Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC

Facility

$57,382.54

Service Code	MSDRG 755
Min. Negotiated Rate	$57,382.54
Max. Negotiated Rate	$57,382.54
Rate for Payer: Hawaii Medical Service Association Commercial	$57,382.54

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$57,382.54

Service Code	MSDRG 754
Min. Negotiated Rate	$57,382.54
Max. Negotiated Rate	$57,382.54
Rate for Payer: Hawaii Medical Service Association Commercial	$57,382.54

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$21,545.12

Service Code	MSDRG 756
Min. Negotiated Rate	$21,545.12
Max. Negotiated Rate	$21,545.12
Rate for Payer: Hawaii Medical Service Association Commercial	$21,545.12

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC

Facility

$43,350.96

Service Code	MSDRG 723
Min. Negotiated Rate	$43,350.96
Max. Negotiated Rate	$43,350.96
Rate for Payer: Hawaii Medical Service Association Commercial	$43,350.96

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$43,350.96

Service Code	MSDRG 722
Min. Negotiated Rate	$43,350.96
Max. Negotiated Rate	$43,350.96
Rate for Payer: Hawaii Medical Service Association Commercial	$43,350.96

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$30,148.94

Service Code	MSDRG 724
Min. Negotiated Rate	$30,148.94
Max. Negotiated Rate	$30,148.94
Rate for Payer: Hawaii Medical Service Association Commercial	$30,148.94

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC

Facility

$38,634.26

Service Code	MSDRG 436
Min. Negotiated Rate	$38,634.26
Max. Negotiated Rate	$38,634.26
Rate for Payer: Hawaii Medical Service Association Commercial	$38,634.26

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC

Facility

$38,634.26

Service Code	MSDRG 435
Min. Negotiated Rate	$38,634.26
Max. Negotiated Rate	$38,634.26
Rate for Payer: Hawaii Medical Service Association Commercial	$38,634.26

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC

Facility

$38,634.26

Service Code	MSDRG 437
Min. Negotiated Rate	$38,634.26
Max. Negotiated Rate	$38,634.26
Rate for Payer: Hawaii Medical Service Association Commercial	$38,634.26

MALIGNANT BREAST DISORDERS WITH CC

Facility

$51,978.49

Service Code	MSDRG 598
Min. Negotiated Rate	$51,978.49
Max. Negotiated Rate	$51,978.49
Rate for Payer: Hawaii Medical Service Association Commercial	$51,978.49

MALIGNANT BREAST DISORDERS WITH MCC

Facility

$51,978.49

Service Code	MSDRG 597
Min. Negotiated Rate	$51,978.49
Max. Negotiated Rate	$51,978.49
Rate for Payer: Hawaii Medical Service Association Commercial	$51,978.49

MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility

$1,753.95

Service Code	MSDRG 599
Min. Negotiated Rate	$1,753.95
Max. Negotiated Rate	$1,753.95
Rate for Payer: Hawaii Medical Service Association Commercial	$1,753.95

MANDIBLE PLATE 3X3 04.503.716

Facility

$2,530.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,265.00
Max. Negotiated Rate	$2,454.10
Rate for Payer: AlohaCare Medicaid	$1,265.00
Rate for Payer: AlohaCare Medicare	$1,922.80
Rate for Payer: Cash Price	$1,518.00
Rate for Payer: Devoted Health Medicare	$2,125.20
Rate for Payer: Hawaii Medical Service Association Medicare	$1,922.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,771.00
Rate for Payer: Health Management Network Commercial	$2,150.50
Rate for Payer: Humana Medicare	$1,922.80
Rate for Payer: Kaiser Permanente Commercial	$2,277.00
Rate for Payer: Kaiser Permanente Medicaid	$1,290.30
Rate for Payer: Kaiser Permanente Medicare	$1,922.80
Rate for Payer: MDX Hawaii PPO	$2,454.10
Rate for Payer: Ohana Health Plan Medicaid	$1,922.80
Rate for Payer: Ohana Health Plan Medicare	$1,922.80
Rate for Payer: UnitedHealthcare Medicare	$1,922.80
Rate for Payer: University Health Alliance Commercial	$1,416.80

MANDIBLE PLATE 3X3 04.503.716

Facility

$2,530.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,416.80
Max. Negotiated Rate	$2,454.10
Rate for Payer: Cash Price	$1,518.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,771.00
Rate for Payer: Health Management Network Commercial	$2,150.50
Rate for Payer: Kaiser Permanente Commercial	$2,277.00
Rate for Payer: MDX Hawaii PPO	$2,454.10
Rate for Payer: University Health Alliance Commercial	$1,416.80

MANDIBLE RAMUS 4.0 04.305.100

Facility

$2,668.00

Hospital Revenue Code	278
Min. Negotiated Rate	$1,494.08
Max. Negotiated Rate	$2,587.96
Rate for Payer: Cash Price	$1,600.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,867.60
Rate for Payer: Health Management Network Commercial	$2,267.80
Rate for Payer: Kaiser Permanente Commercial	$2,401.20
Rate for Payer: MDX Hawaii PPO	$2,587.96
Rate for Payer: University Health Alliance Commercial	$1,494.08

MANDIBLE RAMUS 4.0 04.305.100

Facility

$2,668.00

Hospital Revenue Code	278
Min. Negotiated Rate	$1,334.00
Max. Negotiated Rate	$2,587.96
Rate for Payer: AlohaCare Medicaid	$1,334.00
Rate for Payer: AlohaCare Medicare	$2,027.68
Rate for Payer: Cash Price	$1,600.80
Rate for Payer: Devoted Health Medicare	$2,241.12
Rate for Payer: Hawaii Medical Service Association Medicare	$2,027.68
Rate for Payer: Hawaii Western Management Group Commercial	$1,867.60
Rate for Payer: Health Management Network Commercial	$2,267.80
Rate for Payer: Humana Medicare	$2,027.68
Rate for Payer: Kaiser Permanente Commercial	$2,401.20
Rate for Payer: Kaiser Permanente Medicaid	$1,360.68
Rate for Payer: Kaiser Permanente Medicare	$2,027.68
Rate for Payer: MDX Hawaii PPO	$2,587.96
Rate for Payer: Ohana Health Plan Medicaid	$2,027.68
Rate for Payer: Ohana Health Plan Medicare	$2,027.68
Rate for Payer: UnitedHealthcare Medicare	$2,027.68
Rate for Payer: University Health Alliance Commercial	$1,494.08

MANNITOL 20 % INTRAVENOUS SOLUTION [4749]

Facility

$98.00

Service Code	NDC 00990771512
Hospital Revenue Code	250
Min. Negotiated Rate	$83.30
Max. Negotiated Rate	$95.06
Rate for Payer: Cash Price	$58.80
Rate for Payer: Health Management Network Commercial	$83.30
Rate for Payer: Kaiser Permanente Commercial	$88.20
Rate for Payer: MDX Hawaii PPO	$95.06

MANNITOL 20 % INTRAVENOUS SOLUTION [4749]

Facility

$81.00

Service Code	NDC 00990771503
Hospital Revenue Code	250
Min. Negotiated Rate	$68.85
Max. Negotiated Rate	$78.57
Rate for Payer: Cash Price	$48.60
Rate for Payer: Health Management Network Commercial	$68.85
Rate for Payer: Kaiser Permanente Commercial	$72.90
Rate for Payer: MDX Hawaii PPO	$78.57

MANNITOL 20 % INTRAVENOUS SOLUTION [4749]

Facility

$81.00

Service Code	NDC 00990771513
Hospital Revenue Code	250
Min. Negotiated Rate	$68.85
Max. Negotiated Rate	$78.57
Rate for Payer: Cash Price	$48.60
Rate for Payer: Health Management Network Commercial	$68.85
Rate for Payer: Kaiser Permanente Commercial	$72.90
Rate for Payer: MDX Hawaii PPO	$78.57

MANNITOL 25 % INTRAVENOUS SOLUTION [4750]

Facility

$26.00

Service Code	HCPCS J2150
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: Kaiser Permanente Commercial	$23.40
Rate for Payer: MDX Hawaii PPO	$25.22

MANNITOL 25 % INTRAVENOUS SOLUTION [4750]

Facility

$26.00

Service Code	HCPCS J2150
Hospital Revenue Code	636
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$25.22
Rate for Payer: Humana Medicare	$19.76
Rate for Payer: AlohaCare Medicaid	$13.00
Rate for Payer: AlohaCare Medicare	$19.76
Rate for Payer: Cash Price	$15.60
Rate for Payer: Cash Price	$15.60
Rate for Payer: Devoted Health Medicare	$21.84
Rate for Payer: Hawaii Medical Service Association ABD	$2.24
Rate for Payer: Hawaii Medical Service Association Medicare	$19.76
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2.24
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	$23.40
Rate for Payer: Kaiser Permanente Medicaid	$13.26
Rate for Payer: Kaiser Permanente Medicare	$19.76
Rate for Payer: MDX Hawaii PPO	$25.22
Rate for Payer: Ohana Health Plan Medicaid	$19.76
Rate for Payer: Ohana Health Plan Medicare	$19.76
Rate for Payer: UnitedHealthcare Medicaid	$15.60
Rate for Payer: UnitedHealthcare Medicare	$19.76
Rate for Payer: University Health Alliance Commercial	$18.95

MARGETUXIMAB-CMKB 25 MG/ML INTRAVENOUS SOLUTION [177326]

Facility

$12,417.00

Service Code	HCPCS J9353
Hospital Revenue Code	250
Min. Negotiated Rate	$10,554.45
Max. Negotiated Rate	$12,044.49
Rate for Payer: Cash Price	$7,450.20
Rate for Payer: Cash Price	$2,887.80
Rate for Payer: Health Management Network Commercial	$4,091.05
Rate for Payer: Health Management Network Commercial	$10,554.45
Rate for Payer: Kaiser Permanente Commercial	$11,175.30
Rate for Payer: Kaiser Permanente Commercial	$4,331.70
Rate for Payer: MDX Hawaii PPO	$12,044.49
Rate for Payer: MDX Hawaii PPO	$4,668.61

MARGETUXIMAB-CMKB 25 MG/ML INTRAVENOUS SOLUTION [177326]

Facility

$12,417.00

Service Code	HCPCS J9353
Hospital Revenue Code	636
Min. Negotiated Rate	$50.45
Max. Negotiated Rate	$12,044.49
Rate for Payer: AlohaCare Medicaid	$6,208.50
Rate for Payer: AlohaCare Medicaid	$2,406.50
Rate for Payer: AlohaCare Medicare	$3,657.88
Rate for Payer: AlohaCare Medicare	$9,436.92
Rate for Payer: Cash Price	$7,450.20
Rate for Payer: Cash Price	$7,450.20
Rate for Payer: Cash Price	$2,887.80
Rate for Payer: Cash Price	$2,887.80
Rate for Payer: Devoted Health Medicare	$10,430.28
Rate for Payer: Devoted Health Medicare	$4,042.92
Rate for Payer: Hawaii Medical Service Association ABD	$50.45
Rate for Payer: Hawaii Medical Service Association ABD	$50.45
Rate for Payer: Hawaii Medical Service Association Commercial	$66.59
Rate for Payer: Hawaii Medical Service Association Commercial	$66.59
Rate for Payer: Hawaii Medical Service Association Medicare	$9,436.92
Rate for Payer: Hawaii Medical Service Association Medicare	$3,657.88
Rate for Payer: Hawaii Medical Service Association Non-ABD	$50.45
Rate for Payer: Hawaii Medical Service Association Non-ABD	$50.45
Rate for Payer: Hawaii Western Management Group Commercial	$11,796.15
Rate for Payer: Hawaii Western Management Group Commercial	$4,572.35
Rate for Payer: Health Management Network Commercial	$10,554.45
Rate for Payer: Health Management Network Commercial	$4,091.05
Rate for Payer: Humana Medicare	$9,436.92
Rate for Payer: Humana Medicare	$3,657.88
Rate for Payer: Kaiser Permanente Commercial	$11,175.30
Rate for Payer: Kaiser Permanente Commercial	$4,331.70
Rate for Payer: Kaiser Permanente Medicaid	$6,332.67
Rate for Payer: Kaiser Permanente Medicaid	$2,454.63
Rate for Payer: Kaiser Permanente Medicare	$9,436.92
Rate for Payer: Kaiser Permanente Medicare	$3,657.88
Rate for Payer: MDX Hawaii PPO	$12,044.49
Rate for Payer: MDX Hawaii PPO	$4,668.61
Rate for Payer: Ohana Health Plan Medicaid	$3,657.88
Rate for Payer: Ohana Health Plan Medicaid	$9,436.92
Rate for Payer: Ohana Health Plan Medicare	$9,436.92
Rate for Payer: Ohana Health Plan Medicare	$3,657.88
Rate for Payer: UnitedHealthcare Medicaid	$7,450.20
Rate for Payer: UnitedHealthcare Medicaid	$2,887.80
Rate for Payer: UnitedHealthcare Medicare	$3,657.88
Rate for Payer: UnitedHealthcare Medicare	$9,436.92
Rate for Payer: University Health Alliance Commercial	$9,050.75
Rate for Payer: University Health Alliance Commercial	$3,508.20

MARKERS MARGIN PAINT MMS6/MMC6

Facility

$421.00

Hospital Revenue Code	272
Min. Negotiated Rate	$357.85
Max. Negotiated Rate	$408.37
Rate for Payer: Cash Price	$252.60
Rate for Payer: Health Management Network Commercial	$357.85
Rate for Payer: Kaiser Permanente Commercial	$378.90
Rate for Payer: MDX Hawaii PPO	$408.37

MARKERS MARGIN PAINT MMS6/MMC6

Facility

$421.00

Hospital Revenue Code	272
Min. Negotiated Rate	$210.50
Max. Negotiated Rate	$408.37
Rate for Payer: AlohaCare Medicaid	$210.50
Rate for Payer: AlohaCare Medicare	$319.96
Rate for Payer: Cash Price	$252.60
Rate for Payer: Devoted Health Medicare	$353.64
Rate for Payer: Hawaii Medical Service Association Medicare	$319.96
Rate for Payer: Hawaii Western Management Group Commercial	$399.95
Rate for Payer: Health Management Network Commercial	$357.85
Rate for Payer: Humana Medicare	$319.96
Rate for Payer: Kaiser Permanente Commercial	$378.90
Rate for Payer: Kaiser Permanente Medicaid	$214.71
Rate for Payer: Kaiser Permanente Medicare	$319.96
Rate for Payer: MDX Hawaii PPO	$408.37
Rate for Payer: Ohana Health Plan Medicaid	$319.96
Rate for Payer: Ohana Health Plan Medicare	$319.96
Rate for Payer: UnitedHealthcare Medicare	$319.96
Rate for Payer: University Health Alliance Commercial	$306.87

Know your out-of-pocket cost for care.

All Charges