Rate for Payer: MDX Hawaii PPO	$229.89
Rate for Payer: Ohana Health Plan Medicaid	$15.83
Rate for Payer: Ohana Health Plan Medicare	$14.39
Rate for Payer: UnitedHealthcare Medicaid	$19.89
Rate for Payer: UnitedHealthcare Medicare	$14.39
Rate for Payer: University Health Alliance Commercial	$37.20

HCHG TOXOPLASMA AB IGG

Facility

$179.00

Service Code	HCPCS 86777
Hospital Charge Code	H3020790
Hospital Revenue Code	302
Min. Negotiated Rate	$14.39
Max. Negotiated Rate	$173.63
Rate for Payer: AlohaCare Medicaid	$14.39
Rate for Payer: AlohaCare Medicare	$14.39
Rate for Payer: Cash Price	$116.35
Rate for Payer: Cash Price	$116.35
Rate for Payer: Devoted Health Medicare	$15.83
Rate for Payer: Hawaii Medical Service Association ABD	$19.89
Rate for Payer: Hawaii Medical Service Association Commercial	$17.99
Rate for Payer: Hawaii Medical Service Association Medicare	$14.39
Rate for Payer: Hawaii Medical Service Association Non-ABD	$20.88
Rate for Payer: Hawaii Western Management Group Commercial	$14.39
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Humana Medicare	$14.39
Rate for Payer: Kaiser Permanente Commercial	$112.77
Rate for Payer: Kaiser Permanente Medicaid	$91.29
Rate for Payer: Kaiser Permanente Medicare	$14.39
Rate for Payer: MDX Hawaii PPO	$173.63
Rate for Payer: Ohana Health Plan Medicaid	$15.83
Rate for Payer: Ohana Health Plan Medicare	$14.39
Rate for Payer: UnitedHealthcare Medicaid	$19.89
Rate for Payer: UnitedHealthcare Medicare	$14.39
Rate for Payer: University Health Alliance Commercial	$37.20

HCHG TOXOPLASMA AB IGG

Facility

$179.00

Service Code	HCPCS 86777
Hospital Charge Code	H3020790
Hospital Revenue Code	302
Min. Negotiated Rate	$152.15
Max. Negotiated Rate	$173.63
Rate for Payer: Cash Price	$116.35
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: MDX Hawaii PPO	$173.63

HCHG TOXOPLASMA IGM AB

Facility

$179.00

Service Code	HCPCS 86778
Hospital Charge Code	H3020792
Hospital Revenue Code	302
Min. Negotiated Rate	$14.41
Max. Negotiated Rate	$173.63
Rate for Payer: AlohaCare Medicaid	$14.41
Rate for Payer: AlohaCare Medicare	$14.41
Rate for Payer: Cash Price	$116.35
Rate for Payer: Cash Price	$116.35
Rate for Payer: Devoted Health Medicare	$15.85
Rate for Payer: Hawaii Medical Service Association ABD	$19.90
Rate for Payer: Hawaii Medical Service Association Commercial	$18.01
Rate for Payer: Hawaii Medical Service Association Medicare	$14.41
Rate for Payer: Hawaii Medical Service Association Non-ABD	$20.90
Rate for Payer: Hawaii Western Management Group Commercial	$14.41
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Humana Medicare	$14.41
Rate for Payer: Kaiser Permanente Commercial	$112.77
Rate for Payer: Kaiser Permanente Medicaid	$91.29
Rate for Payer: Kaiser Permanente Medicare	$14.41
Rate for Payer: MDX Hawaii PPO	$173.63
Rate for Payer: Ohana Health Plan Medicaid	$15.85
Rate for Payer: Ohana Health Plan Medicare	$14.41
Rate for Payer: UnitedHealthcare Medicaid	$19.90
Rate for Payer: UnitedHealthcare Medicare	$14.41
Rate for Payer: University Health Alliance Commercial	$37.22

HCHG TOXOPLASMA IGM AB

Facility

$179.00

Service Code	HCPCS 86778
Hospital Charge Code	H3020792
Hospital Revenue Code	302
Min. Negotiated Rate	$152.15
Max. Negotiated Rate	$173.63
Rate for Payer: Cash Price	$116.35
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: MDX Hawaii PPO	$173.63

HCHG TP53 TARGETED SEQ ANA SO

Facility

$2,903.00

Service Code	HCPCS 81352
Hospital Charge Code	K3100006
Hospital Revenue Code	310
Min. Negotiated Rate	$243.84
Max. Negotiated Rate	$2,815.91
Rate for Payer: AlohaCare Medicaid	$329.51
Rate for Payer: AlohaCare Medicare	$329.51
Rate for Payer: Cash Price	$1,886.95
Rate for Payer: Cash Price	$1,886.95
Rate for Payer: Devoted Health Medicare	$362.46
Rate for Payer: Hawaii Medical Service Association ABD	$243.84
Rate for Payer: Hawaii Medical Service Association Commercial	$411.89
Rate for Payer: Hawaii Medical Service Association Medicare	$329.51
Rate for Payer: Hawaii Medical Service Association Non-ABD	$243.84
Rate for Payer: Hawaii Western Management Group Commercial	$329.51
Rate for Payer: Health Management Network Commercial	$2,467.55
Rate for Payer: Humana Medicare	$329.51
Rate for Payer: Kaiser Permanente Commercial	$1,828.89
Rate for Payer: Kaiser Permanente Medicaid	$1,480.53
Rate for Payer: Kaiser Permanente Medicare	$329.51
Rate for Payer: MDX Hawaii PPO	$2,815.91
Rate for Payer: Ohana Health Plan Medicaid	$362.46
Rate for Payer: Ohana Health Plan Medicare	$329.51
Rate for Payer: UnitedHealthcare Medicaid	$247.13
Rate for Payer: UnitedHealthcare Medicare	$329.51
Rate for Payer: University Health Alliance Commercial	$2,116.00

HCHG TP53 TARGETED SEQ ANA SO

Facility

$2,903.00

Service Code	HCPCS 81352
Hospital Charge Code	K3100006
Hospital Revenue Code	310
Min. Negotiated Rate	$2,467.55
Max. Negotiated Rate	$2,815.91
Rate for Payer: Cash Price	$1,886.95
Rate for Payer: Health Management Network Commercial	$2,467.55
Rate for Payer: MDX Hawaii PPO	$2,815.91

HCHG TPMT NUDT15 GENE ANALYSIS COMMON VARIANTS 90

Facility

$2,092.00

Service Code	HCPCS 0034U
Hospital Charge Code	H3001110
Hospital Revenue Code	300
Min. Negotiated Rate	$1,778.20
Max. Negotiated Rate	$2,029.24
Rate for Payer: Cash Price	$1,359.80
Rate for Payer: Health Management Network Commercial	$1,778.20
Rate for Payer: MDX Hawaii PPO	$2,029.24

HCHG TPMT NUDT15 GENE ANALYSIS COMMON VARIANTS 90

Facility

$2,092.00

Service Code	HCPCS 0034U
Hospital Charge Code	H3001110
Hospital Revenue Code	300
Min. Negotiated Rate	$349.63
Max. Negotiated Rate	$2,029.24
Rate for Payer: AlohaCare Medicaid	$466.17
Rate for Payer: AlohaCare Medicare	$466.17
Rate for Payer: Cash Price	$1,359.80
Rate for Payer: Cash Price	$1,359.80
Rate for Payer: Devoted Health Medicare	$512.79
Rate for Payer: Hawaii Medical Service Association Commercial	$582.71
Rate for Payer: Hawaii Medical Service Association Medicare	$466.17
Rate for Payer: Hawaii Western Management Group Commercial	$1,987.40
Rate for Payer: Health Management Network Commercial	$1,778.20
Rate for Payer: Humana Medicare	$466.17
Rate for Payer: Kaiser Permanente Commercial	$1,317.96
Rate for Payer: Kaiser Permanente Medicaid	$1,066.92
Rate for Payer: Kaiser Permanente Medicare	$466.17
Rate for Payer: MDX Hawaii PPO	$2,029.24
Rate for Payer: Ohana Health Plan Medicaid	$512.79
Rate for Payer: Ohana Health Plan Medicare	$466.17
Rate for Payer: UnitedHealthcare Medicaid	$349.63
Rate for Payer: UnitedHealthcare Medicare	$466.17
Rate for Payer: University Health Alliance Commercial	$1,524.86

HCHG TRANSABDOM AMNIOINFUS W/US

Facility

$1,509.00

Service Code	HCPCS 59070
Hospital Charge Code	K7210008
Hospital Revenue Code	721
Min. Negotiated Rate	$301.72
Max. Negotiated Rate	$1,463.73
Rate for Payer: AlohaCare Medicaid	$359.99
Rate for Payer: AlohaCare Medicare	$359.99
Rate for Payer: Cash Price	$980.85
Rate for Payer: Cash Price	$980.85
Rate for Payer: Devoted Health Medicare	$395.99
Rate for Payer: Hawaii Medical Service Association Commercial	$449.99
Rate for Payer: Hawaii Medical Service Association Medicare	$359.99
Rate for Payer: Hawaii Western Management Group Commercial	$1,433.55
Rate for Payer: Health Management Network Commercial	$1,282.65
Rate for Payer: Humana Medicare	$359.99
Rate for Payer: Kaiser Permanente Commercial	$950.67
Rate for Payer: Kaiser Permanente Medicaid	$769.59
Rate for Payer: Kaiser Permanente Medicare	$359.99
Rate for Payer: MDX Hawaii PPO	$1,463.73
Rate for Payer: Ohana Health Plan Medicaid	$395.99
Rate for Payer: Ohana Health Plan Medicare	$359.99
Rate for Payer: UnitedHealthcare Medicaid	$301.72
Rate for Payer: UnitedHealthcare Medicare	$359.99
Rate for Payer: University Health Alliance Commercial	$1,099.91

Know your out-of-pocket cost for care.

All Charges