Kau Hospital

All Charges

Charge

Type

Setting

Price

KIT BIOCUE STD 60ML 800-0611A

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 STD 60ML 800-0611A

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

KIT BIO DISTAL BICEP AR-2260BC

Facility

$2,310.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$716.10
Max. Negotiated Rate	$2,240.70
Rate for Payer: AlohaCare Medicaid	$1,155.00
Rate for Payer: AlohaCare Medicare	$716.10
Rate for Payer: Cash Price	$1,386.00
Rate for Payer: Devoted Health Medicare	$785.40
Rate for Payer: Hawaii Medical Service Association Medicare	$716.10
Rate for Payer: Hawaii Western Management Group Commercial	$1,617.00
Rate for Payer: Health Management Network Commercial	$1,963.50
Rate for Payer: Humana Medicare	$716.10
Rate for Payer: Kaiser Permanente Commercial	$2,079.00
Rate for Payer: Kaiser Permanente Medicaid	$1,178.10
Rate for Payer: Kaiser Permanente Medicare	$716.10
Rate for Payer: MDX Hawaii PPO	$2,240.70
Rate for Payer: Ohana Health Plan Medicaid	$716.10
Rate for Payer: Ohana Health Plan Medicare	$716.10
Rate for Payer: UnitedHealthcare Medicare	$716.10
Rate for Payer: University Health Alliance Commercial	$1,293.60

KIT BIO DISTAL BICEP AR-2260BC

Facility

$2,310.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.60
Max. Negotiated Rate	$2,240.70
Rate for Payer: Cash Price	$1,386.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,617.00
Rate for Payer: Health Management Network Commercial	$1,963.50
Rate for Payer: Kaiser Permanente Commercial	$2,079.00
Rate for Payer: MDX Hawaii PPO	$2,240.70
Rate for Payer: University Health Alliance Commercial	$1,293.60

KIT CATH TRAY SILICONE 16FR

Facility

$94.00

Hospital Revenue Code	272
Min. Negotiated Rate	$29.14
Max. Negotiated Rate	$91.18
Rate for Payer: AlohaCare Medicaid	$47.00
Rate for Payer: AlohaCare Medicare	$29.14
Rate for Payer: Cash Price	$56.40
Rate for Payer: Devoted Health Medicare	$31.96
Rate for Payer: Hawaii Medical Service Association Medicare	$29.14
Rate for Payer: Hawaii Western Management Group Commercial	$89.30
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: Humana Medicare	$29.14
Rate for Payer: Kaiser Permanente Commercial	$84.60
Rate for Payer: Kaiser Permanente Medicaid	$47.94
Rate for Payer: Kaiser Permanente Medicare	$29.14
Rate for Payer: MDX Hawaii PPO	$91.18
Rate for Payer: Ohana Health Plan Medicaid	$29.14
Rate for Payer: Ohana Health Plan Medicare	$29.14
Rate for Payer: UnitedHealthcare Medicare	$29.14
Rate for Payer: University Health Alliance Commercial	$68.52

KIT CATH TRAY SILICONE 16FR

Facility

$94.00

Hospital Revenue Code	272
Min. Negotiated Rate	$79.90
Max. Negotiated Rate	$91.18
Rate for Payer: Cash Price	$56.40
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: Kaiser Permanente Commercial	$84.60
Rate for Payer: MDX Hawaii PPO	$91.18

KIT CENTESIS 5FR CATHETER

Facility

$394.00

Service Code	HCPCS C1729
Hospital Revenue Code	272
Min. Negotiated Rate	$122.14
Max. Negotiated Rate	$382.18
Rate for Payer: AlohaCare Medicaid	$197.00
Rate for Payer: AlohaCare Medicare	$122.14
Rate for Payer: Cash Price	$236.40
Rate for Payer: Devoted Health Medicare	$133.96
Rate for Payer: Hawaii Medical Service Association Medicare	$122.14
Rate for Payer: Hawaii Western Management Group Commercial	$374.30
Rate for Payer: Health Management Network Commercial	$334.90
Rate for Payer: Humana Medicare	$122.14
Rate for Payer: Kaiser Permanente Commercial	$354.60
Rate for Payer: Kaiser Permanente Medicaid	$200.94
Rate for Payer: Kaiser Permanente Medicare	$122.14
Rate for Payer: MDX Hawaii PPO	$382.18
Rate for Payer: Ohana Health Plan Medicaid	$122.14
Rate for Payer: Ohana Health Plan Medicare	$122.14
Rate for Payer: UnitedHealthcare Medicare	$122.14
Rate for Payer: University Health Alliance Commercial	$287.19

KIT CENTESIS 5FR CATHETER

Facility

$394.00

Service Code	HCPCS C1729
Hospital Revenue Code	272
Min. Negotiated Rate	$334.90
Max. Negotiated Rate	$382.18
Rate for Payer: Cash Price	$236.40
Rate for Payer: Health Management Network Commercial	$334.90
Rate for Payer: Kaiser Permanente Commercial	$354.60
Rate for Payer: MDX Hawaii PPO	$382.18

KIT CRICOTHYROTOMY 2MM

Facility

$655.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$556.75
Max. Negotiated Rate	$635.35
Rate for Payer: Cash Price	$393.00
Rate for Payer: Health Management Network Commercial	$556.75
Rate for Payer: Kaiser Permanente Commercial	$589.50
Rate for Payer: MDX Hawaii PPO	$635.35

KIT CRICOTHYROTOMY 2MM

Facility

$655.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$203.05
Max. Negotiated Rate	$635.35
Rate for Payer: AlohaCare Medicaid	$327.50
Rate for Payer: AlohaCare Medicare	$203.05
Rate for Payer: Cash Price	$393.00
Rate for Payer: Devoted Health Medicare	$222.70
Rate for Payer: Hawaii Medical Service Association Medicare	$203.05
Rate for Payer: Hawaii Western Management Group Commercial	$622.25
Rate for Payer: Health Management Network Commercial	$556.75
Rate for Payer: Humana Medicare	$203.05
Rate for Payer: Kaiser Permanente Commercial	$589.50
Rate for Payer: Kaiser Permanente Medicaid	$334.05
Rate for Payer: Kaiser Permanente Medicare	$203.05
Rate for Payer: MDX Hawaii PPO	$635.35
Rate for Payer: Ohana Health Plan Medicaid	$203.05
Rate for Payer: Ohana Health Plan Medicare	$203.05
Rate for Payer: UnitedHealthcare Medicare	$203.05
Rate for Payer: University Health Alliance Commercial	$477.43

KIT CRICOTHYROTOMY 4.0MM

Facility

$569.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$483.65
Max. Negotiated Rate	$551.93
Rate for Payer: Cash Price	$341.40
Rate for Payer: Health Management Network Commercial	$483.65
Rate for Payer: Kaiser Permanente Commercial	$512.10
Rate for Payer: MDX Hawaii PPO	$551.93

KIT CRICOTHYROTOMY 4.0MM

Facility

$569.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$176.39
Max. Negotiated Rate	$551.93
Rate for Payer: AlohaCare Medicaid	$284.50
Rate for Payer: AlohaCare Medicare	$176.39
Rate for Payer: Cash Price	$341.40
Rate for Payer: Devoted Health Medicare	$193.46
Rate for Payer: Hawaii Medical Service Association Medicare	$176.39
Rate for Payer: Hawaii Western Management Group Commercial	$540.55
Rate for Payer: Health Management Network Commercial	$483.65
Rate for Payer: Humana Medicare	$176.39
Rate for Payer: Kaiser Permanente Commercial	$512.10
Rate for Payer: Kaiser Permanente Medicaid	$290.19
Rate for Payer: Kaiser Permanente Medicare	$176.39
Rate for Payer: MDX Hawaii PPO	$551.93
Rate for Payer: Ohana Health Plan Medicaid	$176.39
Rate for Payer: Ohana Health Plan Medicare	$176.39
Rate for Payer: UnitedHealthcare Medicare	$176.39
Rate for Payer: University Health Alliance Commercial	$414.74

KIT DISPOSABLE DX AR-8990DS

Facility

$1,376.00

Hospital Revenue Code	272
Min. Negotiated Rate	$426.56
Max. Negotiated Rate	$1,334.72
Rate for Payer: AlohaCare Medicaid	$688.00
Rate for Payer: AlohaCare Medicare	$426.56
Rate for Payer: Cash Price	$825.60
Rate for Payer: Devoted Health Medicare	$467.84
Rate for Payer: Hawaii Medical Service Association Medicare	$426.56
Rate for Payer: Hawaii Western Management Group Commercial	$1,307.20
Rate for Payer: Health Management Network Commercial	$1,169.60
Rate for Payer: Humana Medicare	$426.56
Rate for Payer: Kaiser Permanente Commercial	$1,238.40
Rate for Payer: Kaiser Permanente Medicaid	$701.76
Rate for Payer: Kaiser Permanente Medicare	$426.56
Rate for Payer: MDX Hawaii PPO	$1,334.72
Rate for Payer: Ohana Health Plan Medicaid	$426.56
Rate for Payer: Ohana Health Plan Medicare	$426.56
Rate for Payer: UnitedHealthcare Medicare	$426.56
Rate for Payer: University Health Alliance Commercial	$1,002.97

KIT DISPOSABLE DX AR-8990DS

Facility

$1,376.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,169.60
Max. Negotiated Rate	$1,334.72
Rate for Payer: Cash Price	$825.60
Rate for Payer: Health Management Network Commercial	$1,169.60
Rate for Payer: Kaiser Permanente Commercial	$1,238.40
Rate for Payer: MDX Hawaii PPO	$1,334.72

KIT DRAINAGE PLEURX 1000ML

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

KIT DRAINAGE PLEURX 1000ML

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

KIT DRAPE DRUG

Facility

$1,938.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,647.30
Max. Negotiated Rate	$1,879.86
Rate for Payer: Cash Price	$1,162.80
Rate for Payer: Health Management Network Commercial	$1,647.30
Rate for Payer: Kaiser Permanente Commercial	$1,744.20
Rate for Payer: MDX Hawaii PPO	$1,879.86

KIT DRAPE DRUG

Facility

$1,938.00

Hospital Revenue Code	272
Min. Negotiated Rate	$600.78
Max. Negotiated Rate	$1,879.86
Rate for Payer: AlohaCare Medicaid	$969.00
Rate for Payer: AlohaCare Medicare	$600.78
Rate for Payer: Cash Price	$1,162.80
Rate for Payer: Devoted Health Medicare	$658.92
Rate for Payer: Hawaii Medical Service Association Medicare	$600.78
Rate for Payer: Hawaii Western Management Group Commercial	$1,841.10
Rate for Payer: Health Management Network Commercial	$1,647.30
Rate for Payer: Humana Medicare	$600.78
Rate for Payer: Kaiser Permanente Commercial	$1,744.20
Rate for Payer: Kaiser Permanente Medicaid	$988.38
Rate for Payer: Kaiser Permanente Medicare	$600.78
Rate for Payer: MDX Hawaii PPO	$1,879.86
Rate for Payer: Ohana Health Plan Medicaid	$600.78
Rate for Payer: Ohana Health Plan Medicare	$600.78
Rate for Payer: UnitedHealthcare Medicare	$600.78
Rate for Payer: University Health Alliance Commercial	$1,412.61

KIT ENDO COMPLIANCE

Facility

$1,222.00

Hospital Revenue Code	272
Min. Negotiated Rate	$378.82
Max. Negotiated Rate	$1,185.34
Rate for Payer: AlohaCare Medicaid	$611.00
Rate for Payer: AlohaCare Medicare	$378.82
Rate for Payer: Cash Price	$733.20
Rate for Payer: Devoted Health Medicare	$415.48
Rate for Payer: Hawaii Medical Service Association Medicare	$378.82
Rate for Payer: Hawaii Western Management Group Commercial	$1,160.90
Rate for Payer: Health Management Network Commercial	$1,038.70
Rate for Payer: Humana Medicare	$378.82
Rate for Payer: Kaiser Permanente Commercial	$1,099.80
Rate for Payer: Kaiser Permanente Medicaid	$623.22
Rate for Payer: Kaiser Permanente Medicare	$378.82
Rate for Payer: MDX Hawaii PPO	$1,185.34
Rate for Payer: Ohana Health Plan Medicaid	$378.82
Rate for Payer: Ohana Health Plan Medicare	$378.82
Rate for Payer: UnitedHealthcare Medicare	$378.82
Rate for Payer: University Health Alliance Commercial	$890.72

KIT ENDO COMPLIANCE

Facility

$1,222.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,038.70
Max. Negotiated Rate	$1,185.34
Rate for Payer: Cash Price	$733.20
Rate for Payer: Health Management Network Commercial	$1,038.70
Rate for Payer: Kaiser Permanente Commercial	$1,099.80
Rate for Payer: MDX Hawaii PPO	$1,185.34

KIT FIBERTAK DISP AR-3650DS

Facility

$1,138.00

Hospital Revenue Code	272
Min. Negotiated Rate	$352.78
Max. Negotiated Rate	$1,103.86
Rate for Payer: AlohaCare Medicaid	$569.00
Rate for Payer: AlohaCare Medicare	$352.78
Rate for Payer: Cash Price	$682.80
Rate for Payer: Devoted Health Medicare	$386.92
Rate for Payer: Hawaii Medical Service Association Medicare	$352.78
Rate for Payer: Hawaii Western Management Group Commercial	$1,081.10
Rate for Payer: Health Management Network Commercial	$967.30
Rate for Payer: Humana Medicare	$352.78
Rate for Payer: Kaiser Permanente Commercial	$1,024.20
Rate for Payer: Kaiser Permanente Medicaid	$580.38
Rate for Payer: Kaiser Permanente Medicare	$352.78
Rate for Payer: MDX Hawaii PPO	$1,103.86
Rate for Payer: Ohana Health Plan Medicaid	$352.78
Rate for Payer: Ohana Health Plan Medicare	$352.78
Rate for Payer: UnitedHealthcare Medicare	$352.78
Rate for Payer: University Health Alliance Commercial	$829.49

KIT FIBERTAK DISP AR-3650DS

Facility

$1,138.00

Hospital Revenue Code	272
Min. Negotiated Rate	$967.30
Max. Negotiated Rate	$1,103.86
Rate for Payer: Cash Price	$682.80
Rate for Payer: Health Management Network Commercial	$967.30
Rate for Payer: Kaiser Permanente Commercial	$1,024.20
Rate for Payer: MDX Hawaii PPO	$1,103.86

KIT FOR PREPARATION OF TC 99M-ALBUMIN 2 MG INTRAVENOUS SOLUTION [209535]

Facility

$113.00

Service Code	NDC 69945013910
Hospital Revenue Code	343
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

KIT FOR PREPARATION OF TC 99M-ALBUMIN 2 MG INTRAVENOUS SOLUTION [209535]

Facility

$113.00

Service Code	NDC 69945013910
Hospital Revenue Code	343
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

KIT FOR PREPARATION OF TC-99M-MEDRONATE SODIUM 20 MG IV SOLUTION [98466]

Facility

$69.00

Service Code	HCPCS A9503
Hospital Revenue Code	343
Min. Negotiated Rate	$21.39
Max. Negotiated Rate	$66.93
Rate for Payer: AlohaCare Medicaid	$34.50
Rate for Payer: AlohaCare Medicare	$21.39
Rate for Payer: Cash Price	$41.40
Rate for Payer: Cash Price	$41.40
Rate for Payer: Devoted Health Medicare	$23.46
Rate for Payer: Hawaii Medical Service Association Medicare	$21.39
Rate for Payer: Hawaii Western Management Group Commercial	$65.55
Rate for Payer: Health Management Network Commercial	$58.65
Rate for Payer: Humana Medicare	$21.39
Rate for Payer: Kaiser Permanente Commercial	$62.10
Rate for Payer: Kaiser Permanente Medicaid	$35.19
Rate for Payer: Kaiser Permanente Medicare	$21.39
Rate for Payer: MDX Hawaii PPO	$66.93
Rate for Payer: Ohana Health Plan Medicaid	$21.39
Rate for Payer: Ohana Health Plan Medicare	$21.39
Rate for Payer: UnitedHealthcare Medicaid	$31.20
Rate for Payer: UnitedHealthcare Medicare	$21.39
Rate for Payer: University Health Alliance Commercial	$50.29

Know your out-of-pocket cost for care.

All Charges