Kau Hospital

All Charges

Charge

Type

Setting

Price

HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC

Facility

$58,093.60

Service Code	MSDRG 422
Min. Negotiated Rate	$58,093.60
Max. Negotiated Rate	$58,093.60
Rate for Payer: Hawaii Medical Service Association Commercial	$58,093.60

HERNIA PATCH VENTRIO 5950040

Facility

$2,435.00

Service Code	HCPCS C1781
Hospital Revenue Code	278
Min. Negotiated Rate	$1,363.60
Max. Negotiated Rate	$2,361.95
Rate for Payer: Cash Price	$1,461.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,704.50
Rate for Payer: Health Management Network Commercial	$2,069.75
Rate for Payer: Kaiser Permanente Commercial	$2,191.50
Rate for Payer: MDX Hawaii PPO	$2,361.95
Rate for Payer: University Health Alliance Commercial	$1,363.60

HERNIA PATCH VENTRIO 5950040

Facility

$2,435.00

Service Code	HCPCS C1781
Hospital Revenue Code	278
Min. Negotiated Rate	$754.85
Max. Negotiated Rate	$2,361.95
Rate for Payer: AlohaCare Medicaid	$1,217.50
Rate for Payer: AlohaCare Medicare	$754.85
Rate for Payer: Cash Price	$1,461.00
Rate for Payer: Devoted Health Medicare	$827.90
Rate for Payer: Hawaii Medical Service Association Medicare	$754.85
Rate for Payer: Hawaii Western Management Group Commercial	$1,704.50
Rate for Payer: Health Management Network Commercial	$2,069.75
Rate for Payer: Humana Medicare	$754.85
Rate for Payer: Kaiser Permanente Commercial	$2,191.50
Rate for Payer: Kaiser Permanente Medicaid	$1,241.85
Rate for Payer: Kaiser Permanente Medicare	$754.85
Rate for Payer: MDX Hawaii PPO	$2,361.95
Rate for Payer: Ohana Health Plan Medicaid	$754.85
Rate for Payer: Ohana Health Plan Medicare	$754.85
Rate for Payer: UnitedHealthcare Medicare	$754.85
Rate for Payer: University Health Alliance Commercial	$1,363.60

HERNIA PATCH VENTRIOST 5950030

Facility

$2,423.00

Service Code	HCPCS C1781
Hospital Revenue Code	278
Min. Negotiated Rate	$751.13
Max. Negotiated Rate	$2,350.31
Rate for Payer: AlohaCare Medicaid	$1,211.50
Rate for Payer: AlohaCare Medicare	$751.13
Rate for Payer: Cash Price	$1,453.80
Rate for Payer: Devoted Health Medicare	$823.82
Rate for Payer: Hawaii Medical Service Association Medicare	$751.13
Rate for Payer: Hawaii Western Management Group Commercial	$1,696.10
Rate for Payer: Health Management Network Commercial	$2,059.55
Rate for Payer: Humana Medicare	$751.13
Rate for Payer: Kaiser Permanente Commercial	$2,180.70
Rate for Payer: Kaiser Permanente Medicaid	$1,235.73
Rate for Payer: Kaiser Permanente Medicare	$751.13
Rate for Payer: MDX Hawaii PPO	$2,350.31
Rate for Payer: Ohana Health Plan Medicaid	$751.13
Rate for Payer: Ohana Health Plan Medicare	$751.13
Rate for Payer: UnitedHealthcare Medicare	$751.13
Rate for Payer: University Health Alliance Commercial	$1,356.88

HERNIA PATCH VENTRIOST 5950030

Facility

$2,423.00

Service Code	HCPCS C1781
Hospital Revenue Code	278
Min. Negotiated Rate	$1,356.88
Max. Negotiated Rate	$2,350.31
Rate for Payer: Cash Price	$1,453.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,696.10
Rate for Payer: Health Management Network Commercial	$2,059.55
Rate for Payer: Kaiser Permanente Commercial	$2,180.70
Rate for Payer: MDX Hawaii PPO	$2,350.31
Rate for Payer: University Health Alliance Commercial	$1,356.88

HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC

Facility

$31,950.30

Service Code	MSDRG 354
Min. Negotiated Rate	$31,950.30
Max. Negotiated Rate	$31,950.30
Rate for Payer: Hawaii Medical Service Association Commercial	$31,950.30

HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC

Facility

$41,407.39

Service Code	MSDRG 353
Min. Negotiated Rate	$41,407.39
Max. Negotiated Rate	$41,407.39
Rate for Payer: Hawaii Medical Service Association Commercial	$41,407.39

HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC

Facility

$23,607.19

Service Code	MSDRG 355
Min. Negotiated Rate	$23,607.19
Max. Negotiated Rate	$23,607.19
Rate for Payer: Hawaii Medical Service Association Commercial	$23,607.19

HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [25174]

Facility

$179.00

Service Code	NDC 00409724803
Hospital Revenue Code	250
Min. Negotiated Rate	$152.15
Max. Negotiated Rate	$173.63
Rate for Payer: Cash Price	$107.40
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: MDX Hawaii PPO	$173.63

HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION [25174]

Facility

$179.00

Service Code	NDC 00409724813
Hospital Revenue Code	250
Min. Negotiated Rate	$152.15
Max. Negotiated Rate	$173.63
Rate for Payer: Cash Price	$107.40
Rate for Payer: Health Management Network Commercial	$152.15
Rate for Payer: Kaiser Permanente Commercial	$161.10
Rate for Payer: MDX Hawaii PPO	$173.63

HEX DRIVE CANNULATE AR-7000-13

Facility

$1,213.00

Hospital Revenue Code	272
Min. Negotiated Rate	$376.03
Max. Negotiated Rate	$1,176.61
Rate for Payer: AlohaCare Medicaid	$606.50
Rate for Payer: AlohaCare Medicare	$376.03
Rate for Payer: Cash Price	$727.80
Rate for Payer: Devoted Health Medicare	$412.42
Rate for Payer: Hawaii Medical Service Association Medicare	$376.03
Rate for Payer: Hawaii Western Management Group Commercial	$1,152.35
Rate for Payer: Health Management Network Commercial	$1,031.05
Rate for Payer: Humana Medicare	$376.03
Rate for Payer: Kaiser Permanente Commercial	$1,091.70
Rate for Payer: Kaiser Permanente Medicaid	$618.63
Rate for Payer: Kaiser Permanente Medicare	$376.03
Rate for Payer: MDX Hawaii PPO	$1,176.61
Rate for Payer: Ohana Health Plan Medicaid	$376.03
Rate for Payer: Ohana Health Plan Medicare	$376.03
Rate for Payer: UnitedHealthcare Medicare	$376.03
Rate for Payer: University Health Alliance Commercial	$884.16

HEX DRIVE CANNULATE AR-7000-13

Facility

$1,213.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,031.05
Max. Negotiated Rate	$1,176.61
Rate for Payer: Cash Price	$727.80
Rate for Payer: Health Management Network Commercial	$1,031.05
Rate for Payer: Kaiser Permanente Commercial	$1,091.70
Rate for Payer: MDX Hawaii PPO	$1,176.61

HEX WRENCH 442-2

Facility

$180.00

Hospital Revenue Code	272
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$174.60
Rate for Payer: AlohaCare Medicaid	$90.00
Rate for Payer: AlohaCare Medicare	$55.80
Rate for Payer: Cash Price	$108.00
Rate for Payer: Devoted Health Medicare	$61.20
Rate for Payer: Hawaii Medical Service Association Medicare	$55.80
Rate for Payer: Hawaii Western Management Group Commercial	$171.00
Rate for Payer: Health Management Network Commercial	$153.00
Rate for Payer: Humana Medicare	$55.80
Rate for Payer: Kaiser Permanente Commercial	$162.00
Rate for Payer: Kaiser Permanente Medicaid	$91.80
Rate for Payer: Kaiser Permanente Medicare	$55.80
Rate for Payer: MDX Hawaii PPO	$174.60
Rate for Payer: Ohana Health Plan Medicaid	$55.80
Rate for Payer: Ohana Health Plan Medicare	$55.80
Rate for Payer: UnitedHealthcare Medicare	$55.80
Rate for Payer: University Health Alliance Commercial	$131.20

HEX WRENCH 442-2

Facility

$180.00

Hospital Revenue Code	272
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$174.60
Rate for Payer: Cash Price	$108.00
Rate for Payer: Health Management Network Commercial	$153.00
Rate for Payer: Kaiser Permanente Commercial	$162.00
Rate for Payer: MDX Hawaii PPO	$174.60

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC

Facility

$48,517.99

Service Code	MSDRG 481
Min. Negotiated Rate	$48,517.99
Max. Negotiated Rate	$48,517.99
Rate for Payer: Hawaii Medical Service Association Commercial	$48,517.99

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC

Facility

$49,750.50

Service Code	MSDRG 480
Min. Negotiated Rate	$49,750.50
Max. Negotiated Rate	$49,750.50
Rate for Payer: Hawaii Medical Service Association Commercial	$49,750.50

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC

Facility

$34,960.45

Service Code	MSDRG 482
Min. Negotiated Rate	$34,960.45
Max. Negotiated Rate	$34,960.45
Rate for Payer: Hawaii Medical Service Association Commercial	$34,960.45

HIP CRYO CUFF 14A01

Facility

$181.00

Hospital Revenue Code	272
Min. Negotiated Rate	$153.85
Max. Negotiated Rate	$175.57
Rate for Payer: Cash Price	$108.60
Rate for Payer: Health Management Network Commercial	$153.85
Rate for Payer: Kaiser Permanente Commercial	$162.90
Rate for Payer: MDX Hawaii PPO	$175.57

HIP CRYO CUFF 14A01

Facility

$181.00

Hospital Revenue Code	272
Min. Negotiated Rate	$56.11
Max. Negotiated Rate	$175.57
Rate for Payer: AlohaCare Medicaid	$90.50
Rate for Payer: AlohaCare Medicare	$56.11
Rate for Payer: Cash Price	$108.60
Rate for Payer: Devoted Health Medicare	$61.54
Rate for Payer: Hawaii Medical Service Association Medicare	$56.11
Rate for Payer: Hawaii Western Management Group Commercial	$171.95
Rate for Payer: Health Management Network Commercial	$153.85
Rate for Payer: Humana Medicare	$56.11
Rate for Payer: Kaiser Permanente Commercial	$162.90
Rate for Payer: Kaiser Permanente Medicaid	$92.31
Rate for Payer: Kaiser Permanente Medicare	$56.11
Rate for Payer: MDX Hawaii PPO	$175.57
Rate for Payer: Ohana Health Plan Medicaid	$56.11
Rate for Payer: Ohana Health Plan Medicare	$56.11
Rate for Payer: UnitedHealthcare Medicare	$56.11
Rate for Payer: University Health Alliance Commercial	$131.93

HIP LINER 36X54 00-8751-011-36

Facility

$2,800.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,568.00
Max. Negotiated Rate	$2,716.00
Rate for Payer: Cash Price	$1,680.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,960.00
Rate for Payer: Health Management Network Commercial	$2,380.00
Rate for Payer: Kaiser Permanente Commercial	$2,520.00
Rate for Payer: MDX Hawaii PPO	$2,716.00
Rate for Payer: University Health Alliance Commercial	$1,568.00

HIP LINER 36X54 00-8751-011-36

Facility

$2,800.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$868.00
Max. Negotiated Rate	$2,716.00
Rate for Payer: AlohaCare Medicaid	$1,400.00
Rate for Payer: AlohaCare Medicare	$868.00
Rate for Payer: Cash Price	$1,680.00
Rate for Payer: Devoted Health Medicare	$952.00
Rate for Payer: Hawaii Medical Service Association Medicare	$868.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,960.00
Rate for Payer: Health Management Network Commercial	$2,380.00
Rate for Payer: Humana Medicare	$868.00
Rate for Payer: Kaiser Permanente Commercial	$2,520.00
Rate for Payer: Kaiser Permanente Medicaid	$1,428.00
Rate for Payer: Kaiser Permanente Medicare	$868.00
Rate for Payer: MDX Hawaii PPO	$2,716.00
Rate for Payer: Ohana Health Plan Medicaid	$868.00
Rate for Payer: Ohana Health Plan Medicare	$868.00
Rate for Payer: UnitedHealthcare Medicare	$868.00
Rate for Payer: University Health Alliance Commercial	$1,568.00

HIP LINER 36X56 00-8751-012-36

Facility

$2,800.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,568.00
Max. Negotiated Rate	$2,716.00
Rate for Payer: Cash Price	$1,680.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,960.00
Rate for Payer: Health Management Network Commercial	$2,380.00
Rate for Payer: Kaiser Permanente Commercial	$2,520.00
Rate for Payer: MDX Hawaii PPO	$2,716.00
Rate for Payer: University Health Alliance Commercial	$1,568.00

HIP LINER 36X56 00-8751-012-36

Facility

$2,800.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$868.00
Max. Negotiated Rate	$2,716.00
Rate for Payer: AlohaCare Medicaid	$1,400.00
Rate for Payer: AlohaCare Medicare	$868.00
Rate for Payer: Cash Price	$1,680.00
Rate for Payer: Devoted Health Medicare	$952.00
Rate for Payer: Hawaii Medical Service Association Medicare	$868.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,960.00
Rate for Payer: Health Management Network Commercial	$2,380.00
Rate for Payer: Humana Medicare	$868.00
Rate for Payer: Kaiser Permanente Commercial	$2,520.00
Rate for Payer: Kaiser Permanente Medicaid	$1,428.00
Rate for Payer: Kaiser Permanente Medicare	$868.00
Rate for Payer: MDX Hawaii PPO	$2,716.00
Rate for Payer: Ohana Health Plan Medicaid	$868.00
Rate for Payer: Ohana Health Plan Medicare	$868.00
Rate for Payer: UnitedHealthcare Medicare	$868.00
Rate for Payer: University Health Alliance Commercial	$1,568.00

HIP LINER 36X60 00-8751-014-36

Facility

$2,800.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$868.00
Max. Negotiated Rate	$2,716.00
Rate for Payer: AlohaCare Medicaid	$1,400.00
Rate for Payer: AlohaCare Medicare	$868.00
Rate for Payer: Cash Price	$1,680.00
Rate for Payer: Devoted Health Medicare	$952.00
Rate for Payer: Hawaii Medical Service Association Medicare	$868.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,960.00
Rate for Payer: Health Management Network Commercial	$2,380.00
Rate for Payer: Humana Medicare	$868.00
Rate for Payer: Kaiser Permanente Commercial	$2,520.00
Rate for Payer: Kaiser Permanente Medicaid	$1,428.00
Rate for Payer: Kaiser Permanente Medicare	$868.00
Rate for Payer: MDX Hawaii PPO	$2,716.00
Rate for Payer: Ohana Health Plan Medicaid	$868.00
Rate for Payer: Ohana Health Plan Medicare	$868.00
Rate for Payer: UnitedHealthcare Medicare	$868.00
Rate for Payer: University Health Alliance Commercial	$1,568.00

HIP LINER 36X60 00-8751-014-36

Facility

$2,800.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,568.00
Max. Negotiated Rate	$2,716.00
Rate for Payer: Cash Price	$1,680.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,960.00
Rate for Payer: Health Management Network Commercial	$2,380.00
Rate for Payer: Kaiser Permanente Commercial	$2,520.00
Rate for Payer: MDX Hawaii PPO	$2,716.00
Rate for Payer: University Health Alliance Commercial	$1,568.00

Know your out-of-pocket cost for care.

All Charges