Kau Hospital

All Charges

Charge

Type

Setting

Price

NAIL FEMORAL 13X380 2339-1336S

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,059.28
Max. Negotiated Rate	$5,299.11
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Kaiser Permanente Commercial	$4,916.70
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL FEMORAL GT LEFT

Facility

$4,867.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,725.52
Max. Negotiated Rate	$4,720.99
Rate for Payer: Cash Price	$2,920.20
Rate for Payer: Hawaii Western Management Group Commercial	$3,406.90
Rate for Payer: Health Management Network Commercial	$4,136.95
Rate for Payer: Kaiser Permanente Commercial	$4,380.30
Rate for Payer: MDX Hawaii PPO	$4,720.99
Rate for Payer: University Health Alliance Commercial	$2,725.52

NAIL FEMORAL GT LEFT

Facility

$4,867.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,508.77
Max. Negotiated Rate	$4,720.99
Rate for Payer: AlohaCare Medicaid	$2,433.50
Rate for Payer: AlohaCare Medicare	$1,508.77
Rate for Payer: Cash Price	$2,920.20
Rate for Payer: Devoted Health Medicare	$1,654.78
Rate for Payer: Hawaii Medical Service Association Medicare	$1,508.77
Rate for Payer: Hawaii Western Management Group Commercial	$3,406.90
Rate for Payer: Health Management Network Commercial	$4,136.95
Rate for Payer: Humana Medicare	$1,508.77
Rate for Payer: Kaiser Permanente Commercial	$4,380.30
Rate for Payer: Kaiser Permanente Medicaid	$2,482.17
Rate for Payer: Kaiser Permanente Medicare	$1,508.77
Rate for Payer: MDX Hawaii PPO	$4,720.99
Rate for Payer: Ohana Health Plan Medicaid	$1,508.77
Rate for Payer: Ohana Health Plan Medicare	$1,508.77
Rate for Payer: UnitedHealthcare Medicare	$1,508.77
Rate for Payer: University Health Alliance Commercial	$2,725.52

NAIL FEMORAL GT LF

Facility

$4,867.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,725.52
Max. Negotiated Rate	$4,720.99
Rate for Payer: Cash Price	$2,920.20
Rate for Payer: Hawaii Western Management Group Commercial	$3,406.90
Rate for Payer: Health Management Network Commercial	$4,136.95
Rate for Payer: Kaiser Permanente Commercial	$4,380.30
Rate for Payer: MDX Hawaii PPO	$4,720.99
Rate for Payer: University Health Alliance Commercial	$2,725.52

NAIL FEMORAL GT LF

Facility

$4,867.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,508.77
Max. Negotiated Rate	$4,720.99
Rate for Payer: AlohaCare Medicaid	$2,433.50
Rate for Payer: AlohaCare Medicare	$1,508.77
Rate for Payer: Cash Price	$2,920.20
Rate for Payer: Devoted Health Medicare	$1,654.78
Rate for Payer: Hawaii Medical Service Association Medicare	$1,508.77
Rate for Payer: Hawaii Western Management Group Commercial	$3,406.90
Rate for Payer: Health Management Network Commercial	$4,136.95
Rate for Payer: Humana Medicare	$1,508.77
Rate for Payer: Kaiser Permanente Commercial	$4,380.30
Rate for Payer: Kaiser Permanente Medicaid	$2,482.17
Rate for Payer: Kaiser Permanente Medicare	$1,508.77
Rate for Payer: MDX Hawaii PPO	$4,720.99
Rate for Payer: Ohana Health Plan Medicaid	$1,508.77
Rate for Payer: Ohana Health Plan Medicare	$1,508.77
Rate for Payer: UnitedHealthcare Medicare	$1,508.77
Rate for Payer: University Health Alliance Commercial	$2,725.52

NAIL FEMORAL GT RIGHT

Facility

$4,867.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,508.77
Max. Negotiated Rate	$4,720.99
Rate for Payer: AlohaCare Medicaid	$2,433.50
Rate for Payer: AlohaCare Medicare	$1,508.77
Rate for Payer: Cash Price	$2,920.20
Rate for Payer: Devoted Health Medicare	$1,654.78
Rate for Payer: Hawaii Medical Service Association Medicare	$1,508.77
Rate for Payer: Hawaii Western Management Group Commercial	$3,406.90
Rate for Payer: Health Management Network Commercial	$4,136.95
Rate for Payer: Humana Medicare	$1,508.77
Rate for Payer: Kaiser Permanente Commercial	$4,380.30
Rate for Payer: Kaiser Permanente Medicaid	$2,482.17
Rate for Payer: Kaiser Permanente Medicare	$1,508.77
Rate for Payer: MDX Hawaii PPO	$4,720.99
Rate for Payer: Ohana Health Plan Medicaid	$1,508.77
Rate for Payer: Ohana Health Plan Medicare	$1,508.77
Rate for Payer: UnitedHealthcare Medicare	$1,508.77
Rate for Payer: University Health Alliance Commercial	$2,725.52

NAIL FEMORAL GT RIGHT

Facility

$4,867.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,725.52
Max. Negotiated Rate	$4,720.99
Rate for Payer: Cash Price	$2,920.20
Rate for Payer: Hawaii Western Management Group Commercial	$3,406.90
Rate for Payer: Health Management Network Commercial	$4,136.95
Rate for Payer: Kaiser Permanente Commercial	$4,380.30
Rate for Payer: MDX Hawaii PPO	$4,720.99
Rate for Payer: University Health Alliance Commercial	$2,725.52

NAIL FEMORAL GT RT 2333-0934S

Facility

$6,082.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,405.92
Max. Negotiated Rate	$5,899.54
Rate for Payer: Cash Price	$3,649.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,257.40
Rate for Payer: Health Management Network Commercial	$5,169.70
Rate for Payer: Kaiser Permanente Commercial	$5,473.80
Rate for Payer: MDX Hawaii PPO	$5,899.54
Rate for Payer: University Health Alliance Commercial	$3,405.92

NAIL FEMORAL GT RT 2333-0934S

Facility

$6,082.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,885.42
Max. Negotiated Rate	$5,899.54
Rate for Payer: AlohaCare Medicaid	$3,041.00
Rate for Payer: AlohaCare Medicare	$1,885.42
Rate for Payer: Cash Price	$3,649.20
Rate for Payer: Devoted Health Medicare	$2,067.88
Rate for Payer: Hawaii Medical Service Association Medicare	$1,885.42
Rate for Payer: Hawaii Western Management Group Commercial	$4,257.40
Rate for Payer: Health Management Network Commercial	$5,169.70
Rate for Payer: Humana Medicare	$1,885.42
Rate for Payer: Kaiser Permanente Commercial	$5,473.80
Rate for Payer: Kaiser Permanente Medicaid	$3,101.82
Rate for Payer: Kaiser Permanente Medicare	$1,885.42
Rate for Payer: MDX Hawaii PPO	$5,899.54
Rate for Payer: Ohana Health Plan Medicaid	$1,885.42
Rate for Payer: Ohana Health Plan Medicare	$1,885.42
Rate for Payer: UnitedHealthcare Medicare	$1,885.42
Rate for Payer: University Health Alliance Commercial	$3,405.92

NAIL FEMORAL GT RT 2333-0936S

Facility

$6,082.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,885.42
Max. Negotiated Rate	$5,899.54
Rate for Payer: AlohaCare Medicaid	$3,041.00
Rate for Payer: AlohaCare Medicare	$1,885.42
Rate for Payer: Cash Price	$3,649.20
Rate for Payer: Devoted Health Medicare	$2,067.88
Rate for Payer: Hawaii Medical Service Association Medicare	$1,885.42
Rate for Payer: Hawaii Western Management Group Commercial	$4,257.40
Rate for Payer: Health Management Network Commercial	$5,169.70
Rate for Payer: Humana Medicare	$1,885.42
Rate for Payer: Kaiser Permanente Commercial	$5,473.80
Rate for Payer: Kaiser Permanente Medicaid	$3,101.82
Rate for Payer: Kaiser Permanente Medicare	$1,885.42
Rate for Payer: MDX Hawaii PPO	$5,899.54
Rate for Payer: Ohana Health Plan Medicaid	$1,885.42
Rate for Payer: Ohana Health Plan Medicare	$1,885.42
Rate for Payer: UnitedHealthcare Medicare	$1,885.42
Rate for Payer: University Health Alliance Commercial	$3,405.92

NAIL FEMORAL GT RT 2333-0936S

Facility

$6,082.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,405.92
Max. Negotiated Rate	$5,899.54
Rate for Payer: Cash Price	$3,649.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,257.40
Rate for Payer: Health Management Network Commercial	$5,169.70
Rate for Payer: Kaiser Permanente Commercial	$5,473.80
Rate for Payer: MDX Hawaii PPO	$5,899.54
Rate for Payer: University Health Alliance Commercial	$3,405.92

NAIL FEMORAL GT RT 2333-1032S

Facility

$4,867.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,725.52
Max. Negotiated Rate	$4,720.99
Rate for Payer: Cash Price	$2,920.20
Rate for Payer: Hawaii Western Management Group Commercial	$3,406.90
Rate for Payer: Health Management Network Commercial	$4,136.95
Rate for Payer: Kaiser Permanente Commercial	$4,380.30
Rate for Payer: MDX Hawaii PPO	$4,720.99
Rate for Payer: University Health Alliance Commercial	$2,725.52

NAIL FEMORAL GT RT 2333-1032S

Facility

$4,867.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,508.77
Max. Negotiated Rate	$4,720.99
Rate for Payer: AlohaCare Medicaid	$2,433.50
Rate for Payer: AlohaCare Medicare	$1,508.77
Rate for Payer: Cash Price	$2,920.20
Rate for Payer: Devoted Health Medicare	$1,654.78
Rate for Payer: Hawaii Medical Service Association Medicare	$1,508.77
Rate for Payer: Hawaii Western Management Group Commercial	$3,406.90
Rate for Payer: Health Management Network Commercial	$4,136.95
Rate for Payer: Humana Medicare	$1,508.77
Rate for Payer: Kaiser Permanente Commercial	$4,380.30
Rate for Payer: Kaiser Permanente Medicaid	$2,482.17
Rate for Payer: Kaiser Permanente Medicare	$1,508.77
Rate for Payer: MDX Hawaii PPO	$4,720.99
Rate for Payer: Ohana Health Plan Medicaid	$1,508.77
Rate for Payer: Ohana Health Plan Medicare	$1,508.77
Rate for Payer: UnitedHealthcare Medicare	$1,508.77
Rate for Payer: University Health Alliance Commercial	$2,725.52

NAIL FEMORAL RETRO 2339-1138S

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,693.53
Max. Negotiated Rate	$5,299.11
Rate for Payer: AlohaCare Medicaid	$2,731.50
Rate for Payer: AlohaCare Medicare	$1,693.53
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Devoted Health Medicare	$1,857.42
Rate for Payer: Hawaii Medical Service Association Medicare	$1,693.53
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Humana Medicare	$1,693.53
Rate for Payer: Kaiser Permanente Commercial	$4,916.70
Rate for Payer: Kaiser Permanente Medicaid	$2,786.13
Rate for Payer: Kaiser Permanente Medicare	$1,693.53
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: Ohana Health Plan Medicaid	$1,693.53
Rate for Payer: Ohana Health Plan Medicare	$1,693.53
Rate for Payer: UnitedHealthcare Medicare	$1,693.53
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL FEMORAL RETRO 2339-1138S

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,059.28
Max. Negotiated Rate	$5,299.11
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Kaiser Permanente Commercial	$4,916.70
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL FEMORAL RETROGRADE

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,059.28
Max. Negotiated Rate	$5,299.11
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Kaiser Permanente Commercial	$4,916.70
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL FEMORAL RETROGRADE

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,693.53
Max. Negotiated Rate	$5,299.11
Rate for Payer: AlohaCare Medicaid	$2,731.50
Rate for Payer: AlohaCare Medicare	$1,693.53
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Devoted Health Medicare	$1,857.42
Rate for Payer: Hawaii Medical Service Association Medicare	$1,693.53
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Humana Medicare	$1,693.53
Rate for Payer: Kaiser Permanente Commercial	$4,916.70
Rate for Payer: Kaiser Permanente Medicaid	$2,786.13
Rate for Payer: Kaiser Permanente Medicare	$1,693.53
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: Ohana Health Plan Medicaid	$1,693.53
Rate for Payer: Ohana Health Plan Medicare	$1,693.53
Rate for Payer: UnitedHealthcare Medicare	$1,693.53
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL FEMORAL RETROGRADE 13X340

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,693.53
Max. Negotiated Rate	$5,299.11
Rate for Payer: AlohaCare Medicaid	$2,731.50
Rate for Payer: AlohaCare Medicare	$1,693.53
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Devoted Health Medicare	$1,857.42
Rate for Payer: Hawaii Medical Service Association Medicare	$1,693.53
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Humana Medicare	$1,693.53
Rate for Payer: Kaiser Permanente Commercial	$4,916.70
Rate for Payer: Kaiser Permanente Medicaid	$2,786.13
Rate for Payer: Kaiser Permanente Medicare	$1,693.53
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: Ohana Health Plan Medicaid	$1,693.53
Rate for Payer: Ohana Health Plan Medicare	$1,693.53
Rate for Payer: UnitedHealthcare Medicare	$1,693.53
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL FEMORAL RETROGRADE 13X340

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,059.28
Max. Negotiated Rate	$5,299.11
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Kaiser Permanente Commercial	$4,916.70
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL FEMOR RETRGRDE 2339-1036S

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,693.53
Max. Negotiated Rate	$5,299.11
Rate for Payer: AlohaCare Medicaid	$2,731.50
Rate for Payer: AlohaCare Medicare	$1,693.53
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Devoted Health Medicare	$1,857.42
Rate for Payer: Hawaii Medical Service Association Medicare	$1,693.53
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Humana Medicare	$1,693.53
Rate for Payer: Kaiser Permanente Commercial	$4,916.70
Rate for Payer: Kaiser Permanente Medicaid	$2,786.13
Rate for Payer: Kaiser Permanente Medicare	$1,693.53
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: Ohana Health Plan Medicaid	$1,693.53
Rate for Payer: Ohana Health Plan Medicare	$1,693.53
Rate for Payer: UnitedHealthcare Medicare	$1,693.53
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL FEMOR RETRGRDE 2339-1036S

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,059.28
Max. Negotiated Rate	$5,299.11
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Kaiser Permanente Commercial	$4,916.70
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL FEMOR RETRGRDE 2339-1136S

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,693.53
Max. Negotiated Rate	$5,299.11
Rate for Payer: AlohaCare Medicaid	$2,731.50
Rate for Payer: AlohaCare Medicare	$1,693.53
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Devoted Health Medicare	$1,857.42
Rate for Payer: Hawaii Medical Service Association Medicare	$1,693.53
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Humana Medicare	$1,693.53
Rate for Payer: Kaiser Permanente Commercial	$4,916.70
Rate for Payer: Kaiser Permanente Medicaid	$2,786.13
Rate for Payer: Kaiser Permanente Medicare	$1,693.53
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: Ohana Health Plan Medicaid	$1,693.53
Rate for Payer: Ohana Health Plan Medicare	$1,693.53
Rate for Payer: UnitedHealthcare Medicare	$1,693.53
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL FEMOR RETRGRDE 2339-1136S

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,059.28
Max. Negotiated Rate	$5,299.11
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Kaiser Permanente Commercial	$4,916.70
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL FEMUR 10X380 04.003.356S

Facility

$3,806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,179.86
Max. Negotiated Rate	$3,691.82
Rate for Payer: AlohaCare Medicaid	$1,903.00
Rate for Payer: AlohaCare Medicare	$1,179.86
Rate for Payer: Cash Price	$2,283.60
Rate for Payer: Devoted Health Medicare	$1,294.04
Rate for Payer: Hawaii Medical Service Association Medicare	$1,179.86
Rate for Payer: Hawaii Western Management Group Commercial	$2,664.20
Rate for Payer: Health Management Network Commercial	$3,235.10
Rate for Payer: Humana Medicare	$1,179.86
Rate for Payer: Kaiser Permanente Commercial	$3,425.40
Rate for Payer: Kaiser Permanente Medicaid	$1,941.06
Rate for Payer: Kaiser Permanente Medicare	$1,179.86
Rate for Payer: MDX Hawaii PPO	$3,691.82
Rate for Payer: Ohana Health Plan Medicaid	$1,179.86
Rate for Payer: Ohana Health Plan Medicare	$1,179.86
Rate for Payer: UnitedHealthcare Medicare	$1,179.86
Rate for Payer: University Health Alliance Commercial	$2,131.36

NAIL FEMUR 10X380 04.003.356S

Facility

$3,806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,131.36
Max. Negotiated Rate	$3,691.82
Rate for Payer: Cash Price	$2,283.60
Rate for Payer: Hawaii Western Management Group Commercial	$2,664.20
Rate for Payer: Health Management Network Commercial	$3,235.10
Rate for Payer: Kaiser Permanente Commercial	$3,425.40
Rate for Payer: MDX Hawaii PPO	$3,691.82
Rate for Payer: University Health Alliance Commercial	$2,131.36

Know your out-of-pocket cost for care.

All Charges