Kau Hospital

All Charges

Charge

Type

Setting

Price

OSELTAMIVIR 75 MG CAPSULE [26546]

Facility

$39.00

Service Code	NDC 64380079901
Hospital Revenue Code	250
Min. Negotiated Rate	$33.15
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$23.40
Rate for Payer: Health Management Network Commercial	$33.15
Rate for Payer: Kaiser Permanente Commercial	$35.10
Rate for Payer: MDX Hawaii PPO	$37.83

OSELTAMIVIR CAPSULES (TAMIFLU) 75 MG (TAKE HOME) [4080396]

Facility

$15.00

Service Code	NDC 00004080184
Hospital Revenue Code	253
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$14.55
Rate for Payer: Cash Price	$9.00
Rate for Payer: Health Management Network Commercial	$12.75
Rate for Payer: Kaiser Permanente Commercial	$13.50
Rate for Payer: MDX Hawaii PPO	$14.55

OSELTAMIVIR CAPSULES (TAMIFLU) 75 MG (TAKE HOME) [4080396]

Facility

$15.00

Service Code	NDC 00004080184
Hospital Revenue Code	253
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$14.55
Rate for Payer: AlohaCare Medicaid	$7.50
Rate for Payer: AlohaCare Medicare	$4.65
Rate for Payer: Cash Price	$9.00
Rate for Payer: Devoted Health Medicare	$5.10
Rate for Payer: Hawaii Medical Service Association Medicare	$4.65
Rate for Payer: Hawaii Western Management Group Commercial	$14.25
Rate for Payer: Health Management Network Commercial	$12.75
Rate for Payer: Humana Medicare	$4.65
Rate for Payer: Kaiser Permanente Commercial	$13.50
Rate for Payer: Kaiser Permanente Medicaid	$7.65
Rate for Payer: Kaiser Permanente Medicare	$4.65
Rate for Payer: MDX Hawaii PPO	$14.55
Rate for Payer: Ohana Health Plan Medicaid	$4.65
Rate for Payer: Ohana Health Plan Medicare	$4.65
Rate for Payer: UnitedHealthcare Medicare	$4.65
Rate for Payer: University Health Alliance Commercial	$10.93

OSTEOMYELITIS WITH CC

Facility

$39,013.49

Service Code	MSDRG 540
Min. Negotiated Rate	$39,013.49
Max. Negotiated Rate	$39,013.49
Rate for Payer: Hawaii Medical Service Association Commercial	$39,013.49

OSTEOMYELITIS WITH MCC

Facility

$39,013.49

Service Code	MSDRG 539
Min. Negotiated Rate	$39,013.49
Max. Negotiated Rate	$39,013.49
Rate for Payer: Hawaii Medical Service Association Commercial	$39,013.49

OSTEOMYELITIS WITHOUT CC/MCC

Facility

$39,013.49

Service Code	MSDRG 541
Min. Negotiated Rate	$39,013.49
Max. Negotiated Rate	$39,013.49
Rate for Payer: Hawaii Medical Service Association Commercial	$39,013.49

OSTEOSET BEAD KT 5ML 8400-0611

Facility

$2,446.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,369.76
Max. Negotiated Rate	$2,372.62
Rate for Payer: Cash Price	$1,467.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,712.20
Rate for Payer: Health Management Network Commercial	$2,079.10
Rate for Payer: Kaiser Permanente Commercial	$2,201.40
Rate for Payer: MDX Hawaii PPO	$2,372.62
Rate for Payer: University Health Alliance Commercial	$1,369.76

OSTEOSET BEAD KT 5ML 8400-0611

Facility

$2,446.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$758.26
Max. Negotiated Rate	$2,372.62
Rate for Payer: AlohaCare Medicaid	$1,223.00
Rate for Payer: AlohaCare Medicare	$758.26
Rate for Payer: Cash Price	$1,467.60
Rate for Payer: Devoted Health Medicare	$831.64
Rate for Payer: Hawaii Medical Service Association Medicare	$758.26
Rate for Payer: Hawaii Western Management Group Commercial	$1,712.20
Rate for Payer: Health Management Network Commercial	$2,079.10
Rate for Payer: Humana Medicare	$758.26
Rate for Payer: Kaiser Permanente Commercial	$2,201.40
Rate for Payer: Kaiser Permanente Medicaid	$1,247.46
Rate for Payer: Kaiser Permanente Medicare	$758.26
Rate for Payer: MDX Hawaii PPO	$2,372.62
Rate for Payer: Ohana Health Plan Medicaid	$758.26
Rate for Payer: Ohana Health Plan Medicare	$758.26
Rate for Payer: UnitedHealthcare Medicare	$758.26
Rate for Payer: University Health Alliance Commercial	$1,369.76

OSTEOVATION 5CC FRMLA 390-0005

Facility

$105.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$32.55
Max. Negotiated Rate	$101.85
Rate for Payer: AlohaCare Medicaid	$52.50
Rate for Payer: AlohaCare Medicare	$32.55
Rate for Payer: Cash Price	$63.00
Rate for Payer: Devoted Health Medicare	$35.70
Rate for Payer: Hawaii Medical Service Association Medicare	$32.55
Rate for Payer: Hawaii Western Management Group Commercial	$73.50
Rate for Payer: Health Management Network Commercial	$89.25
Rate for Payer: Humana Medicare	$32.55
Rate for Payer: Kaiser Permanente Commercial	$94.50
Rate for Payer: Kaiser Permanente Medicaid	$53.55
Rate for Payer: Kaiser Permanente Medicare	$32.55
Rate for Payer: MDX Hawaii PPO	$101.85
Rate for Payer: Ohana Health Plan Medicaid	$32.55
Rate for Payer: Ohana Health Plan Medicare	$32.55
Rate for Payer: UnitedHealthcare Medicare	$32.55
Rate for Payer: University Health Alliance Commercial	$58.80

OSTEOVATION 5CC FRMLA 390-0005

Facility

$105.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$58.80
Max. Negotiated Rate	$101.85
Rate for Payer: Cash Price	$63.00
Rate for Payer: Hawaii Western Management Group Commercial	$73.50
Rate for Payer: Health Management Network Commercial	$89.25
Rate for Payer: Kaiser Permanente Commercial	$94.50
Rate for Payer: MDX Hawaii PPO	$101.85
Rate for Payer: University Health Alliance Commercial	$58.80

OSTOMY CONE IRRIGATOR

Facility

$77.00

Hospital Revenue Code	272
Min. Negotiated Rate	$23.87
Max. Negotiated Rate	$74.69
Rate for Payer: AlohaCare Medicaid	$38.50
Rate for Payer: AlohaCare Medicare	$23.87
Rate for Payer: Cash Price	$46.20
Rate for Payer: Devoted Health Medicare	$26.18
Rate for Payer: Hawaii Medical Service Association Medicare	$23.87
Rate for Payer: Hawaii Western Management Group Commercial	$73.15
Rate for Payer: Health Management Network Commercial	$65.45
Rate for Payer: Humana Medicare	$23.87
Rate for Payer: Kaiser Permanente Commercial	$69.30
Rate for Payer: Kaiser Permanente Medicaid	$39.27
Rate for Payer: Kaiser Permanente Medicare	$23.87
Rate for Payer: MDX Hawaii PPO	$74.69
Rate for Payer: Ohana Health Plan Medicaid	$23.87
Rate for Payer: Ohana Health Plan Medicare	$23.87
Rate for Payer: UnitedHealthcare Medicare	$23.87
Rate for Payer: University Health Alliance Commercial	$56.13

OSTOMY CONE IRRIGATOR

Facility

$77.00

Hospital Revenue Code	272
Min. Negotiated Rate	$65.45
Max. Negotiated Rate	$74.69
Rate for Payer: Cash Price	$46.20
Rate for Payer: Health Management Network Commercial	$65.45
Rate for Payer: Kaiser Permanente Commercial	$69.30
Rate for Payer: MDX Hawaii PPO	$74.69

OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC

Facility

$10,618.50

Service Code	MSDRG 818
Min. Negotiated Rate	$10,618.50
Max. Negotiated Rate	$10,618.50
Rate for Payer: Hawaii Medical Service Association Commercial	$10,618.50

OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC

Facility

$10,618.50

Service Code	MSDRG 817
Min. Negotiated Rate	$10,618.50
Max. Negotiated Rate	$10,618.50
Rate for Payer: Hawaii Medical Service Association Commercial	$10,618.50

OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC

Facility

$10,334.07

Service Code	MSDRG 819
Min. Negotiated Rate	$10,334.07
Max. Negotiated Rate	$10,334.07
Rate for Payer: Hawaii Medical Service Association Commercial	$10,334.07

OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC

Facility

$9,314.89

Service Code	MSDRG 832
Min. Negotiated Rate	$9,314.89
Max. Negotiated Rate	$9,314.89
Rate for Payer: Hawaii Medical Service Association Commercial	$9,314.89

OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC

Facility

$9,314.89

Service Code	MSDRG 831
Min. Negotiated Rate	$9,314.89
Max. Negotiated Rate	$9,314.89
Rate for Payer: Hawaii Medical Service Association Commercial	$9,314.89

OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC

Facility

$9,172.67

Service Code	MSDRG 833
Min. Negotiated Rate	$9,172.67
Max. Negotiated Rate	$9,172.67
Rate for Payer: Hawaii Medical Service Association Commercial	$9,172.67

OTHER CARDIOTHORACIC PROCEDURES WITH MCC

Facility

$112,679.31

Service Code	MSDRG 228
Min. Negotiated Rate	$112,679.31
Max. Negotiated Rate	$112,679.31
Rate for Payer: Hawaii Medical Service Association Commercial	$112,679.31

OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC

Facility

$112,679.31

Service Code	MSDRG 229
Min. Negotiated Rate	$112,679.31
Max. Negotiated Rate	$112,679.31
Rate for Payer: Hawaii Medical Service Association Commercial	$112,679.31

OTHER CEREBROVASCULAR DISORDERS WITH CC

Facility

$26,238.11

Service Code	MSDRG 071
Min. Negotiated Rate	$26,238.11
Max. Negotiated Rate	$26,238.11
Rate for Payer: Hawaii Medical Service Association Commercial	$26,238.11

OTHER CEREBROVASCULAR DISORDERS WITH MCC

Facility

$27,968.36

Service Code	MSDRG 070
Min. Negotiated Rate	$27,968.36
Max. Negotiated Rate	$27,968.36
Rate for Payer: Hawaii Medical Service Association Commercial	$27,968.36

OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC

Facility

$16,235.87

Service Code	MSDRG 072
Min. Negotiated Rate	$16,235.87
Max. Negotiated Rate	$16,235.87
Rate for Payer: Hawaii Medical Service Association Commercial	$16,235.87

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC

Facility

$26,641.05

Service Code	MSDRG 315
Min. Negotiated Rate	$26,641.05
Max. Negotiated Rate	$26,641.05
Rate for Payer: Hawaii Medical Service Association Commercial	$26,641.05

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC

Facility

$39,724.55

Service Code	MSDRG 314
Min. Negotiated Rate	$39,724.55
Max. Negotiated Rate	$39,724.55
Rate for Payer: Hawaii Medical Service Association Commercial	$39,724.55

Know your out-of-pocket cost for care.

All Charges