Kau Hospital

All Charges

Charge

Type

Setting

Price

AQUAMANTYS MALLEABLE BIPOLAR

Facility

$1,885.00

Hospital Revenue Code	272
Min. Negotiated Rate	$584.35
Max. Negotiated Rate	$1,828.45
Rate for Payer: AlohaCare Medicaid	$942.50
Rate for Payer: AlohaCare Medicare	$584.35
Rate for Payer: Cash Price	$1,131.00
Rate for Payer: Devoted Health Medicare	$640.90
Rate for Payer: Hawaii Medical Service Association Medicare	$584.35
Rate for Payer: Hawaii Western Management Group Commercial	$1,790.75
Rate for Payer: Health Management Network Commercial	$1,602.25
Rate for Payer: Humana Medicare	$584.35
Rate for Payer: Kaiser Permanente Commercial	$1,696.50
Rate for Payer: Kaiser Permanente Medicaid	$961.35
Rate for Payer: Kaiser Permanente Medicare	$584.35
Rate for Payer: MDX Hawaii PPO	$1,828.45
Rate for Payer: Ohana Health Plan Medicaid	$584.35
Rate for Payer: Ohana Health Plan Medicare	$584.35
Rate for Payer: UnitedHealthcare Medicare	$584.35
Rate for Payer: University Health Alliance Commercial	$1,373.98

ARCOM HUM BEARING XL 44-36

Facility

$769.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$238.39
Max. Negotiated Rate	$745.93
Rate for Payer: AlohaCare Medicaid	$384.50
Rate for Payer: AlohaCare Medicare	$238.39
Rate for Payer: Cash Price	$461.40
Rate for Payer: Devoted Health Medicare	$261.46
Rate for Payer: Hawaii Medical Service Association Medicare	$238.39
Rate for Payer: Hawaii Western Management Group Commercial	$538.30
Rate for Payer: Health Management Network Commercial	$653.65
Rate for Payer: Humana Medicare	$238.39
Rate for Payer: Kaiser Permanente Commercial	$692.10
Rate for Payer: Kaiser Permanente Medicaid	$392.19
Rate for Payer: Kaiser Permanente Medicare	$238.39
Rate for Payer: MDX Hawaii PPO	$745.93
Rate for Payer: Ohana Health Plan Medicaid	$238.39
Rate for Payer: Ohana Health Plan Medicare	$238.39
Rate for Payer: UnitedHealthcare Medicare	$238.39
Rate for Payer: University Health Alliance Commercial	$430.64

ARCOM HUM BEARING XL 44-36

Facility

$769.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$430.64
Max. Negotiated Rate	$745.93
Rate for Payer: Cash Price	$461.40
Rate for Payer: Hawaii Western Management Group Commercial	$538.30
Rate for Payer: Health Management Network Commercial	$653.65
Rate for Payer: Kaiser Permanente Commercial	$692.10
Rate for Payer: MDX Hawaii PPO	$745.93
Rate for Payer: University Health Alliance Commercial	$430.64

ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [167780]

Facility

$735.00

Service Code	HCPCS J0891
Hospital Revenue Code	636
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$712.95
Rate for Payer: AlohaCare Medicaid	$367.50
Rate for Payer: AlohaCare Medicaid	$416.00
Rate for Payer: AlohaCare Medicare	$257.92
Rate for Payer: AlohaCare Medicare	$227.85
Rate for Payer: Cash Price	$499.20
Rate for Payer: Cash Price	$441.00
Rate for Payer: Cash Price	$499.20
Rate for Payer: Cash Price	$441.00
Rate for Payer: Devoted Health Medicare	$249.90
Rate for Payer: Devoted Health Medicare	$282.88
Rate for Payer: Hawaii Medical Service Association ABD	$1.82
Rate for Payer: Hawaii Medical Service Association ABD	$1.82
Rate for Payer: Hawaii Medical Service Association Commercial	$2.27
Rate for Payer: Hawaii Medical Service Association Commercial	$2.27
Rate for Payer: Hawaii Medical Service Association Medicare	$257.92
Rate for Payer: Hawaii Medical Service Association Medicare	$227.85
Rate for Payer: Hawaii Medical Service Association Non-ABD	$1.82
Rate for Payer: Hawaii Medical Service Association Non-ABD	$1.82
Rate for Payer: Hawaii Western Management Group Commercial	$698.25
Rate for Payer: Hawaii Western Management Group Commercial	$790.40
Rate for Payer: Health Management Network Commercial	$707.20
Rate for Payer: Health Management Network Commercial	$624.75
Rate for Payer: Humana Medicare	$227.85
Rate for Payer: Humana Medicare	$257.92
Rate for Payer: Kaiser Permanente Commercial	$661.50
Rate for Payer: Kaiser Permanente Commercial	$748.80
Rate for Payer: Kaiser Permanente Medicaid	$424.32
Rate for Payer: Kaiser Permanente Medicaid	$374.85
Rate for Payer: Kaiser Permanente Medicare	$227.85
Rate for Payer: Kaiser Permanente Medicare	$257.92
Rate for Payer: MDX Hawaii PPO	$712.95
Rate for Payer: MDX Hawaii PPO	$807.04
Rate for Payer: Ohana Health Plan Medicaid	$257.92
Rate for Payer: Ohana Health Plan Medicaid	$227.85
Rate for Payer: Ohana Health Plan Medicare	$227.85
Rate for Payer: Ohana Health Plan Medicare	$257.92
Rate for Payer: UnitedHealthcare Medicaid	$499.20
Rate for Payer: UnitedHealthcare Medicaid	$441.00
Rate for Payer: UnitedHealthcare Medicare	$227.85
Rate for Payer: UnitedHealthcare Medicare	$257.92
Rate for Payer: University Health Alliance Commercial	$535.74
Rate for Payer: University Health Alliance Commercial	$606.44

ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [167780]

Facility

$735.00

Service Code	HCPCS J0891
Hospital Revenue Code	250
Min. Negotiated Rate	$624.75
Max. Negotiated Rate	$712.95
Rate for Payer: Cash Price	$441.00
Rate for Payer: Cash Price	$499.20
Rate for Payer: Health Management Network Commercial	$624.75
Rate for Payer: Health Management Network Commercial	$707.20
Rate for Payer: Kaiser Permanente Commercial	$661.50
Rate for Payer: Kaiser Permanente Commercial	$748.80
Rate for Payer: MDX Hawaii PPO	$807.04
Rate for Payer: MDX Hawaii PPO	$712.95

ARGYLER 2PART ADPTR 8888415604

Facility

$798.00

Hospital Revenue Code	272
Min. Negotiated Rate	$247.38
Max. Negotiated Rate	$774.06
Rate for Payer: AlohaCare Medicaid	$399.00
Rate for Payer: AlohaCare Medicare	$247.38
Rate for Payer: Cash Price	$478.80
Rate for Payer: Devoted Health Medicare	$271.32
Rate for Payer: Hawaii Medical Service Association Medicare	$247.38
Rate for Payer: Hawaii Western Management Group Commercial	$758.10
Rate for Payer: Health Management Network Commercial	$678.30
Rate for Payer: Humana Medicare	$247.38
Rate for Payer: Kaiser Permanente Commercial	$718.20
Rate for Payer: Kaiser Permanente Medicaid	$406.98
Rate for Payer: Kaiser Permanente Medicare	$247.38
Rate for Payer: MDX Hawaii PPO	$774.06
Rate for Payer: Ohana Health Plan Medicaid	$247.38
Rate for Payer: Ohana Health Plan Medicare	$247.38
Rate for Payer: UnitedHealthcare Medicare	$247.38
Rate for Payer: University Health Alliance Commercial	$581.66

ARGYLER 2PART ADPTR 8888415604

Facility

$798.00

Hospital Revenue Code	272
Min. Negotiated Rate	$678.30
Max. Negotiated Rate	$774.06
Rate for Payer: Cash Price	$478.80
Rate for Payer: Health Management Network Commercial	$678.30
Rate for Payer: Kaiser Permanente Commercial	$718.20
Rate for Payer: MDX Hawaii PPO	$774.06

ARIPIPRAZOLE 10 MG TABLET [34369]

Facility

$80.00

Service Code	NDC 62332009930
Hospital Revenue Code	637
Min. Negotiated Rate	$24.80
Max. Negotiated Rate	$77.60
Rate for Payer: AlohaCare Medicaid	$40.00
Rate for Payer: AlohaCare Medicare	$24.80
Rate for Payer: Cash Price	$48.00
Rate for Payer: Devoted Health Medicare	$27.20
Rate for Payer: Hawaii Medical Service Association Medicare	$24.80
Rate for Payer: Hawaii Western Management Group Commercial	$76.00
Rate for Payer: Health Management Network Commercial	$68.00
Rate for Payer: Humana Medicare	$24.80
Rate for Payer: Kaiser Permanente Commercial	$72.00
Rate for Payer: Kaiser Permanente Medicaid	$40.80
Rate for Payer: Kaiser Permanente Medicare	$24.80
Rate for Payer: MDX Hawaii PPO	$77.60
Rate for Payer: Ohana Health Plan Medicaid	$24.80
Rate for Payer: Ohana Health Plan Medicare	$24.80
Rate for Payer: UnitedHealthcare Medicare	$24.80
Rate for Payer: University Health Alliance Commercial	$58.31

ARIPIPRAZOLE 10 MG TABLET [34369]

Facility

$80.00

Service Code	NDC 62332009930
Hospital Revenue Code	250
Min. Negotiated Rate	$68.00
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$48.00
Rate for Payer: Health Management Network Commercial	$68.00
Rate for Payer: Kaiser Permanente Commercial	$72.00
Rate for Payer: MDX Hawaii PPO	$77.60

ARIPIPRAZOLE 10 MG TABLET [34369]

Facility

$75.00

Service Code	NDC 50268008915
Hospital Revenue Code	637
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$72.75
Rate for Payer: AlohaCare Medicaid	$37.50
Rate for Payer: AlohaCare Medicare	$23.25
Rate for Payer: Cash Price	$45.00
Rate for Payer: Devoted Health Medicare	$25.50
Rate for Payer: Hawaii Medical Service Association Medicare	$23.25
Rate for Payer: Hawaii Western Management Group Commercial	$71.25
Rate for Payer: Health Management Network Commercial	$63.75
Rate for Payer: Humana Medicare	$23.25
Rate for Payer: Kaiser Permanente Commercial	$67.50
Rate for Payer: Kaiser Permanente Medicaid	$38.25
Rate for Payer: Kaiser Permanente Medicare	$23.25
Rate for Payer: MDX Hawaii PPO	$72.75
Rate for Payer: Ohana Health Plan Medicaid	$23.25
Rate for Payer: Ohana Health Plan Medicare	$23.25
Rate for Payer: UnitedHealthcare Medicare	$23.25
Rate for Payer: University Health Alliance Commercial	$54.67

ARIPIPRAZOLE 10 MG TABLET [34369]

Facility

$75.00

Service Code	NDC 50268008915
Hospital Revenue Code	250
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$72.75
Rate for Payer: Cash Price	$45.00
Rate for Payer: Health Management Network Commercial	$63.75
Rate for Payer: Kaiser Permanente Commercial	$67.50
Rate for Payer: MDX Hawaii PPO	$72.75

ARIPIPRAZOLE 15 MG TABLET [34370]

Facility

$80.00

Service Code	NDC 62332010030
Hospital Revenue Code	637
Min. Negotiated Rate	$24.80
Max. Negotiated Rate	$77.60
Rate for Payer: AlohaCare Medicaid	$40.00
Rate for Payer: AlohaCare Medicare	$24.80
Rate for Payer: Cash Price	$48.00
Rate for Payer: Devoted Health Medicare	$27.20
Rate for Payer: Hawaii Medical Service Association Medicare	$24.80
Rate for Payer: Hawaii Western Management Group Commercial	$76.00
Rate for Payer: Health Management Network Commercial	$68.00
Rate for Payer: Humana Medicare	$24.80
Rate for Payer: Kaiser Permanente Commercial	$72.00
Rate for Payer: Kaiser Permanente Medicaid	$40.80
Rate for Payer: Kaiser Permanente Medicare	$24.80
Rate for Payer: MDX Hawaii PPO	$77.60
Rate for Payer: Ohana Health Plan Medicaid	$24.80
Rate for Payer: Ohana Health Plan Medicare	$24.80
Rate for Payer: UnitedHealthcare Medicare	$24.80
Rate for Payer: University Health Alliance Commercial	$58.31

ARIPIPRAZOLE 15 MG TABLET [34370]

Facility

$77.00

Service Code	NDC 50268009012
Hospital Revenue Code	637
Min. Negotiated Rate	$23.87
Max. Negotiated Rate	$74.69
Rate for Payer: AlohaCare Medicaid	$38.50
Rate for Payer: AlohaCare Medicare	$23.87
Rate for Payer: Cash Price	$46.20
Rate for Payer: Devoted Health Medicare	$26.18
Rate for Payer: Hawaii Medical Service Association Medicare	$23.87
Rate for Payer: Hawaii Western Management Group Commercial	$73.15
Rate for Payer: Health Management Network Commercial	$65.45
Rate for Payer: Humana Medicare	$23.87
Rate for Payer: Kaiser Permanente Commercial	$69.30
Rate for Payer: Kaiser Permanente Medicaid	$39.27
Rate for Payer: Kaiser Permanente Medicare	$23.87
Rate for Payer: MDX Hawaii PPO	$74.69
Rate for Payer: Ohana Health Plan Medicaid	$23.87
Rate for Payer: Ohana Health Plan Medicare	$23.87
Rate for Payer: UnitedHealthcare Medicare	$23.87
Rate for Payer: University Health Alliance Commercial	$56.13

ARIPIPRAZOLE 15 MG TABLET [34370]

Facility

$80.00

Service Code	NDC 62332010030
Hospital Revenue Code	250
Min. Negotiated Rate	$68.00
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$48.00
Rate for Payer: Health Management Network Commercial	$68.00
Rate for Payer: Kaiser Permanente Commercial	$72.00
Rate for Payer: MDX Hawaii PPO	$77.60

ARIPIPRAZOLE 15 MG TABLET [34370]

Facility

$77.00

Service Code	NDC 50268009012
Hospital Revenue Code	250
Min. Negotiated Rate	$65.45
Max. Negotiated Rate	$74.69
Rate for Payer: Cash Price	$46.20
Rate for Payer: Health Management Network Commercial	$65.45
Rate for Payer: Kaiser Permanente Commercial	$69.30
Rate for Payer: MDX Hawaii PPO	$74.69

ARIPIPRAZOLE 20 MG TABLET [34371]

Facility

$114.00

Service Code	NDC 31722082930
Hospital Revenue Code	637
Min. Negotiated Rate	$35.34
Max. Negotiated Rate	$110.58
Rate for Payer: AlohaCare Medicaid	$57.00
Rate for Payer: AlohaCare Medicare	$35.34
Rate for Payer: Cash Price	$68.40
Rate for Payer: Devoted Health Medicare	$38.76
Rate for Payer: Hawaii Medical Service Association Medicare	$35.34
Rate for Payer: Hawaii Western Management Group Commercial	$108.30
Rate for Payer: Health Management Network Commercial	$96.90
Rate for Payer: Humana Medicare	$35.34
Rate for Payer: Kaiser Permanente Commercial	$102.60
Rate for Payer: Kaiser Permanente Medicaid	$58.14
Rate for Payer: Kaiser Permanente Medicare	$35.34
Rate for Payer: MDX Hawaii PPO	$110.58
Rate for Payer: Ohana Health Plan Medicaid	$35.34
Rate for Payer: Ohana Health Plan Medicare	$35.34
Rate for Payer: UnitedHealthcare Medicare	$35.34
Rate for Payer: University Health Alliance Commercial	$83.09

ARIPIPRAZOLE 20 MG TABLET [34371]

Facility

$114.00

Service Code	NDC 31722082930
Hospital Revenue Code	250
Min. Negotiated Rate	$96.90
Max. Negotiated Rate	$110.58
Rate for Payer: Cash Price	$68.40
Rate for Payer: Health Management Network Commercial	$96.90
Rate for Payer: Kaiser Permanente Commercial	$102.60
Rate for Payer: MDX Hawaii PPO	$110.58

ARIPIPRAZOLE 20 MG TABLET [34371]

Facility

$113.00

Service Code	NDC 62332010130
Hospital Revenue Code	637
Min. Negotiated Rate	$35.03
Max. Negotiated Rate	$109.61
Rate for Payer: AlohaCare Medicaid	$56.50
Rate for Payer: AlohaCare Medicare	$35.03
Rate for Payer: Cash Price	$67.80
Rate for Payer: Devoted Health Medicare	$38.42
Rate for Payer: Hawaii Medical Service Association Medicare	$35.03
Rate for Payer: Hawaii Western Management Group Commercial	$107.35
Rate for Payer: Health Management Network Commercial	$96.05
Rate for Payer: Humana Medicare	$35.03
Rate for Payer: Kaiser Permanente Commercial	$101.70
Rate for Payer: Kaiser Permanente Medicaid	$57.63
Rate for Payer: Kaiser Permanente Medicare	$35.03
Rate for Payer: MDX Hawaii PPO	$109.61
Rate for Payer: Ohana Health Plan Medicaid	$35.03
Rate for Payer: Ohana Health Plan Medicare	$35.03
Rate for Payer: UnitedHealthcare Medicare	$35.03
Rate for Payer: University Health Alliance Commercial	$82.37

ARIPIPRAZOLE 20 MG TABLET [34371]

Facility

$113.00

Service Code	NDC 62332010130
Hospital Revenue Code	250
Min. Negotiated Rate	$96.05
Max. Negotiated Rate	$109.61
Rate for Payer: Cash Price	$67.80
Rate for Payer: Health Management Network Commercial	$96.05
Rate for Payer: Kaiser Permanente Commercial	$101.70
Rate for Payer: MDX Hawaii PPO	$109.61

ARIPIPRAZOLE 2 MG TABLET [70306]

Facility

$80.00

Service Code	NDC 62332009730
Hospital Revenue Code	637
Min. Negotiated Rate	$24.80
Max. Negotiated Rate	$77.60
Rate for Payer: AlohaCare Medicaid	$40.00
Rate for Payer: AlohaCare Medicare	$24.80
Rate for Payer: Cash Price	$48.00
Rate for Payer: Devoted Health Medicare	$27.20
Rate for Payer: Hawaii Medical Service Association Medicare	$24.80
Rate for Payer: Hawaii Western Management Group Commercial	$76.00
Rate for Payer: Health Management Network Commercial	$68.00
Rate for Payer: Humana Medicare	$24.80
Rate for Payer: Kaiser Permanente Commercial	$72.00
Rate for Payer: Kaiser Permanente Medicaid	$40.80
Rate for Payer: Kaiser Permanente Medicare	$24.80
Rate for Payer: MDX Hawaii PPO	$77.60
Rate for Payer: Ohana Health Plan Medicaid	$24.80
Rate for Payer: Ohana Health Plan Medicare	$24.80
Rate for Payer: UnitedHealthcare Medicare	$24.80
Rate for Payer: University Health Alliance Commercial	$58.31

ARIPIPRAZOLE 2 MG TABLET [70306]

Facility

$80.00

Service Code	NDC 62332009730
Hospital Revenue Code	250
Min. Negotiated Rate	$68.00
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$48.00
Rate for Payer: Health Management Network Commercial	$68.00
Rate for Payer: Kaiser Permanente Commercial	$72.00
Rate for Payer: MDX Hawaii PPO	$77.60

ARIPIPRAZOLE 30 MG TABLET [34372]

Facility

$113.00

Service Code	NDC 62332010230
Hospital Revenue Code	250
Min. Negotiated Rate	$96.05
Max. Negotiated Rate	$109.61
Rate for Payer: Cash Price	$67.80
Rate for Payer: Health Management Network Commercial	$96.05
Rate for Payer: Kaiser Permanente Commercial	$101.70
Rate for Payer: MDX Hawaii PPO	$109.61

ARIPIPRAZOLE 30 MG TABLET [34372]

Facility

$10.00

Service Code	NDC 60687021321
Hospital Revenue Code	637
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$9.70
Rate for Payer: AlohaCare Medicaid	$5.00
Rate for Payer: AlohaCare Medicare	$3.10
Rate for Payer: Cash Price	$6.00
Rate for Payer: Devoted Health Medicare	$3.40
Rate for Payer: Hawaii Medical Service Association Medicare	$3.10
Rate for Payer: Hawaii Western Management Group Commercial	$9.50
Rate for Payer: Health Management Network Commercial	$8.50
Rate for Payer: Humana Medicare	$3.10
Rate for Payer: Kaiser Permanente Commercial	$9.00
Rate for Payer: Kaiser Permanente Medicaid	$5.10
Rate for Payer: Kaiser Permanente Medicare	$3.10
Rate for Payer: MDX Hawaii PPO	$9.70
Rate for Payer: Ohana Health Plan Medicaid	$3.10
Rate for Payer: Ohana Health Plan Medicare	$3.10
Rate for Payer: UnitedHealthcare Medicare	$3.10
Rate for Payer: University Health Alliance Commercial	$7.29

ARIPIPRAZOLE 30 MG TABLET [34372]

Facility

$10.00

Service Code	NDC 60687021321
Hospital Revenue Code	250
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$6.00
Rate for Payer: Health Management Network Commercial	$8.50
Rate for Payer: Kaiser Permanente Commercial	$9.00
Rate for Payer: MDX Hawaii PPO	$9.70

ARIPIPRAZOLE 30 MG TABLET [34372]

Facility

$113.00

Service Code	NDC 62332010230
Hospital Revenue Code	637
Min. Negotiated Rate	$35.03
Max. Negotiated Rate	$109.61
Rate for Payer: AlohaCare Medicaid	$56.50
Rate for Payer: AlohaCare Medicare	$35.03
Rate for Payer: Cash Price	$67.80
Rate for Payer: Devoted Health Medicare	$38.42
Rate for Payer: Hawaii Medical Service Association Medicare	$35.03
Rate for Payer: Hawaii Western Management Group Commercial	$107.35
Rate for Payer: Health Management Network Commercial	$96.05
Rate for Payer: Humana Medicare	$35.03
Rate for Payer: Kaiser Permanente Commercial	$101.70
Rate for Payer: Kaiser Permanente Medicaid	$57.63
Rate for Payer: Kaiser Permanente Medicare	$35.03
Rate for Payer: MDX Hawaii PPO	$109.61
Rate for Payer: Ohana Health Plan Medicaid	$35.03
Rate for Payer: Ohana Health Plan Medicare	$35.03
Rate for Payer: UnitedHealthcare Medicare	$35.03
Rate for Payer: University Health Alliance Commercial	$82.37

Know your out-of-pocket cost for care.

All Charges