Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION [7876]

Facility

IP

$42.00

Service Code	HCPCS J3411
Hospital Revenue Code	250
Min. Negotiated Rate	$35.70
Max. Negotiated Rate	$40.74
Rate for Payer: Cash Price	$25.20
Rate for Payer: Health Management Network Commercial	$35.70
Rate for Payer: Kaiser Permanente Commercial	$37.80
Rate for Payer: MDX Hawaii PPO	$40.74

THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION [7876]

Facility

OP

$42.00

Service Code	HCPCS J3411
Hospital Revenue Code	636
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$40.74
Rate for Payer: AlohaCare Medicaid	$21.00
Rate for Payer: AlohaCare Medicare	$13.02
Rate for Payer: Cash Price	$25.20
Rate for Payer: Cash Price	$25.20
Rate for Payer: Devoted Health Medicare	$14.28
Rate for Payer: Hawaii Medical Service Association ABD	$1.79
Rate for Payer: Hawaii Medical Service Association Medicare	$13.02
Rate for Payer: Hawaii Medical Service Association Non-ABD	$1.79
Rate for Payer: Hawaii Western Management Group Commercial	$39.90
Rate for Payer: Health Management Network Commercial	$35.70
Rate for Payer: Humana Medicare	$13.02
Rate for Payer: Kaiser Permanente Commercial	$37.80
Rate for Payer: Kaiser Permanente Medicaid	$21.42
Rate for Payer: Kaiser Permanente Medicare	$13.02
Rate for Payer: MDX Hawaii PPO	$40.74
Rate for Payer: Ohana Health Plan Medicaid	$13.02
Rate for Payer: Ohana Health Plan Medicare	$13.02
Rate for Payer: UnitedHealthcare Medicaid	$25.20
Rate for Payer: UnitedHealthcare Medicare	$13.02
Rate for Payer: University Health Alliance Commercial	$30.61

THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET [11538]

Facility

IP

$1.00

Service Code	NDC 93410000000
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.60
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: Kaiser Permanente Commercial	$0.90
Rate for Payer: MDX Hawaii PPO	$0.97

THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET [11538]

Facility

OP

$1.00

Service Code	NDC 93410000000
Hospital Revenue Code	637
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.97
Rate for Payer: AlohaCare Medicaid	$0.50
Rate for Payer: AlohaCare Medicare	$0.31
Rate for Payer: Cash Price	$0.60
Rate for Payer: Devoted Health Medicare	$0.34
Rate for Payer: Hawaii Medical Service Association Medicare	$0.31
Rate for Payer: Hawaii Western Management Group Commercial	$0.95
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: Humana Medicare	$0.31
Rate for Payer: Kaiser Permanente Commercial	$0.90
Rate for Payer: Kaiser Permanente Medicaid	$0.51
Rate for Payer: Kaiser Permanente Medicare	$0.31
Rate for Payer: MDX Hawaii PPO	$0.97
Rate for Payer: Ohana Health Plan Medicaid	$0.31
Rate for Payer: Ohana Health Plan Medicare	$0.31
Rate for Payer: UnitedHealthcare Medicare	$0.31
Rate for Payer: University Health Alliance Commercial	$0.73

THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET [11538]

Facility

OP

$1.00

Service Code	NDC 11661000000
Hospital Revenue Code	637
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.97
Rate for Payer: AlohaCare Medicaid	$0.50
Rate for Payer: AlohaCare Medicare	$0.31
Rate for Payer: Cash Price	$0.60
Rate for Payer: Devoted Health Medicare	$0.34
Rate for Payer: Hawaii Medical Service Association Medicare	$0.31
Rate for Payer: Hawaii Western Management Group Commercial	$0.95
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: Humana Medicare	$0.31
Rate for Payer: Kaiser Permanente Commercial	$0.90
Rate for Payer: Kaiser Permanente Medicaid	$0.51
Rate for Payer: Kaiser Permanente Medicare	$0.31
Rate for Payer: MDX Hawaii PPO	$0.97
Rate for Payer: Ohana Health Plan Medicaid	$0.31
Rate for Payer: Ohana Health Plan Medicare	$0.31
Rate for Payer: UnitedHealthcare Medicare	$0.31
Rate for Payer: University Health Alliance Commercial	$0.73

THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET [11538]

Facility

IP

$1.00

Service Code	NDC 93425000000
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.60
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: Kaiser Permanente Commercial	$0.90
Rate for Payer: MDX Hawaii PPO	$0.97

THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET [11538]

Facility

IP

$1.00

Service Code	NDC 11661000000
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.60
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: Kaiser Permanente Commercial	$0.90
Rate for Payer: MDX Hawaii PPO	$0.97

THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET [11538]

Facility

OP

$1.00

Service Code	NDC 93425000000
Hospital Revenue Code	637
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.97
Rate for Payer: AlohaCare Medicaid	$0.50
Rate for Payer: AlohaCare Medicare	$0.31
Rate for Payer: Cash Price	$0.60
Rate for Payer: Devoted Health Medicare	$0.34
Rate for Payer: Hawaii Medical Service Association Medicare	$0.31
Rate for Payer: Hawaii Western Management Group Commercial	$0.95
Rate for Payer: Health Management Network Commercial	$0.85
Rate for Payer: Humana Medicare	$0.31
Rate for Payer: Kaiser Permanente Commercial	$0.90
Rate for Payer: Kaiser Permanente Medicaid	$0.51
Rate for Payer: Kaiser Permanente Medicare	$0.31
Rate for Payer: MDX Hawaii PPO	$0.97
Rate for Payer: Ohana Health Plan Medicaid	$0.31
Rate for Payer: Ohana Health Plan Medicare	$0.31
Rate for Payer: UnitedHealthcare Medicare	$0.31
Rate for Payer: University Health Alliance Commercial	$0.73

THIGHTROPE ABS AR-1588TN-1

Facility

OP

$973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$301.63
Max. Negotiated Rate	$943.81
Rate for Payer: AlohaCare Medicaid	$486.50
Rate for Payer: AlohaCare Medicare	$301.63
Rate for Payer: Cash Price	$583.80
Rate for Payer: Devoted Health Medicare	$330.82
Rate for Payer: Hawaii Medical Service Association Medicare	$301.63
Rate for Payer: Hawaii Western Management Group Commercial	$681.10
Rate for Payer: Health Management Network Commercial	$827.05
Rate for Payer: Humana Medicare	$301.63
Rate for Payer: Kaiser Permanente Commercial	$875.70
Rate for Payer: Kaiser Permanente Medicaid	$496.23
Rate for Payer: Kaiser Permanente Medicare	$301.63
Rate for Payer: MDX Hawaii PPO	$943.81
Rate for Payer: Ohana Health Plan Medicaid	$301.63
Rate for Payer: Ohana Health Plan Medicare	$301.63
Rate for Payer: UnitedHealthcare Medicare	$301.63
Rate for Payer: University Health Alliance Commercial	$544.88

THIGHTROPE ABS AR-1588TN-1

Facility

IP

$973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$544.88
Max. Negotiated Rate	$943.81
Rate for Payer: Cash Price	$583.80
Rate for Payer: Hawaii Western Management Group Commercial	$681.10
Rate for Payer: Health Management Network Commercial	$827.05
Rate for Payer: Kaiser Permanente Commercial	$875.70
Rate for Payer: MDX Hawaii PPO	$943.81
Rate for Payer: University Health Alliance Commercial	$544.88

THORACIC ENDO TGU262610

Facility

OP

$35,872.00

Hospital Revenue Code	278
Min. Negotiated Rate	$11,120.32
Max. Negotiated Rate	$34,795.84
Rate for Payer: AlohaCare Medicaid	$17,936.00
Rate for Payer: AlohaCare Medicare	$11,120.32
Rate for Payer: Cash Price	$21,523.20
Rate for Payer: Devoted Health Medicare	$12,196.48
Rate for Payer: Hawaii Medical Service Association Medicare	$11,120.32
Rate for Payer: Hawaii Western Management Group Commercial	$25,110.40
Rate for Payer: Health Management Network Commercial	$30,491.20
Rate for Payer: Humana Medicare	$11,120.32
Rate for Payer: Kaiser Permanente Commercial	$32,284.80
Rate for Payer: Kaiser Permanente Medicaid	$18,294.72
Rate for Payer: Kaiser Permanente Medicare	$11,120.32
Rate for Payer: MDX Hawaii PPO	$34,795.84
Rate for Payer: Ohana Health Plan Medicaid	$11,120.32
Rate for Payer: Ohana Health Plan Medicare	$11,120.32
Rate for Payer: UnitedHealthcare Medicare	$11,120.32
Rate for Payer: University Health Alliance Commercial	$20,088.32

THORACIC ENDO TGU262610

Facility

IP

$35,872.00

Hospital Revenue Code	278
Min. Negotiated Rate	$20,088.32
Max. Negotiated Rate	$34,795.84
Rate for Payer: Cash Price	$21,523.20
Rate for Payer: Hawaii Western Management Group Commercial	$25,110.40
Rate for Payer: Health Management Network Commercial	$30,491.20
Rate for Payer: Kaiser Permanente Commercial	$32,284.80
Rate for Payer: MDX Hawaii PPO	$34,795.84
Rate for Payer: University Health Alliance Commercial	$20,088.32

THRD 2.4 X78 HEX 03.507.002

Facility

IP

$1,054.00

Hospital Revenue Code	272
Min. Negotiated Rate	$895.90
Max. Negotiated Rate	$1,022.38
Rate for Payer: Cash Price	$632.40
Rate for Payer: Health Management Network Commercial	$895.90
Rate for Payer: Kaiser Permanente Commercial	$948.60
Rate for Payer: MDX Hawaii PPO	$1,022.38

THRD 2.4 X78 HEX 03.507.002

Facility

OP

$1,054.00

Hospital Revenue Code	272
Min. Negotiated Rate	$326.74
Max. Negotiated Rate	$1,022.38
Rate for Payer: AlohaCare Medicaid	$527.00
Rate for Payer: AlohaCare Medicare	$326.74
Rate for Payer: Cash Price	$632.40
Rate for Payer: Devoted Health Medicare	$358.36
Rate for Payer: Hawaii Medical Service Association Medicare	$326.74
Rate for Payer: Hawaii Western Management Group Commercial	$1,001.30
Rate for Payer: Health Management Network Commercial	$895.90
Rate for Payer: Humana Medicare	$326.74
Rate for Payer: Kaiser Permanente Commercial	$948.60
Rate for Payer: Kaiser Permanente Medicaid	$537.54
Rate for Payer: Kaiser Permanente Medicare	$326.74
Rate for Payer: MDX Hawaii PPO	$1,022.38
Rate for Payer: Ohana Health Plan Medicaid	$326.74
Rate for Payer: Ohana Health Plan Medicare	$326.74
Rate for Payer: UnitedHealthcare Medicare	$326.74
Rate for Payer: University Health Alliance Commercial	$768.26

THREE-FLUTTED DRILL BIT 315.92

Facility

OP

$838.00

Hospital Revenue Code	272
Min. Negotiated Rate	$259.78
Max. Negotiated Rate	$812.86
Rate for Payer: AlohaCare Medicaid	$419.00
Rate for Payer: AlohaCare Medicare	$259.78
Rate for Payer: Cash Price	$502.80
Rate for Payer: Devoted Health Medicare	$284.92
Rate for Payer: Hawaii Medical Service Association Medicare	$259.78
Rate for Payer: Hawaii Western Management Group Commercial	$796.10
Rate for Payer: Health Management Network Commercial	$712.30
Rate for Payer: Humana Medicare	$259.78
Rate for Payer: Kaiser Permanente Commercial	$754.20
Rate for Payer: Kaiser Permanente Medicaid	$427.38
Rate for Payer: Kaiser Permanente Medicare	$259.78
Rate for Payer: MDX Hawaii PPO	$812.86
Rate for Payer: Ohana Health Plan Medicaid	$259.78
Rate for Payer: Ohana Health Plan Medicare	$259.78
Rate for Payer: UnitedHealthcare Medicare	$259.78
Rate for Payer: University Health Alliance Commercial	$610.82

THREE-FLUTTED DRILL BIT 315.92

Facility

IP

$838.00

Hospital Revenue Code	272
Min. Negotiated Rate	$712.30
Max. Negotiated Rate	$812.86
Rate for Payer: Cash Price	$502.80
Rate for Payer: Health Management Network Commercial	$712.30
Rate for Payer: Kaiser Permanente Commercial	$754.20
Rate for Payer: MDX Hawaii PPO	$812.86

THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION [89570]

Facility

IP

$155.00

Service Code	NDC 00338032401
Hospital Revenue Code	250
Min. Negotiated Rate	$131.75
Max. Negotiated Rate	$150.35
Rate for Payer: Cash Price	$93.00
Rate for Payer: Health Management Network Commercial	$131.75
Rate for Payer: Kaiser Permanente Commercial	$139.50
Rate for Payer: MDX Hawaii PPO	$150.35

THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION [89570]

Facility

IP

$155.00

Service Code	NDC 00338032201
Hospital Revenue Code	250
Min. Negotiated Rate	$131.75
Max. Negotiated Rate	$150.35
Rate for Payer: Cash Price	$93.00
Rate for Payer: Health Management Network Commercial	$131.75
Rate for Payer: Kaiser Permanente Commercial	$139.50
Rate for Payer: MDX Hawaii PPO	$150.35

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC

Facility

IP

$21,047.38

Service Code	MSDRG 626
Min. Negotiated Rate	$21,047.38
Max. Negotiated Rate	$21,047.38
Rate for Payer: Hawaii Medical Service Association Commercial	$21,047.38

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC

Facility

IP

$21,047.38

Service Code	MSDRG 625
Min. Negotiated Rate	$21,047.38
Max. Negotiated Rate	$21,047.38
Rate for Payer: Hawaii Medical Service Association Commercial	$21,047.38

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC

Facility

IP

$21,047.38

Service Code	MSDRG 627
Min. Negotiated Rate	$21,047.38
Max. Negotiated Rate	$21,047.38
Rate for Payer: Hawaii Medical Service Association Commercial	$21,047.38

THYROID (PORK) 60 MG TABLET [150728]

Facility

OP

$5.00

Service Code	NDC 42192033001
Hospital Revenue Code	637
Min. Negotiated Rate	$1.55
Max. Negotiated Rate	$4.85
Rate for Payer: AlohaCare Medicaid	$2.50
Rate for Payer: AlohaCare Medicare	$1.55
Rate for Payer: Cash Price	$3.00
Rate for Payer: Devoted Health Medicare	$1.70
Rate for Payer: Hawaii Medical Service Association Medicare	$1.55
Rate for Payer: Hawaii Western Management Group Commercial	$4.75
Rate for Payer: Health Management Network Commercial	$4.25
Rate for Payer: Humana Medicare	$1.55
Rate for Payer: Kaiser Permanente Commercial	$4.50
Rate for Payer: Kaiser Permanente Medicaid	$2.55
Rate for Payer: Kaiser Permanente Medicare	$1.55
Rate for Payer: MDX Hawaii PPO	$4.85
Rate for Payer: Ohana Health Plan Medicaid	$1.55
Rate for Payer: Ohana Health Plan Medicare	$1.55
Rate for Payer: UnitedHealthcare Medicare	$1.55
Rate for Payer: University Health Alliance Commercial	$3.64

THYROID (PORK) 60 MG TABLET [150728]

Facility

IP

$5.00

Service Code	NDC 42192033001
Hospital Revenue Code	250
Min. Negotiated Rate	$4.25
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.00
Rate for Payer: Health Management Network Commercial	$4.25
Rate for Payer: Kaiser Permanente Commercial	$4.50
Rate for Payer: MDX Hawaii PPO	$4.85

THYROTROPIN ALFA 0.9 MG INTRAMUSCULAR SOLUTION [180696]

Facility

IP

$2,927.00

Service Code	HCPCS J3240
Hospital Revenue Code	250
Min. Negotiated Rate	$2,487.95
Max. Negotiated Rate	$2,839.19
Rate for Payer: Cash Price	$1,756.20
Rate for Payer: Health Management Network Commercial	$2,487.95
Rate for Payer: Kaiser Permanente Commercial	$2,634.30
Rate for Payer: MDX Hawaii PPO	$2,839.19

THYROTROPIN ALFA 0.9 MG INTRAMUSCULAR SOLUTION [180696]

Facility

OP

$2,927.00

Service Code	HCPCS J3240
Hospital Revenue Code	636
Min. Negotiated Rate	$907.37
Max. Negotiated Rate	$2,839.19
Rate for Payer: AlohaCare Medicaid	$1,463.50
Rate for Payer: AlohaCare Medicare	$907.37
Rate for Payer: Cash Price	$1,756.20
Rate for Payer: Cash Price	$1,756.20
Rate for Payer: Devoted Health Medicare	$995.18
Rate for Payer: Hawaii Medical Service Association ABD	$2,113.24
Rate for Payer: Hawaii Medical Service Association Commercial	$2,656.68
Rate for Payer: Hawaii Medical Service Association Medicare	$907.37
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,113.24
Rate for Payer: Hawaii Western Management Group Commercial	$2,780.65
Rate for Payer: Health Management Network Commercial	$2,487.95
Rate for Payer: Humana Medicare	$907.37
Rate for Payer: Kaiser Permanente Commercial	$2,634.30
Rate for Payer: Kaiser Permanente Medicaid	$1,492.77
Rate for Payer: Kaiser Permanente Medicare	$907.37
Rate for Payer: MDX Hawaii PPO	$2,839.19
Rate for Payer: Ohana Health Plan Medicaid	$907.37
Rate for Payer: Ohana Health Plan Medicare	$907.37
Rate for Payer: UnitedHealthcare Medicaid	$1,756.20
Rate for Payer: UnitedHealthcare Medicare	$907.37
Rate for Payer: University Health Alliance Commercial	$2,133.49

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