Kau Hospital

All Charges

Charge

Type

Setting

Price

EXCALIBUR 5.5MM AR-8550EX

Facility

$236.00

Hospital Revenue Code	272
Min. Negotiated Rate	$73.16
Max. Negotiated Rate	$228.92
Rate for Payer: AlohaCare Medicaid	$118.00
Rate for Payer: AlohaCare Medicare	$73.16
Rate for Payer: Cash Price	$141.60
Rate for Payer: Devoted Health Medicare	$80.24
Rate for Payer: Hawaii Medical Service Association Medicare	$73.16
Rate for Payer: Hawaii Western Management Group Commercial	$224.20
Rate for Payer: Health Management Network Commercial	$200.60
Rate for Payer: Humana Medicare	$73.16
Rate for Payer: Kaiser Permanente Commercial	$212.40
Rate for Payer: Kaiser Permanente Medicaid	$120.36
Rate for Payer: Kaiser Permanente Medicare	$73.16
Rate for Payer: MDX Hawaii PPO	$228.92
Rate for Payer: Ohana Health Plan Medicaid	$73.16
Rate for Payer: Ohana Health Plan Medicare	$73.16
Rate for Payer: UnitedHealthcare Medicare	$73.16
Rate for Payer: University Health Alliance Commercial	$172.02

EXCALIBUR 5.5MM AR-8550EX

Facility

$236.00

Hospital Revenue Code	272
Min. Negotiated Rate	$200.60
Max. Negotiated Rate	$228.92
Rate for Payer: Cash Price	$141.60
Rate for Payer: Health Management Network Commercial	$200.60
Rate for Payer: Kaiser Permanente Commercial	$212.40
Rate for Payer: MDX Hawaii PPO	$228.92

EXCLUDER 14.5/10CM PLC141000

Facility

$11,204.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,473.24
Max. Negotiated Rate	$10,867.88
Rate for Payer: AlohaCare Medicaid	$5,602.00
Rate for Payer: AlohaCare Medicare	$3,473.24
Rate for Payer: Cash Price	$6,722.40
Rate for Payer: Devoted Health Medicare	$3,809.36
Rate for Payer: Hawaii Medical Service Association Medicare	$3,473.24
Rate for Payer: Hawaii Western Management Group Commercial	$7,842.80
Rate for Payer: Health Management Network Commercial	$9,523.40
Rate for Payer: Humana Medicare	$3,473.24
Rate for Payer: Kaiser Permanente Commercial	$10,083.60
Rate for Payer: Kaiser Permanente Medicaid	$5,714.04
Rate for Payer: Kaiser Permanente Medicare	$3,473.24
Rate for Payer: MDX Hawaii PPO	$10,867.88
Rate for Payer: Ohana Health Plan Medicaid	$3,473.24
Rate for Payer: Ohana Health Plan Medicare	$3,473.24
Rate for Payer: UnitedHealthcare Medicare	$3,473.24
Rate for Payer: University Health Alliance Commercial	$6,274.24

EXCLUDER 14.5/10CM PLC141000

Facility

$11,204.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,274.24
Max. Negotiated Rate	$10,867.88
Rate for Payer: Cash Price	$6,722.40
Rate for Payer: Hawaii Western Management Group Commercial	$7,842.80
Rate for Payer: Health Management Network Commercial	$9,523.40
Rate for Payer: Kaiser Permanente Commercial	$10,083.60
Rate for Payer: MDX Hawaii PPO	$10,867.88
Rate for Payer: University Health Alliance Commercial	$6,274.24

EXCLUDER 14.5X14 PLC141400

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,577.40
Max. Negotiated Rate	$11,193.80
Rate for Payer: AlohaCare Medicaid	$5,770.00
Rate for Payer: AlohaCare Medicare	$3,577.40
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Devoted Health Medicare	$3,923.60
Rate for Payer: Hawaii Medical Service Association Medicare	$3,577.40
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Humana Medicare	$3,577.40
Rate for Payer: Kaiser Permanente Commercial	$10,386.00
Rate for Payer: Kaiser Permanente Medicaid	$5,885.40
Rate for Payer: Kaiser Permanente Medicare	$3,577.40
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: Ohana Health Plan Medicaid	$3,577.40
Rate for Payer: Ohana Health Plan Medicare	$3,577.40
Rate for Payer: UnitedHealthcare Medicare	$3,577.40
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER 14.5X14 PLC141400

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,462.40
Max. Negotiated Rate	$11,193.80
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Kaiser Permanente Commercial	$10,386.00
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER 15FR 23X4.5 CXA280005

Facility

$11,074.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,201.44
Max. Negotiated Rate	$10,741.78
Rate for Payer: Cash Price	$6,644.40
Rate for Payer: Hawaii Western Management Group Commercial	$7,751.80
Rate for Payer: Health Management Network Commercial	$9,412.90
Rate for Payer: Kaiser Permanente Commercial	$9,966.60
Rate for Payer: MDX Hawaii PPO	$10,741.78
Rate for Payer: University Health Alliance Commercial	$6,201.44

EXCLUDER 15FR 23X4.5 CXA280005

Facility

$11,074.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,432.94
Max. Negotiated Rate	$10,741.78
Rate for Payer: AlohaCare Medicaid	$5,537.00
Rate for Payer: AlohaCare Medicare	$3,432.94
Rate for Payer: Cash Price	$6,644.40
Rate for Payer: Devoted Health Medicare	$3,765.16
Rate for Payer: Hawaii Medical Service Association Medicare	$3,432.94
Rate for Payer: Hawaii Western Management Group Commercial	$7,751.80
Rate for Payer: Health Management Network Commercial	$9,412.90
Rate for Payer: Humana Medicare	$3,432.94
Rate for Payer: Kaiser Permanente Commercial	$9,966.60
Rate for Payer: Kaiser Permanente Medicaid	$5,647.74
Rate for Payer: Kaiser Permanente Medicare	$3,432.94
Rate for Payer: MDX Hawaii PPO	$10,741.78
Rate for Payer: Ohana Health Plan Medicaid	$3,432.94
Rate for Payer: Ohana Health Plan Medicare	$3,432.94
Rate for Payer: UnitedHealthcare Medicare	$3,432.94
Rate for Payer: University Health Alliance Commercial	$6,201.44

EXCLUDER 23X4.5 15FR CXA230005

Facility

$10,004.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,101.24
Max. Negotiated Rate	$9,703.88
Rate for Payer: AlohaCare Medicaid	$5,002.00
Rate for Payer: AlohaCare Medicare	$3,101.24
Rate for Payer: Cash Price	$6,002.40
Rate for Payer: Devoted Health Medicare	$3,401.36
Rate for Payer: Hawaii Medical Service Association Medicare	$3,101.24
Rate for Payer: Hawaii Western Management Group Commercial	$7,002.80
Rate for Payer: Health Management Network Commercial	$8,503.40
Rate for Payer: Humana Medicare	$3,101.24
Rate for Payer: Kaiser Permanente Commercial	$9,003.60
Rate for Payer: Kaiser Permanente Medicaid	$5,102.04
Rate for Payer: Kaiser Permanente Medicare	$3,101.24
Rate for Payer: MDX Hawaii PPO	$9,703.88
Rate for Payer: Ohana Health Plan Medicaid	$3,101.24
Rate for Payer: Ohana Health Plan Medicare	$3,101.24
Rate for Payer: UnitedHealthcare Medicare	$3,101.24
Rate for Payer: University Health Alliance Commercial	$5,602.24

EXCLUDER 23X4.5 15FR CXA230005

Facility

$10,004.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,602.24
Max. Negotiated Rate	$9,703.88
Rate for Payer: Cash Price	$6,002.40
Rate for Payer: Hawaii Western Management Group Commercial	$7,002.80
Rate for Payer: Health Management Network Commercial	$8,503.40
Rate for Payer: Kaiser Permanente Commercial	$9,003.60
Rate for Payer: MDX Hawaii PPO	$9,703.88
Rate for Payer: University Health Alliance Commercial	$5,602.24

EXCLUDER AAA 12X10 PLC121000

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,577.40
Max. Negotiated Rate	$11,193.80
Rate for Payer: AlohaCare Medicaid	$5,770.00
Rate for Payer: AlohaCare Medicare	$3,577.40
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Devoted Health Medicare	$3,923.60
Rate for Payer: Hawaii Medical Service Association Medicare	$3,577.40
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Humana Medicare	$3,577.40
Rate for Payer: Kaiser Permanente Commercial	$10,386.00
Rate for Payer: Kaiser Permanente Medicaid	$5,885.40
Rate for Payer: Kaiser Permanente Medicare	$3,577.40
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: Ohana Health Plan Medicaid	$3,577.40
Rate for Payer: Ohana Health Plan Medicare	$3,577.40
Rate for Payer: UnitedHealthcare Medicare	$3,577.40
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER AAA 12X10 PLC121000

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,462.40
Max. Negotiated Rate	$11,193.80
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Kaiser Permanente Commercial	$10,386.00
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER AAA 12X12 PLC121200

Facility

$11,204.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,473.24
Max. Negotiated Rate	$10,867.88
Rate for Payer: AlohaCare Medicaid	$5,602.00
Rate for Payer: AlohaCare Medicare	$3,473.24
Rate for Payer: Cash Price	$6,722.40
Rate for Payer: Devoted Health Medicare	$3,809.36
Rate for Payer: Hawaii Medical Service Association Medicare	$3,473.24
Rate for Payer: Hawaii Western Management Group Commercial	$7,842.80
Rate for Payer: Health Management Network Commercial	$9,523.40
Rate for Payer: Humana Medicare	$3,473.24
Rate for Payer: Kaiser Permanente Commercial	$10,083.60
Rate for Payer: Kaiser Permanente Medicaid	$5,714.04
Rate for Payer: Kaiser Permanente Medicare	$3,473.24
Rate for Payer: MDX Hawaii PPO	$10,867.88
Rate for Payer: Ohana Health Plan Medicaid	$3,473.24
Rate for Payer: Ohana Health Plan Medicare	$3,473.24
Rate for Payer: UnitedHealthcare Medicare	$3,473.24
Rate for Payer: University Health Alliance Commercial	$6,274.24

EXCLUDER AAA 12X12 PLC121200

Facility

$11,204.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,274.24
Max. Negotiated Rate	$10,867.88
Rate for Payer: Cash Price	$6,722.40
Rate for Payer: Hawaii Western Management Group Commercial	$7,842.80
Rate for Payer: Health Management Network Commercial	$9,523.40
Rate for Payer: Kaiser Permanente Commercial	$10,083.60
Rate for Payer: MDX Hawaii PPO	$10,867.88
Rate for Payer: University Health Alliance Commercial	$6,274.24

EXCLUDER AAA 16X10X7 PLL161007

Facility

$7,506.00

Hospital Revenue Code	278
Min. Negotiated Rate	$4,203.36
Max. Negotiated Rate	$7,280.82
Rate for Payer: Cash Price	$4,503.60
Rate for Payer: Hawaii Western Management Group Commercial	$5,254.20
Rate for Payer: Health Management Network Commercial	$6,380.10
Rate for Payer: Kaiser Permanente Commercial	$6,755.40
Rate for Payer: MDX Hawaii PPO	$7,280.82
Rate for Payer: University Health Alliance Commercial	$4,203.36

EXCLUDER AAA 16X10X7 PLL161007

Facility

$7,506.00

Hospital Revenue Code	278
Min. Negotiated Rate	$2,326.86
Max. Negotiated Rate	$7,280.82
Rate for Payer: AlohaCare Medicaid	$3,753.00
Rate for Payer: AlohaCare Medicare	$2,326.86
Rate for Payer: Cash Price	$4,503.60
Rate for Payer: Devoted Health Medicare	$2,552.04
Rate for Payer: Hawaii Medical Service Association Medicare	$2,326.86
Rate for Payer: Hawaii Western Management Group Commercial	$5,254.20
Rate for Payer: Health Management Network Commercial	$6,380.10
Rate for Payer: Humana Medicare	$2,326.86
Rate for Payer: Kaiser Permanente Commercial	$6,755.40
Rate for Payer: Kaiser Permanente Medicaid	$3,828.06
Rate for Payer: Kaiser Permanente Medicare	$2,326.86
Rate for Payer: MDX Hawaii PPO	$7,280.82
Rate for Payer: Ohana Health Plan Medicaid	$2,326.86
Rate for Payer: Ohana Health Plan Medicare	$2,326.86
Rate for Payer: UnitedHealthcare Medicare	$2,326.86
Rate for Payer: University Health Alliance Commercial	$4,203.36

EXCLUDER AAA 23MM CXT231412

Facility

$31,656.00

Hospital Revenue Code	278
Min. Negotiated Rate	$17,727.36
Max. Negotiated Rate	$30,706.32
Rate for Payer: Cash Price	$18,993.60
Rate for Payer: Hawaii Western Management Group Commercial	$22,159.20
Rate for Payer: Health Management Network Commercial	$26,907.60
Rate for Payer: Kaiser Permanente Commercial	$28,490.40
Rate for Payer: MDX Hawaii PPO	$30,706.32
Rate for Payer: University Health Alliance Commercial	$17,727.36

EXCLUDER AAA 23MM CXT231412

Facility

$31,656.00

Hospital Revenue Code	278
Min. Negotiated Rate	$9,813.36
Max. Negotiated Rate	$30,706.32
Rate for Payer: AlohaCare Medicaid	$15,828.00
Rate for Payer: AlohaCare Medicare	$9,813.36
Rate for Payer: Cash Price	$18,993.60
Rate for Payer: Devoted Health Medicare	$10,763.04
Rate for Payer: Hawaii Medical Service Association Medicare	$9,813.36
Rate for Payer: Hawaii Western Management Group Commercial	$22,159.20
Rate for Payer: Health Management Network Commercial	$26,907.60
Rate for Payer: Humana Medicare	$9,813.36
Rate for Payer: Kaiser Permanente Commercial	$28,490.40
Rate for Payer: Kaiser Permanente Medicaid	$16,144.56
Rate for Payer: Kaiser Permanente Medicare	$9,813.36
Rate for Payer: MDX Hawaii PPO	$30,706.32
Rate for Payer: Ohana Health Plan Medicaid	$9,813.36
Rate for Payer: Ohana Health Plan Medicare	$9,813.36
Rate for Payer: UnitedHealthcare Medicare	$9,813.36
Rate for Payer: University Health Alliance Commercial	$17,727.36

EXCLUDER AAA CXA200005

Facility

$10,004.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,101.24
Max. Negotiated Rate	$9,703.88
Rate for Payer: AlohaCare Medicaid	$5,002.00
Rate for Payer: AlohaCare Medicare	$3,101.24
Rate for Payer: Cash Price	$6,002.40
Rate for Payer: Devoted Health Medicare	$3,401.36
Rate for Payer: Hawaii Medical Service Association Medicare	$3,101.24
Rate for Payer: Hawaii Western Management Group Commercial	$7,002.80
Rate for Payer: Health Management Network Commercial	$8,503.40
Rate for Payer: Humana Medicare	$3,101.24
Rate for Payer: Kaiser Permanente Commercial	$9,003.60
Rate for Payer: Kaiser Permanente Medicaid	$5,102.04
Rate for Payer: Kaiser Permanente Medicare	$3,101.24
Rate for Payer: MDX Hawaii PPO	$9,703.88
Rate for Payer: Ohana Health Plan Medicaid	$3,101.24
Rate for Payer: Ohana Health Plan Medicare	$3,101.24
Rate for Payer: UnitedHealthcare Medicare	$3,101.24
Rate for Payer: University Health Alliance Commercial	$5,602.24

EXCLUDER AAA CXA200005

Facility

$10,004.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,602.24
Max. Negotiated Rate	$9,703.88
Rate for Payer: Cash Price	$6,002.40
Rate for Payer: Hawaii Western Management Group Commercial	$7,002.80
Rate for Payer: Health Management Network Commercial	$8,503.40
Rate for Payer: Kaiser Permanente Commercial	$9,003.60
Rate for Payer: MDX Hawaii PPO	$9,703.88
Rate for Payer: University Health Alliance Commercial	$5,602.24

EXCLUDER AAA ENDOPRO PLC121400

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,462.40
Max. Negotiated Rate	$11,193.80
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Kaiser Permanente Commercial	$10,386.00
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER AAA ENDOPRO PLC121400

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,577.40
Max. Negotiated Rate	$11,193.80
Rate for Payer: AlohaCare Medicaid	$5,770.00
Rate for Payer: AlohaCare Medicare	$3,577.40
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Devoted Health Medicare	$3,923.60
Rate for Payer: Hawaii Medical Service Association Medicare	$3,577.40
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Humana Medicare	$3,577.40
Rate for Payer: Kaiser Permanente Commercial	$10,386.00
Rate for Payer: Kaiser Permanente Medicaid	$5,885.40
Rate for Payer: Kaiser Permanente Medicare	$3,577.40
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: Ohana Health Plan Medicaid	$3,577.40
Rate for Payer: Ohana Health Plan Medicare	$3,577.40
Rate for Payer: UnitedHealthcare Medicare	$3,577.40
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER AAA PLL161200

Facility

$10,360.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,211.60
Max. Negotiated Rate	$10,049.20
Rate for Payer: AlohaCare Medicaid	$5,180.00
Rate for Payer: AlohaCare Medicare	$3,211.60
Rate for Payer: Cash Price	$6,216.00
Rate for Payer: Devoted Health Medicare	$3,522.40
Rate for Payer: Hawaii Medical Service Association Medicare	$3,211.60
Rate for Payer: Hawaii Western Management Group Commercial	$7,252.00
Rate for Payer: Health Management Network Commercial	$8,806.00
Rate for Payer: Humana Medicare	$3,211.60
Rate for Payer: Kaiser Permanente Commercial	$9,324.00
Rate for Payer: Kaiser Permanente Medicaid	$5,283.60
Rate for Payer: Kaiser Permanente Medicare	$3,211.60
Rate for Payer: MDX Hawaii PPO	$10,049.20
Rate for Payer: Ohana Health Plan Medicaid	$3,211.60
Rate for Payer: Ohana Health Plan Medicare	$3,211.60
Rate for Payer: UnitedHealthcare Medicare	$3,211.60
Rate for Payer: University Health Alliance Commercial	$5,801.60

EXCLUDER AAA PLL161200

Facility

$10,360.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,801.60
Max. Negotiated Rate	$10,049.20
Rate for Payer: Cash Price	$6,216.00
Rate for Payer: Hawaii Western Management Group Commercial	$7,252.00
Rate for Payer: Health Management Network Commercial	$8,806.00
Rate for Payer: Kaiser Permanente Commercial	$9,324.00
Rate for Payer: MDX Hawaii PPO	$10,049.20
Rate for Payer: University Health Alliance Commercial	$5,801.60

EXCLUDER AAA PLL161407

Facility

$7,986.00

Hospital Revenue Code	278
Min. Negotiated Rate	$4,472.16
Max. Negotiated Rate	$7,746.42
Rate for Payer: Cash Price	$4,791.60
Rate for Payer: Hawaii Western Management Group Commercial	$5,590.20
Rate for Payer: Health Management Network Commercial	$6,788.10
Rate for Payer: Kaiser Permanente Commercial	$7,187.40
Rate for Payer: MDX Hawaii PPO	$7,746.42
Rate for Payer: University Health Alliance Commercial	$4,472.16

Know your out-of-pocket cost for care.

All Charges