Kau Hospital

All Charges

Charge

Type

Setting

Price

DRILL BIT 2X110MM 4806-110-20

Facility

$638.00

Hospital Revenue Code	272
Min. Negotiated Rate	$197.78
Max. Negotiated Rate	$618.86
Rate for Payer: AlohaCare Medicaid	$319.00
Rate for Payer: AlohaCare Medicare	$197.78
Rate for Payer: Cash Price	$382.80
Rate for Payer: Devoted Health Medicare	$216.92
Rate for Payer: Hawaii Medical Service Association Medicare	$197.78
Rate for Payer: Hawaii Western Management Group Commercial	$606.10
Rate for Payer: Health Management Network Commercial	$542.30
Rate for Payer: Humana Medicare	$197.78
Rate for Payer: Kaiser Permanente Commercial	$574.20
Rate for Payer: Kaiser Permanente Medicaid	$325.38
Rate for Payer: Kaiser Permanente Medicare	$197.78
Rate for Payer: MDX Hawaii PPO	$618.86
Rate for Payer: Ohana Health Plan Medicaid	$197.78
Rate for Payer: Ohana Health Plan Medicare	$197.78
Rate for Payer: UnitedHealthcare Medicare	$197.78
Rate for Payer: University Health Alliance Commercial	$465.04

DRILL BIT 2X110MM 4806-110-20

Facility

$638.00

Hospital Revenue Code	272
Min. Negotiated Rate	$542.30
Max. Negotiated Rate	$618.86
Rate for Payer: Cash Price	$382.80
Rate for Payer: Health Management Network Commercial	$542.30
Rate for Payer: Kaiser Permanente Commercial	$574.20
Rate for Payer: MDX Hawaii PPO	$618.86

DRILL BIT 3.0MM AR-8943-36

Facility

$453.00

Hospital Revenue Code	272
Min. Negotiated Rate	$385.05
Max. Negotiated Rate	$439.41
Rate for Payer: Cash Price	$271.80
Rate for Payer: Health Management Network Commercial	$385.05
Rate for Payer: Kaiser Permanente Commercial	$407.70
Rate for Payer: MDX Hawaii PPO	$439.41

DRILL BIT 3.0MM AR-8943-36

Facility

$453.00

Hospital Revenue Code	272
Min. Negotiated Rate	$140.43
Max. Negotiated Rate	$439.41
Rate for Payer: AlohaCare Medicaid	$226.50
Rate for Payer: AlohaCare Medicare	$140.43
Rate for Payer: Cash Price	$271.80
Rate for Payer: Devoted Health Medicare	$154.02
Rate for Payer: Hawaii Medical Service Association Medicare	$140.43
Rate for Payer: Hawaii Western Management Group Commercial	$430.35
Rate for Payer: Health Management Network Commercial	$385.05
Rate for Payer: Humana Medicare	$140.43
Rate for Payer: Kaiser Permanente Commercial	$407.70
Rate for Payer: Kaiser Permanente Medicaid	$231.03
Rate for Payer: Kaiser Permanente Medicare	$140.43
Rate for Payer: MDX Hawaii PPO	$439.41
Rate for Payer: Ohana Health Plan Medicaid	$140.43
Rate for Payer: Ohana Health Plan Medicare	$140.43
Rate for Payer: UnitedHealthcare Medicare	$140.43
Rate for Payer: University Health Alliance Commercial	$330.19

DRILL BIT 3.0MM CANN 310.804

Facility

$1,724.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$1,465.40
Max. Negotiated Rate	$1,672.28
Rate for Payer: Cash Price	$1,034.40
Rate for Payer: Health Management Network Commercial	$1,465.40
Rate for Payer: Kaiser Permanente Commercial	$1,551.60
Rate for Payer: MDX Hawaii PPO	$1,672.28

DRILL BIT 3.0MM CANN 310.804

Facility

$1,724.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$534.44
Max. Negotiated Rate	$1,672.28
Rate for Payer: AlohaCare Medicaid	$862.00
Rate for Payer: AlohaCare Medicare	$534.44
Rate for Payer: Cash Price	$1,034.40
Rate for Payer: Devoted Health Medicare	$586.16
Rate for Payer: Hawaii Medical Service Association Medicare	$534.44
Rate for Payer: Hawaii Western Management Group Commercial	$1,637.80
Rate for Payer: Health Management Network Commercial	$1,465.40
Rate for Payer: Humana Medicare	$534.44
Rate for Payer: Kaiser Permanente Commercial	$1,551.60
Rate for Payer: Kaiser Permanente Medicaid	$879.24
Rate for Payer: Kaiser Permanente Medicare	$534.44
Rate for Payer: MDX Hawaii PPO	$1,672.28
Rate for Payer: Ohana Health Plan Medicaid	$534.44
Rate for Payer: Ohana Health Plan Medicare	$534.44
Rate for Payer: UnitedHealthcare Medicare	$534.44
Rate for Payer: University Health Alliance Commercial	$1,256.62

DRILL BIT 3.0MM CANNULATED

Facility

$1,749.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,486.65
Max. Negotiated Rate	$1,696.53
Rate for Payer: Cash Price	$1,049.40
Rate for Payer: Health Management Network Commercial	$1,486.65
Rate for Payer: Kaiser Permanente Commercial	$1,574.10
Rate for Payer: MDX Hawaii PPO	$1,696.53

DRILL BIT 3.0MM CANNULATED

Facility

$1,749.00

Hospital Revenue Code	272
Min. Negotiated Rate	$542.19
Max. Negotiated Rate	$1,696.53
Rate for Payer: AlohaCare Medicaid	$874.50
Rate for Payer: AlohaCare Medicare	$542.19
Rate for Payer: Cash Price	$1,049.40
Rate for Payer: Devoted Health Medicare	$594.66
Rate for Payer: Hawaii Medical Service Association Medicare	$542.19
Rate for Payer: Hawaii Western Management Group Commercial	$1,661.55
Rate for Payer: Health Management Network Commercial	$1,486.65
Rate for Payer: Humana Medicare	$542.19
Rate for Payer: Kaiser Permanente Commercial	$1,574.10
Rate for Payer: Kaiser Permanente Medicaid	$891.99
Rate for Payer: Kaiser Permanente Medicare	$542.19
Rate for Payer: MDX Hawaii PPO	$1,696.53
Rate for Payer: Ohana Health Plan Medicaid	$542.19
Rate for Payer: Ohana Health Plan Medicare	$542.19
Rate for Payer: UnitedHealthcare Medicare	$542.19
Rate for Payer: University Health Alliance Commercial	$1,274.85

DRILL BIT 3.0MM DIAMOND

Facility

$494.00

Hospital Revenue Code	272
Min. Negotiated Rate	$153.14
Max. Negotiated Rate	$479.18
Rate for Payer: AlohaCare Medicaid	$247.00
Rate for Payer: AlohaCare Medicare	$153.14
Rate for Payer: Cash Price	$296.40
Rate for Payer: Devoted Health Medicare	$167.96
Rate for Payer: Hawaii Medical Service Association Medicare	$153.14
Rate for Payer: Hawaii Western Management Group Commercial	$469.30
Rate for Payer: Health Management Network Commercial	$419.90
Rate for Payer: Humana Medicare	$153.14
Rate for Payer: Kaiser Permanente Commercial	$444.60
Rate for Payer: Kaiser Permanente Medicaid	$251.94
Rate for Payer: Kaiser Permanente Medicare	$153.14
Rate for Payer: MDX Hawaii PPO	$479.18
Rate for Payer: Ohana Health Plan Medicaid	$153.14
Rate for Payer: Ohana Health Plan Medicare	$153.14
Rate for Payer: UnitedHealthcare Medicare	$153.14
Rate for Payer: University Health Alliance Commercial	$360.08

DRILL BIT 3.0MM DIAMOND

Facility

$494.00

Hospital Revenue Code	272
Min. Negotiated Rate	$419.90
Max. Negotiated Rate	$479.18
Rate for Payer: Cash Price	$296.40
Rate for Payer: Health Management Network Commercial	$419.90
Rate for Payer: Kaiser Permanente Commercial	$444.60
Rate for Payer: MDX Hawaii PPO	$479.18

DRILL BIT 3.0MM PRECISION

Facility

$1,580.00

Hospital Revenue Code	272
Min. Negotiated Rate	$489.80
Max. Negotiated Rate	$1,532.60
Rate for Payer: AlohaCare Medicaid	$790.00
Rate for Payer: AlohaCare Medicare	$489.80
Rate for Payer: Cash Price	$948.00
Rate for Payer: Devoted Health Medicare	$537.20
Rate for Payer: Hawaii Medical Service Association Medicare	$489.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,501.00
Rate for Payer: Health Management Network Commercial	$1,343.00
Rate for Payer: Humana Medicare	$489.80
Rate for Payer: Kaiser Permanente Commercial	$1,422.00
Rate for Payer: Kaiser Permanente Medicaid	$805.80
Rate for Payer: Kaiser Permanente Medicare	$489.80
Rate for Payer: MDX Hawaii PPO	$1,532.60
Rate for Payer: Ohana Health Plan Medicaid	$489.80
Rate for Payer: Ohana Health Plan Medicare	$489.80
Rate for Payer: UnitedHealthcare Medicare	$489.80
Rate for Payer: University Health Alliance Commercial	$1,151.66

DRILL BIT 3.0MM PRECISION

Facility

$1,580.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,343.00
Max. Negotiated Rate	$1,532.60
Rate for Payer: Cash Price	$948.00
Rate for Payer: Health Management Network Commercial	$1,343.00
Rate for Payer: Kaiser Permanente Commercial	$1,422.00
Rate for Payer: MDX Hawaii PPO	$1,532.60

DRILL BIT 3.0MM QR 320-2030

Facility

$538.00

Hospital Revenue Code	272
Min. Negotiated Rate	$166.78
Max. Negotiated Rate	$521.86
Rate for Payer: AlohaCare Medicaid	$269.00
Rate for Payer: AlohaCare Medicare	$166.78
Rate for Payer: Cash Price	$322.80
Rate for Payer: Devoted Health Medicare	$182.92
Rate for Payer: Hawaii Medical Service Association Medicare	$166.78
Rate for Payer: Hawaii Western Management Group Commercial	$511.10
Rate for Payer: Health Management Network Commercial	$457.30
Rate for Payer: Humana Medicare	$166.78
Rate for Payer: Kaiser Permanente Commercial	$484.20
Rate for Payer: Kaiser Permanente Medicaid	$274.38
Rate for Payer: Kaiser Permanente Medicare	$166.78
Rate for Payer: MDX Hawaii PPO	$521.86
Rate for Payer: Ohana Health Plan Medicaid	$166.78
Rate for Payer: Ohana Health Plan Medicare	$166.78
Rate for Payer: UnitedHealthcare Medicare	$166.78
Rate for Payer: University Health Alliance Commercial	$392.15

DRILL BIT 3.0MM QR 320-2030

Facility

$538.00

Hospital Revenue Code	272
Min. Negotiated Rate	$457.30
Max. Negotiated Rate	$521.86
Rate for Payer: Cash Price	$322.80
Rate for Payer: Health Management Network Commercial	$457.30
Rate for Payer: Kaiser Permanente Commercial	$484.20
Rate for Payer: MDX Hawaii PPO	$521.86

DRILL BIT 3.1MM 5901-1126

Facility

$294.00

Hospital Revenue Code	272
Min. Negotiated Rate	$91.14
Max. Negotiated Rate	$285.18
Rate for Payer: AlohaCare Medicaid	$147.00
Rate for Payer: AlohaCare Medicare	$91.14
Rate for Payer: Cash Price	$176.40
Rate for Payer: Devoted Health Medicare	$99.96
Rate for Payer: Hawaii Medical Service Association Medicare	$91.14
Rate for Payer: Hawaii Western Management Group Commercial	$279.30
Rate for Payer: Health Management Network Commercial	$249.90
Rate for Payer: Humana Medicare	$91.14
Rate for Payer: Kaiser Permanente Commercial	$264.60
Rate for Payer: Kaiser Permanente Medicaid	$149.94
Rate for Payer: Kaiser Permanente Medicare	$91.14
Rate for Payer: MDX Hawaii PPO	$285.18
Rate for Payer: Ohana Health Plan Medicaid	$91.14
Rate for Payer: Ohana Health Plan Medicare	$91.14
Rate for Payer: UnitedHealthcare Medicare	$91.14
Rate for Payer: University Health Alliance Commercial	$214.30

DRILL BIT 3.1MM 5901-1126

Facility

$294.00

Hospital Revenue Code	272
Min. Negotiated Rate	$249.90
Max. Negotiated Rate	$285.18
Rate for Payer: Cash Price	$176.40
Rate for Payer: Health Management Network Commercial	$249.90
Rate for Payer: Kaiser Permanente Commercial	$264.60
Rate for Payer: MDX Hawaii PPO	$285.18

DRILL BIT 3.2/200MM 1-1101101

Facility

$527.00

Hospital Revenue Code	272
Min. Negotiated Rate	$163.37
Max. Negotiated Rate	$511.19
Rate for Payer: AlohaCare Medicaid	$263.50
Rate for Payer: AlohaCare Medicare	$163.37
Rate for Payer: Cash Price	$316.20
Rate for Payer: Devoted Health Medicare	$179.18
Rate for Payer: Hawaii Medical Service Association Medicare	$163.37
Rate for Payer: Hawaii Western Management Group Commercial	$500.65
Rate for Payer: Health Management Network Commercial	$447.95
Rate for Payer: Humana Medicare	$163.37
Rate for Payer: Kaiser Permanente Commercial	$474.30
Rate for Payer: Kaiser Permanente Medicaid	$268.77
Rate for Payer: Kaiser Permanente Medicare	$163.37
Rate for Payer: MDX Hawaii PPO	$511.19
Rate for Payer: Ohana Health Plan Medicaid	$163.37
Rate for Payer: Ohana Health Plan Medicare	$163.37
Rate for Payer: UnitedHealthcare Medicare	$163.37
Rate for Payer: University Health Alliance Commercial	$384.13

DRILL BIT 3.2/200MM 1-1101101

Facility

$527.00

Hospital Revenue Code	272
Min. Negotiated Rate	$447.95
Max. Negotiated Rate	$511.19
Rate for Payer: Cash Price	$316.20
Rate for Payer: Health Management Network Commercial	$447.95
Rate for Payer: Kaiser Permanente Commercial	$474.30
Rate for Payer: MDX Hawaii PPO	$511.19

DRILL BIT 32-467619

Facility

$536.00

Hospital Revenue Code	272
Min. Negotiated Rate	$455.60
Max. Negotiated Rate	$519.92
Rate for Payer: Cash Price	$321.60
Rate for Payer: Health Management Network Commercial	$455.60
Rate for Payer: Kaiser Permanente Commercial	$482.40
Rate for Payer: MDX Hawaii PPO	$519.92

DRILL BIT 32-467619

Facility

$536.00

Hospital Revenue Code	272
Min. Negotiated Rate	$166.16
Max. Negotiated Rate	$519.92
Rate for Payer: AlohaCare Medicaid	$268.00
Rate for Payer: AlohaCare Medicare	$166.16
Rate for Payer: Cash Price	$321.60
Rate for Payer: Devoted Health Medicare	$182.24
Rate for Payer: Hawaii Medical Service Association Medicare	$166.16
Rate for Payer: Hawaii Western Management Group Commercial	$509.20
Rate for Payer: Health Management Network Commercial	$455.60
Rate for Payer: Humana Medicare	$166.16
Rate for Payer: Kaiser Permanente Commercial	$482.40
Rate for Payer: Kaiser Permanente Medicaid	$273.36
Rate for Payer: Kaiser Permanente Medicare	$166.16
Rate for Payer: MDX Hawaii PPO	$519.92
Rate for Payer: Ohana Health Plan Medicaid	$166.16
Rate for Payer: Ohana Health Plan Medicare	$166.16
Rate for Payer: UnitedHealthcare Medicare	$166.16
Rate for Payer: University Health Alliance Commercial	$390.69

DRILL BIT 3.2 CAN 01-1010-009

Facility

$1,932.00

Hospital Revenue Code	272
Min. Negotiated Rate	$598.92
Max. Negotiated Rate	$1,874.04
Rate for Payer: AlohaCare Medicaid	$966.00
Rate for Payer: AlohaCare Medicare	$598.92
Rate for Payer: Cash Price	$1,159.20
Rate for Payer: Devoted Health Medicare	$656.88
Rate for Payer: Hawaii Medical Service Association Medicare	$598.92
Rate for Payer: Hawaii Western Management Group Commercial	$1,835.40
Rate for Payer: Health Management Network Commercial	$1,642.20
Rate for Payer: Humana Medicare	$598.92
Rate for Payer: Kaiser Permanente Commercial	$1,738.80
Rate for Payer: Kaiser Permanente Medicaid	$985.32
Rate for Payer: Kaiser Permanente Medicare	$598.92
Rate for Payer: MDX Hawaii PPO	$1,874.04
Rate for Payer: Ohana Health Plan Medicaid	$598.92
Rate for Payer: Ohana Health Plan Medicare	$598.92
Rate for Payer: UnitedHealthcare Medicare	$598.92
Rate for Payer: University Health Alliance Commercial	$1,408.23

DRILL BIT 3.2 CAN 01-1010-009

Facility

$1,932.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,642.20
Max. Negotiated Rate	$1,874.04
Rate for Payer: Cash Price	$1,159.20
Rate for Payer: Health Management Network Commercial	$1,642.20
Rate for Payer: Kaiser Permanente Commercial	$1,738.80
Rate for Payer: MDX Hawaii PPO	$1,874.04

DRILL BIT 3.2MM 110017537

Facility

$896.00

Hospital Revenue Code	272
Min. Negotiated Rate	$277.76
Max. Negotiated Rate	$869.12
Rate for Payer: AlohaCare Medicaid	$448.00
Rate for Payer: AlohaCare Medicare	$277.76
Rate for Payer: Cash Price	$537.60
Rate for Payer: Devoted Health Medicare	$304.64
Rate for Payer: Hawaii Medical Service Association Medicare	$277.76
Rate for Payer: Hawaii Western Management Group Commercial	$851.20
Rate for Payer: Health Management Network Commercial	$761.60
Rate for Payer: Humana Medicare	$277.76
Rate for Payer: Kaiser Permanente Commercial	$806.40
Rate for Payer: Kaiser Permanente Medicaid	$456.96
Rate for Payer: Kaiser Permanente Medicare	$277.76
Rate for Payer: MDX Hawaii PPO	$869.12
Rate for Payer: Ohana Health Plan Medicaid	$277.76
Rate for Payer: Ohana Health Plan Medicare	$277.76
Rate for Payer: UnitedHealthcare Medicare	$277.76
Rate for Payer: University Health Alliance Commercial	$653.09

DRILL BIT 3.2MM 110017537

Facility

$896.00

Hospital Revenue Code	272
Min. Negotiated Rate	$761.60
Max. Negotiated Rate	$869.12
Rate for Payer: Cash Price	$537.60
Rate for Payer: Health Management Network Commercial	$761.60
Rate for Payer: Kaiser Permanente Commercial	$806.40
Rate for Payer: MDX Hawaii PPO	$869.12

DRILL BIT 3.2MM 2129-57-012

Facility

$394.00

Hospital Revenue Code	272
Min. Negotiated Rate	$334.90
Max. Negotiated Rate	$382.18
Rate for Payer: Cash Price	$236.40
Rate for Payer: Health Management Network Commercial	$334.90
Rate for Payer: Kaiser Permanente Commercial	$354.60
Rate for Payer: MDX Hawaii PPO	$382.18

Know your out-of-pocket cost for care.

All Charges