Kau Hospital

All Charges

Charge

Type

Setting

Price

TRANSCAROTID 8X40 SR-0840-CS

Facility

$5,400.00

Service Code	HCPCS C1876
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

TRANSCAROTID 9X40 SR-0940-CS

Facility

$5,400.00

Service Code	HCPCS C1876
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

TRANSCAROTID 9X40 SR-0940-CS

Facility

$5,400.00

Service Code	HCPCS C1876
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

TRANSCAROTID SYS SR-200-NPS

Facility

$7,500.00

Service Code	HCPCS C1884
Hospital Revenue Code	272
Min. Negotiated Rate	$2,325.00
Max. Negotiated Rate	$7,275.00
Rate for Payer: AlohaCare Medicaid	$3,750.00
Rate for Payer: AlohaCare Medicare	$2,325.00
Rate for Payer: Cash Price	$4,500.00
Rate for Payer: Devoted Health Medicare	$2,550.00
Rate for Payer: Hawaii Medical Service Association Medicare	$2,325.00
Rate for Payer: Hawaii Western Management Group Commercial	$7,125.00
Rate for Payer: Health Management Network Commercial	$6,375.00
Rate for Payer: Humana Medicare	$2,325.00
Rate for Payer: Kaiser Permanente Commercial	$6,750.00
Rate for Payer: Kaiser Permanente Medicaid	$3,825.00
Rate for Payer: Kaiser Permanente Medicare	$2,325.00
Rate for Payer: MDX Hawaii PPO	$7,275.00
Rate for Payer: Ohana Health Plan Medicaid	$2,325.00
Rate for Payer: Ohana Health Plan Medicare	$2,325.00
Rate for Payer: UnitedHealthcare Medicare	$2,325.00
Rate for Payer: University Health Alliance Commercial	$5,466.75

TRANSCAROTID SYS SR-200-NPS

Facility

$7,500.00

Service Code	HCPCS C1884
Hospital Revenue Code	272
Min. Negotiated Rate	$6,375.00
Max. Negotiated Rate	$7,275.00
Rate for Payer: Cash Price	$4,500.00
Rate for Payer: Health Management Network Commercial	$6,375.00
Rate for Payer: Kaiser Permanente Commercial	$6,750.00
Rate for Payer: MDX Hawaii PPO	$7,275.00

TRANSFIXATN PIN 6X225MM 294.50

Facility

$641.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$358.96
Max. Negotiated Rate	$621.77
Rate for Payer: Cash Price	$384.60
Rate for Payer: Hawaii Western Management Group Commercial	$448.70
Rate for Payer: Health Management Network Commercial	$544.85
Rate for Payer: Kaiser Permanente Commercial	$576.90
Rate for Payer: MDX Hawaii PPO	$621.77
Rate for Payer: University Health Alliance Commercial	$358.96

TRANSFIXATN PIN 6X225MM 294.50

Facility

$641.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$198.71
Max. Negotiated Rate	$621.77
Rate for Payer: AlohaCare Medicaid	$320.50
Rate for Payer: AlohaCare Medicare	$198.71
Rate for Payer: Cash Price	$384.60
Rate for Payer: Devoted Health Medicare	$217.94
Rate for Payer: Hawaii Medical Service Association Medicare	$198.71
Rate for Payer: Hawaii Western Management Group Commercial	$448.70
Rate for Payer: Health Management Network Commercial	$544.85
Rate for Payer: Humana Medicare	$198.71
Rate for Payer: Kaiser Permanente Commercial	$576.90
Rate for Payer: Kaiser Permanente Medicaid	$326.91
Rate for Payer: Kaiser Permanente Medicare	$198.71
Rate for Payer: MDX Hawaii PPO	$621.77
Rate for Payer: Ohana Health Plan Medicaid	$198.71
Rate for Payer: Ohana Health Plan Medicare	$198.71
Rate for Payer: UnitedHealthcare Medicare	$198.71
Rate for Payer: University Health Alliance Commercial	$358.96

TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC

Facility

$17,468.37

Service Code	MSDRG 069
Min. Negotiated Rate	$17,468.37
Max. Negotiated Rate	$17,468.37
Rate for Payer: Hawaii Medical Service Association Commercial	$17,468.37

TRANSPEC SPECIMEN DEVICE

Facility

$249.00

Hospital Revenue Code	272
Min. Negotiated Rate	$77.19
Max. Negotiated Rate	$241.53
Rate for Payer: AlohaCare Medicaid	$124.50
Rate for Payer: AlohaCare Medicare	$77.19
Rate for Payer: Cash Price	$149.40
Rate for Payer: Devoted Health Medicare	$84.66
Rate for Payer: Hawaii Medical Service Association Medicare	$77.19
Rate for Payer: Hawaii Western Management Group Commercial	$236.55
Rate for Payer: Health Management Network Commercial	$211.65
Rate for Payer: Humana Medicare	$77.19
Rate for Payer: Kaiser Permanente Commercial	$224.10
Rate for Payer: Kaiser Permanente Medicaid	$126.99
Rate for Payer: Kaiser Permanente Medicare	$77.19
Rate for Payer: MDX Hawaii PPO	$241.53
Rate for Payer: Ohana Health Plan Medicaid	$77.19
Rate for Payer: Ohana Health Plan Medicare	$77.19
Rate for Payer: UnitedHealthcare Medicare	$77.19
Rate for Payer: University Health Alliance Commercial	$181.50

TRANSPEC SPECIMEN DEVICE

Facility

$249.00

Hospital Revenue Code	272
Min. Negotiated Rate	$211.65
Max. Negotiated Rate	$241.53
Rate for Payer: Cash Price	$149.40
Rate for Payer: Health Management Network Commercial	$211.65
Rate for Payer: Kaiser Permanente Commercial	$224.10
Rate for Payer: MDX Hawaii PPO	$241.53

TRANSTIBIAL KIT #AR-1897S

Facility

$889.00

Hospital Revenue Code	272
Min. Negotiated Rate	$275.59
Max. Negotiated Rate	$862.33
Rate for Payer: AlohaCare Medicaid	$444.50
Rate for Payer: AlohaCare Medicare	$275.59
Rate for Payer: Cash Price	$533.40
Rate for Payer: Devoted Health Medicare	$302.26
Rate for Payer: Hawaii Medical Service Association Medicare	$275.59
Rate for Payer: Hawaii Western Management Group Commercial	$844.55
Rate for Payer: Health Management Network Commercial	$755.65
Rate for Payer: Humana Medicare	$275.59
Rate for Payer: Kaiser Permanente Commercial	$800.10
Rate for Payer: Kaiser Permanente Medicaid	$453.39
Rate for Payer: Kaiser Permanente Medicare	$275.59
Rate for Payer: MDX Hawaii PPO	$862.33
Rate for Payer: Ohana Health Plan Medicaid	$275.59
Rate for Payer: Ohana Health Plan Medicare	$275.59
Rate for Payer: UnitedHealthcare Medicare	$275.59
Rate for Payer: University Health Alliance Commercial	$647.99

TRANSTIBIAL KIT #AR-1897S

Facility

$889.00

Hospital Revenue Code	272
Min. Negotiated Rate	$755.65
Max. Negotiated Rate	$862.33
Rate for Payer: Cash Price	$533.40
Rate for Payer: Health Management Network Commercial	$755.65
Rate for Payer: Kaiser Permanente Commercial	$800.10
Rate for Payer: MDX Hawaii PPO	$862.33

TRANSURETHRAL PROCEDURES WITH CC

Facility

$21,165.89

Service Code	MSDRG 669
Min. Negotiated Rate	$21,165.89
Max. Negotiated Rate	$21,165.89
Rate for Payer: Hawaii Medical Service Association Commercial	$21,165.89

TRANSURETHRAL PROCEDURES WITH MCC

Facility

$21,165.89

Service Code	MSDRG 668
Min. Negotiated Rate	$21,165.89
Max. Negotiated Rate	$21,165.89
Rate for Payer: Hawaii Medical Service Association Commercial	$21,165.89

TRANSURETHRAL PROCEDURES WITHOUT CC/MCC

Facility

$18,771.98

Service Code	MSDRG 670
Min. Negotiated Rate	$18,771.98
Max. Negotiated Rate	$18,771.98
Rate for Payer: Hawaii Medical Service Association Commercial	$18,771.98

TRANSURETHRAL PROSTATECTOMY WITH CC/MCC

Facility

$17,681.69

Service Code	MSDRG 713
Min. Negotiated Rate	$17,681.69
Max. Negotiated Rate	$17,681.69
Rate for Payer: Hawaii Medical Service Association Commercial	$17,681.69

TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC

Facility

$14,007.88

Service Code	MSDRG 714
Min. Negotiated Rate	$14,007.88
Max. Negotiated Rate	$14,007.88
Rate for Payer: Hawaii Medical Service Association Commercial	$14,007.88

TRASTUZUMAB 600 MG-HYALURONIDASE-OYSK 10,000 UNIT/5 ML SUBCUT SOLUTION [167781]

Facility

$6,111.00

Service Code	HCPCS J9356
Hospital Revenue Code	250
Min. Negotiated Rate	$5,194.35
Max. Negotiated Rate	$5,927.67
Rate for Payer: Cash Price	$3,666.60
Rate for Payer: Health Management Network Commercial	$5,194.35
Rate for Payer: Kaiser Permanente Commercial	$5,499.90
Rate for Payer: MDX Hawaii PPO	$5,927.67

TRASTUZUMAB 600 MG-HYALURONIDASE-OYSK 10,000 UNIT/5 ML SUBCUT SOLUTION [167781]

Facility

$6,111.00

Service Code	HCPCS J9356
Hospital Revenue Code	636
Min. Negotiated Rate	$62.97
Max. Negotiated Rate	$5,927.67
Rate for Payer: AlohaCare Medicaid	$3,055.50
Rate for Payer: AlohaCare Medicare	$1,894.41
Rate for Payer: Cash Price	$3,666.60
Rate for Payer: Cash Price	$3,666.60
Rate for Payer: Devoted Health Medicare	$2,077.74
Rate for Payer: Hawaii Medical Service Association ABD	$62.97
Rate for Payer: Hawaii Medical Service Association Commercial	$74.89
Rate for Payer: Hawaii Medical Service Association Medicare	$1,894.41
Rate for Payer: Hawaii Medical Service Association Non-ABD	$62.97
Rate for Payer: Hawaii Western Management Group Commercial	$5,805.45
Rate for Payer: Health Management Network Commercial	$5,194.35
Rate for Payer: Humana Medicare	$1,894.41
Rate for Payer: Kaiser Permanente Commercial	$5,499.90
Rate for Payer: Kaiser Permanente Medicaid	$3,116.61
Rate for Payer: Kaiser Permanente Medicare	$1,894.41
Rate for Payer: MDX Hawaii PPO	$5,927.67
Rate for Payer: Ohana Health Plan Medicaid	$1,894.41
Rate for Payer: Ohana Health Plan Medicare	$1,894.41
Rate for Payer: UnitedHealthcare Medicaid	$3,666.60
Rate for Payer: UnitedHealthcare Medicare	$1,894.41
Rate for Payer: University Health Alliance Commercial	$4,454.31

TRASTUZUMAB-ANNS 150 MG/7.15ML IV (WET SOLR VIAL) [430170301]

Facility

$2,133.00

Service Code	HCPCS Q5117
Hospital Revenue Code	250
Min. Negotiated Rate	$1,813.05
Max. Negotiated Rate	$2,069.01
Rate for Payer: Cash Price	$1,279.80
Rate for Payer: Health Management Network Commercial	$1,813.05
Rate for Payer: Kaiser Permanente Commercial	$1,919.70
Rate for Payer: MDX Hawaii PPO	$2,069.01

TRASTUZUMAB-ANNS 150 MG/7.15ML IV (WET SOLR VIAL) [430170301]

Facility

$2,133.00

Service Code	HCPCS Q5117
Hospital Revenue Code	636
Min. Negotiated Rate	$43.28
Max. Negotiated Rate	$2,069.01
Rate for Payer: AlohaCare Medicaid	$1,066.50
Rate for Payer: AlohaCare Medicare	$661.23
Rate for Payer: Cash Price	$1,279.80
Rate for Payer: Cash Price	$1,279.80
Rate for Payer: Devoted Health Medicare	$725.22
Rate for Payer: Hawaii Medical Service Association ABD	$43.28
Rate for Payer: Hawaii Medical Service Association Commercial	$70.47
Rate for Payer: Hawaii Medical Service Association Medicare	$661.23
Rate for Payer: Hawaii Medical Service Association Non-ABD	$43.28
Rate for Payer: Hawaii Western Management Group Commercial	$2,026.35
Rate for Payer: Health Management Network Commercial	$1,813.05
Rate for Payer: Humana Medicare	$661.23
Rate for Payer: Kaiser Permanente Commercial	$1,919.70
Rate for Payer: Kaiser Permanente Medicaid	$1,087.83
Rate for Payer: Kaiser Permanente Medicare	$661.23
Rate for Payer: MDX Hawaii PPO	$2,069.01
Rate for Payer: Ohana Health Plan Medicaid	$661.23
Rate for Payer: Ohana Health Plan Medicare	$661.23
Rate for Payer: UnitedHealthcare Medicaid	$1,279.80
Rate for Payer: UnitedHealthcare Medicare	$661.23
Rate for Payer: University Health Alliance Commercial	$1,554.74

TRASTUZUMAB-ANNS 420 MG INTRAVENOUS SOLUTION [168930]

Facility

$5,070.00

Service Code	HCPCS Q5117
Hospital Revenue Code	250
Min. Negotiated Rate	$4,309.50
Max. Negotiated Rate	$4,917.90
Rate for Payer: Cash Price	$3,042.00
Rate for Payer: Health Management Network Commercial	$4,309.50
Rate for Payer: Kaiser Permanente Commercial	$4,563.00
Rate for Payer: MDX Hawaii PPO	$4,917.90

TRASTUZUMAB-ANNS 420 MG INTRAVENOUS SOLUTION [168930]

Facility

$5,070.00

Service Code	HCPCS Q5117
Hospital Revenue Code	636
Min. Negotiated Rate	$43.28
Max. Negotiated Rate	$4,917.90
Rate for Payer: AlohaCare Medicaid	$2,535.00
Rate for Payer: AlohaCare Medicare	$1,571.70
Rate for Payer: Cash Price	$3,042.00
Rate for Payer: Cash Price	$3,042.00
Rate for Payer: Devoted Health Medicare	$1,723.80
Rate for Payer: Hawaii Medical Service Association ABD	$43.28
Rate for Payer: Hawaii Medical Service Association Commercial	$70.47
Rate for Payer: Hawaii Medical Service Association Medicare	$1,571.70
Rate for Payer: Hawaii Medical Service Association Non-ABD	$43.28
Rate for Payer: Hawaii Western Management Group Commercial	$4,816.50
Rate for Payer: Health Management Network Commercial	$4,309.50
Rate for Payer: Humana Medicare	$1,571.70
Rate for Payer: Kaiser Permanente Commercial	$4,563.00
Rate for Payer: Kaiser Permanente Medicaid	$2,585.70
Rate for Payer: Kaiser Permanente Medicare	$1,571.70
Rate for Payer: MDX Hawaii PPO	$4,917.90
Rate for Payer: Ohana Health Plan Medicaid	$1,571.70
Rate for Payer: Ohana Health Plan Medicare	$1,571.70
Rate for Payer: UnitedHealthcare Medicaid	$3,042.00
Rate for Payer: UnitedHealthcare Medicare	$1,571.70
Rate for Payer: University Health Alliance Commercial	$3,695.52

TRASTUZUMAB-DKST 150 MG/7.15ML IV (WET SOLR VIAL) [430170123]

Facility

$1,148.00

Service Code	HCPCS Q5114
Hospital Revenue Code	250
Min. Negotiated Rate	$975.80
Max. Negotiated Rate	$1,113.56
Rate for Payer: Cash Price	$688.80
Rate for Payer: Cash Price	$977.40
Rate for Payer: Health Management Network Commercial	$975.80
Rate for Payer: Health Management Network Commercial	$1,384.65
Rate for Payer: Kaiser Permanente Commercial	$1,033.20
Rate for Payer: Kaiser Permanente Commercial	$1,466.10
Rate for Payer: MDX Hawaii PPO	$1,580.13
Rate for Payer: MDX Hawaii PPO	$1,113.56

TRASTUZUMAB-DKST 150 MG/7.15ML IV (WET SOLR VIAL) [430170123]

Facility

$1,148.00

Service Code	HCPCS Q5114
Hospital Revenue Code	636
Min. Negotiated Rate	$44.59
Max. Negotiated Rate	$1,113.56
Rate for Payer: AlohaCare Medicaid	$574.00
Rate for Payer: AlohaCare Medicaid	$814.50
Rate for Payer: AlohaCare Medicare	$504.99
Rate for Payer: AlohaCare Medicare	$355.88
Rate for Payer: Cash Price	$977.40
Rate for Payer: Cash Price	$688.80
Rate for Payer: Cash Price	$977.40
Rate for Payer: Cash Price	$688.80
Rate for Payer: Devoted Health Medicare	$390.32
Rate for Payer: Devoted Health Medicare	$553.86
Rate for Payer: Hawaii Medical Service Association ABD	$44.59
Rate for Payer: Hawaii Medical Service Association ABD	$44.59
Rate for Payer: Hawaii Medical Service Association Commercial	$44.73
Rate for Payer: Hawaii Medical Service Association Commercial	$44.73
Rate for Payer: Hawaii Medical Service Association Medicare	$504.99
Rate for Payer: Hawaii Medical Service Association Medicare	$355.88
Rate for Payer: Hawaii Medical Service Association Non-ABD	$44.59
Rate for Payer: Hawaii Medical Service Association Non-ABD	$44.59
Rate for Payer: Hawaii Western Management Group Commercial	$1,090.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,547.55
Rate for Payer: Health Management Network Commercial	$1,384.65
Rate for Payer: Health Management Network Commercial	$975.80
Rate for Payer: Humana Medicare	$355.88
Rate for Payer: Humana Medicare	$504.99
Rate for Payer: Kaiser Permanente Commercial	$1,033.20
Rate for Payer: Kaiser Permanente Commercial	$1,466.10
Rate for Payer: Kaiser Permanente Medicaid	$830.79
Rate for Payer: Kaiser Permanente Medicaid	$585.48
Rate for Payer: Kaiser Permanente Medicare	$355.88
Rate for Payer: Kaiser Permanente Medicare	$504.99
Rate for Payer: MDX Hawaii PPO	$1,113.56
Rate for Payer: MDX Hawaii PPO	$1,580.13
Rate for Payer: Ohana Health Plan Medicaid	$504.99
Rate for Payer: Ohana Health Plan Medicaid	$355.88
Rate for Payer: Ohana Health Plan Medicare	$355.88
Rate for Payer: Ohana Health Plan Medicare	$504.99
Rate for Payer: UnitedHealthcare Medicaid	$977.40
Rate for Payer: UnitedHealthcare Medicaid	$688.80
Rate for Payer: UnitedHealthcare Medicare	$355.88
Rate for Payer: UnitedHealthcare Medicare	$504.99
Rate for Payer: University Health Alliance Commercial	$836.78
Rate for Payer: University Health Alliance Commercial	$1,187.38

Know your out-of-pocket cost for care.

All Charges