Kahuku Medical Center

All Charges

Charge

Type

Setting

Price

MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC

Facility

$23,180.56

Service Code	MSDRG 507
Min. Negotiated Rate	$23,180.56
Max. Negotiated Rate	$23,180.56
Rate for Payer: Hawaii Medical Service Association Commercial	$23,180.56

MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC

Facility

$23,180.56

Service Code	MSDRG 508
Min. Negotiated Rate	$23,180.56
Max. Negotiated Rate	$23,180.56
Rate for Payer: Hawaii Medical Service Association Commercial	$23,180.56

MAJOR SKIN DISORDERS WITH MCC

Facility

$40,506.72

Service Code	MSDRG 595
Min. Negotiated Rate	$40,506.72
Max. Negotiated Rate	$40,506.72
Rate for Payer: Hawaii Medical Service Association Commercial	$40,506.72

MAJOR SKIN DISORDERS WITHOUT MCC

Facility

$32,495.44

Service Code	MSDRG 596
Min. Negotiated Rate	$32,495.44
Max. Negotiated Rate	$32,495.44
Rate for Payer: Hawaii Medical Service Association Commercial	$32,495.44

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$65,227.90

Service Code	MSDRG 330
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$65,227.90
Rate for Payer: Hawaii Medical Service Association Commercial	$65,227.90
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$80,563.10

Service Code	MSDRG 329
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$80,563.10
Rate for Payer: Hawaii Medical Service Association Commercial	$80,563.10
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$36,524.78

Service Code	MSDRG 331
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$36,524.78
Rate for Payer: Hawaii Medical Service Association Commercial	$36,524.78
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR THUMB OR JOINT PROCEDURES

Facility

$34,865.64

Service Code	MSDRG 506
Min. Negotiated Rate	$34,865.64
Max. Negotiated Rate	$34,865.64
Rate for Payer: Hawaii Medical Service Association Commercial	$34,865.64

Malaria Smear, Thick DLS

Facility

$78.00

Service Code	HCPCS 87015
Hospital Charge Code	422870155
Hospital Revenue Code	300
Min. Negotiated Rate	$6.68
Max. Negotiated Rate	$75.66
Rate for Payer: AlohaCare Medicaid	$39.00
Rate for Payer: AlohaCare Medicare	$32.76
Rate for Payer: Cash Price	$50.70
Rate for Payer: Cash Price	$50.70
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$71.76
Rate for Payer: Devoted Health Medicare	$32.76
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$9.23
Rate for Payer: Hawaii Medical Service Association Commercial	$8.35
Rate for Payer: Hawaii Medical Service Association Medicare	$32.76
Rate for Payer: Hawaii Western Management Group Commercial	$6.68
Rate for Payer: Health Management Network Commercial	$66.30
Rate for Payer: Humana Medicare	$32.76
Rate for Payer: Kaiser Permanente Commercial	$70.20
Rate for Payer: Kaiser Permanente Medicaid	$39.78
Rate for Payer: Kaiser Permanente Medicare	$32.76
Rate for Payer: MDX Hawaii PPO	$75.66
Rate for Payer: Ohana Health Plan Medicaid	$32.76
Rate for Payer: Ohana Health Plan Medicare	$32.76
Rate for Payer: UnitedHealthcare Medicaid	$9.23
Rate for Payer: UnitedHealthcare Medicare	$32.76
Rate for Payer: University Health Alliance Commercial	$17.26

Malaria Smear, Thick DLS

Facility

$78.00

Service Code	HCPCS 87015
Hospital Charge Code	422870155
Hospital Revenue Code	300
Min. Negotiated Rate	$66.30
Max. Negotiated Rate	$75.66
Rate for Payer: Cash Price	$50.70
Rate for Payer: Health Management Network Commercial	$66.30
Rate for Payer: Kaiser Permanente Commercial	$70.20
Rate for Payer: MDX Hawaii PPO	$75.66

Malaria Smear, Thin DLS

Facility

$138.00

Service Code	HCPCS 87207
Hospital Charge Code	422870155
Hospital Revenue Code	300
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$133.86
Rate for Payer: AlohaCare Medicaid	$69.00
Rate for Payer: AlohaCare Medicare	$57.96
Rate for Payer: Cash Price	$89.70
Rate for Payer: Cash Price	$89.70
Rate for Payer: Deseret Mutual Benefit Administrators Commercial	$126.96
Rate for Payer: Devoted Health Medicare	$57.96
Rate for Payer: Hawaii Medical Service Association ABD/Non-ABD	$8.37
Rate for Payer: Hawaii Medical Service Association Commercial	$7.49
Rate for Payer: Hawaii Medical Service Association Medicare	$57.96
Rate for Payer: Hawaii Western Management Group Commercial	$5.99
Rate for Payer: Health Management Network Commercial	$117.30
Rate for Payer: Humana Medicare	$57.96
Rate for Payer: Kaiser Permanente Commercial	$124.20
Rate for Payer: Kaiser Permanente Medicaid	$70.38
Rate for Payer: Kaiser Permanente Medicare	$57.96
Rate for Payer: MDX Hawaii PPO	$133.86
Rate for Payer: Ohana Health Plan Medicaid	$57.96
Rate for Payer: Ohana Health Plan Medicare	$57.96
Rate for Payer: UnitedHealthcare Medicaid	$8.37
Rate for Payer: UnitedHealthcare Medicare	$57.96
Rate for Payer: University Health Alliance Commercial	$15.48

Malaria Smear, Thin DLS

Facility

$138.00

Service Code	HCPCS 87207
Hospital Charge Code	422870155
Hospital Revenue Code	300
Min. Negotiated Rate	$117.30
Max. Negotiated Rate	$133.86
Rate for Payer: Cash Price	$89.70
Rate for Payer: Health Management Network Commercial	$117.30
Rate for Payer: Kaiser Permanente Commercial	$124.20
Rate for Payer: MDX Hawaii PPO	$133.86

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

MA Mammogram Diagnostic Bilateral

Facility

$504.00

Service Code	HCPCS G0204
Hospital Charge Code	424G02040
Hospital Revenue Code	403
Min. Negotiated Rate	$428.40
Max. Negotiated Rate	$488.88
Rate for Payer: Cash Price	$327.60
Rate for Payer: Health Management Network Commercial	$428.40
Rate for Payer: Kaiser Permanente Commercial	$453.60
Rate for Payer: MDX Hawaii PPO	$488.88

Know your out-of-pocket cost for care.

All Charges