Kau Hospital

All Charges

Charge

Type

Setting

Price

TUBE 16F ENFIT GASTRO

Facility

$140.00

Hospital Revenue Code	272
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$135.80
Rate for Payer: AlohaCare Medicaid	$70.00
Rate for Payer: AlohaCare Medicare	$43.40
Rate for Payer: Cash Price	$84.00
Rate for Payer: Devoted Health Medicare	$47.60
Rate for Payer: Hawaii Medical Service Association Medicare	$43.40
Rate for Payer: Hawaii Western Management Group Commercial	$133.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Humana Medicare	$43.40
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: Kaiser Permanente Medicaid	$71.40
Rate for Payer: Kaiser Permanente Medicare	$43.40
Rate for Payer: MDX Hawaii PPO	$135.80
Rate for Payer: Ohana Health Plan Medicaid	$43.40
Rate for Payer: Ohana Health Plan Medicare	$43.40
Rate for Payer: UnitedHealthcare Medicare	$43.40
Rate for Payer: University Health Alliance Commercial	$102.05

TUBE 18FR ENFIT GASTRO

Facility

$140.00

Hospital Revenue Code	272
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$135.80
Rate for Payer: Cash Price	$84.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: MDX Hawaii PPO	$135.80

TUBE 18FR ENFIT GASTRO

Facility

$140.00

Hospital Revenue Code	272
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$135.80
Rate for Payer: AlohaCare Medicaid	$70.00
Rate for Payer: AlohaCare Medicare	$43.40
Rate for Payer: Cash Price	$84.00
Rate for Payer: Devoted Health Medicare	$47.60
Rate for Payer: Hawaii Medical Service Association Medicare	$43.40
Rate for Payer: Hawaii Western Management Group Commercial	$133.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Humana Medicare	$43.40
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: Kaiser Permanente Medicaid	$71.40
Rate for Payer: Kaiser Permanente Medicare	$43.40
Rate for Payer: MDX Hawaii PPO	$135.80
Rate for Payer: Ohana Health Plan Medicaid	$43.40
Rate for Payer: Ohana Health Plan Medicare	$43.40
Rate for Payer: UnitedHealthcare Medicare	$43.40
Rate for Payer: University Health Alliance Commercial	$102.05

TUBE 20FR ENFIT GASTRO

Facility

$140.00

Hospital Revenue Code	272
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$135.80
Rate for Payer: AlohaCare Medicaid	$70.00
Rate for Payer: AlohaCare Medicare	$43.40
Rate for Payer: Cash Price	$84.00
Rate for Payer: Devoted Health Medicare	$47.60
Rate for Payer: Hawaii Medical Service Association Medicare	$43.40
Rate for Payer: Hawaii Western Management Group Commercial	$133.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Humana Medicare	$43.40
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: Kaiser Permanente Medicaid	$71.40
Rate for Payer: Kaiser Permanente Medicare	$43.40
Rate for Payer: MDX Hawaii PPO	$135.80
Rate for Payer: Ohana Health Plan Medicaid	$43.40
Rate for Payer: Ohana Health Plan Medicare	$43.40
Rate for Payer: UnitedHealthcare Medicare	$43.40
Rate for Payer: University Health Alliance Commercial	$102.05

TUBE 20FR ENFIT GASTRO

Facility

$140.00

Hospital Revenue Code	272
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$135.80
Rate for Payer: Cash Price	$84.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: MDX Hawaii PPO	$135.80

TUBE CHEST THALQUIK 10F

Facility

$732.00

Service Code	HCPCS C1729
Hospital Revenue Code	272
Min. Negotiated Rate	$226.92
Max. Negotiated Rate	$710.04
Rate for Payer: AlohaCare Medicaid	$366.00
Rate for Payer: AlohaCare Medicare	$226.92
Rate for Payer: Cash Price	$439.20
Rate for Payer: Devoted Health Medicare	$248.88
Rate for Payer: Hawaii Medical Service Association Medicare	$226.92
Rate for Payer: Hawaii Western Management Group Commercial	$695.40
Rate for Payer: Health Management Network Commercial	$622.20
Rate for Payer: Humana Medicare	$226.92
Rate for Payer: Kaiser Permanente Commercial	$658.80
Rate for Payer: Kaiser Permanente Medicaid	$373.32
Rate for Payer: Kaiser Permanente Medicare	$226.92
Rate for Payer: MDX Hawaii PPO	$710.04
Rate for Payer: Ohana Health Plan Medicaid	$226.92
Rate for Payer: Ohana Health Plan Medicare	$226.92
Rate for Payer: UnitedHealthcare Medicare	$226.92
Rate for Payer: University Health Alliance Commercial	$533.55

TUBE CHEST THALQUIK 10F

Facility

$732.00

Service Code	HCPCS C1729
Hospital Revenue Code	272
Min. Negotiated Rate	$622.20
Max. Negotiated Rate	$710.04
Rate for Payer: Cash Price	$439.20
Rate for Payer: Health Management Network Commercial	$622.20
Rate for Payer: Kaiser Permanente Commercial	$658.80
Rate for Payer: MDX Hawaii PPO	$710.04

TUBE CHEST THALQUIK 8F

Facility

$678.00

Service Code	HCPCS C1729
Hospital Revenue Code	272
Min. Negotiated Rate	$576.30
Max. Negotiated Rate	$657.66
Rate for Payer: Cash Price	$406.80
Rate for Payer: Health Management Network Commercial	$576.30
Rate for Payer: Kaiser Permanente Commercial	$610.20
Rate for Payer: MDX Hawaii PPO	$657.66

TUBE CHEST THALQUIK 8F

Facility

$678.00

Service Code	HCPCS C1729
Hospital Revenue Code	272
Min. Negotiated Rate	$210.18
Max. Negotiated Rate	$657.66
Rate for Payer: AlohaCare Medicaid	$339.00
Rate for Payer: AlohaCare Medicare	$210.18
Rate for Payer: Cash Price	$406.80
Rate for Payer: Devoted Health Medicare	$230.52
Rate for Payer: Hawaii Medical Service Association Medicare	$210.18
Rate for Payer: Hawaii Western Management Group Commercial	$644.10
Rate for Payer: Health Management Network Commercial	$576.30
Rate for Payer: Humana Medicare	$210.18
Rate for Payer: Kaiser Permanente Commercial	$610.20
Rate for Payer: Kaiser Permanente Medicaid	$345.78
Rate for Payer: Kaiser Permanente Medicare	$210.18
Rate for Payer: MDX Hawaii PPO	$657.66
Rate for Payer: Ohana Health Plan Medicaid	$210.18
Rate for Payer: Ohana Health Plan Medicare	$210.18
Rate for Payer: UnitedHealthcare Medicare	$210.18
Rate for Payer: University Health Alliance Commercial	$494.19

TUBE DISTAL ATTACHMENT

Facility

$634.00

Hospital Revenue Code	272
Min. Negotiated Rate	$196.54
Max. Negotiated Rate	$614.98
Rate for Payer: AlohaCare Medicaid	$317.00
Rate for Payer: AlohaCare Medicare	$196.54
Rate for Payer: Cash Price	$380.40
Rate for Payer: Devoted Health Medicare	$215.56
Rate for Payer: Hawaii Medical Service Association Medicare	$196.54
Rate for Payer: Hawaii Western Management Group Commercial	$602.30
Rate for Payer: Health Management Network Commercial	$538.90
Rate for Payer: Humana Medicare	$196.54
Rate for Payer: Kaiser Permanente Commercial	$570.60
Rate for Payer: Kaiser Permanente Medicaid	$323.34
Rate for Payer: Kaiser Permanente Medicare	$196.54
Rate for Payer: MDX Hawaii PPO	$614.98
Rate for Payer: Ohana Health Plan Medicaid	$196.54
Rate for Payer: Ohana Health Plan Medicare	$196.54
Rate for Payer: UnitedHealthcare Medicare	$196.54
Rate for Payer: University Health Alliance Commercial	$462.12

TUBE DISTAL ATTACHMENT

Facility

$634.00

Hospital Revenue Code	272
Min. Negotiated Rate	$538.90
Max. Negotiated Rate	$614.98
Rate for Payer: Cash Price	$380.40
Rate for Payer: Health Management Network Commercial	$538.90
Rate for Payer: Kaiser Permanente Commercial	$570.60
Rate for Payer: MDX Hawaii PPO	$614.98

TUBE EMG

Facility

$1,068.00

Hospital Revenue Code	272
Min. Negotiated Rate	$331.08
Max. Negotiated Rate	$1,035.96
Rate for Payer: AlohaCare Medicaid	$534.00
Rate for Payer: AlohaCare Medicare	$331.08
Rate for Payer: Cash Price	$640.80
Rate for Payer: Devoted Health Medicare	$363.12
Rate for Payer: Hawaii Medical Service Association Medicare	$331.08
Rate for Payer: Hawaii Western Management Group Commercial	$1,014.60
Rate for Payer: Health Management Network Commercial	$907.80
Rate for Payer: Humana Medicare	$331.08
Rate for Payer: Kaiser Permanente Commercial	$961.20
Rate for Payer: Kaiser Permanente Medicaid	$544.68
Rate for Payer: Kaiser Permanente Medicare	$331.08
Rate for Payer: MDX Hawaii PPO	$1,035.96
Rate for Payer: Ohana Health Plan Medicaid	$331.08
Rate for Payer: Ohana Health Plan Medicare	$331.08
Rate for Payer: UnitedHealthcare Medicare	$331.08
Rate for Payer: University Health Alliance Commercial	$778.47

TUBE EMG

Facility

$1,068.00

Hospital Revenue Code	272
Min. Negotiated Rate	$907.80
Max. Negotiated Rate	$1,035.96
Rate for Payer: Cash Price	$640.80
Rate for Payer: Health Management Network Commercial	$907.80
Rate for Payer: Kaiser Permanente Commercial	$961.20
Rate for Payer: MDX Hawaii PPO	$1,035.96

TUBE EMG ENDOTRACH SZ6

Facility

$1,495.00

Hospital Revenue Code	270
Min. Negotiated Rate	$463.45
Max. Negotiated Rate	$1,450.15
Rate for Payer: AlohaCare Medicaid	$747.50
Rate for Payer: AlohaCare Medicare	$463.45
Rate for Payer: Cash Price	$897.00
Rate for Payer: Devoted Health Medicare	$508.30
Rate for Payer: Hawaii Medical Service Association Medicare	$463.45
Rate for Payer: Hawaii Western Management Group Commercial	$1,420.25
Rate for Payer: Health Management Network Commercial	$1,270.75
Rate for Payer: Humana Medicare	$463.45
Rate for Payer: Kaiser Permanente Commercial	$1,345.50
Rate for Payer: Kaiser Permanente Medicaid	$762.45
Rate for Payer: Kaiser Permanente Medicare	$463.45
Rate for Payer: MDX Hawaii PPO	$1,450.15
Rate for Payer: Ohana Health Plan Medicaid	$463.45
Rate for Payer: Ohana Health Plan Medicare	$463.45
Rate for Payer: UnitedHealthcare Medicare	$463.45
Rate for Payer: University Health Alliance Commercial	$1,089.71

TUBE EMG ENDOTRACH SZ6

Facility

$1,495.00

Hospital Revenue Code	270
Min. Negotiated Rate	$1,270.75
Max. Negotiated Rate	$1,450.15
Rate for Payer: Cash Price	$897.00
Rate for Payer: Health Management Network Commercial	$1,270.75
Rate for Payer: Kaiser Permanente Commercial	$1,345.50
Rate for Payer: MDX Hawaii PPO	$1,450.15

TUBE EMG ENDOTRACH SZ7

Facility

$1,540.00

Hospital Revenue Code	270
Min. Negotiated Rate	$1,309.00
Max. Negotiated Rate	$1,493.80
Rate for Payer: Cash Price	$924.00
Rate for Payer: Health Management Network Commercial	$1,309.00
Rate for Payer: Kaiser Permanente Commercial	$1,386.00
Rate for Payer: MDX Hawaii PPO	$1,493.80

TUBE EMG ENDOTRACH SZ7

Facility

$1,540.00

Hospital Revenue Code	270
Min. Negotiated Rate	$477.40
Max. Negotiated Rate	$1,493.80
Rate for Payer: AlohaCare Medicaid	$770.00
Rate for Payer: AlohaCare Medicare	$477.40
Rate for Payer: Cash Price	$924.00
Rate for Payer: Devoted Health Medicare	$523.60
Rate for Payer: Hawaii Medical Service Association Medicare	$477.40
Rate for Payer: Hawaii Western Management Group Commercial	$1,463.00
Rate for Payer: Health Management Network Commercial	$1,309.00
Rate for Payer: Humana Medicare	$477.40
Rate for Payer: Kaiser Permanente Commercial	$1,386.00
Rate for Payer: Kaiser Permanente Medicaid	$785.40
Rate for Payer: Kaiser Permanente Medicare	$477.40
Rate for Payer: MDX Hawaii PPO	$1,493.80
Rate for Payer: Ohana Health Plan Medicaid	$477.40
Rate for Payer: Ohana Health Plan Medicare	$477.40
Rate for Payer: UnitedHealthcare Medicare	$477.40
Rate for Payer: University Health Alliance Commercial	$1,122.51

TUBE FEEDING KANGA 24F

Facility

$125.00

Service Code	HCPCS B4087
Hospital Revenue Code	272
Min. Negotiated Rate	$38.22
Max. Negotiated Rate	$121.25
Rate for Payer: AlohaCare Medicaid	$62.50
Rate for Payer: AlohaCare Medicare	$38.75
Rate for Payer: Cash Price	$75.00
Rate for Payer: Cash Price	$75.00
Rate for Payer: Devoted Health Medicare	$42.50
Rate for Payer: Hawaii Medical Service Association Medicare	$38.75
Rate for Payer: Hawaii Western Management Group Commercial	$118.75
Rate for Payer: Health Management Network Commercial	$106.25
Rate for Payer: Humana Medicare	$38.75
Rate for Payer: Kaiser Permanente Commercial	$112.50
Rate for Payer: Kaiser Permanente Medicaid	$63.75
Rate for Payer: Kaiser Permanente Medicare	$38.75
Rate for Payer: MDX Hawaii PPO	$121.25
Rate for Payer: Ohana Health Plan Medicaid	$38.75
Rate for Payer: Ohana Health Plan Medicare	$38.75
Rate for Payer: UnitedHealthcare Medicaid	$38.22
Rate for Payer: UnitedHealthcare Medicare	$38.75
Rate for Payer: University Health Alliance Commercial	$91.11

TUBE FEEDING KANGA 24F

Facility

$125.00

Service Code	HCPCS B4087
Hospital Revenue Code	272
Min. Negotiated Rate	$106.25
Max. Negotiated Rate	$121.25
Rate for Payer: Cash Price	$75.00
Rate for Payer: Health Management Network Commercial	$106.25
Rate for Payer: Kaiser Permanente Commercial	$112.50
Rate for Payer: MDX Hawaii PPO	$121.25

TUBE IRRIG CYSTO Y-TUBE

Facility

$108.00

Hospital Revenue Code	272
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$104.76
Rate for Payer: Cash Price	$64.80
Rate for Payer: Health Management Network Commercial	$91.80
Rate for Payer: Kaiser Permanente Commercial	$97.20
Rate for Payer: MDX Hawaii PPO	$104.76

TUBE IRRIG CYSTO Y-TUBE

Facility

$108.00

Hospital Revenue Code	272
Min. Negotiated Rate	$33.48
Max. Negotiated Rate	$104.76
Rate for Payer: AlohaCare Medicaid	$54.00
Rate for Payer: AlohaCare Medicare	$33.48
Rate for Payer: Cash Price	$64.80
Rate for Payer: Devoted Health Medicare	$36.72
Rate for Payer: Hawaii Medical Service Association Medicare	$33.48
Rate for Payer: Hawaii Western Management Group Commercial	$102.60
Rate for Payer: Health Management Network Commercial	$91.80
Rate for Payer: Humana Medicare	$33.48
Rate for Payer: Kaiser Permanente Commercial	$97.20
Rate for Payer: Kaiser Permanente Medicaid	$55.08
Rate for Payer: Kaiser Permanente Medicare	$33.48
Rate for Payer: MDX Hawaii PPO	$104.76
Rate for Payer: Ohana Health Plan Medicaid	$33.48
Rate for Payer: Ohana Health Plan Medicare	$33.48
Rate for Payer: UnitedHealthcare Medicare	$33.48
Rate for Payer: University Health Alliance Commercial	$78.72

TUBE LASER ENDO 6MM DUAL CUFF

Facility

$367.00

Hospital Revenue Code	272
Min. Negotiated Rate	$311.95
Max. Negotiated Rate	$355.99
Rate for Payer: Cash Price	$220.20
Rate for Payer: Health Management Network Commercial	$311.95
Rate for Payer: Kaiser Permanente Commercial	$330.30
Rate for Payer: MDX Hawaii PPO	$355.99

TUBE LASER ENDO 6MM DUAL CUFF

Facility

$367.00

Hospital Revenue Code	272
Min. Negotiated Rate	$113.77
Max. Negotiated Rate	$355.99
Rate for Payer: AlohaCare Medicaid	$183.50
Rate for Payer: AlohaCare Medicare	$113.77
Rate for Payer: Cash Price	$220.20
Rate for Payer: Devoted Health Medicare	$124.78
Rate for Payer: Hawaii Medical Service Association Medicare	$113.77
Rate for Payer: Hawaii Western Management Group Commercial	$348.65
Rate for Payer: Health Management Network Commercial	$311.95
Rate for Payer: Humana Medicare	$113.77
Rate for Payer: Kaiser Permanente Commercial	$330.30
Rate for Payer: Kaiser Permanente Medicaid	$187.17
Rate for Payer: Kaiser Permanente Medicare	$113.77
Rate for Payer: MDX Hawaii PPO	$355.99
Rate for Payer: Ohana Health Plan Medicaid	$113.77
Rate for Payer: Ohana Health Plan Medicare	$113.77
Rate for Payer: UnitedHealthcare Medicare	$113.77
Rate for Payer: University Health Alliance Commercial	$267.51

TUBE NERVEAN EMG

Facility

$1,068.00

Hospital Revenue Code	272
Min. Negotiated Rate	$907.80
Max. Negotiated Rate	$1,035.96
Rate for Payer: Cash Price	$640.80
Rate for Payer: Health Management Network Commercial	$907.80
Rate for Payer: Kaiser Permanente Commercial	$961.20
Rate for Payer: MDX Hawaii PPO	$1,035.96

TUBE NERVEAN EMG

Facility

$1,068.00

Hospital Revenue Code	272
Min. Negotiated Rate	$331.08
Max. Negotiated Rate	$1,035.96
Rate for Payer: AlohaCare Medicaid	$534.00
Rate for Payer: AlohaCare Medicare	$331.08
Rate for Payer: Cash Price	$640.80
Rate for Payer: Devoted Health Medicare	$363.12
Rate for Payer: Hawaii Medical Service Association Medicare	$331.08
Rate for Payer: Hawaii Western Management Group Commercial	$1,014.60
Rate for Payer: Health Management Network Commercial	$907.80
Rate for Payer: Humana Medicare	$331.08
Rate for Payer: Kaiser Permanente Commercial	$961.20
Rate for Payer: Kaiser Permanente Medicaid	$544.68
Rate for Payer: Kaiser Permanente Medicare	$331.08
Rate for Payer: MDX Hawaii PPO	$1,035.96
Rate for Payer: Ohana Health Plan Medicaid	$331.08
Rate for Payer: Ohana Health Plan Medicare	$331.08
Rate for Payer: UnitedHealthcare Medicare	$331.08
Rate for Payer: University Health Alliance Commercial	$778.47

Know your out-of-pocket cost for care.

All Charges