Kau Hospital

All Charges

Charge

Type

Setting

Price

IMPLAN OSSICULAR CENTERED PART

Facility

$1,568.00

Hospital Revenue Code	278
Min. Negotiated Rate	$486.08
Max. Negotiated Rate	$1,520.96
Rate for Payer: AlohaCare Medicaid	$784.00
Rate for Payer: AlohaCare Medicare	$486.08
Rate for Payer: Cash Price	$940.80
Rate for Payer: Devoted Health Medicare	$533.12
Rate for Payer: Hawaii Medical Service Association Medicare	$486.08
Rate for Payer: Hawaii Western Management Group Commercial	$1,097.60
Rate for Payer: Health Management Network Commercial	$1,332.80
Rate for Payer: Humana Medicare	$486.08
Rate for Payer: Kaiser Permanente Commercial	$1,411.20
Rate for Payer: Kaiser Permanente Medicaid	$799.68
Rate for Payer: Kaiser Permanente Medicare	$486.08
Rate for Payer: MDX Hawaii PPO	$1,520.96
Rate for Payer: Ohana Health Plan Medicaid	$486.08
Rate for Payer: Ohana Health Plan Medicare	$486.08
Rate for Payer: UnitedHealthcare Medicare	$486.08
Rate for Payer: University Health Alliance Commercial	$878.08

IMPLAN OSSICULAR CENTERED PART

Facility

$1,568.00

Hospital Revenue Code	278
Min. Negotiated Rate	$878.08
Max. Negotiated Rate	$1,520.96
Rate for Payer: Cash Price	$940.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,097.60
Rate for Payer: Health Management Network Commercial	$1,332.80
Rate for Payer: Kaiser Permanente Commercial	$1,411.20
Rate for Payer: MDX Hawaii PPO	$1,520.96
Rate for Payer: University Health Alliance Commercial	$878.08

IMPLAN OSSICULAR PARTIAL

Facility

$1,503.00

Hospital Revenue Code	278
Min. Negotiated Rate	$465.93
Max. Negotiated Rate	$1,457.91
Rate for Payer: AlohaCare Medicaid	$751.50
Rate for Payer: AlohaCare Medicare	$465.93
Rate for Payer: Cash Price	$901.80
Rate for Payer: Devoted Health Medicare	$511.02
Rate for Payer: Hawaii Medical Service Association Medicare	$465.93
Rate for Payer: Hawaii Western Management Group Commercial	$1,052.10
Rate for Payer: Health Management Network Commercial	$1,277.55
Rate for Payer: Humana Medicare	$465.93
Rate for Payer: Kaiser Permanente Commercial	$1,352.70
Rate for Payer: Kaiser Permanente Medicaid	$766.53
Rate for Payer: Kaiser Permanente Medicare	$465.93
Rate for Payer: MDX Hawaii PPO	$1,457.91
Rate for Payer: Ohana Health Plan Medicaid	$465.93
Rate for Payer: Ohana Health Plan Medicare	$465.93
Rate for Payer: UnitedHealthcare Medicare	$465.93
Rate for Payer: University Health Alliance Commercial	$841.68

IMPLAN OSSICULAR PARTIAL

Facility

$1,503.00

Hospital Revenue Code	278
Min. Negotiated Rate	$841.68
Max. Negotiated Rate	$1,457.91
Rate for Payer: Cash Price	$901.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,052.10
Rate for Payer: Health Management Network Commercial	$1,277.55
Rate for Payer: Kaiser Permanente Commercial	$1,352.70
Rate for Payer: MDX Hawaii PPO	$1,457.91
Rate for Payer: University Health Alliance Commercial	$841.68

IMPLAN OSSICULAR PROST

Facility

$1,460.00

Hospital Revenue Code	278
Min. Negotiated Rate	$452.60
Max. Negotiated Rate	$1,416.20
Rate for Payer: AlohaCare Medicaid	$730.00
Rate for Payer: AlohaCare Medicare	$452.60
Rate for Payer: Cash Price	$876.00
Rate for Payer: Devoted Health Medicare	$496.40
Rate for Payer: Hawaii Medical Service Association Medicare	$452.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,022.00
Rate for Payer: Health Management Network Commercial	$1,241.00
Rate for Payer: Humana Medicare	$452.60
Rate for Payer: Kaiser Permanente Commercial	$1,314.00
Rate for Payer: Kaiser Permanente Medicaid	$744.60
Rate for Payer: Kaiser Permanente Medicare	$452.60
Rate for Payer: MDX Hawaii PPO	$1,416.20
Rate for Payer: Ohana Health Plan Medicaid	$452.60
Rate for Payer: Ohana Health Plan Medicare	$452.60
Rate for Payer: UnitedHealthcare Medicare	$452.60
Rate for Payer: University Health Alliance Commercial	$817.60

IMPLAN OSSICULAR PROST

Facility

$1,460.00

Hospital Revenue Code	278
Min. Negotiated Rate	$817.60
Max. Negotiated Rate	$1,416.20
Rate for Payer: Cash Price	$876.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,022.00
Rate for Payer: Health Management Network Commercial	$1,241.00
Rate for Payer: Kaiser Permanente Commercial	$1,314.00
Rate for Payer: MDX Hawaii PPO	$1,416.20
Rate for Payer: University Health Alliance Commercial	$817.60

IMPLAN OSS NIT PISTON .6X4.25

Facility

$1,265.00

Hospital Revenue Code	278
Min. Negotiated Rate	$708.40
Max. Negotiated Rate	$1,227.05
Rate for Payer: Cash Price	$759.00
Rate for Payer: Hawaii Western Management Group Commercial	$885.50
Rate for Payer: Health Management Network Commercial	$1,075.25
Rate for Payer: Kaiser Permanente Commercial	$1,138.50
Rate for Payer: MDX Hawaii PPO	$1,227.05
Rate for Payer: University Health Alliance Commercial	$708.40

IMPLAN OSS NIT PISTON .6X4.25

Facility

$1,265.00

Hospital Revenue Code	278
Min. Negotiated Rate	$392.15
Max. Negotiated Rate	$1,227.05
Rate for Payer: AlohaCare Medicaid	$632.50
Rate for Payer: AlohaCare Medicare	$392.15
Rate for Payer: Cash Price	$759.00
Rate for Payer: Devoted Health Medicare	$430.10
Rate for Payer: Hawaii Medical Service Association Medicare	$392.15
Rate for Payer: Hawaii Western Management Group Commercial	$885.50
Rate for Payer: Health Management Network Commercial	$1,075.25
Rate for Payer: Humana Medicare	$392.15
Rate for Payer: Kaiser Permanente Commercial	$1,138.50
Rate for Payer: Kaiser Permanente Medicaid	$645.15
Rate for Payer: Kaiser Permanente Medicare	$392.15
Rate for Payer: MDX Hawaii PPO	$1,227.05
Rate for Payer: Ohana Health Plan Medicaid	$392.15
Rate for Payer: Ohana Health Plan Medicare	$392.15
Rate for Payer: UnitedHealthcare Medicare	$392.15
Rate for Payer: University Health Alliance Commercial	$708.40

IMPLAN OSS NIT PISTON .6X4.5

Facility

$1,253.00

Hospital Revenue Code	278
Min. Negotiated Rate	$388.43
Max. Negotiated Rate	$1,215.41
Rate for Payer: AlohaCare Medicaid	$626.50
Rate for Payer: AlohaCare Medicare	$388.43
Rate for Payer: Cash Price	$751.80
Rate for Payer: Devoted Health Medicare	$426.02
Rate for Payer: Hawaii Medical Service Association Medicare	$388.43
Rate for Payer: Hawaii Western Management Group Commercial	$877.10
Rate for Payer: Health Management Network Commercial	$1,065.05
Rate for Payer: Humana Medicare	$388.43
Rate for Payer: Kaiser Permanente Commercial	$1,127.70
Rate for Payer: Kaiser Permanente Medicaid	$639.03
Rate for Payer: Kaiser Permanente Medicare	$388.43
Rate for Payer: MDX Hawaii PPO	$1,215.41
Rate for Payer: Ohana Health Plan Medicaid	$388.43
Rate for Payer: Ohana Health Plan Medicare	$388.43
Rate for Payer: UnitedHealthcare Medicare	$388.43
Rate for Payer: University Health Alliance Commercial	$701.68

IMPLAN OSS NIT PISTON .6X4.5

Facility

$1,253.00

Hospital Revenue Code	278
Min. Negotiated Rate	$701.68
Max. Negotiated Rate	$1,215.41
Rate for Payer: Cash Price	$751.80
Rate for Payer: Hawaii Western Management Group Commercial	$877.10
Rate for Payer: Health Management Network Commercial	$1,065.05
Rate for Payer: Kaiser Permanente Commercial	$1,127.70
Rate for Payer: MDX Hawaii PPO	$1,215.41
Rate for Payer: University Health Alliance Commercial	$701.68

IMPLAN PENILE PRO RES 100ML

Facility

$6,530.00

Service Code	HCPCS C1813
Hospital Revenue Code	278
Min. Negotiated Rate	$3,656.80
Max. Negotiated Rate	$6,334.10
Rate for Payer: Cash Price	$3,918.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,571.00
Rate for Payer: Health Management Network Commercial	$5,550.50
Rate for Payer: Kaiser Permanente Commercial	$5,877.00
Rate for Payer: MDX Hawaii PPO	$6,334.10
Rate for Payer: University Health Alliance Commercial	$3,656.80

IMPLAN PENILE PRO RES 100ML

Facility

$6,530.00

Service Code	HCPCS C1813
Hospital Revenue Code	278
Min. Negotiated Rate	$2,024.30
Max. Negotiated Rate	$6,334.10
Rate for Payer: AlohaCare Medicaid	$3,265.00
Rate for Payer: AlohaCare Medicare	$2,024.30
Rate for Payer: Cash Price	$3,918.00
Rate for Payer: Devoted Health Medicare	$2,220.20
Rate for Payer: Hawaii Medical Service Association Medicare	$2,024.30
Rate for Payer: Hawaii Western Management Group Commercial	$4,571.00
Rate for Payer: Health Management Network Commercial	$5,550.50
Rate for Payer: Humana Medicare	$2,024.30
Rate for Payer: Kaiser Permanente Commercial	$5,877.00
Rate for Payer: Kaiser Permanente Medicaid	$3,330.30
Rate for Payer: Kaiser Permanente Medicare	$2,024.30
Rate for Payer: MDX Hawaii PPO	$6,334.10
Rate for Payer: Ohana Health Plan Medicaid	$2,024.30
Rate for Payer: Ohana Health Plan Medicare	$2,024.30
Rate for Payer: UnitedHealthcare Medicare	$2,024.30
Rate for Payer: University Health Alliance Commercial	$3,656.80

IMPLAN PENILE PUMP 15X12

Facility

$27,550.00

Service Code	HCPCS C1813
Hospital Revenue Code	278
Min. Negotiated Rate	$15,428.00
Max. Negotiated Rate	$26,723.50
Rate for Payer: Cash Price	$16,530.00
Rate for Payer: Hawaii Western Management Group Commercial	$19,285.00
Rate for Payer: Health Management Network Commercial	$23,417.50
Rate for Payer: Kaiser Permanente Commercial	$24,795.00
Rate for Payer: MDX Hawaii PPO	$26,723.50
Rate for Payer: University Health Alliance Commercial	$15,428.00

IMPLAN PENILE PUMP 15X12

Facility

$27,550.00

Service Code	HCPCS C1813
Hospital Revenue Code	278
Min. Negotiated Rate	$8,540.50
Max. Negotiated Rate	$26,723.50
Rate for Payer: AlohaCare Medicaid	$13,775.00
Rate for Payer: AlohaCare Medicare	$8,540.50
Rate for Payer: Cash Price	$16,530.00
Rate for Payer: Devoted Health Medicare	$9,367.00
Rate for Payer: Hawaii Medical Service Association Medicare	$8,540.50
Rate for Payer: Hawaii Western Management Group Commercial	$19,285.00
Rate for Payer: Health Management Network Commercial	$23,417.50
Rate for Payer: Humana Medicare	$8,540.50
Rate for Payer: Kaiser Permanente Commercial	$24,795.00
Rate for Payer: Kaiser Permanente Medicaid	$14,050.50
Rate for Payer: Kaiser Permanente Medicare	$8,540.50
Rate for Payer: MDX Hawaii PPO	$26,723.50
Rate for Payer: Ohana Health Plan Medicaid	$8,540.50
Rate for Payer: Ohana Health Plan Medicare	$8,540.50
Rate for Payer: UnitedHealthcare Medicare	$8,540.50
Rate for Payer: University Health Alliance Commercial	$15,428.00

IMPLAN PORT CHRONOFLEX 8FR

Facility

$889.00

Service Code	HCPCS C1788
Hospital Revenue Code	278
Min. Negotiated Rate	$275.59
Max. Negotiated Rate	$862.33
Rate for Payer: AlohaCare Medicaid	$444.50
Rate for Payer: AlohaCare Medicare	$275.59
Rate for Payer: Cash Price	$533.40
Rate for Payer: Devoted Health Medicare	$302.26
Rate for Payer: Hawaii Medical Service Association Medicare	$275.59
Rate for Payer: Hawaii Western Management Group Commercial	$622.30
Rate for Payer: Health Management Network Commercial	$755.65
Rate for Payer: Humana Medicare	$275.59
Rate for Payer: Kaiser Permanente Commercial	$800.10
Rate for Payer: Kaiser Permanente Medicaid	$453.39
Rate for Payer: Kaiser Permanente Medicare	$275.59
Rate for Payer: MDX Hawaii PPO	$862.33
Rate for Payer: Ohana Health Plan Medicaid	$275.59
Rate for Payer: Ohana Health Plan Medicare	$275.59
Rate for Payer: UnitedHealthcare Medicare	$275.59
Rate for Payer: University Health Alliance Commercial	$497.84

IMPLAN PORT CHRONOFLEX 8FR

Facility

$889.00

Service Code	HCPCS C1788
Hospital Revenue Code	278
Min. Negotiated Rate	$497.84
Max. Negotiated Rate	$862.33
Rate for Payer: Cash Price	$533.40
Rate for Payer: Hawaii Western Management Group Commercial	$622.30
Rate for Payer: Health Management Network Commercial	$755.65
Rate for Payer: Kaiser Permanente Commercial	$800.10
Rate for Payer: MDX Hawaii PPO	$862.33
Rate for Payer: University Health Alliance Commercial	$497.84

IMPLAN PULSE GENERATOR IV

Facility

$36,450.00

Service Code	HCPCS C1767
Hospital Revenue Code	278
Min. Negotiated Rate	$11,299.50
Max. Negotiated Rate	$35,356.50
Rate for Payer: AlohaCare Medicaid	$18,225.00
Rate for Payer: AlohaCare Medicare	$11,299.50
Rate for Payer: Cash Price	$21,870.00
Rate for Payer: Devoted Health Medicare	$12,393.00
Rate for Payer: Hawaii Medical Service Association Medicare	$11,299.50
Rate for Payer: Hawaii Western Management Group Commercial	$25,515.00
Rate for Payer: Health Management Network Commercial	$30,982.50
Rate for Payer: Humana Medicare	$11,299.50
Rate for Payer: Kaiser Permanente Commercial	$32,805.00
Rate for Payer: Kaiser Permanente Medicaid	$18,589.50
Rate for Payer: Kaiser Permanente Medicare	$11,299.50
Rate for Payer: MDX Hawaii PPO	$35,356.50
Rate for Payer: Ohana Health Plan Medicaid	$11,299.50
Rate for Payer: Ohana Health Plan Medicare	$11,299.50
Rate for Payer: UnitedHealthcare Medicare	$11,299.50
Rate for Payer: University Health Alliance Commercial	$20,412.00

IMPLAN PULSE GENERATOR IV

Facility

$36,450.00

Service Code	HCPCS C1767
Hospital Revenue Code	278
Min. Negotiated Rate	$20,412.00
Max. Negotiated Rate	$35,356.50
Rate for Payer: Cash Price	$21,870.00
Rate for Payer: Hawaii Western Management Group Commercial	$25,515.00
Rate for Payer: Health Management Network Commercial	$30,982.50
Rate for Payer: Kaiser Permanente Commercial	$32,805.00
Rate for Payer: MDX Hawaii PPO	$35,356.50
Rate for Payer: University Health Alliance Commercial	$20,412.00

IMPLAN PUMP PENILE PRO 24X12

Facility

$24,754.00

Service Code	HCPCS C1813
Hospital Revenue Code	278
Min. Negotiated Rate	$7,673.74
Max. Negotiated Rate	$24,011.38
Rate for Payer: AlohaCare Medicaid	$12,377.00
Rate for Payer: AlohaCare Medicare	$7,673.74
Rate for Payer: Cash Price	$14,852.40
Rate for Payer: Devoted Health Medicare	$8,416.36
Rate for Payer: Hawaii Medical Service Association Medicare	$7,673.74
Rate for Payer: Hawaii Western Management Group Commercial	$17,327.80
Rate for Payer: Health Management Network Commercial	$21,040.90
Rate for Payer: Humana Medicare	$7,673.74
Rate for Payer: Kaiser Permanente Commercial	$22,278.60
Rate for Payer: Kaiser Permanente Medicaid	$12,624.54
Rate for Payer: Kaiser Permanente Medicare	$7,673.74
Rate for Payer: MDX Hawaii PPO	$24,011.38
Rate for Payer: Ohana Health Plan Medicaid	$7,673.74
Rate for Payer: Ohana Health Plan Medicare	$7,673.74
Rate for Payer: UnitedHealthcare Medicare	$7,673.74
Rate for Payer: University Health Alliance Commercial	$13,862.24

IMPLAN PUMP PENILE PRO 24X12

Facility

$24,754.00

Service Code	HCPCS C1813
Hospital Revenue Code	278
Min. Negotiated Rate	$13,862.24
Max. Negotiated Rate	$24,011.38
Rate for Payer: Cash Price	$14,852.40
Rate for Payer: Hawaii Western Management Group Commercial	$17,327.80
Rate for Payer: Health Management Network Commercial	$21,040.90
Rate for Payer: Kaiser Permanente Commercial	$22,278.60
Rate for Payer: MDX Hawaii PPO	$24,011.38
Rate for Payer: University Health Alliance Commercial	$13,862.24

IMPLAN PUMP PENILE PRO INFRA

Facility

$24,970.00

Service Code	HCPCS C1813
Hospital Revenue Code	278
Min. Negotiated Rate	$7,740.70
Max. Negotiated Rate	$24,220.90
Rate for Payer: AlohaCare Medicaid	$12,485.00
Rate for Payer: AlohaCare Medicare	$7,740.70
Rate for Payer: Cash Price	$14,982.00
Rate for Payer: Devoted Health Medicare	$8,489.80
Rate for Payer: Hawaii Medical Service Association Medicare	$7,740.70
Rate for Payer: Hawaii Western Management Group Commercial	$17,479.00
Rate for Payer: Health Management Network Commercial	$21,224.50
Rate for Payer: Humana Medicare	$7,740.70
Rate for Payer: Kaiser Permanente Commercial	$22,473.00
Rate for Payer: Kaiser Permanente Medicaid	$12,734.70
Rate for Payer: Kaiser Permanente Medicare	$7,740.70
Rate for Payer: MDX Hawaii PPO	$24,220.90
Rate for Payer: Ohana Health Plan Medicaid	$7,740.70
Rate for Payer: Ohana Health Plan Medicare	$7,740.70
Rate for Payer: UnitedHealthcare Medicare	$7,740.70
Rate for Payer: University Health Alliance Commercial	$13,983.20

IMPLAN PUMP PENILE PRO INFRA

Facility

$24,970.00

Service Code	HCPCS C1813
Hospital Revenue Code	278
Min. Negotiated Rate	$13,983.20
Max. Negotiated Rate	$24,220.90
Rate for Payer: Cash Price	$14,982.00
Rate for Payer: Hawaii Western Management Group Commercial	$17,479.00
Rate for Payer: Health Management Network Commercial	$21,224.50
Rate for Payer: Kaiser Permanente Commercial	$22,473.00
Rate for Payer: MDX Hawaii PPO	$24,220.90
Rate for Payer: University Health Alliance Commercial	$13,983.20

IMPLAN PUMP PENILE PROTHESIS

Facility

$25,510.00

Service Code	HCPCS C1813
Hospital Revenue Code	278
Min. Negotiated Rate	$14,285.60
Max. Negotiated Rate	$24,744.70
Rate for Payer: Cash Price	$15,306.00
Rate for Payer: Hawaii Western Management Group Commercial	$17,857.00
Rate for Payer: Health Management Network Commercial	$21,683.50
Rate for Payer: Kaiser Permanente Commercial	$22,959.00
Rate for Payer: MDX Hawaii PPO	$24,744.70
Rate for Payer: University Health Alliance Commercial	$14,285.60

IMPLAN PUMP PENILE PROTHESIS

Facility

$25,510.00

Service Code	HCPCS C1813
Hospital Revenue Code	278
Min. Negotiated Rate	$7,908.10
Max. Negotiated Rate	$24,744.70
Rate for Payer: AlohaCare Medicaid	$12,755.00
Rate for Payer: AlohaCare Medicare	$7,908.10
Rate for Payer: Cash Price	$15,306.00
Rate for Payer: Devoted Health Medicare	$8,673.40
Rate for Payer: Hawaii Medical Service Association Medicare	$7,908.10
Rate for Payer: Hawaii Western Management Group Commercial	$17,857.00
Rate for Payer: Health Management Network Commercial	$21,683.50
Rate for Payer: Humana Medicare	$7,908.10
Rate for Payer: Kaiser Permanente Commercial	$22,959.00
Rate for Payer: Kaiser Permanente Medicaid	$13,010.10
Rate for Payer: Kaiser Permanente Medicare	$7,908.10
Rate for Payer: MDX Hawaii PPO	$24,744.70
Rate for Payer: Ohana Health Plan Medicaid	$7,908.10
Rate for Payer: Ohana Health Plan Medicare	$7,908.10
Rate for Payer: UnitedHealthcare Medicare	$7,908.10
Rate for Payer: University Health Alliance Commercial	$14,285.60

IMPLAN SILICONE SHEETING

Facility

$225.00

Hospital Revenue Code	278
Min. Negotiated Rate	$69.75
Max. Negotiated Rate	$218.25
Rate for Payer: AlohaCare Medicaid	$112.50
Rate for Payer: AlohaCare Medicare	$69.75
Rate for Payer: Cash Price	$135.00
Rate for Payer: Devoted Health Medicare	$76.50
Rate for Payer: Hawaii Medical Service Association Medicare	$69.75
Rate for Payer: Hawaii Western Management Group Commercial	$157.50
Rate for Payer: Health Management Network Commercial	$191.25
Rate for Payer: Humana Medicare	$69.75
Rate for Payer: Kaiser Permanente Commercial	$202.50
Rate for Payer: Kaiser Permanente Medicaid	$114.75
Rate for Payer: Kaiser Permanente Medicare	$69.75
Rate for Payer: MDX Hawaii PPO	$218.25
Rate for Payer: Ohana Health Plan Medicaid	$69.75
Rate for Payer: Ohana Health Plan Medicare	$69.75
Rate for Payer: UnitedHealthcare Medicare	$69.75
Rate for Payer: University Health Alliance Commercial	$126.00

Know your out-of-pocket cost for care.

All Charges