Kau Hospital

All Charges

Charge

Type

Setting

Price

PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION [40475]

Facility

$2,397.00

Service Code	HCPCS J9264
Hospital Revenue Code	636
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$2,325.09
Rate for Payer: AlohaCare Medicaid	$1,198.50
Rate for Payer: AlohaCare Medicaid	$1,233.50
Rate for Payer: AlohaCare Medicare	$764.77
Rate for Payer: AlohaCare Medicare	$743.07
Rate for Payer: Cash Price	$1,438.20
Rate for Payer: Cash Price	$1,438.20
Rate for Payer: Cash Price	$1,480.20
Rate for Payer: Cash Price	$1,480.20
Rate for Payer: Devoted Health Medicare	$814.98
Rate for Payer: Devoted Health Medicare	$838.78
Rate for Payer: Hawaii Medical Service Association ABD	$12.12
Rate for Payer: Hawaii Medical Service Association ABD	$12.12
Rate for Payer: Hawaii Medical Service Association Commercial	$7.53
Rate for Payer: Hawaii Medical Service Association Commercial	$7.53
Rate for Payer: Hawaii Medical Service Association Medicare	$743.07
Rate for Payer: Hawaii Medical Service Association Medicare	$764.77
Rate for Payer: Hawaii Medical Service Association Non-ABD	$12.12
Rate for Payer: Hawaii Medical Service Association Non-ABD	$12.12
Rate for Payer: Hawaii Western Management Group Commercial	$2,277.15
Rate for Payer: Hawaii Western Management Group Commercial	$2,343.65
Rate for Payer: Health Management Network Commercial	$2,037.45
Rate for Payer: Health Management Network Commercial	$2,096.95
Rate for Payer: Humana Medicare	$743.07
Rate for Payer: Humana Medicare	$764.77
Rate for Payer: Kaiser Permanente Commercial	$2,157.30
Rate for Payer: Kaiser Permanente Commercial	$2,220.30
Rate for Payer: Kaiser Permanente Medicaid	$1,222.47
Rate for Payer: Kaiser Permanente Medicaid	$1,258.17
Rate for Payer: Kaiser Permanente Medicare	$743.07
Rate for Payer: Kaiser Permanente Medicare	$764.77
Rate for Payer: MDX Hawaii PPO	$2,325.09
Rate for Payer: MDX Hawaii PPO	$2,392.99
Rate for Payer: Ohana Health Plan Medicaid	$764.77
Rate for Payer: Ohana Health Plan Medicaid	$743.07
Rate for Payer: Ohana Health Plan Medicare	$743.07
Rate for Payer: Ohana Health Plan Medicare	$764.77
Rate for Payer: UnitedHealthcare Medicaid	$1,438.20
Rate for Payer: UnitedHealthcare Medicaid	$1,480.20
Rate for Payer: UnitedHealthcare Medicare	$764.77
Rate for Payer: UnitedHealthcare Medicare	$743.07
Rate for Payer: University Health Alliance Commercial	$1,747.17
Rate for Payer: University Health Alliance Commercial	$1,798.20

PADDING CAST MOLESKIN 683640

Facility

$215.00

Hospital Revenue Code	272
Min. Negotiated Rate	$182.75
Max. Negotiated Rate	$208.55
Rate for Payer: Cash Price	$129.00
Rate for Payer: Health Management Network Commercial	$182.75
Rate for Payer: Kaiser Permanente Commercial	$193.50
Rate for Payer: MDX Hawaii PPO	$208.55

PADDING CAST MOLESKIN 683640

Facility

$215.00

Hospital Revenue Code	272
Min. Negotiated Rate	$66.65
Max. Negotiated Rate	$208.55
Rate for Payer: AlohaCare Medicaid	$107.50
Rate for Payer: AlohaCare Medicare	$66.65
Rate for Payer: Cash Price	$129.00
Rate for Payer: Devoted Health Medicare	$73.10
Rate for Payer: Hawaii Medical Service Association Medicare	$66.65
Rate for Payer: Hawaii Western Management Group Commercial	$204.25
Rate for Payer: Health Management Network Commercial	$182.75
Rate for Payer: Humana Medicare	$66.65
Rate for Payer: Kaiser Permanente Commercial	$193.50
Rate for Payer: Kaiser Permanente Medicaid	$109.65
Rate for Payer: Kaiser Permanente Medicare	$66.65
Rate for Payer: MDX Hawaii PPO	$208.55
Rate for Payer: Ohana Health Plan Medicaid	$66.65
Rate for Payer: Ohana Health Plan Medicare	$66.65
Rate for Payer: UnitedHealthcare Medicare	$66.65
Rate for Payer: University Health Alliance Commercial	$156.71

PADS PRESSURE IMP 907-GP-10

Facility

$239.00

Hospital Revenue Code	272
Min. Negotiated Rate	$203.15
Max. Negotiated Rate	$231.83
Rate for Payer: Cash Price	$143.40
Rate for Payer: Health Management Network Commercial	$203.15
Rate for Payer: Kaiser Permanente Commercial	$215.10
Rate for Payer: MDX Hawaii PPO	$231.83

PADS PRESSURE IMP 907-GP-10

Facility

$239.00

Hospital Revenue Code	272
Min. Negotiated Rate	$74.09
Max. Negotiated Rate	$231.83
Rate for Payer: AlohaCare Medicaid	$119.50
Rate for Payer: AlohaCare Medicare	$74.09
Rate for Payer: Cash Price	$143.40
Rate for Payer: Devoted Health Medicare	$81.26
Rate for Payer: Hawaii Medical Service Association Medicare	$74.09
Rate for Payer: Hawaii Western Management Group Commercial	$227.05
Rate for Payer: Health Management Network Commercial	$203.15
Rate for Payer: Humana Medicare	$74.09
Rate for Payer: Kaiser Permanente Commercial	$215.10
Rate for Payer: Kaiser Permanente Medicaid	$121.89
Rate for Payer: Kaiser Permanente Medicare	$74.09
Rate for Payer: MDX Hawaii PPO	$231.83
Rate for Payer: Ohana Health Plan Medicaid	$74.09
Rate for Payer: Ohana Health Plan Medicare	$74.09
Rate for Payer: UnitedHealthcare Medicare	$74.09
Rate for Payer: University Health Alliance Commercial	$174.21

PALACOS BONE CEMENT R+G

Facility

$1,033.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$320.23
Max. Negotiated Rate	$1,002.01
Rate for Payer: AlohaCare Medicaid	$516.50
Rate for Payer: AlohaCare Medicare	$320.23
Rate for Payer: Cash Price	$619.80
Rate for Payer: Devoted Health Medicare	$351.22
Rate for Payer: Hawaii Medical Service Association Medicare	$320.23
Rate for Payer: Hawaii Western Management Group Commercial	$723.10
Rate for Payer: Health Management Network Commercial	$878.05
Rate for Payer: Humana Medicare	$320.23
Rate for Payer: Kaiser Permanente Commercial	$929.70
Rate for Payer: Kaiser Permanente Medicaid	$526.83
Rate for Payer: Kaiser Permanente Medicare	$320.23
Rate for Payer: MDX Hawaii PPO	$1,002.01
Rate for Payer: Ohana Health Plan Medicaid	$320.23
Rate for Payer: Ohana Health Plan Medicare	$320.23
Rate for Payer: UnitedHealthcare Medicare	$320.23
Rate for Payer: University Health Alliance Commercial	$578.48

PALACOS BONE CEMENT R+G

Facility

$1,033.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$578.48
Max. Negotiated Rate	$1,002.01
Rate for Payer: Cash Price	$619.80
Rate for Payer: Hawaii Western Management Group Commercial	$723.10
Rate for Payer: Health Management Network Commercial	$878.05
Rate for Payer: Kaiser Permanente Commercial	$929.70
Rate for Payer: MDX Hawaii PPO	$1,002.01
Rate for Payer: University Health Alliance Commercial	$578.48

PALINDROME CATH

Facility

$1,470.00

Service Code	HCPCS C1750
Hospital Revenue Code	272
Min. Negotiated Rate	$1,249.50
Max. Negotiated Rate	$1,425.90
Rate for Payer: Cash Price	$882.00
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: Kaiser Permanente Commercial	$1,323.00
Rate for Payer: MDX Hawaii PPO	$1,425.90

PALINDROME CATH

Facility

$1,470.00

Service Code	HCPCS C1750
Hospital Revenue Code	272
Min. Negotiated Rate	$455.70
Max. Negotiated Rate	$1,425.90
Rate for Payer: AlohaCare Medicaid	$735.00
Rate for Payer: AlohaCare Medicare	$455.70
Rate for Payer: Cash Price	$882.00
Rate for Payer: Devoted Health Medicare	$499.80
Rate for Payer: Hawaii Medical Service Association Medicare	$455.70
Rate for Payer: Hawaii Western Management Group Commercial	$1,396.50
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: Humana Medicare	$455.70
Rate for Payer: Kaiser Permanente Commercial	$1,323.00
Rate for Payer: Kaiser Permanente Medicaid	$749.70
Rate for Payer: Kaiser Permanente Medicare	$455.70
Rate for Payer: MDX Hawaii PPO	$1,425.90
Rate for Payer: Ohana Health Plan Medicaid	$455.70
Rate for Payer: Ohana Health Plan Medicare	$455.70
Rate for Payer: UnitedHealthcare Medicare	$455.70
Rate for Payer: University Health Alliance Commercial	$1,071.48

PALINDROME CATH 8888145018

Facility

$1,753.00

Service Code	HCPCS C1750
Hospital Revenue Code	272
Min. Negotiated Rate	$1,490.05
Max. Negotiated Rate	$1,700.41
Rate for Payer: Cash Price	$1,051.80
Rate for Payer: Health Management Network Commercial	$1,490.05
Rate for Payer: Kaiser Permanente Commercial	$1,577.70
Rate for Payer: MDX Hawaii PPO	$1,700.41

PALINDROME CATH 8888145018

Facility

$1,753.00

Service Code	HCPCS C1750
Hospital Revenue Code	272
Min. Negotiated Rate	$543.43
Max. Negotiated Rate	$1,700.41
Rate for Payer: AlohaCare Medicaid	$876.50
Rate for Payer: AlohaCare Medicare	$543.43
Rate for Payer: Cash Price	$1,051.80
Rate for Payer: Devoted Health Medicare	$596.02
Rate for Payer: Hawaii Medical Service Association Medicare	$543.43
Rate for Payer: Hawaii Western Management Group Commercial	$1,665.35
Rate for Payer: Health Management Network Commercial	$1,490.05
Rate for Payer: Humana Medicare	$543.43
Rate for Payer: Kaiser Permanente Commercial	$1,577.70
Rate for Payer: Kaiser Permanente Medicaid	$894.03
Rate for Payer: Kaiser Permanente Medicare	$543.43
Rate for Payer: MDX Hawaii PPO	$1,700.41
Rate for Payer: Ohana Health Plan Medicaid	$543.43
Rate for Payer: Ohana Health Plan Medicare	$543.43
Rate for Payer: UnitedHealthcare Medicare	$543.43
Rate for Payer: University Health Alliance Commercial	$1,277.76

PALINDROME DIALY CATH 14.5 L

Facility

$1,470.00

Service Code	HCPCS C1750
Hospital Revenue Code	272
Min. Negotiated Rate	$1,249.50
Max. Negotiated Rate	$1,425.90
Rate for Payer: Cash Price	$882.00
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: Kaiser Permanente Commercial	$1,323.00
Rate for Payer: MDX Hawaii PPO	$1,425.90

PALINDROME DIALY CATH 14.5 L

Facility

$1,470.00

Service Code	HCPCS C1750
Hospital Revenue Code	272
Min. Negotiated Rate	$455.70
Max. Negotiated Rate	$1,425.90
Rate for Payer: AlohaCare Medicaid	$735.00
Rate for Payer: AlohaCare Medicare	$455.70
Rate for Payer: Cash Price	$882.00
Rate for Payer: Devoted Health Medicare	$499.80
Rate for Payer: Hawaii Medical Service Association Medicare	$455.70
Rate for Payer: Hawaii Western Management Group Commercial	$1,396.50
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: Humana Medicare	$455.70
Rate for Payer: Kaiser Permanente Commercial	$1,323.00
Rate for Payer: Kaiser Permanente Medicaid	$749.70
Rate for Payer: Kaiser Permanente Medicare	$455.70
Rate for Payer: MDX Hawaii PPO	$1,425.90
Rate for Payer: Ohana Health Plan Medicaid	$455.70
Rate for Payer: Ohana Health Plan Medicare	$455.70
Rate for Payer: UnitedHealthcare Medicare	$455.70
Rate for Payer: University Health Alliance Commercial	$1,071.48

PALINDROME SPORT 8888119368P

Facility

$1,470.00

Service Code	HCPCS C1750
Hospital Revenue Code	272
Min. Negotiated Rate	$455.70
Max. Negotiated Rate	$1,425.90
Rate for Payer: AlohaCare Medicaid	$735.00
Rate for Payer: AlohaCare Medicare	$455.70
Rate for Payer: Cash Price	$882.00
Rate for Payer: Devoted Health Medicare	$499.80
Rate for Payer: Hawaii Medical Service Association Medicare	$455.70
Rate for Payer: Hawaii Western Management Group Commercial	$1,396.50
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: Humana Medicare	$455.70
Rate for Payer: Kaiser Permanente Commercial	$1,323.00
Rate for Payer: Kaiser Permanente Medicaid	$749.70
Rate for Payer: Kaiser Permanente Medicare	$455.70
Rate for Payer: MDX Hawaii PPO	$1,425.90
Rate for Payer: Ohana Health Plan Medicaid	$455.70
Rate for Payer: Ohana Health Plan Medicare	$455.70
Rate for Payer: UnitedHealthcare Medicare	$455.70
Rate for Payer: University Health Alliance Commercial	$1,071.48

PALINDROME SPORT 8888119368P

Facility

$1,470.00

Service Code	HCPCS C1750
Hospital Revenue Code	272
Min. Negotiated Rate	$1,249.50
Max. Negotiated Rate	$1,425.90
Rate for Payer: Cash Price	$882.00
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: Kaiser Permanente Commercial	$1,323.00
Rate for Payer: MDX Hawaii PPO	$1,425.90

PALINDROME SPORT KIT

Facility

$1,470.00

Service Code	HCPCS C1750
Hospital Revenue Code	272
Min. Negotiated Rate	$455.70
Max. Negotiated Rate	$1,425.90
Rate for Payer: AlohaCare Medicaid	$735.00
Rate for Payer: AlohaCare Medicare	$455.70
Rate for Payer: Cash Price	$882.00
Rate for Payer: Devoted Health Medicare	$499.80
Rate for Payer: Hawaii Medical Service Association Medicare	$455.70
Rate for Payer: Hawaii Western Management Group Commercial	$1,396.50
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: Humana Medicare	$455.70
Rate for Payer: Kaiser Permanente Commercial	$1,323.00
Rate for Payer: Kaiser Permanente Medicaid	$749.70
Rate for Payer: Kaiser Permanente Medicare	$455.70
Rate for Payer: MDX Hawaii PPO	$1,425.90
Rate for Payer: Ohana Health Plan Medicaid	$455.70
Rate for Payer: Ohana Health Plan Medicare	$455.70
Rate for Payer: UnitedHealthcare Medicare	$455.70
Rate for Payer: University Health Alliance Commercial	$1,071.48

PALINDROME SPORT KIT

Facility

$1,470.00

Service Code	HCPCS C1750
Hospital Revenue Code	272
Min. Negotiated Rate	$1,249.50
Max. Negotiated Rate	$1,425.90
Rate for Payer: Cash Price	$882.00
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: Kaiser Permanente Commercial	$1,323.00
Rate for Payer: MDX Hawaii PPO	$1,425.90

PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR [78064]

Facility

$77.00

Service Code	NDC 27808022301
Hospital Revenue Code	250
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

PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR [78064]

Facility

$77.00

Service Code	NDC 27808022301
Hospital Revenue Code	637
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

PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR [78065]

Facility

$77.00

Service Code	NDC 65162028203
Hospital Revenue Code	637
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

PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR [78065]

Facility

$77.00

Service Code	NDC 65162028203
Hospital Revenue Code	250
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

PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR [78065]

Facility

$77.00

Service Code	NDC 27808022401
Hospital Revenue Code	637
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

PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR [78065]

Facility

$77.00

Service Code	NDC 27808022401
Hospital Revenue Code	250
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

PALIPERIDONE PALMITATE 117 MG/0.75 ML INTRAMUSCULAR SYRINGE [166236]

Facility

$2,642.00

Service Code	HCPCS J2426
Hospital Revenue Code	636
Min. Negotiated Rate	$15.08
Max. Negotiated Rate	$2,562.74
Rate for Payer: AlohaCare Medicaid	$1,321.00
Rate for Payer: AlohaCare Medicare	$819.02
Rate for Payer: Cash Price	$1,585.20
Rate for Payer: Cash Price	$1,585.20
Rate for Payer: Devoted Health Medicare	$898.28
Rate for Payer: Hawaii Medical Service Association ABD	$15.08
Rate for Payer: Hawaii Medical Service Association Commercial	$18.85
Rate for Payer: Hawaii Medical Service Association Medicare	$819.02
Rate for Payer: Hawaii Medical Service Association Non-ABD	$15.08
Rate for Payer: Hawaii Western Management Group Commercial	$2,509.90
Rate for Payer: Health Management Network Commercial	$2,245.70
Rate for Payer: Humana Medicare	$819.02
Rate for Payer: Kaiser Permanente Commercial	$2,377.80
Rate for Payer: Kaiser Permanente Medicaid	$1,347.42
Rate for Payer: Kaiser Permanente Medicare	$819.02
Rate for Payer: MDX Hawaii PPO	$2,562.74
Rate for Payer: Ohana Health Plan Medicaid	$819.02
Rate for Payer: Ohana Health Plan Medicare	$819.02
Rate for Payer: UnitedHealthcare Medicaid	$1,585.20
Rate for Payer: UnitedHealthcare Medicare	$819.02
Rate for Payer: University Health Alliance Commercial	$1,925.75

PALIPERIDONE PALMITATE 117 MG/0.75 ML INTRAMUSCULAR SYRINGE [166236]

Facility

$2,642.00

Service Code	HCPCS J2426
Hospital Revenue Code	250
Min. Negotiated Rate	$2,245.70
Max. Negotiated Rate	$2,562.74
Rate for Payer: Cash Price	$1,585.20
Rate for Payer: Health Management Network Commercial	$2,245.70
Rate for Payer: Kaiser Permanente Commercial	$2,377.80
Rate for Payer: MDX Hawaii PPO	$2,562.74

Know your out-of-pocket cost for care.

All Charges