Kau Hospital

All Charges

Charge

Type

Setting

Price

KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC

Facility

$31,144.43

Service Code	MSDRG 661
Min. Negotiated Rate	$31,144.43
Max. Negotiated Rate	$31,144.43
Rate for Payer: Hawaii Medical Service Association Commercial	$31,144.43

KIDNEY AND URINARY TRACT INFECTIONS WITH MCC

Facility

$17,539.48

Service Code	MSDRG 689
Min. Negotiated Rate	$17,539.48
Max. Negotiated Rate	$17,539.48
Rate for Payer: Hawaii Medical Service Association Commercial	$17,539.48

KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC

Facility

$14,979.66

Service Code	MSDRG 690
Min. Negotiated Rate	$14,979.66
Max. Negotiated Rate	$14,979.66
Rate for Payer: Hawaii Medical Service Association Commercial	$14,979.66

KIDNEY AND URINARY TRACT NEOPLASMS WITH CC

Facility

$30,931.11

Service Code	MSDRG 687
Min. Negotiated Rate	$30,931.11
Max. Negotiated Rate	$30,931.11
Rate for Payer: Hawaii Medical Service Association Commercial	$30,931.11

KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC

Facility

$30,931.11

Service Code	MSDRG 686
Min. Negotiated Rate	$30,931.11
Max. Negotiated Rate	$30,931.11
Rate for Payer: Hawaii Medical Service Association Commercial	$30,931.11

KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC

Facility

$30,931.11

Service Code	MSDRG 688
Min. Negotiated Rate	$30,931.11
Max. Negotiated Rate	$30,931.11
Rate for Payer: Hawaii Medical Service Association Commercial	$30,931.11

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC

Facility

$20,525.93

Service Code	MSDRG 695
Min. Negotiated Rate	$20,525.93
Max. Negotiated Rate	$20,525.93
Rate for Payer: Hawaii Medical Service Association Commercial	$20,525.93

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC

Facility

$20,525.93

Service Code	MSDRG 696
Min. Negotiated Rate	$20,525.93
Max. Negotiated Rate	$20,525.93
Rate for Payer: Hawaii Medical Service Association Commercial	$20,525.93

KIDNEY TRANSPLANT

Facility

$154,726.66

Service Code	MSDRG 652
Min. Negotiated Rate	$154,726.66
Max. Negotiated Rate	$154,726.66
Rate for Payer: Hawaii Medical Service Association Commercial	$154,726.66

KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC

Facility

$154,726.66

Service Code	MSDRG 650
Min. Negotiated Rate	$154,726.66
Max. Negotiated Rate	$154,726.66
Rate for Payer: Hawaii Medical Service Association Commercial	$154,726.66

KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC

Facility

$154,726.66

Service Code	MSDRG 651
Min. Negotiated Rate	$154,726.66
Max. Negotiated Rate	$154,726.66
Rate for Payer: Hawaii Medical Service Association Commercial	$154,726.66

KII FIOS OBTURATOR 5X100 CTF03

Facility

$360.00

Hospital Revenue Code	272
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$349.20
Rate for Payer: AlohaCare Medicaid	$180.00
Rate for Payer: AlohaCare Medicare	$111.60
Rate for Payer: Cash Price	$216.00
Rate for Payer: Devoted Health Medicare	$122.40
Rate for Payer: Hawaii Medical Service Association Medicare	$111.60
Rate for Payer: Hawaii Western Management Group Commercial	$342.00
Rate for Payer: Health Management Network Commercial	$306.00
Rate for Payer: Humana Medicare	$111.60
Rate for Payer: Kaiser Permanente Commercial	$324.00
Rate for Payer: Kaiser Permanente Medicaid	$183.60
Rate for Payer: Kaiser Permanente Medicare	$111.60
Rate for Payer: MDX Hawaii PPO	$349.20
Rate for Payer: Ohana Health Plan Medicaid	$111.60
Rate for Payer: Ohana Health Plan Medicare	$111.60
Rate for Payer: UnitedHealthcare Medicare	$111.60
Rate for Payer: University Health Alliance Commercial	$262.40

KII FIOS OBTURATOR 5X100 CTF03

Facility

$360.00

Hospital Revenue Code	272
Min. Negotiated Rate	$306.00
Max. Negotiated Rate	$349.20
Rate for Payer: Cash Price	$216.00
Rate for Payer: Health Management Network Commercial	$306.00
Rate for Payer: Kaiser Permanente Commercial	$324.00
Rate for Payer: MDX Hawaii PPO	$349.20

KII SLEEVE 5X100 CFS02

Facility

$225.00

Hospital Revenue Code	272
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	$213.75
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	$164.00

KII SLEEVE 5X100 CFS02

Facility

$225.00

Hospital Revenue Code	272
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$218.25
Rate for Payer: Cash Price	$135.00
Rate for Payer: Health Management Network Commercial	$191.25
Rate for Payer: Kaiser Permanente Commercial	$202.50
Rate for Payer: MDX Hawaii PPO	$218.25

KIRSCHNER WIRE 47-186-78

Facility

$126.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$39.06
Max. Negotiated Rate	$122.22
Rate for Payer: AlohaCare Medicaid	$63.00
Rate for Payer: AlohaCare Medicare	$39.06
Rate for Payer: Cash Price	$75.60
Rate for Payer: Devoted Health Medicare	$42.84
Rate for Payer: Hawaii Medical Service Association Medicare	$39.06
Rate for Payer: Hawaii Western Management Group Commercial	$119.70
Rate for Payer: Health Management Network Commercial	$107.10
Rate for Payer: Humana Medicare	$39.06
Rate for Payer: Kaiser Permanente Commercial	$113.40
Rate for Payer: Kaiser Permanente Medicaid	$64.26
Rate for Payer: Kaiser Permanente Medicare	$39.06
Rate for Payer: MDX Hawaii PPO	$122.22
Rate for Payer: Ohana Health Plan Medicaid	$39.06
Rate for Payer: Ohana Health Plan Medicare	$39.06
Rate for Payer: UnitedHealthcare Medicare	$39.06
Rate for Payer: University Health Alliance Commercial	$91.84

KIRSCHNER WIRE 47-186-78

Facility

$126.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$107.10
Max. Negotiated Rate	$122.22
Rate for Payer: Cash Price	$75.60
Rate for Payer: Health Management Network Commercial	$107.10
Rate for Payer: Kaiser Permanente Commercial	$113.40
Rate for Payer: MDX Hawaii PPO	$122.22

KIT 3.0 SUTURE TAK AR-1938DS

Facility

$1,084.00

Hospital Revenue Code	272
Min. Negotiated Rate	$921.40
Max. Negotiated Rate	$1,051.48
Rate for Payer: Cash Price	$650.40
Rate for Payer: Health Management Network Commercial	$921.40
Rate for Payer: Kaiser Permanente Commercial	$975.60
Rate for Payer: MDX Hawaii PPO	$1,051.48

KIT 3.0 SUTURE TAK AR-1938DS

Facility

$1,084.00

Hospital Revenue Code	272
Min. Negotiated Rate	$336.04
Max. Negotiated Rate	$1,051.48
Rate for Payer: AlohaCare Medicaid	$542.00
Rate for Payer: AlohaCare Medicare	$336.04
Rate for Payer: Cash Price	$650.40
Rate for Payer: Devoted Health Medicare	$368.56
Rate for Payer: Hawaii Medical Service Association Medicare	$336.04
Rate for Payer: Hawaii Western Management Group Commercial	$1,029.80
Rate for Payer: Health Management Network Commercial	$921.40
Rate for Payer: Humana Medicare	$336.04
Rate for Payer: Kaiser Permanente Commercial	$975.60
Rate for Payer: Kaiser Permanente Medicaid	$552.84
Rate for Payer: Kaiser Permanente Medicare	$336.04
Rate for Payer: MDX Hawaii PPO	$1,051.48
Rate for Payer: Ohana Health Plan Medicaid	$336.04
Rate for Payer: Ohana Health Plan Medicare	$336.04
Rate for Payer: UnitedHealthcare Medicare	$336.04
Rate for Payer: University Health Alliance Commercial	$790.13

KIT 3MM SUTURETAK #AR-1934DS-2

Facility

$859.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$266.29
Max. Negotiated Rate	$833.23
Rate for Payer: AlohaCare Medicaid	$429.50
Rate for Payer: AlohaCare Medicare	$266.29
Rate for Payer: Cash Price	$515.40
Rate for Payer: Devoted Health Medicare	$292.06
Rate for Payer: Hawaii Medical Service Association Medicare	$266.29
Rate for Payer: Hawaii Western Management Group Commercial	$816.05
Rate for Payer: Health Management Network Commercial	$730.15
Rate for Payer: Humana Medicare	$266.29
Rate for Payer: Kaiser Permanente Commercial	$773.10
Rate for Payer: Kaiser Permanente Medicaid	$438.09
Rate for Payer: Kaiser Permanente Medicare	$266.29
Rate for Payer: MDX Hawaii PPO	$833.23
Rate for Payer: Ohana Health Plan Medicaid	$266.29
Rate for Payer: Ohana Health Plan Medicare	$266.29
Rate for Payer: UnitedHealthcare Medicare	$266.29
Rate for Payer: University Health Alliance Commercial	$626.13

KIT 3MM SUTURETAK #AR-1934DS-2

Facility

$859.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$730.15
Max. Negotiated Rate	$833.23
Rate for Payer: Cash Price	$515.40
Rate for Payer: Health Management Network Commercial	$730.15
Rate for Payer: Kaiser Permanente Commercial	$773.10
Rate for Payer: MDX Hawaii PPO	$833.23

KIT ANKLE SPRAIN CARE UNIVERS

Facility

$111.00

Service Code	HCPCS L4350
Hospital Revenue Code	274
Min. Negotiated Rate	$62.16
Max. Negotiated Rate	$107.67
Rate for Payer: Cash Price	$66.60
Rate for Payer: Hawaii Western Management Group Commercial	$77.70
Rate for Payer: Health Management Network Commercial	$94.35
Rate for Payer: Kaiser Permanente Commercial	$99.90
Rate for Payer: MDX Hawaii PPO	$107.67
Rate for Payer: University Health Alliance Commercial	$62.16

KIT ANKLE SPRAIN CARE UNIVERS

Facility

$111.00

Service Code	HCPCS L4350
Hospital Revenue Code	274
Min. Negotiated Rate	$34.41
Max. Negotiated Rate	$107.67
Rate for Payer: AlohaCare Medicaid	$55.50
Rate for Payer: AlohaCare Medicare	$34.41
Rate for Payer: Cash Price	$66.60
Rate for Payer: Cash Price	$66.60
Rate for Payer: Devoted Health Medicare	$37.74
Rate for Payer: Hawaii Medical Service Association Medicare	$34.41
Rate for Payer: Hawaii Western Management Group Commercial	$77.70
Rate for Payer: Health Management Network Commercial	$94.35
Rate for Payer: Humana Medicare	$34.41
Rate for Payer: Kaiser Permanente Commercial	$99.90
Rate for Payer: Kaiser Permanente Medicaid	$56.61
Rate for Payer: Kaiser Permanente Medicare	$34.41
Rate for Payer: MDX Hawaii PPO	$107.67
Rate for Payer: Ohana Health Plan Medicaid	$34.41
Rate for Payer: Ohana Health Plan Medicare	$34.41
Rate for Payer: UnitedHealthcare Medicaid	$81.51
Rate for Payer: UnitedHealthcare Medicare	$34.41
Rate for Payer: University Health Alliance Commercial	$62.16

KIT BIOCUE MINI 30ML 800-0610A

Facility

$5,104.00

Hospital Revenue Code	272
Min. Negotiated Rate	$4,338.40
Max. Negotiated Rate	$4,950.88
Rate for Payer: Cash Price	$3,062.40
Rate for Payer: Health Management Network Commercial	$4,338.40
Rate for Payer: Kaiser Permanente Commercial	$4,593.60
Rate for Payer: MDX Hawaii PPO	$4,950.88

KIT BIOCUE MINI 30ML 800-0610A

Facility

$5,104.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,582.24
Max. Negotiated Rate	$4,950.88
Rate for Payer: AlohaCare Medicaid	$2,552.00
Rate for Payer: AlohaCare Medicare	$1,582.24
Rate for Payer: Cash Price	$3,062.40
Rate for Payer: Devoted Health Medicare	$1,735.36
Rate for Payer: Hawaii Medical Service Association Medicare	$1,582.24
Rate for Payer: Hawaii Western Management Group Commercial	$4,848.80
Rate for Payer: Health Management Network Commercial	$4,338.40
Rate for Payer: Humana Medicare	$1,582.24
Rate for Payer: Kaiser Permanente Commercial	$4,593.60
Rate for Payer: Kaiser Permanente Medicaid	$2,603.04
Rate for Payer: Kaiser Permanente Medicare	$1,582.24
Rate for Payer: MDX Hawaii PPO	$4,950.88
Rate for Payer: Ohana Health Plan Medicaid	$1,582.24
Rate for Payer: Ohana Health Plan Medicare	$1,582.24
Rate for Payer: UnitedHealthcare Medicare	$1,582.24
Rate for Payer: University Health Alliance Commercial	$3,720.31

Know your out-of-pocket cost for care.

All Charges