Kau Hospital

All Charges

Charge

Type

Setting

Price

TUBE OVERTUBE GASTRIC

Facility

$844.00

Hospital Revenue Code	272
Min. Negotiated Rate	$261.64
Max. Negotiated Rate	$818.68
Rate for Payer: AlohaCare Medicaid	$422.00
Rate for Payer: AlohaCare Medicare	$261.64
Rate for Payer: Cash Price	$506.40
Rate for Payer: Devoted Health Medicare	$286.96
Rate for Payer: Hawaii Medical Service Association Medicare	$261.64
Rate for Payer: Hawaii Western Management Group Commercial	$801.80
Rate for Payer: Health Management Network Commercial	$717.40
Rate for Payer: Humana Medicare	$261.64
Rate for Payer: Kaiser Permanente Commercial	$759.60
Rate for Payer: Kaiser Permanente Medicaid	$430.44
Rate for Payer: Kaiser Permanente Medicare	$261.64
Rate for Payer: MDX Hawaii PPO	$818.68
Rate for Payer: Ohana Health Plan Medicaid	$261.64
Rate for Payer: Ohana Health Plan Medicare	$261.64
Rate for Payer: UnitedHealthcare Medicare	$261.64
Rate for Payer: University Health Alliance Commercial	$615.19

TUBE OVERTUBE GASTRIC

Facility

$844.00

Hospital Revenue Code	272
Min. Negotiated Rate	$717.40
Max. Negotiated Rate	$818.68
Rate for Payer: Cash Price	$506.40
Rate for Payer: Health Management Network Commercial	$717.40
Rate for Payer: Kaiser Permanente Commercial	$759.60
Rate for Payer: MDX Hawaii PPO	$818.68

TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION [8259]

Facility

$20.00

Service Code	NDC 00004080210
Hospital Revenue Code	250
Min. Negotiated Rate	$17.00
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$12.00
Rate for Payer: Health Management Network Commercial	$17.00
Rate for Payer: Kaiser Permanente Commercial	$18.00
Rate for Payer: MDX Hawaii PPO	$19.40

TUBERCULIN PPD 5 UNITS/0.1 ML SYRINGE [4080264]

Facility

$20.00

Service Code	NDC 00004080210
Hospital Revenue Code	250
Min. Negotiated Rate	$17.00
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$12.00
Rate for Payer: Health Management Network Commercial	$17.00
Rate for Payer: Kaiser Permanente Commercial	$18.00
Rate for Payer: MDX Hawaii PPO	$19.40

TUBE RIA 520MM 314.746S

Facility

$1,589.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,350.65
Max. Negotiated Rate	$1,541.33
Rate for Payer: Cash Price	$953.40
Rate for Payer: Health Management Network Commercial	$1,350.65
Rate for Payer: Kaiser Permanente Commercial	$1,430.10
Rate for Payer: MDX Hawaii PPO	$1,541.33

TUBE RIA 520MM 314.746S

Facility

$1,589.00

Hospital Revenue Code	272
Min. Negotiated Rate	$492.59
Max. Negotiated Rate	$1,541.33
Rate for Payer: AlohaCare Medicaid	$794.50
Rate for Payer: AlohaCare Medicare	$492.59
Rate for Payer: Cash Price	$953.40
Rate for Payer: Devoted Health Medicare	$540.26
Rate for Payer: Hawaii Medical Service Association Medicare	$492.59
Rate for Payer: Hawaii Western Management Group Commercial	$1,509.55
Rate for Payer: Health Management Network Commercial	$1,350.65
Rate for Payer: Humana Medicare	$492.59
Rate for Payer: Kaiser Permanente Commercial	$1,430.10
Rate for Payer: Kaiser Permanente Medicaid	$810.39
Rate for Payer: Kaiser Permanente Medicare	$492.59
Rate for Payer: MDX Hawaii PPO	$1,541.33
Rate for Payer: Ohana Health Plan Medicaid	$492.59
Rate for Payer: Ohana Health Plan Medicare	$492.59
Rate for Payer: UnitedHealthcare Medicare	$492.59
Rate for Payer: University Health Alliance Commercial	$1,158.22

TUBE SILICONE MOD 1.32MM

Facility

$146.00

Hospital Revenue Code	272
Min. Negotiated Rate	$45.26
Max. Negotiated Rate	$141.62
Rate for Payer: AlohaCare Medicaid	$73.00
Rate for Payer: AlohaCare Medicare	$45.26
Rate for Payer: Cash Price	$87.60
Rate for Payer: Devoted Health Medicare	$49.64
Rate for Payer: Hawaii Medical Service Association Medicare	$45.26
Rate for Payer: Hawaii Western Management Group Commercial	$138.70
Rate for Payer: Health Management Network Commercial	$124.10
Rate for Payer: Humana Medicare	$45.26
Rate for Payer: Kaiser Permanente Commercial	$131.40
Rate for Payer: Kaiser Permanente Medicaid	$74.46
Rate for Payer: Kaiser Permanente Medicare	$45.26
Rate for Payer: MDX Hawaii PPO	$141.62
Rate for Payer: Ohana Health Plan Medicaid	$45.26
Rate for Payer: Ohana Health Plan Medicare	$45.26
Rate for Payer: UnitedHealthcare Medicare	$45.26
Rate for Payer: University Health Alliance Commercial	$106.42

TUBE SILICONE MOD 1.32MM

Facility

$146.00

Hospital Revenue Code	272
Min. Negotiated Rate	$124.10
Max. Negotiated Rate	$141.62
Rate for Payer: Cash Price	$87.60
Rate for Payer: Health Management Network Commercial	$124.10
Rate for Payer: Kaiser Permanente Commercial	$131.40
Rate for Payer: MDX Hawaii PPO	$141.62

TUBE TRACH BIVONA 9.0M

Facility

$457.00

Hospital Revenue Code	272
Min. Negotiated Rate	$141.67
Max. Negotiated Rate	$443.29
Rate for Payer: AlohaCare Medicaid	$228.50
Rate for Payer: AlohaCare Medicare	$141.67
Rate for Payer: Cash Price	$274.20
Rate for Payer: Devoted Health Medicare	$155.38
Rate for Payer: Hawaii Medical Service Association Medicare	$141.67
Rate for Payer: Hawaii Western Management Group Commercial	$434.15
Rate for Payer: Health Management Network Commercial	$388.45
Rate for Payer: Humana Medicare	$141.67
Rate for Payer: Kaiser Permanente Commercial	$411.30
Rate for Payer: Kaiser Permanente Medicaid	$233.07
Rate for Payer: Kaiser Permanente Medicare	$141.67
Rate for Payer: MDX Hawaii PPO	$443.29
Rate for Payer: Ohana Health Plan Medicaid	$141.67
Rate for Payer: Ohana Health Plan Medicare	$141.67
Rate for Payer: UnitedHealthcare Medicare	$141.67
Rate for Payer: University Health Alliance Commercial	$333.11

TUBE TRACH BIVONA 9.0M

Facility

$457.00

Hospital Revenue Code	272
Min. Negotiated Rate	$388.45
Max. Negotiated Rate	$443.29
Rate for Payer: Cash Price	$274.20
Rate for Payer: Health Management Network Commercial	$388.45
Rate for Payer: Kaiser Permanente Commercial	$411.30
Rate for Payer: MDX Hawaii PPO	$443.29

TUBING INSUF HIFLOW

Facility

$217.00

Hospital Revenue Code	272
Min. Negotiated Rate	$184.45
Max. Negotiated Rate	$210.49
Rate for Payer: Cash Price	$130.20
Rate for Payer: Health Management Network Commercial	$184.45
Rate for Payer: Kaiser Permanente Commercial	$195.30
Rate for Payer: MDX Hawaii PPO	$210.49

TUBING INSUF HIFLOW

Facility

$217.00

Hospital Revenue Code	272
Min. Negotiated Rate	$67.27
Max. Negotiated Rate	$210.49
Rate for Payer: AlohaCare Medicaid	$108.50
Rate for Payer: AlohaCare Medicare	$67.27
Rate for Payer: Cash Price	$130.20
Rate for Payer: Devoted Health Medicare	$73.78
Rate for Payer: Hawaii Medical Service Association Medicare	$67.27
Rate for Payer: Hawaii Western Management Group Commercial	$206.15
Rate for Payer: Health Management Network Commercial	$184.45
Rate for Payer: Humana Medicare	$67.27
Rate for Payer: Kaiser Permanente Commercial	$195.30
Rate for Payer: Kaiser Permanente Medicaid	$110.67
Rate for Payer: Kaiser Permanente Medicare	$67.27
Rate for Payer: MDX Hawaii PPO	$210.49
Rate for Payer: Ohana Health Plan Medicaid	$67.27
Rate for Payer: Ohana Health Plan Medicare	$67.27
Rate for Payer: UnitedHealthcare Medicare	$67.27
Rate for Payer: University Health Alliance Commercial	$158.17

TUBING MYOSURE INFLOW

Facility

$473.00

Hospital Revenue Code	272
Min. Negotiated Rate	$402.05
Max. Negotiated Rate	$458.81
Rate for Payer: Cash Price	$283.80
Rate for Payer: Health Management Network Commercial	$402.05
Rate for Payer: Kaiser Permanente Commercial	$425.70
Rate for Payer: MDX Hawaii PPO	$458.81

TUBING MYOSURE INFLOW

Facility

$473.00

Hospital Revenue Code	272
Min. Negotiated Rate	$146.63
Max. Negotiated Rate	$458.81
Rate for Payer: AlohaCare Medicaid	$236.50
Rate for Payer: AlohaCare Medicare	$146.63
Rate for Payer: Cash Price	$283.80
Rate for Payer: Devoted Health Medicare	$160.82
Rate for Payer: Hawaii Medical Service Association Medicare	$146.63
Rate for Payer: Hawaii Western Management Group Commercial	$449.35
Rate for Payer: Health Management Network Commercial	$402.05
Rate for Payer: Humana Medicare	$146.63
Rate for Payer: Kaiser Permanente Commercial	$425.70
Rate for Payer: Kaiser Permanente Medicaid	$241.23
Rate for Payer: Kaiser Permanente Medicare	$146.63
Rate for Payer: MDX Hawaii PPO	$458.81
Rate for Payer: Ohana Health Plan Medicaid	$146.63
Rate for Payer: Ohana Health Plan Medicare	$146.63
Rate for Payer: UnitedHealthcare Medicare	$146.63
Rate for Payer: University Health Alliance Commercial	$344.77

TUBING MYOSURE OUTFLOW

Facility

$139.00

Hospital Revenue Code	272
Min. Negotiated Rate	$43.09
Max. Negotiated Rate	$134.83
Rate for Payer: AlohaCare Medicaid	$69.50
Rate for Payer: AlohaCare Medicare	$43.09
Rate for Payer: Cash Price	$83.40
Rate for Payer: Devoted Health Medicare	$47.26
Rate for Payer: Hawaii Medical Service Association Medicare	$43.09
Rate for Payer: Hawaii Western Management Group Commercial	$132.05
Rate for Payer: Health Management Network Commercial	$118.15
Rate for Payer: Humana Medicare	$43.09
Rate for Payer: Kaiser Permanente Commercial	$125.10
Rate for Payer: Kaiser Permanente Medicaid	$70.89
Rate for Payer: Kaiser Permanente Medicare	$43.09
Rate for Payer: MDX Hawaii PPO	$134.83
Rate for Payer: Ohana Health Plan Medicaid	$43.09
Rate for Payer: Ohana Health Plan Medicare	$43.09
Rate for Payer: UnitedHealthcare Medicare	$43.09
Rate for Payer: University Health Alliance Commercial	$101.32

TUBING MYOSURE OUTFLOW

Facility

$139.00

Hospital Revenue Code	272
Min. Negotiated Rate	$118.15
Max. Negotiated Rate	$134.83
Rate for Payer: Cash Price	$83.40
Rate for Payer: Health Management Network Commercial	$118.15
Rate for Payer: Kaiser Permanente Commercial	$125.10
Rate for Payer: MDX Hawaii PPO	$134.83

TUBING SUCTN-IRR 12FT

Facility

$128.00

Hospital Revenue Code	272
Min. Negotiated Rate	$108.80
Max. Negotiated Rate	$124.16
Rate for Payer: Cash Price	$76.80
Rate for Payer: Health Management Network Commercial	$108.80
Rate for Payer: Kaiser Permanente Commercial	$115.20
Rate for Payer: MDX Hawaii PPO	$124.16

TUBING SUCTN-IRR 12FT

Facility

$128.00

Hospital Revenue Code	272
Min. Negotiated Rate	$39.68
Max. Negotiated Rate	$124.16
Rate for Payer: AlohaCare Medicaid	$64.00
Rate for Payer: AlohaCare Medicare	$39.68
Rate for Payer: Cash Price	$76.80
Rate for Payer: Devoted Health Medicare	$43.52
Rate for Payer: Hawaii Medical Service Association Medicare	$39.68
Rate for Payer: Hawaii Western Management Group Commercial	$121.60
Rate for Payer: Health Management Network Commercial	$108.80
Rate for Payer: Humana Medicare	$39.68
Rate for Payer: Kaiser Permanente Commercial	$115.20
Rate for Payer: Kaiser Permanente Medicaid	$65.28
Rate for Payer: Kaiser Permanente Medicare	$39.68
Rate for Payer: MDX Hawaii PPO	$124.16
Rate for Payer: Ohana Health Plan Medicaid	$39.68
Rate for Payer: Ohana Health Plan Medicare	$39.68
Rate for Payer: UnitedHealthcare Medicare	$39.68
Rate for Payer: University Health Alliance Commercial	$93.30

TUBING SWIVEL HANDLE

Facility

$96.00

Hospital Revenue Code	272
Min. Negotiated Rate	$81.60
Max. Negotiated Rate	$93.12
Rate for Payer: Cash Price	$57.60
Rate for Payer: Health Management Network Commercial	$81.60
Rate for Payer: Kaiser Permanente Commercial	$86.40
Rate for Payer: MDX Hawaii PPO	$93.12

TUBING SWIVEL HANDLE

Facility

$96.00

Hospital Revenue Code	272
Min. Negotiated Rate	$29.76
Max. Negotiated Rate	$93.12
Rate for Payer: AlohaCare Medicaid	$48.00
Rate for Payer: AlohaCare Medicare	$29.76
Rate for Payer: Cash Price	$57.60
Rate for Payer: Devoted Health Medicare	$32.64
Rate for Payer: Hawaii Medical Service Association Medicare	$29.76
Rate for Payer: Hawaii Western Management Group Commercial	$91.20
Rate for Payer: Health Management Network Commercial	$81.60
Rate for Payer: Humana Medicare	$29.76
Rate for Payer: Kaiser Permanente Commercial	$86.40
Rate for Payer: Kaiser Permanente Medicaid	$48.96
Rate for Payer: Kaiser Permanente Medicare	$29.76
Rate for Payer: MDX Hawaii PPO	$93.12
Rate for Payer: Ohana Health Plan Medicaid	$29.76
Rate for Payer: Ohana Health Plan Medicare	$29.76
Rate for Payer: UnitedHealthcare Medicare	$29.76
Rate for Payer: University Health Alliance Commercial	$69.97

TUBULAR LCK SS 12H AR-8943T-12

Facility

$1,502.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$465.62
Max. Negotiated Rate	$1,456.94
Rate for Payer: AlohaCare Medicaid	$751.00
Rate for Payer: AlohaCare Medicare	$465.62
Rate for Payer: Cash Price	$901.20
Rate for Payer: Devoted Health Medicare	$510.68
Rate for Payer: Hawaii Medical Service Association Medicare	$465.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,051.40
Rate for Payer: Health Management Network Commercial	$1,276.70
Rate for Payer: Humana Medicare	$465.62
Rate for Payer: Kaiser Permanente Commercial	$1,351.80
Rate for Payer: Kaiser Permanente Medicaid	$766.02
Rate for Payer: Kaiser Permanente Medicare	$465.62
Rate for Payer: MDX Hawaii PPO	$1,456.94
Rate for Payer: Ohana Health Plan Medicaid	$465.62
Rate for Payer: Ohana Health Plan Medicare	$465.62
Rate for Payer: UnitedHealthcare Medicare	$465.62
Rate for Payer: University Health Alliance Commercial	$841.12

TUBULAR LCK SS 12H AR-8943T-12

Facility

$1,502.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$841.12
Max. Negotiated Rate	$1,456.94
Rate for Payer: Cash Price	$901.20
Rate for Payer: Hawaii Western Management Group Commercial	$1,051.40
Rate for Payer: Health Management Network Commercial	$1,276.70
Rate for Payer: Kaiser Permanente Commercial	$1,351.80
Rate for Payer: MDX Hawaii PPO	$1,456.94
Rate for Payer: University Health Alliance Commercial	$841.12

TUBULAR PLATE 1/3 4H 241.34

Facility

$422.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$236.32
Max. Negotiated Rate	$409.34
Rate for Payer: Cash Price	$253.20
Rate for Payer: Hawaii Western Management Group Commercial	$295.40
Rate for Payer: Health Management Network Commercial	$358.70
Rate for Payer: Kaiser Permanente Commercial	$379.80
Rate for Payer: MDX Hawaii PPO	$409.34
Rate for Payer: University Health Alliance Commercial	$236.32

TUBULAR PLATE 1/3 4H 241.34

Facility

$422.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$130.82
Max. Negotiated Rate	$409.34
Rate for Payer: AlohaCare Medicaid	$211.00
Rate for Payer: AlohaCare Medicare	$130.82
Rate for Payer: Cash Price	$253.20
Rate for Payer: Devoted Health Medicare	$143.48
Rate for Payer: Hawaii Medical Service Association Medicare	$130.82
Rate for Payer: Hawaii Western Management Group Commercial	$295.40
Rate for Payer: Health Management Network Commercial	$358.70
Rate for Payer: Humana Medicare	$130.82
Rate for Payer: Kaiser Permanente Commercial	$379.80
Rate for Payer: Kaiser Permanente Medicaid	$215.22
Rate for Payer: Kaiser Permanente Medicare	$130.82
Rate for Payer: MDX Hawaii PPO	$409.34
Rate for Payer: Ohana Health Plan Medicaid	$130.82
Rate for Payer: Ohana Health Plan Medicare	$130.82
Rate for Payer: UnitedHealthcare Medicare	$130.82
Rate for Payer: University Health Alliance Commercial	$236.32

TUNNELER SHEATH LG BLU 9009-16

Facility

$257.00

Service Code	HCPCS C1894
Hospital Revenue Code	272
Min. Negotiated Rate	$79.67
Max. Negotiated Rate	$249.29
Rate for Payer: AlohaCare Medicaid	$128.50
Rate for Payer: AlohaCare Medicare	$79.67
Rate for Payer: Cash Price	$154.20
Rate for Payer: Devoted Health Medicare	$87.38
Rate for Payer: Hawaii Medical Service Association Medicare	$79.67
Rate for Payer: Hawaii Western Management Group Commercial	$244.15
Rate for Payer: Health Management Network Commercial	$218.45
Rate for Payer: Humana Medicare	$79.67
Rate for Payer: Kaiser Permanente Commercial	$231.30
Rate for Payer: Kaiser Permanente Medicaid	$131.07
Rate for Payer: Kaiser Permanente Medicare	$79.67
Rate for Payer: MDX Hawaii PPO	$249.29
Rate for Payer: Ohana Health Plan Medicaid	$79.67
Rate for Payer: Ohana Health Plan Medicare	$79.67
Rate for Payer: UnitedHealthcare Medicare	$79.67
Rate for Payer: University Health Alliance Commercial	$187.33

Know your out-of-pocket cost for care.

All Charges