Kau Hospital

All Charges

Charge

Type

Setting

Price

PERSONA FEM CMT CCR NRW SZ2 L

Facility

$15,814.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$4,902.34
Max. Negotiated Rate	$15,339.58
Rate for Payer: AlohaCare Medicaid	$7,907.00
Rate for Payer: AlohaCare Medicare	$4,902.34
Rate for Payer: Cash Price	$9,488.40
Rate for Payer: Devoted Health Medicare	$5,376.76
Rate for Payer: Hawaii Medical Service Association Medicare	$4,902.34
Rate for Payer: Hawaii Western Management Group Commercial	$11,069.80
Rate for Payer: Health Management Network Commercial	$13,441.90
Rate for Payer: Humana Medicare	$4,902.34
Rate for Payer: Kaiser Permanente Commercial	$14,232.60
Rate for Payer: Kaiser Permanente Medicaid	$8,065.14
Rate for Payer: Kaiser Permanente Medicare	$4,902.34
Rate for Payer: MDX Hawaii PPO	$15,339.58
Rate for Payer: Ohana Health Plan Medicaid	$4,902.34
Rate for Payer: Ohana Health Plan Medicare	$4,902.34
Rate for Payer: UnitedHealthcare Medicare	$4,902.34
Rate for Payer: University Health Alliance Commercial	$8,855.84

PERSONA FEM CMT CCR NRW SZ2 L

Facility

$15,814.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$8,855.84
Max. Negotiated Rate	$15,339.58
Rate for Payer: Cash Price	$9,488.40
Rate for Payer: Hawaii Western Management Group Commercial	$11,069.80
Rate for Payer: Health Management Network Commercial	$13,441.90
Rate for Payer: Kaiser Permanente Commercial	$14,232.60
Rate for Payer: MDX Hawaii PPO	$15,339.58
Rate for Payer: University Health Alliance Commercial	$8,855.84

PERSONA FEM CMT CCR NRW SZ2 R

Facility

$15,814.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$8,855.84
Max. Negotiated Rate	$15,339.58
Rate for Payer: Cash Price	$9,488.40
Rate for Payer: Hawaii Western Management Group Commercial	$11,069.80
Rate for Payer: Health Management Network Commercial	$13,441.90
Rate for Payer: Kaiser Permanente Commercial	$14,232.60
Rate for Payer: MDX Hawaii PPO	$15,339.58
Rate for Payer: University Health Alliance Commercial	$8,855.84

PERSONA FEM CMT CCR NRW SZ2 R

Facility

$15,814.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$4,902.34
Max. Negotiated Rate	$15,339.58
Rate for Payer: AlohaCare Medicaid	$7,907.00
Rate for Payer: AlohaCare Medicare	$4,902.34
Rate for Payer: Cash Price	$9,488.40
Rate for Payer: Devoted Health Medicare	$5,376.76
Rate for Payer: Hawaii Medical Service Association Medicare	$4,902.34
Rate for Payer: Hawaii Western Management Group Commercial	$11,069.80
Rate for Payer: Health Management Network Commercial	$13,441.90
Rate for Payer: Humana Medicare	$4,902.34
Rate for Payer: Kaiser Permanente Commercial	$14,232.60
Rate for Payer: Kaiser Permanente Medicaid	$8,065.14
Rate for Payer: Kaiser Permanente Medicare	$4,902.34
Rate for Payer: MDX Hawaii PPO	$15,339.58
Rate for Payer: Ohana Health Plan Medicaid	$4,902.34
Rate for Payer: Ohana Health Plan Medicare	$4,902.34
Rate for Payer: UnitedHealthcare Medicare	$4,902.34
Rate for Payer: University Health Alliance Commercial	$8,855.84

PERSONA FEM CMT CCR NRW SZ3 L

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: AlohaCare Medicaid	$2,700.00
Rate for Payer: AlohaCare Medicare	$1,674.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Devoted Health Medicare	$1,836.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,674.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Humana Medicare	$1,674.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: Kaiser Permanente Medicaid	$2,754.00
Rate for Payer: Kaiser Permanente Medicare	$1,674.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: Ohana Health Plan Medicaid	$1,674.00
Rate for Payer: Ohana Health Plan Medicare	$1,674.00
Rate for Payer: UnitedHealthcare Medicare	$1,674.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ3 L

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$3,024.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ3 R

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$3,024.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ3 R

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: AlohaCare Medicaid	$2,700.00
Rate for Payer: AlohaCare Medicare	$1,674.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Devoted Health Medicare	$1,836.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,674.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Humana Medicare	$1,674.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: Kaiser Permanente Medicaid	$2,754.00
Rate for Payer: Kaiser Permanente Medicare	$1,674.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: Ohana Health Plan Medicaid	$1,674.00
Rate for Payer: Ohana Health Plan Medicare	$1,674.00
Rate for Payer: UnitedHealthcare Medicare	$1,674.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ4 L

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: AlohaCare Medicaid	$2,700.00
Rate for Payer: AlohaCare Medicare	$1,674.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Devoted Health Medicare	$1,836.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,674.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Humana Medicare	$1,674.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: Kaiser Permanente Medicaid	$2,754.00
Rate for Payer: Kaiser Permanente Medicare	$1,674.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: Ohana Health Plan Medicaid	$1,674.00
Rate for Payer: Ohana Health Plan Medicare	$1,674.00
Rate for Payer: UnitedHealthcare Medicare	$1,674.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ4 L

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$3,024.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ4 R

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: AlohaCare Medicaid	$2,700.00
Rate for Payer: AlohaCare Medicare	$1,674.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Devoted Health Medicare	$1,836.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,674.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Humana Medicare	$1,674.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: Kaiser Permanente Medicaid	$2,754.00
Rate for Payer: Kaiser Permanente Medicare	$1,674.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: Ohana Health Plan Medicaid	$1,674.00
Rate for Payer: Ohana Health Plan Medicare	$1,674.00
Rate for Payer: UnitedHealthcare Medicare	$1,674.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ4 R

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$3,024.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ5 L

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: AlohaCare Medicaid	$2,700.00
Rate for Payer: AlohaCare Medicare	$1,674.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Devoted Health Medicare	$1,836.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,674.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Humana Medicare	$1,674.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: Kaiser Permanente Medicaid	$2,754.00
Rate for Payer: Kaiser Permanente Medicare	$1,674.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: Ohana Health Plan Medicaid	$1,674.00
Rate for Payer: Ohana Health Plan Medicare	$1,674.00
Rate for Payer: UnitedHealthcare Medicare	$1,674.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ5 L

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$3,024.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ5 R

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$3,024.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ5 R

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: AlohaCare Medicaid	$2,700.00
Rate for Payer: AlohaCare Medicare	$1,674.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Devoted Health Medicare	$1,836.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,674.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Humana Medicare	$1,674.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: Kaiser Permanente Medicaid	$2,754.00
Rate for Payer: Kaiser Permanente Medicare	$1,674.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: Ohana Health Plan Medicaid	$1,674.00
Rate for Payer: Ohana Health Plan Medicare	$1,674.00
Rate for Payer: UnitedHealthcare Medicare	$1,674.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ6 L

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$3,024.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ6 L

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: AlohaCare Medicaid	$2,700.00
Rate for Payer: AlohaCare Medicare	$1,674.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Devoted Health Medicare	$1,836.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,674.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Humana Medicare	$1,674.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: Kaiser Permanente Medicaid	$2,754.00
Rate for Payer: Kaiser Permanente Medicare	$1,674.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: Ohana Health Plan Medicaid	$1,674.00
Rate for Payer: Ohana Health Plan Medicare	$1,674.00
Rate for Payer: UnitedHealthcare Medicare	$1,674.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ6 R

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$3,024.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ6 R

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: AlohaCare Medicaid	$2,700.00
Rate for Payer: AlohaCare Medicare	$1,674.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Devoted Health Medicare	$1,836.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,674.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Humana Medicare	$1,674.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: Kaiser Permanente Medicaid	$2,754.00
Rate for Payer: Kaiser Permanente Medicare	$1,674.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: Ohana Health Plan Medicaid	$1,674.00
Rate for Payer: Ohana Health Plan Medicare	$1,674.00
Rate for Payer: UnitedHealthcare Medicare	$1,674.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ7 L

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$3,024.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ7 L

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: AlohaCare Medicaid	$2,700.00
Rate for Payer: AlohaCare Medicare	$1,674.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Devoted Health Medicare	$1,836.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,674.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Humana Medicare	$1,674.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: Kaiser Permanente Medicaid	$2,754.00
Rate for Payer: Kaiser Permanente Medicare	$1,674.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: Ohana Health Plan Medicaid	$1,674.00
Rate for Payer: Ohana Health Plan Medicare	$1,674.00
Rate for Payer: UnitedHealthcare Medicare	$1,674.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ7 R

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: AlohaCare Medicaid	$2,700.00
Rate for Payer: AlohaCare Medicare	$1,674.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Devoted Health Medicare	$1,836.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,674.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Humana Medicare	$1,674.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: Kaiser Permanente Medicaid	$2,754.00
Rate for Payer: Kaiser Permanente Medicare	$1,674.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: Ohana Health Plan Medicaid	$1,674.00
Rate for Payer: Ohana Health Plan Medicare	$1,674.00
Rate for Payer: UnitedHealthcare Medicare	$1,674.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ7 R

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$3,024.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

PERSONA FEM CMT CCR NRW SZ8 L

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,238.00
Rate for Payer: AlohaCare Medicaid	$2,700.00
Rate for Payer: AlohaCare Medicare	$1,674.00
Rate for Payer: Cash Price	$3,240.00
Rate for Payer: Devoted Health Medicare	$1,836.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,674.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,780.00
Rate for Payer: Health Management Network Commercial	$4,590.00
Rate for Payer: Humana Medicare	$1,674.00
Rate for Payer: Kaiser Permanente Commercial	$4,860.00
Rate for Payer: Kaiser Permanente Medicaid	$2,754.00
Rate for Payer: Kaiser Permanente Medicare	$1,674.00
Rate for Payer: MDX Hawaii PPO	$5,238.00
Rate for Payer: Ohana Health Plan Medicaid	$1,674.00
Rate for Payer: Ohana Health Plan Medicare	$1,674.00
Rate for Payer: UnitedHealthcare Medicare	$1,674.00
Rate for Payer: University Health Alliance Commercial	$3,024.00

Know your out-of-pocket cost for care.

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