Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

ZIPRASIDONE 20 MG CAPSULE [29778]

Facility

IP

$26.00

Service Code	NDC 68084010311
Hospital Revenue Code	250
Min. Negotiated Rate	$22.10
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$15.60
Rate for Payer: Health Management Network Commercial	$22.10
Rate for Payer: MDX Hawaii PPO	$25.22

ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION [33175]

Facility

OP

$99.00

Service Code	HCPCS J3486
Hospital Revenue Code	636
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$96.03
Rate for Payer: Cash Price	$59.40
Rate for Payer: Cash Price	$59.40
Rate for Payer: Hawaii Medical Service Association ABD	$3.14
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3.14
Rate for Payer: Hawaii Western Management Group Commercial	$94.05
Rate for Payer: Health Management Network Commercial	$84.15
Rate for Payer: Kaiser Permanente Commercial	$62.37
Rate for Payer: Kaiser Permanente Medicaid	$50.49
Rate for Payer: MDX Hawaii PPO	$96.03
Rate for Payer: UnitedHealthcare Medicaid	$59.40
Rate for Payer: University Health Alliance Commercial	$72.16

ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION [33175]

Facility

IP

$99.00

Service Code	HCPCS J3486
Hospital Revenue Code	250
Min. Negotiated Rate	$84.15
Max. Negotiated Rate	$96.03
Rate for Payer: Cash Price	$59.40
Rate for Payer: Health Management Network Commercial	$84.15
Rate for Payer: MDX Hawaii PPO	$96.03

ZIPRASIDONE 40 MG CAPSULE [29779]

Facility

IP

$27.00

Service Code	NDC 68001045106
Hospital Revenue Code	250
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$16.20
Rate for Payer: Health Management Network Commercial	$22.95
Rate for Payer: MDX Hawaii PPO	$26.19

ZIPRASIDONE 40 MG CAPSULE [29779]

Facility

OP

$27.00

Service Code	NDC 68001045106
Hospital Revenue Code	637
Min. Negotiated Rate	$13.77
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$16.20
Rate for Payer: Hawaii Western Management Group Commercial	$25.65
Rate for Payer: Health Management Network Commercial	$22.95
Rate for Payer: Kaiser Permanente Commercial	$17.01
Rate for Payer: Kaiser Permanente Medicaid	$13.77
Rate for Payer: MDX Hawaii PPO	$26.19
Rate for Payer: University Health Alliance Commercial	$19.68

ZIPRASIDONE 40 MG CAPSULE [29779]

Facility

OP

$26.00

Service Code	NDC 68084010409
Hospital Revenue Code	637
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$15.60
Rate for Payer: Hawaii Western Management Group Commercial	$24.70
Rate for Payer: Health Management Network Commercial	$22.10
Rate for Payer: Kaiser Permanente Commercial	$16.38
Rate for Payer: Kaiser Permanente Medicaid	$13.26
Rate for Payer: MDX Hawaii PPO	$25.22
Rate for Payer: University Health Alliance Commercial	$18.95

ZIPRASIDONE 40 MG CAPSULE [29779]

Facility

IP

$26.00

Service Code	NDC 68084010411
Hospital Revenue Code	250
Min. Negotiated Rate	$22.10
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$15.60
Rate for Payer: Health Management Network Commercial	$22.10
Rate for Payer: MDX Hawaii PPO	$25.22

ZIPRASIDONE 40 MG CAPSULE [29779]

Facility

IP

$12.00

Service Code	NDC 50268081212
Hospital Revenue Code	250
Min. Negotiated Rate	$10.20
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$7.20
Rate for Payer: Health Management Network Commercial	$10.20
Rate for Payer: MDX Hawaii PPO	$11.64

ZIPRASIDONE 40 MG CAPSULE [29779]

Facility

IP

$26.00

Service Code	NDC 68084010409
Hospital Revenue Code	250
Min. Negotiated Rate	$22.10
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$15.60
Rate for Payer: Health Management Network Commercial	$22.10
Rate for Payer: MDX Hawaii PPO	$25.22

ZIPRASIDONE 40 MG CAPSULE [29779]

Facility

OP

$26.00

Service Code	NDC 68084010411
Hospital Revenue Code	637
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$15.60
Rate for Payer: Hawaii Western Management Group Commercial	$24.70
Rate for Payer: Health Management Network Commercial	$22.10
Rate for Payer: Kaiser Permanente Commercial	$16.38
Rate for Payer: Kaiser Permanente Medicaid	$13.26
Rate for Payer: MDX Hawaii PPO	$25.22
Rate for Payer: University Health Alliance Commercial	$18.95

ZIPRASIDONE 40 MG CAPSULE [29779]

Facility

OP

$12.00

Service Code	NDC 50268081212
Hospital Revenue Code	637
Min. Negotiated Rate	$6.12
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$7.20
Rate for Payer: Hawaii Western Management Group Commercial	$11.40
Rate for Payer: Health Management Network Commercial	$10.20
Rate for Payer: Kaiser Permanente Commercial	$7.56
Rate for Payer: Kaiser Permanente Medicaid	$6.12
Rate for Payer: MDX Hawaii PPO	$11.64
Rate for Payer: University Health Alliance Commercial	$8.75

ZIPWIRE GLIDEWIRE M0066802061

Facility

OP

$183.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$93.33
Max. Negotiated Rate	$177.51
Rate for Payer: Cash Price	$109.80
Rate for Payer: Hawaii Western Management Group Commercial	$173.85
Rate for Payer: Health Management Network Commercial	$155.55
Rate for Payer: Kaiser Permanente Commercial	$115.29
Rate for Payer: Kaiser Permanente Medicaid	$93.33
Rate for Payer: MDX Hawaii PPO	$177.51
Rate for Payer: University Health Alliance Commercial	$133.39

ZIPWIRE GLIDEWIRE M0066802061

Facility

IP

$183.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$155.55
Max. Negotiated Rate	$177.51
Rate for Payer: Cash Price	$109.80
Rate for Payer: Health Management Network Commercial	$155.55
Rate for Payer: MDX Hawaii PPO	$177.51

ZIV-AFLIBERCEPT 100 MG/4 ML (25 MG/ML) INTRAVENOUS SOLUTION [117162]

Facility

IP

$4,954.00

Service Code	HCPCS J9400
Hospital Revenue Code	250
Min. Negotiated Rate	$4,210.90
Max. Negotiated Rate	$4,805.38
Rate for Payer: Cash Price	$2,972.40
Rate for Payer: Cash Price	$1,728.00
Rate for Payer: Health Management Network Commercial	$2,448.00
Rate for Payer: Health Management Network Commercial	$4,210.90
Rate for Payer: MDX Hawaii PPO	$2,793.60
Rate for Payer: MDX Hawaii PPO	$4,805.38

ZIV-AFLIBERCEPT 100 MG/4 ML (25 MG/ML) INTRAVENOUS SOLUTION [117162]

Facility

OP

$2,880.00

Service Code	HCPCS J9400
Hospital Revenue Code	636
Min. Negotiated Rate	$7.98
Max. Negotiated Rate	$2,793.60
Rate for Payer: AlohaCare Medicaid	$8.61
Rate for Payer: AlohaCare Medicaid	$8.61
Rate for Payer: AlohaCare Medicare	$8.61
Rate for Payer: AlohaCare Medicare	$8.61
Rate for Payer: Cash Price	$2,972.40
Rate for Payer: Cash Price	$2,972.40
Rate for Payer: Cash Price	$1,728.00
Rate for Payer: Cash Price	$1,728.00
Rate for Payer: Devoted Health Medicare	$9.47
Rate for Payer: Devoted Health Medicare	$9.47
Rate for Payer: Hawaii Medical Service Association ABD	$7.98
Rate for Payer: Hawaii Medical Service Association ABD	$7.98
Rate for Payer: Hawaii Medical Service Association Commercial	$10.76
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 Medicare	$8.61
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.98
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.98
Rate for Payer: Hawaii Western Management Group Commercial	$4,706.30
Rate for Payer: Hawaii Western Management Group Commercial	$2,736.00
Rate for Payer: Health Management Network Commercial	$2,448.00
Rate for Payer: Health Management Network Commercial	$4,210.90
Rate for Payer: Humana Medicare	$8.61
Rate for Payer: Humana Medicare	$8.61
Rate for Payer: Kaiser Permanente Commercial	$1,814.40
Rate for Payer: Kaiser Permanente Commercial	$3,121.02
Rate for Payer: Kaiser Permanente Medicaid	$1,468.80
Rate for Payer: Kaiser Permanente Medicaid	$2,526.54
Rate for Payer: Kaiser Permanente Medicare	$8.61
Rate for Payer: Kaiser Permanente Medicare	$8.61
Rate for Payer: MDX Hawaii PPO	$2,793.60
Rate for Payer: MDX Hawaii PPO	$4,805.38
Rate for Payer: Ohana Health Plan Medicaid	$9.47
Rate for Payer: Ohana Health Plan Medicaid	$9.47
Rate for Payer: Ohana Health Plan Medicare	$8.61
Rate for Payer: Ohana Health Plan Medicare	$8.61
Rate for Payer: UnitedHealthcare Medicaid	$1,728.00
Rate for Payer: UnitedHealthcare Medicaid	$2,972.40
Rate for Payer: UnitedHealthcare Medicare	$8.61
Rate for Payer: UnitedHealthcare Medicare	$8.61
Rate for Payer: University Health Alliance Commercial	$3,610.97
Rate for Payer: University Health Alliance Commercial	$2,099.23

ZIV-AFLIBERCEPT 200 MG/8 ML (25 MG/ML) INTRAVENOUS SOLUTION [117163]

Facility

IP

$4,954.00

Service Code	HCPCS J9400
Hospital Revenue Code	250
Min. Negotiated Rate	$4,210.90
Max. Negotiated Rate	$4,805.38
Rate for Payer: Cash Price	$2,972.40
Rate for Payer: Cash Price	$3,456.00
Rate for Payer: Health Management Network Commercial	$4,210.90
Rate for Payer: Health Management Network Commercial	$4,896.00
Rate for Payer: MDX Hawaii PPO	$4,805.38
Rate for Payer: MDX Hawaii PPO	$5,587.20

ZIV-AFLIBERCEPT 200 MG/8 ML (25 MG/ML) INTRAVENOUS SOLUTION [117163]

Facility

OP

$5,760.00

Service Code	HCPCS J9400
Hospital Revenue Code	636
Min. Negotiated Rate	$7.98
Max. Negotiated Rate	$5,587.20
Rate for Payer: AlohaCare Medicaid	$8.61
Rate for Payer: AlohaCare Medicaid	$8.61
Rate for Payer: AlohaCare Medicare	$8.61
Rate for Payer: AlohaCare Medicare	$8.61
Rate for Payer: Cash Price	$3,456.00
Rate for Payer: Cash Price	$3,456.00
Rate for Payer: Cash Price	$2,972.40
Rate for Payer: Cash Price	$2,972.40
Rate for Payer: Devoted Health Medicare	$9.47
Rate for Payer: Devoted Health Medicare	$9.47
Rate for Payer: Hawaii Medical Service Association ABD	$7.98
Rate for Payer: Hawaii Medical Service Association ABD	$7.98
Rate for Payer: Hawaii Medical Service Association Commercial	$10.76
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 Medicare	$8.61
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.98
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.98
Rate for Payer: Hawaii Western Management Group Commercial	$4,706.30
Rate for Payer: Hawaii Western Management Group Commercial	$5,472.00
Rate for Payer: Health Management Network Commercial	$4,210.90
Rate for Payer: Health Management Network Commercial	$4,896.00
Rate for Payer: Humana Medicare	$8.61
Rate for Payer: Humana Medicare	$8.61
Rate for Payer: Kaiser Permanente Commercial	$3,121.02
Rate for Payer: Kaiser Permanente Commercial	$3,628.80
Rate for Payer: Kaiser Permanente Medicaid	$2,937.60
Rate for Payer: Kaiser Permanente Medicaid	$2,526.54
Rate for Payer: Kaiser Permanente Medicare	$8.61
Rate for Payer: Kaiser Permanente Medicare	$8.61
Rate for Payer: MDX Hawaii PPO	$5,587.20
Rate for Payer: MDX Hawaii PPO	$4,805.38
Rate for Payer: Ohana Health Plan Medicaid	$9.47
Rate for Payer: Ohana Health Plan Medicaid	$9.47
Rate for Payer: Ohana Health Plan Medicare	$8.61
Rate for Payer: Ohana Health Plan Medicare	$8.61
Rate for Payer: UnitedHealthcare Medicaid	$3,456.00
Rate for Payer: UnitedHealthcare Medicaid	$2,972.40
Rate for Payer: UnitedHealthcare Medicare	$8.61
Rate for Payer: UnitedHealthcare Medicare	$8.61
Rate for Payer: University Health Alliance Commercial	$4,198.46
Rate for Payer: University Health Alliance Commercial	$3,610.97

ZOLBETUXIMAB-CLZB 100 MG INTRAVENOUS SOLUTION [234229]

Facility

IP

$2,420.00

Service Code	NDC 00469342510
Hospital Revenue Code	250
Min. Negotiated Rate	$2,057.00
Max. Negotiated Rate	$2,347.40
Rate for Payer: Cash Price	$1,452.00
Rate for Payer: Health Management Network Commercial	$2,057.00
Rate for Payer: MDX Hawaii PPO	$2,347.40

ZOLBETUXIMAB-CLZB 300 MG INTRAVENOUS SOLUTION [235396]

Facility

IP

$6,260.00

Service Code	NDC 00469442530
Hospital Revenue Code	250
Min. Negotiated Rate	$5,321.00
Max. Negotiated Rate	$6,072.20
Rate for Payer: Cash Price	$3,756.00
Rate for Payer: Health Management Network Commercial	$5,321.00
Rate for Payer: MDX Hawaii PPO	$6,072.20

ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION [35640]

Facility

IP

$1,062.00

Service Code	HCPCS J3489
Hospital Revenue Code	250
Min. Negotiated Rate	$902.70
Max. Negotiated Rate	$1,030.14
Rate for Payer: Cash Price	$637.20
Rate for Payer: Cash Price	$135.00
Rate for Payer: Health Management Network Commercial	$191.25
Rate for Payer: Health Management Network Commercial	$902.70
Rate for Payer: MDX Hawaii PPO	$1,030.14
Rate for Payer: MDX Hawaii PPO	$218.25

ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION [35640]

Facility

OP

$225.00

Service Code	HCPCS J3489
Hospital Revenue Code	636
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$218.25
Rate for Payer: Cash Price	$135.00
Rate for Payer: Cash Price	$637.20
Rate for Payer: Cash Price	$637.20
Rate for Payer: Cash Price	$135.00
Rate for Payer: Hawaii Medical Service Association ABD	$5.20
Rate for Payer: Hawaii Medical Service Association ABD	$5.20
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5.20
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5.20
Rate for Payer: Hawaii Western Management Group Commercial	$1,008.90
Rate for Payer: Hawaii Western Management Group Commercial	$213.75
Rate for Payer: Health Management Network Commercial	$902.70
Rate for Payer: Health Management Network Commercial	$191.25
Rate for Payer: Kaiser Permanente Commercial	$669.06
Rate for Payer: Kaiser Permanente Commercial	$141.75
Rate for Payer: Kaiser Permanente Medicaid	$114.75
Rate for Payer: Kaiser Permanente Medicaid	$541.62
Rate for Payer: MDX Hawaii PPO	$1,030.14
Rate for Payer: MDX Hawaii PPO	$218.25
Rate for Payer: UnitedHealthcare Medicaid	$637.20
Rate for Payer: UnitedHealthcare Medicaid	$135.00
Rate for Payer: University Health Alliance Commercial	$774.09
Rate for Payer: University Health Alliance Commercial	$164.00

ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK [81434]

Facility

OP

$630.00

Service Code	HCPCS J3489
Hospital Revenue Code	636
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$611.10
Rate for Payer: Cash Price	$378.00
Rate for Payer: Cash Price	$882.00
Rate for Payer: Cash Price	$882.00
Rate for Payer: Cash Price	$378.00
Rate for Payer: Hawaii Medical Service Association ABD	$5.20
Rate for Payer: Hawaii Medical Service Association ABD	$5.20
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5.20
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5.20
Rate for Payer: Hawaii Western Management Group Commercial	$1,396.50
Rate for Payer: Hawaii Western Management Group Commercial	$598.50
Rate for Payer: Health Management Network Commercial	$535.50
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: Kaiser Permanente Commercial	$396.90
Rate for Payer: Kaiser Permanente Commercial	$926.10
Rate for Payer: Kaiser Permanente Medicaid	$749.70
Rate for Payer: Kaiser Permanente Medicaid	$321.30
Rate for Payer: MDX Hawaii PPO	$611.10
Rate for Payer: MDX Hawaii PPO	$1,425.90
Rate for Payer: UnitedHealthcare Medicaid	$882.00
Rate for Payer: UnitedHealthcare Medicaid	$378.00
Rate for Payer: University Health Alliance Commercial	$1,071.48
Rate for Payer: University Health Alliance Commercial	$459.21

ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK [81434]

Facility

IP

$1,470.00

Service Code	HCPCS J3489
Hospital Revenue Code	250
Min. Negotiated Rate	$1,249.50
Max. Negotiated Rate	$1,425.90
Rate for Payer: Cash Price	$882.00
Rate for Payer: Cash Price	$378.00
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: Health Management Network Commercial	$535.50
Rate for Payer: MDX Hawaii PPO	$1,425.90
Rate for Payer: MDX Hawaii PPO	$611.10

ZOLMITRIPTAN 2.5 MG DISINTEGRATING TABLET [29868]

Facility

IP

$127.00

Service Code	NDC 68382071586
Hospital Revenue Code	250
Min. Negotiated Rate	$107.95
Max. Negotiated Rate	$123.19
Rate for Payer: Cash Price	$76.20
Rate for Payer: Health Management Network Commercial	$107.95
Rate for Payer: MDX Hawaii PPO	$123.19

ZOLMITRIPTAN 2.5 MG DISINTEGRATING TABLET [29868]

Facility

IP

$127.00

Service Code	NDC 68382071569
Hospital Revenue Code	250
Min. Negotiated Rate	$107.95
Max. Negotiated Rate	$123.19
Rate for Payer: Cash Price	$76.20
Rate for Payer: Health Management Network Commercial	$107.95
Rate for Payer: MDX Hawaii PPO	$123.19