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Test for Rupture of Fetal Membranes

Hawaii rates for HCPCS 84112

A laboratory test performed on a fluid sample collected from the vagina during pregnancy to check for a specific protein that leaks out when the membranes surrounding the baby have broken. It gives a yes-or-no result and helps confirm or rule out rupture of membranes when the diagnosis is not clear from a physical exam alone. It is used in pregnant patients with symptoms suggestive of their water breaking.

Rates data updated July 2026.

How much does Test for Rupture of Fetal Membranes cost?

$135

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $135 for this service. Most negotiated rates run $112 to $158.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $98 · 10th to 90th $81 to $117Professionalmedian $145 · 10th to 90th $100 to $174
$100$200facility $98professional $145

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$97.72
Typical High
$117.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$117.49
HMSA
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$144.54
Typical High
$158.49
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$117.49
Typical High
$190.55
United
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$91.20
Typical High
$147.91
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$151.36
Typical High
$213.80

Where Hawaii sits

The same service costs 3.0 times more in South Dakota than in Connecticut. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Hawaii· 5th of 51

$135

SD $186CT $61.66

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.