Kona Community Hospital

All Charges

Charge

Type

Setting

Price

HCHG UREA NITROGEN

Facility

$61.00

Service Code	HCPCS 84520
Hospital Charge Code	H3010296
Hospital Revenue Code	301
Min. Negotiated Rate	$51.85
Max. Negotiated Rate	$59.17
Rate for Payer: Cash Price	$39.65
Rate for Payer: Health Management Network Commercial	$51.85
Rate for Payer: MDX Hawaii PPO	$59.17

HCHG UREA NITROGEN

Facility

$61.00

Service Code	HCPCS 84520
Hospital Charge Code	H3010296
Hospital Revenue Code	301
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$59.17
Rate for Payer: AlohaCare Medicaid	$3.95
Rate for Payer: AlohaCare Medicare	$3.95
Rate for Payer: Cash Price	$39.65
Rate for Payer: Cash Price	$39.65
Rate for Payer: Devoted Health Medicare	$4.34
Rate for Payer: Hawaii Medical Service Association ABD	$5.45
Rate for Payer: Hawaii Medical Service Association Commercial	$4.94
Rate for Payer: Hawaii Medical Service Association Medicare	$3.95
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5.72
Rate for Payer: Hawaii Western Management Group Commercial	$3.95
Rate for Payer: Health Management Network Commercial	$51.85
Rate for Payer: Humana Medicare	$3.95
Rate for Payer: Kaiser Permanente Commercial	$38.43
Rate for Payer: Kaiser Permanente Medicaid	$31.11
Rate for Payer: Kaiser Permanente Medicare	$3.95
Rate for Payer: MDX Hawaii PPO	$59.17
Rate for Payer: Ohana Health Plan Medicaid	$4.34
Rate for Payer: Ohana Health Plan Medicare	$3.95
Rate for Payer: UnitedHealthcare Medicaid	$5.45
Rate for Payer: UnitedHealthcare Medicare	$3.95
Rate for Payer: University Health Alliance Commercial	$10.19

HCHG UREA NITROGEN-URINE

Facility

$65.00

Service Code	HCPCS 84540
Hospital Charge Code	H3011260
Hospital Revenue Code	301
Min. Negotiated Rate	$5.56
Max. Negotiated Rate	$63.05
Rate for Payer: AlohaCare Medicaid	$5.56
Rate for Payer: AlohaCare Medicare	$5.56
Rate for Payer: Cash Price	$42.25
Rate for Payer: Cash Price	$42.25
Rate for Payer: Devoted Health Medicare	$6.12
Rate for Payer: Hawaii Medical Service Association ABD	$6.56
Rate for Payer: Hawaii Medical Service Association Commercial	$6.95
Rate for Payer: Hawaii Medical Service Association Medicare	$5.56
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6.89
Rate for Payer: Hawaii Western Management Group Commercial	$5.56
Rate for Payer: Health Management Network Commercial	$55.25
Rate for Payer: Humana Medicare	$5.56
Rate for Payer: Kaiser Permanente Commercial	$40.95
Rate for Payer: Kaiser Permanente Medicaid	$33.15
Rate for Payer: Kaiser Permanente Medicare	$5.56
Rate for Payer: MDX Hawaii PPO	$63.05
Rate for Payer: Ohana Health Plan Medicaid	$6.12
Rate for Payer: Ohana Health Plan Medicare	$5.56
Rate for Payer: UnitedHealthcare Medicaid	$6.56
Rate for Payer: UnitedHealthcare Medicare	$5.56
Rate for Payer: University Health Alliance Commercial	$12.28

HCHG UREA NITROGEN-URINE

Facility

$65.00

Service Code	HCPCS 84540
Hospital Charge Code	H3011260
Hospital Revenue Code	301
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$63.05
Rate for Payer: Cash Price	$42.25
Rate for Payer: Health Management Network Commercial	$55.25
Rate for Payer: MDX Hawaii PPO	$63.05

HCHG URETHROCYSTOGRAM *

Facility

$1,275.00

Service Code	HCPCS 74450
Hospital Charge Code	H3200856
Hospital Revenue Code	320
Min. Negotiated Rate	$48.23
Max. Negotiated Rate	$1,236.75
Rate for Payer: AlohaCare Medicaid	$281.87
Rate for Payer: AlohaCare Medicare	$281.87
Rate for Payer: Cash Price	$828.75
Rate for Payer: Cash Price	$828.75
Rate for Payer: Devoted Health Medicare	$310.06
Rate for Payer: Hawaii Medical Service Association ABD	$48.23
Rate for Payer: Hawaii Medical Service Association Commercial	$352.34
Rate for Payer: Hawaii Medical Service Association Medicare	$281.87
Rate for Payer: Hawaii Medical Service Association Non-ABD	$52.32
Rate for Payer: Hawaii Western Management Group Commercial	$281.87
Rate for Payer: Health Management Network Commercial	$1,083.75
Rate for Payer: Humana Medicare	$281.87
Rate for Payer: Kaiser Permanente Commercial	$803.25
Rate for Payer: Kaiser Permanente Medicaid	$650.25
Rate for Payer: Kaiser Permanente Medicare	$281.87
Rate for Payer: MDX Hawaii PPO	$1,236.75
Rate for Payer: Ohana Health Plan Medicaid	$310.06
Rate for Payer: Ohana Health Plan Medicare	$281.87
Rate for Payer: UnitedHealthcare Medicaid	$48.23
Rate for Payer: UnitedHealthcare Medicare	$281.87
Rate for Payer: University Health Alliance Commercial	$929.35

HCHG URETHROCYSTOGRAM *

Facility

$1,275.00

Service Code	HCPCS 74450
Hospital Charge Code	H3200856
Hospital Revenue Code	320
Min. Negotiated Rate	$1,083.75
Max. Negotiated Rate	$1,236.75
Rate for Payer: Cash Price	$828.75
Rate for Payer: Health Management Network Commercial	$1,083.75
Rate for Payer: MDX Hawaii PPO	$1,236.75

HCHG URIC ACID BLOOD

Facility

$77.00

Service Code	HCPCS 84550
Hospital Charge Code	H3011262
Hospital Revenue Code	301
Min. Negotiated Rate	$65.45
Max. Negotiated Rate	$74.69
Rate for Payer: Cash Price	$50.05
Rate for Payer: Health Management Network Commercial	$65.45
Rate for Payer: MDX Hawaii PPO	$74.69

HCHG URIC ACID BLOOD

Facility

$77.00

Service Code	HCPCS 84550
Hospital Charge Code	H3011262
Hospital Revenue Code	301
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$74.69
Rate for Payer: AlohaCare Medicaid	$4.52
Rate for Payer: AlohaCare Medicare	$4.52
Rate for Payer: Cash Price	$50.05
Rate for Payer: Cash Price	$50.05
Rate for Payer: Devoted Health Medicare	$4.97
Rate for Payer: Hawaii Medical Service Association ABD	$6.25
Rate for Payer: Hawaii Medical Service Association Commercial	$5.65
Rate for Payer: Hawaii Medical Service Association Medicare	$4.52
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6.56
Rate for Payer: Hawaii Western Management Group Commercial	$4.52
Rate for Payer: Health Management Network Commercial	$65.45
Rate for Payer: Humana Medicare	$4.52
Rate for Payer: Kaiser Permanente Commercial	$48.51
Rate for Payer: Kaiser Permanente Medicaid	$39.27
Rate for Payer: Kaiser Permanente Medicare	$4.52
Rate for Payer: MDX Hawaii PPO	$74.69
Rate for Payer: Ohana Health Plan Medicaid	$4.97
Rate for Payer: Ohana Health Plan Medicare	$4.52
Rate for Payer: UnitedHealthcare Medicaid	$6.25
Rate for Payer: UnitedHealthcare Medicare	$4.52
Rate for Payer: University Health Alliance Commercial	$11.67

HCHG URIC ACID BODY FLUID

Facility

$59.00

Service Code	HCPCS 84560
Hospital Charge Code	H3011266
Hospital Revenue Code	301
Min. Negotiated Rate	$5.08
Max. Negotiated Rate	$57.23
Rate for Payer: AlohaCare Medicaid	$5.08
Rate for Payer: AlohaCare Medicare	$5.08
Rate for Payer: Cash Price	$38.35
Rate for Payer: Cash Price	$38.35
Rate for Payer: Devoted Health Medicare	$5.59
Rate for Payer: Hawaii Medical Service Association ABD	$6.56
Rate for Payer: Hawaii Medical Service Association Commercial	$6.35
Rate for Payer: Hawaii Medical Service Association Medicare	$5.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6.89
Rate for Payer: Hawaii Western Management Group Commercial	$5.08
Rate for Payer: Health Management Network Commercial	$50.15
Rate for Payer: Humana Medicare	$5.08
Rate for Payer: Kaiser Permanente Commercial	$37.17
Rate for Payer: Kaiser Permanente Medicaid	$30.09
Rate for Payer: Kaiser Permanente Medicare	$5.08
Rate for Payer: MDX Hawaii PPO	$57.23
Rate for Payer: Ohana Health Plan Medicaid	$5.59
Rate for Payer: Ohana Health Plan Medicare	$5.08
Rate for Payer: UnitedHealthcare Medicaid	$6.56
Rate for Payer: UnitedHealthcare Medicare	$5.08
Rate for Payer: University Health Alliance Commercial	$12.28

HCHG URIC ACID BODY FLUID

Facility

$59.00

Service Code	HCPCS 84560
Hospital Charge Code	H3011266
Hospital Revenue Code	301
Min. Negotiated Rate	$50.15
Max. Negotiated Rate	$57.23
Rate for Payer: Cash Price	$38.35
Rate for Payer: Health Management Network Commercial	$50.15
Rate for Payer: MDX Hawaii PPO	$57.23

HCHG URIC ACID URINE

Facility

$59.00

Service Code	HCPCS 84560
Hospital Charge Code	H3011268
Hospital Revenue Code	301
Min. Negotiated Rate	$5.08
Max. Negotiated Rate	$57.23
Rate for Payer: AlohaCare Medicaid	$5.08
Rate for Payer: AlohaCare Medicare	$5.08
Rate for Payer: Cash Price	$38.35
Rate for Payer: Cash Price	$38.35
Rate for Payer: Devoted Health Medicare	$5.59
Rate for Payer: Hawaii Medical Service Association ABD	$6.56
Rate for Payer: Hawaii Medical Service Association Commercial	$6.35
Rate for Payer: Hawaii Medical Service Association Medicare	$5.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6.89
Rate for Payer: Hawaii Western Management Group Commercial	$5.08
Rate for Payer: Health Management Network Commercial	$50.15
Rate for Payer: Humana Medicare	$5.08
Rate for Payer: Kaiser Permanente Commercial	$37.17
Rate for Payer: Kaiser Permanente Medicaid	$30.09
Rate for Payer: Kaiser Permanente Medicare	$5.08
Rate for Payer: MDX Hawaii PPO	$57.23
Rate for Payer: Ohana Health Plan Medicaid	$5.59
Rate for Payer: Ohana Health Plan Medicare	$5.08
Rate for Payer: UnitedHealthcare Medicaid	$6.56
Rate for Payer: UnitedHealthcare Medicare	$5.08
Rate for Payer: University Health Alliance Commercial	$12.28

HCHG URIC ACID URINE

Facility

$59.00

Service Code	HCPCS 84560
Hospital Charge Code	H3011268
Hospital Revenue Code	301
Min. Negotiated Rate	$50.15
Max. Negotiated Rate	$57.23
Rate for Payer: Cash Price	$38.35
Rate for Payer: Health Management Network Commercial	$50.15
Rate for Payer: MDX Hawaii PPO	$57.23

HCHG URINALYSIS MICRO ONLY

Facility

$38.00

Service Code	HCPCS 81015
Hospital Charge Code	H3070114
Hospital Revenue Code	307
Min. Negotiated Rate	$3.05
Max. Negotiated Rate	$36.86
Rate for Payer: AlohaCare Medicaid	$3.05
Rate for Payer: AlohaCare Medicare	$3.05
Rate for Payer: Cash Price	$24.70
Rate for Payer: Cash Price	$24.70
Rate for Payer: Devoted Health Medicare	$3.35
Rate for Payer: Hawaii Medical Service Association ABD	$4.20
Rate for Payer: Hawaii Medical Service Association Commercial	$3.81
Rate for Payer: Hawaii Medical Service Association Medicare	$3.05
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4.41
Rate for Payer: Hawaii Western Management Group Commercial	$3.05
Rate for Payer: Health Management Network Commercial	$32.30
Rate for Payer: Humana Medicare	$3.05
Rate for Payer: Kaiser Permanente Commercial	$23.94
Rate for Payer: Kaiser Permanente Medicaid	$19.38
Rate for Payer: Kaiser Permanente Medicare	$3.05
Rate for Payer: MDX Hawaii PPO	$36.86
Rate for Payer: Ohana Health Plan Medicaid	$3.35
Rate for Payer: Ohana Health Plan Medicare	$3.05
Rate for Payer: UnitedHealthcare Medicaid	$4.20
Rate for Payer: UnitedHealthcare Medicare	$3.05
Rate for Payer: University Health Alliance Commercial	$7.84

HCHG URINALYSIS MICRO ONLY

Facility

$38.00

Service Code	HCPCS 81015
Hospital Charge Code	H3070114
Hospital Revenue Code	307
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: MDX Hawaii PPO	$36.86

HCHG URINALYSIS, REFLEX MICROSCOPIC

Facility

$39.00

Service Code	HCPCS 81003
Hospital Charge Code	H3070135
Hospital Revenue Code	307
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$37.83
Rate for Payer: AlohaCare Medicaid	$2.25
Rate for Payer: AlohaCare Medicare	$2.25
Rate for Payer: Cash Price	$25.35
Rate for Payer: Cash Price	$25.35
Rate for Payer: Devoted Health Medicare	$2.48
Rate for Payer: Hawaii Medical Service Association ABD	$3.10
Rate for Payer: Hawaii Medical Service Association Commercial	$2.81
Rate for Payer: Hawaii Medical Service Association Medicare	$2.25
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3.26
Rate for Payer: Hawaii Western Management Group Commercial	$2.25
Rate for Payer: Health Management Network Commercial	$33.15
Rate for Payer: Humana Medicare	$2.25
Rate for Payer: Kaiser Permanente Commercial	$24.57
Rate for Payer: Kaiser Permanente Medicaid	$19.89
Rate for Payer: Kaiser Permanente Medicare	$2.25
Rate for Payer: MDX Hawaii PPO	$37.83
Rate for Payer: Ohana Health Plan Medicaid	$2.48
Rate for Payer: Ohana Health Plan Medicare	$2.25
Rate for Payer: UnitedHealthcare Medicaid	$3.10
Rate for Payer: UnitedHealthcare Medicare	$2.25
Rate for Payer: University Health Alliance Commercial	$5.81

HCHG URINALYSIS, REFLEX MICROSCOPIC

Facility

$39.00

Service Code	HCPCS 81003
Hospital Charge Code	H3070135
Hospital Revenue Code	307
Min. Negotiated Rate	$33.15
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$25.35
Rate for Payer: Health Management Network Commercial	$33.15
Rate for Payer: MDX Hawaii PPO	$37.83

HCHG URINE DRUG SCREEN #2, MEDICAL REFLEX

Facility

$393.00

Service Code	HCPCS 80307
Hospital Charge Code	H3011690
Hospital Revenue Code	301
Min. Negotiated Rate	$334.05
Max. Negotiated Rate	$381.21
Rate for Payer: Cash Price	$255.45
Rate for Payer: Health Management Network Commercial	$334.05
Rate for Payer: MDX Hawaii PPO	$381.21

HCHG URINE DRUG SCREEN #2, MEDICAL REFLEX

Facility

$393.00

Service Code	HCPCS 80307
Hospital Charge Code	H3011690
Hospital Revenue Code	301
Min. Negotiated Rate	$47.89
Max. Negotiated Rate	$381.21
Rate for Payer: AlohaCare Medicaid	$62.14
Rate for Payer: AlohaCare Medicare	$62.14
Rate for Payer: Cash Price	$255.45
Rate for Payer: Cash Price	$255.45
Rate for Payer: Devoted Health Medicare	$68.35
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	$62.14
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	$334.05
Rate for Payer: Humana Medicare	$62.14
Rate for Payer: Kaiser Permanente Commercial	$247.59
Rate for Payer: Kaiser Permanente Medicaid	$200.43
Rate for Payer: Kaiser Permanente Medicare	$62.14
Rate for Payer: MDX Hawaii PPO	$381.21
Rate for Payer: Ohana Health Plan Medicaid	$68.35
Rate for Payer: Ohana Health Plan Medicare	$62.14
Rate for Payer: UnitedHealthcare Medicaid	$47.89
Rate for Payer: UnitedHealthcare Medicare	$62.14
Rate for Payer: University Health Alliance Commercial	$147.65

HCHG URINE DRUG SCREEN, POC

Facility

$119.00

Service Code	HCPCS 80305
Hospital Charge Code	H3011825
Hospital Revenue Code	301
Min. Negotiated Rate	$8.98
Max. Negotiated Rate	$115.43
Rate for Payer: AlohaCare Medicaid	$12.60
Rate for Payer: AlohaCare Medicare	$12.60
Rate for Payer: Cash Price	$77.35
Rate for Payer: Cash Price	$77.35
Rate for Payer: Devoted Health Medicare	$13.86
Rate for Payer: Hawaii Medical Service Association ABD	$19.03
Rate for Payer: Hawaii Medical Service Association Commercial	$15.75
Rate for Payer: Hawaii Medical Service Association Medicare	$12.60
Rate for Payer: Hawaii Medical Service Association Non-ABD	$21.11
Rate for Payer: Hawaii Western Management Group Commercial	$12.60
Rate for Payer: Health Management Network Commercial	$101.15
Rate for Payer: Humana Medicare	$12.60
Rate for Payer: Kaiser Permanente Commercial	$74.97
Rate for Payer: Kaiser Permanente Medicaid	$60.69
Rate for Payer: Kaiser Permanente Medicare	$12.60
Rate for Payer: MDX Hawaii PPO	$115.43
Rate for Payer: Ohana Health Plan Medicaid	$13.86
Rate for Payer: Ohana Health Plan Medicare	$12.60
Rate for Payer: UnitedHealthcare Medicaid	$8.98
Rate for Payer: UnitedHealthcare Medicare	$12.60
Rate for Payer: University Health Alliance Commercial	$27.68

HCHG URINE DRUG SCREEN, POC

Facility

$119.00

Service Code	HCPCS 80305
Hospital Charge Code	H3011825
Hospital Revenue Code	301
Min. Negotiated Rate	$101.15
Max. Negotiated Rate	$115.43
Rate for Payer: Cash Price	$77.35
Rate for Payer: Health Management Network Commercial	$101.15
Rate for Payer: MDX Hawaii PPO	$115.43

HCHG URINE PREGNANCY TEST, VISUAL COLOR COMP

Facility

$63.00

Service Code	HCPCS 81025
Hospital Charge Code	H3011270
Hospital Revenue Code	307
Min. Negotiated Rate	$8.61
Max. Negotiated Rate	$61.11
Rate for Payer: AlohaCare Medicaid	$8.61
Rate for Payer: AlohaCare Medicare	$8.61
Rate for Payer: Cash Price	$40.95
Rate for Payer: Cash Price	$40.95
Rate for Payer: Devoted Health Medicare	$9.47
Rate for Payer: Hawaii Medical Service Association ABD	$8.74
Rate for Payer: Hawaii Medical Service Association Commercial	$10.76
Rate for Payer: Hawaii Medical Service Association Medicare	$8.61
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9.18
Rate for Payer: Hawaii Western Management Group Commercial	$8.61
Rate for Payer: Health Management Network Commercial	$53.55
Rate for Payer: Humana Medicare	$8.61
Rate for Payer: Kaiser Permanente Commercial	$39.69
Rate for Payer: Kaiser Permanente Medicaid	$32.13
Rate for Payer: Kaiser Permanente Medicare	$8.61
Rate for Payer: MDX Hawaii PPO	$61.11
Rate for Payer: Ohana Health Plan Medicaid	$9.47
Rate for Payer: Ohana Health Plan Medicare	$8.61
Rate for Payer: UnitedHealthcare Medicaid	$8.74
Rate for Payer: UnitedHealthcare Medicare	$8.61
Rate for Payer: University Health Alliance Commercial	$16.35

HCHG URINE PREGNANCY TEST, VISUAL COLOR COMP

Facility

$63.00

Service Code	HCPCS 81025
Hospital Charge Code	H3011270
Hospital Revenue Code	307
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 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP

Facility

$47.00

Service Code	HCPCS 81002
Hospital Charge Code	H3070136
Hospital Revenue Code	307
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$45.59
Rate for Payer: AlohaCare Medicaid	$3.48
Rate for Payer: AlohaCare Medicare	$3.48
Rate for Payer: Cash Price	$30.55
Rate for Payer: Cash Price	$30.55
Rate for Payer: Devoted Health Medicare	$3.83
Rate for Payer: Hawaii Medical Service Association ABD	$3.54
Rate for Payer: Hawaii Medical Service Association Commercial	$4.35
Rate for Payer: Hawaii Medical Service Association Medicare	$3.48
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3.72
Rate for Payer: Hawaii Western Management Group Commercial	$3.48
Rate for Payer: Health Management Network Commercial	$39.95
Rate for Payer: Humana Medicare	$3.48
Rate for Payer: Kaiser Permanente Commercial	$29.61
Rate for Payer: Kaiser Permanente Medicaid	$23.97
Rate for Payer: Kaiser Permanente Medicare	$3.48
Rate for Payer: MDX Hawaii PPO	$45.59
Rate for Payer: Ohana Health Plan Medicaid	$3.83
Rate for Payer: Ohana Health Plan Medicare	$3.48
Rate for Payer: UnitedHealthcare Medicaid	$3.54
Rate for Payer: UnitedHealthcare Medicare	$3.48
Rate for Payer: University Health Alliance Commercial	$6.60

HCHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP

Facility

$47.00

Service Code	HCPCS 81002
Hospital Charge Code	H3070136
Hospital Revenue Code	307
Min. Negotiated Rate	$39.95
Max. Negotiated Rate	$45.59
Rate for Payer: Cash Price	$30.55
Rate for Payer: Health Management Network Commercial	$39.95
Rate for Payer: MDX Hawaii PPO	$45.59

HCHG US ABD AORTA AAA SCREENING

Facility

$708.00

Service Code	HCPCS 76706
Hospital Charge Code	H4020293
Hospital Revenue Code	402
Min. Negotiated Rate	$46.35
Max. Negotiated Rate	$686.76
Rate for Payer: AlohaCare Medicaid	$123.50
Rate for Payer: AlohaCare Medicare	$123.50
Rate for Payer: Cash Price	$460.20
Rate for Payer: Cash Price	$460.20
Rate for Payer: Devoted Health Medicare	$135.85
Rate for Payer: Hawaii Medical Service Association ABD	$46.35
Rate for Payer: Hawaii Medical Service Association Commercial	$154.38
Rate for Payer: Hawaii Medical Service Association Medicare	$123.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$63.32
Rate for Payer: Hawaii Western Management Group Commercial	$123.50
Rate for Payer: Health Management Network Commercial	$601.80
Rate for Payer: Humana Medicare	$123.50
Rate for Payer: Kaiser Permanente Commercial	$446.04
Rate for Payer: Kaiser Permanente Medicaid	$361.08
Rate for Payer: Kaiser Permanente Medicare	$123.50
Rate for Payer: MDX Hawaii PPO	$686.76
Rate for Payer: Ohana Health Plan Medicaid	$135.85
Rate for Payer: Ohana Health Plan Medicare	$123.50
Rate for Payer: UnitedHealthcare Medicaid	$71.33
Rate for Payer: UnitedHealthcare Medicare	$123.50
Rate for Payer: University Health Alliance Commercial	$196.82

Know your out-of-pocket cost for care.

All Charges