Ultrasound, abdomen at Samuel Mahelona Memorial Hospital. CPT 76700.
What Samuel Mahelona Memorial Hospital publishes for this service, straight from its standard-charges file, last updated June 15, 2026.
Outpatient / ER
$94.90cash price (self-pay)
$158list price
$38.17–$735range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AlohaCare | Medicare | $38.17 |
| Ohana Health Plan | Medicare | $38.17 |
| Devoted Health | Medicare | $41.99 |
| AlohaCare | Medicaid | $76.97 |
| Ohana Health Plan | Medicaid | $76.97 |
| UnitedHealthcare | Medicaid | $76.97 |
| Hawaii Western Management Group | Commercial | $131 |
| Hawaii Medical Service Association | Commercial | $134 |
| Health Management Network | Commercial | $134 |
| Kaiser Permanente | Commercial | $242 |
| Hawaii Medical Service Association | Medicare | $247 |
| Kaiser Permanente | Medicare | $247 |
| UnitedHealthcare | Medicare | $247 |
| Hawaii Medical Service Association | ABD | $250 |
| Hawaii Medical Service Association | Non-ABD | $252 |
| University Health Alliance | Commercial | $268 |
| Humana | Medicare | $379 |
| Kaiser Permanente | Medicaid | $387 |
| MDX Hawaii | PPO | $735 |
Inpatient
$493cash price (self-pay)
$758list price
$644–$735range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Management Network | Commercial | $644 |
| Kaiser Permanente | Commercial | $682 |
| MDX Hawaii | PPO | $735 |
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