Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Reinforced Reload 60mm Extra Thick SIGTRSB60AXT [3643884]

Facility

$2,421.27

Hospital Charge Code	3643884
Hospital Revenue Code	272
Min. Negotiated Rate	$1,234.85
Max. Negotiated Rate	$2,348.63
Rate for Payer: Cash Price	$1,573.83
Rate for Payer: Hawaii Western Management Group Commercial	$2,300.21
Rate for Payer: Health Management Network Commercial	$2,058.08
Rate for Payer: Kaiser Permanente Commercial	$1,525.40
Rate for Payer: Kaiser Permanente Medicaid	$1,234.85
Rate for Payer: MDX Hawaii PPO	$2,348.63
Rate for Payer: University Health Alliance Commercial	$1,764.86

Reinforced Reload 60mm Extra Thick SIGTRSB60AXT [3643884]

Facility

$2,421.27

Hospital Charge Code	3643884
Hospital Revenue Code	272
Min. Negotiated Rate	$2,058.08
Max. Negotiated Rate	$2,348.63
Rate for Payer: Cash Price	$1,573.83
Rate for Payer: Health Management Network Commercial	$2,058.08
Rate for Payer: MDX Hawaii PPO	$2,348.63

Reinforced Reload 60mm Med/thick Sigtrsb60amt [3643883]

Facility

$2,133.40

Hospital Charge Code	3643883
Hospital Revenue Code	272
Min. Negotiated Rate	$1,813.39
Max. Negotiated Rate	$2,069.40
Rate for Payer: Cash Price	$1,386.71
Rate for Payer: Health Management Network Commercial	$1,813.39
Rate for Payer: MDX Hawaii PPO	$2,069.40

Reinforced Reload 60mm Med/thick Sigtrsb60amt [3643883]

Facility

$2,133.40

Hospital Charge Code	3643883
Hospital Revenue Code	272
Min. Negotiated Rate	$1,088.03
Max. Negotiated Rate	$2,069.40
Rate for Payer: Cash Price	$1,386.71
Rate for Payer: Hawaii Western Management Group Commercial	$2,026.73
Rate for Payer: Health Management Network Commercial	$1,813.39
Rate for Payer: Kaiser Permanente Commercial	$1,344.04
Rate for Payer: Kaiser Permanente Medicaid	$1,088.03
Rate for Payer: MDX Hawaii PPO	$2,069.40
Rate for Payer: University Health Alliance Commercial	$1,555.04

REINSERTION OF RUPTURED BICEPS OR TRICEPS TENDON, DISTAL, WITH OR WITHOUT TENDON GRAFT

Facility

$9,429.30

Service Code	CPT 24342
Hospital Revenue Code	360
Min. Negotiated Rate	$521.33
Max. Negotiated Rate	$9,429.30
Rate for Payer: AlohaCare Medicaid	$8,572.09
Rate for Payer: AlohaCare Medicare	$8,572.09
Rate for Payer: Devoted Health Medicare	$9,429.30
Rate for Payer: Hawaii Medical Service Association ABD	$848.00
Rate for Payer: Hawaii Medical Service Association Commercial	$9,416.00
Rate for Payer: Hawaii Medical Service Association Medicare	$8,572.09
Rate for Payer: Hawaii Medical Service Association Non-ABD	$849.21
Rate for Payer: Humana Medicare	$8,572.09
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$8,572.09
Rate for Payer: Ohana Health Plan Medicaid	$9,429.30
Rate for Payer: Ohana Health Plan Medicare	$8,572.09
Rate for Payer: UnitedHealthcare Medicaid	$521.33
Rate for Payer: UnitedHealthcare Medicare	$8,572.09
Rate for Payer: University Health Alliance Commercial	$6,743.44

Reliatack Reload Deep Absorb Tacks RELTACK8RDPT [3644379]

Facility

$993.49

Hospital Charge Code	3644379
Hospital Revenue Code	272
Min. Negotiated Rate	$506.68
Max. Negotiated Rate	$963.69
Rate for Payer: Cash Price	$645.77
Rate for Payer: Hawaii Western Management Group Commercial	$943.82
Rate for Payer: Health Management Network Commercial	$844.47
Rate for Payer: Kaiser Permanente Commercial	$625.90
Rate for Payer: Kaiser Permanente Medicaid	$506.68
Rate for Payer: MDX Hawaii PPO	$963.69
Rate for Payer: University Health Alliance Commercial	$724.15

Reliatack Reload Deep Absorb Tacks RELTACK8RDPT [3644379]

Facility

$993.49

Hospital Charge Code	3644379
Hospital Revenue Code	272
Min. Negotiated Rate	$844.47
Max. Negotiated Rate	$963.69
Rate for Payer: Cash Price	$645.77
Rate for Payer: Health Management Network Commercial	$844.47
Rate for Payer: MDX Hawaii PPO	$963.69

RELTACK10RSW Lap Tacker Articul Reliatack Reload [3643113]

Facility

$1,064.40

Hospital Charge Code	3643113
Hospital Revenue Code	272
Min. Negotiated Rate	$904.74
Max. Negotiated Rate	$1,032.47
Rate for Payer: Cash Price	$691.86
Rate for Payer: Health Management Network Commercial	$904.74
Rate for Payer: MDX Hawaii PPO	$1,032.47

RELTACK10RSW Lap Tacker Articul Reliatack Reload [3643113]

Facility

$1,064.40

Hospital Charge Code	3643113
Hospital Revenue Code	272
Min. Negotiated Rate	$542.84
Max. Negotiated Rate	$1,032.47
Rate for Payer: Cash Price	$691.86
Rate for Payer: Hawaii Western Management Group Commercial	$1,011.18
Rate for Payer: Health Management Network Commercial	$904.74
Rate for Payer: Kaiser Permanente Commercial	$670.57
Rate for Payer: Kaiser Permanente Medicaid	$542.84
Rate for Payer: MDX Hawaii PPO	$1,032.47
Rate for Payer: University Health Alliance Commercial	$775.84

REMDESIVIR 100 MG IV RECON.SOLN.

Facility

$1,590.90

Service Code	HCPCS J0248
Hospital Revenue Code	636
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$1,543.17
Rate for Payer: AlohaCare Medicaid	$6.90
Rate for Payer: AlohaCare Medicare	$6.90
Rate for Payer: Cash Price	$1,034.08
Rate for Payer: Cash Price	$1,034.08
Rate for Payer: Devoted Health Medicare	$7.59
Rate for Payer: Hawaii Medical Service Association ABD	$6.73
Rate for Payer: Hawaii Medical Service Association Commercial	$8.62
Rate for Payer: Hawaii Medical Service Association Medicare	$6.90
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6.73
Rate for Payer: Hawaii Western Management Group Commercial	$1,511.36
Rate for Payer: Health Management Network Commercial	$1,352.27
Rate for Payer: Humana Medicare	$6.90
Rate for Payer: Kaiser Permanente Commercial	$1,002.27
Rate for Payer: Kaiser Permanente Medicaid	$811.36
Rate for Payer: Kaiser Permanente Medicare	$6.90
Rate for Payer: MDX Hawaii PPO	$1,543.17
Rate for Payer: Ohana Health Plan Medicaid	$7.59
Rate for Payer: Ohana Health Plan Medicare	$6.90
Rate for Payer: UnitedHealthcare Medicaid	$954.54
Rate for Payer: UnitedHealthcare Medicare	$6.90
Rate for Payer: University Health Alliance Commercial	$1,159.61

REMDESIVIR 100 MG IV RECON.SOLN.

Facility

$1,590.90

Service Code	HCPCS J0248
Hospital Revenue Code	250
Min. Negotiated Rate	$1,352.27
Max. Negotiated Rate	$1,543.17
Rate for Payer: Cash Price	$1,034.08
Rate for Payer: Health Management Network Commercial	$1,352.27
Rate for Payer: MDX Hawaii PPO	$1,543.17

REMOVAL, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT

Facility

$2,837.00

Service Code	CPT 11982
Hospital Revenue Code	360
Min. Negotiated Rate	$99.44
Max. Negotiated Rate	$2,837.00
Rate for Payer: AlohaCare Medicaid	$527.74
Rate for Payer: AlohaCare Medicare	$527.74
Rate for Payer: Devoted Health Medicare	$580.51
Rate for Payer: Hawaii Medical Service Association Commercial	$659.67
Rate for Payer: Hawaii Medical Service Association Medicare	$527.74
Rate for Payer: Humana Medicare	$527.74
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$527.74
Rate for Payer: Ohana Health Plan Medicaid	$580.51
Rate for Payer: Ohana Health Plan Medicare	$527.74
Rate for Payer: UnitedHealthcare Medicaid	$99.44
Rate for Payer: UnitedHealthcare Medicare	$527.74

REMOVAL OF ANAL SETON, OTHER MARKER

Facility

$2,837.00

Service Code	CPT 46030
Hospital Revenue Code	360
Min. Negotiated Rate	$393.00
Max. Negotiated Rate	$2,837.00
Rate for Payer: AlohaCare Medicaid	$1,413.65
Rate for Payer: AlohaCare Medicare	$1,413.65
Rate for Payer: Devoted Health Medicare	$1,555.02
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,833.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,413.65
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Humana Medicare	$1,413.65
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$1,413.65
Rate for Payer: Ohana Health Plan Medicaid	$1,555.02
Rate for Payer: Ohana Health Plan Medicare	$1,413.65
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$1,413.65

REMOVAL OF FOREIGN BODY, FOOT; DEEP

Facility

$6,183.00

Service Code	CPT 28192
Hospital Revenue Code	360
Min. Negotiated Rate	$456.03
Max. Negotiated Rate	$6,183.00
Rate for Payer: AlohaCare Medicaid	$1,951.11
Rate for Payer: AlohaCare Medicare	$1,951.11
Rate for Payer: Devoted Health Medicare	$2,146.22
Rate for Payer: Hawaii Medical Service Association ABD	$695.00
Rate for Payer: Hawaii Medical Service Association Commercial	$6,183.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,951.11
Rate for Payer: Hawaii Medical Service Association Non-ABD	$700.72
Rate for Payer: Humana Medicare	$1,951.11
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$1,951.11
Rate for Payer: Ohana Health Plan Medicaid	$2,146.22
Rate for Payer: Ohana Health Plan Medicare	$1,951.11
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$1,951.11
Rate for Payer: University Health Alliance Commercial	$5,160.40

REMOVAL OF IMPACTED VAGINAL FOREIGN BODY (SEPARATE PROCEDURE) UNDER ANESTHESIA (OTHER THAN LOCAL)

Facility

$5,160.40

Service Code	CPT 57415
Hospital Revenue Code	360
Min. Negotiated Rate	$393.00
Max. Negotiated Rate	$5,160.40
Rate for Payer: AlohaCare Medicaid	$3,824.16
Rate for Payer: AlohaCare Medicare	$3,824.16
Rate for Payer: Devoted Health Medicare	$4,206.58
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,833.00
Rate for Payer: Hawaii Medical Service Association Medicare	$3,824.16
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Humana Medicare	$3,824.16
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$3,824.16
Rate for Payer: Ohana Health Plan Medicaid	$4,206.58
Rate for Payer: Ohana Health Plan Medicare	$3,824.16
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$3,824.16
Rate for Payer: University Health Alliance Commercial	$5,160.40

REMOVAL OF IMPLANT; DEEP (EG, BURIED WIRE, PIN, SCREW, METAL BAND, NAIL, ROD OR PLATE)

Facility

$6,743.44

Service Code	CPT 20680
Hospital Revenue Code	360
Min. Negotiated Rate	$456.03
Max. Negotiated Rate	$6,743.44
Rate for Payer: AlohaCare Medicaid	$3,431.47
Rate for Payer: AlohaCare Medicare	$3,431.47
Rate for Payer: Devoted Health Medicare	$3,774.62
Rate for Payer: Hawaii Medical Service Association ABD	$695.00
Rate for Payer: Hawaii Medical Service Association Commercial	$6,183.00
Rate for Payer: Hawaii Medical Service Association Medicare	$3,431.47
Rate for Payer: Hawaii Medical Service Association Non-ABD	$700.72
Rate for Payer: Humana Medicare	$3,431.47
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$3,431.47
Rate for Payer: Ohana Health Plan Medicaid	$3,774.62
Rate for Payer: Ohana Health Plan Medicare	$3,431.47
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$3,431.47
Rate for Payer: University Health Alliance Commercial	$6,743.44

REMOVAL OF IMPLANT; SUPERFICIAL (EG, BURIED WIRE, PIN OR ROD) (SEPARATE PROCEDURE)

Facility

$4,035.20

Service Code	CPT 20670
Hospital Revenue Code	360
Min. Negotiated Rate	$393.00
Max. Negotiated Rate	$4,035.20
Rate for Payer: AlohaCare Medicaid	$1,951.11
Rate for Payer: AlohaCare Medicare	$1,951.11
Rate for Payer: Devoted Health Medicare	$2,146.22
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,833.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,951.11
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Humana Medicare	$1,951.11
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$1,951.11
Rate for Payer: Ohana Health Plan Medicaid	$2,146.22
Rate for Payer: Ohana Health Plan Medicare	$1,951.11
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$1,951.11
Rate for Payer: University Health Alliance Commercial	$4,035.20

REMOVAL OF INDWELLING TUNNELED PLEURAL CATHETER WITH CUFF

Facility

$4,035.20

Service Code	CPT 32552
Hospital Revenue Code	360
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$4,035.20
Rate for Payer: AlohaCare Medicaid	$741.06
Rate for Payer: AlohaCare Medicare	$741.06
Rate for Payer: Devoted Health Medicare	$815.17
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,833.00
Rate for Payer: Hawaii Medical Service Association Medicare	$741.06
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Humana Medicare	$741.06
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$741.06
Rate for Payer: Ohana Health Plan Medicaid	$815.17
Rate for Payer: Ohana Health Plan Medicare	$741.06
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$741.06
Rate for Payer: University Health Alliance Commercial	$4,035.20

REMOVAL OF INTRAUTERINE DEVICE (IUD)

Facility

$4,035.20

Service Code	CPT 58301
Hospital Revenue Code	360
Min. Negotiated Rate	$47.15
Max. Negotiated Rate	$4,035.20
Rate for Payer: AlohaCare Medicaid	$359.99
Rate for Payer: AlohaCare Medicare	$359.99
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: Humana Medicare	$359.99
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$359.99
Rate for Payer: Ohana Health Plan Medicaid	$395.99
Rate for Payer: Ohana Health Plan Medicare	$359.99
Rate for Payer: UnitedHealthcare Medicaid	$47.15
Rate for Payer: UnitedHealthcare Medicare	$359.99
Rate for Payer: University Health Alliance Commercial	$4,035.20

REMOVAL OF RUPTURED BREAST IMPLANT, INCLUDING IMPLANT CONTENTS (EG, SALINE, SILICONE GEL)

Facility

$6,183.00

Service Code	CPT 19330
Hospital Revenue Code	360
Min. Negotiated Rate	$456.03
Max. Negotiated Rate	$6,183.00
Rate for Payer: AlohaCare Medicaid	$4,625.48
Rate for Payer: AlohaCare Medicare	$4,625.48
Rate for Payer: Devoted Health Medicare	$5,088.03
Rate for Payer: Hawaii Medical Service Association ABD	$695.00
Rate for Payer: Hawaii Medical Service Association Commercial	$6,183.00
Rate for Payer: Hawaii Medical Service Association Medicare	$4,625.48
Rate for Payer: Hawaii Medical Service Association Non-ABD	$700.72
Rate for Payer: Humana Medicare	$4,625.48
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$4,625.48
Rate for Payer: Ohana Health Plan Medicaid	$5,088.03
Rate for Payer: Ohana Health Plan Medicare	$4,625.48
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$4,625.48
Rate for Payer: University Health Alliance Commercial	$4,035.20

REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCLUDING 15 LESIONS

Facility

$2,837.00

Service Code	CPT 11200
Hospital Revenue Code	360
Min. Negotiated Rate	$37.52
Max. Negotiated Rate	$2,837.00
Rate for Payer: AlohaCare Medicaid	$237.02
Rate for Payer: AlohaCare Medicare	$237.02
Rate for Payer: Devoted Health Medicare	$260.72
Rate for Payer: Hawaii Medical Service Association Commercial	$296.27
Rate for Payer: Hawaii Medical Service Association Medicare	$237.02
Rate for Payer: Humana Medicare	$237.02
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$237.02
Rate for Payer: Ohana Health Plan Medicaid	$260.72
Rate for Payer: Ohana Health Plan Medicare	$237.02
Rate for Payer: UnitedHealthcare Medicaid	$37.52
Rate for Payer: UnitedHealthcare Medicare	$237.02

REMOVAL OF TUNNELED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT OR PUMP, CENTRAL OR PERIPHERAL INSERTION

Facility

$2,837.00

Service Code	CPT 36590
Hospital Revenue Code	360
Min. Negotiated Rate	$393.00
Max. Negotiated Rate	$2,837.00
Rate for Payer: AlohaCare Medicaid	$1,859.62
Rate for Payer: AlohaCare Medicare	$1,859.62
Rate for Payer: Devoted Health Medicare	$2,045.58
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,833.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,859.62
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Humana Medicare	$1,859.62
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$1,859.62
Rate for Payer: Ohana Health Plan Medicaid	$2,045.58
Rate for Payer: Ohana Health Plan Medicare	$1,859.62
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$1,859.62

REMOVAL OF TUNNELED INTRAPERITONEAL CATHETER

Facility

$6,183.00

Service Code	CPT 49422
Hospital Revenue Code	360
Min. Negotiated Rate	$456.03
Max. Negotiated Rate	$6,183.00
Rate for Payer: AlohaCare Medicaid	$3,730.07
Rate for Payer: AlohaCare Medicare	$3,730.07
Rate for Payer: Devoted Health Medicare	$4,103.08
Rate for Payer: Hawaii Medical Service Association ABD	$695.00
Rate for Payer: Hawaii Medical Service Association Commercial	$6,183.00
Rate for Payer: Hawaii Medical Service Association Medicare	$3,730.07
Rate for Payer: Hawaii Medical Service Association Non-ABD	$700.72
Rate for Payer: Humana Medicare	$3,730.07
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$3,730.07
Rate for Payer: Ohana Health Plan Medicaid	$4,103.08
Rate for Payer: Ohana Health Plan Medicare	$3,730.07
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$3,730.07

REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SYSTEM

Facility

$6,183.00

Service Code	CPT 20694
Hospital Revenue Code	360
Min. Negotiated Rate	$456.03
Max. Negotiated Rate	$6,183.00
Rate for Payer: AlohaCare Medicaid	$1,899.59
Rate for Payer: AlohaCare Medicare	$1,899.59
Rate for Payer: Devoted Health Medicare	$2,089.55
Rate for Payer: Hawaii Medical Service Association ABD	$695.00
Rate for Payer: Hawaii Medical Service Association Commercial	$6,183.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,899.59
Rate for Payer: Hawaii Medical Service Association Non-ABD	$700.72
Rate for Payer: Humana Medicare	$1,899.59
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$1,899.59
Rate for Payer: Ohana Health Plan Medicaid	$2,089.55
Rate for Payer: Ohana Health Plan Medicare	$1,899.59
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$1,899.59
Rate for Payer: University Health Alliance Commercial	$4,035.20

REMOVAL (VIA SNARE/CAPTURE) AND REPLACEMENT OF INTERNALLY DWELLING URETERAL STENT VIA TRANSURETHRAL APPROACH, WITHOUT USE OF CYSTOSCOPY, INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION

Facility

$6,183.00

Service Code	CPT 50385
Hospital Revenue Code	360
Min. Negotiated Rate	$456.03
Max. Negotiated Rate	$6,183.00
Rate for Payer: AlohaCare Medicaid	$2,469.46
Rate for Payer: AlohaCare Medicare	$2,469.46
Rate for Payer: Devoted Health Medicare	$2,716.41
Rate for Payer: Hawaii Medical Service Association ABD	$695.00
Rate for Payer: Hawaii Medical Service Association Commercial	$6,183.00
Rate for Payer: Hawaii Medical Service Association Medicare	$2,469.46
Rate for Payer: Hawaii Medical Service Association Non-ABD	$700.72
Rate for Payer: Humana Medicare	$2,469.46
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$2,469.46
Rate for Payer: Ohana Health Plan Medicaid	$2,716.41
Rate for Payer: Ohana Health Plan Medicare	$2,469.46
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$2,469.46

Know your out-of-pocket cost for care.

All Charges