Kau Hospital

All Charges

Charge

Type

Setting

Price

VENTRALIGHT MESH 6" 5990020

Facility

$5,268.00

Service Code	HCPCS C1781
Hospital Revenue Code	278
Min. Negotiated Rate	$2,950.08
Max. Negotiated Rate	$5,109.96
Rate for Payer: Cash Price	$3,160.80
Rate for Payer: Hawaii Western Management Group Commercial	$3,687.60
Rate for Payer: Health Management Network Commercial	$4,477.80
Rate for Payer: Kaiser Permanente Commercial	$4,741.20
Rate for Payer: MDX Hawaii PPO	$5,109.96
Rate for Payer: University Health Alliance Commercial	$2,950.08

VENTRALIGHT MESH 6" 5990020

Facility

$5,268.00

Service Code	HCPCS C1781
Hospital Revenue Code	278
Min. Negotiated Rate	$1,633.08
Max. Negotiated Rate	$5,109.96
Rate for Payer: AlohaCare Medicaid	$2,634.00
Rate for Payer: AlohaCare Medicare	$1,633.08
Rate for Payer: Cash Price	$3,160.80
Rate for Payer: Devoted Health Medicare	$1,791.12
Rate for Payer: Hawaii Medical Service Association Medicare	$1,633.08
Rate for Payer: Hawaii Western Management Group Commercial	$3,687.60
Rate for Payer: Health Management Network Commercial	$4,477.80
Rate for Payer: Humana Medicare	$1,633.08
Rate for Payer: Kaiser Permanente Commercial	$4,741.20
Rate for Payer: Kaiser Permanente Medicaid	$2,686.68
Rate for Payer: Kaiser Permanente Medicare	$1,633.08
Rate for Payer: MDX Hawaii PPO	$5,109.96
Rate for Payer: Ohana Health Plan Medicaid	$1,633.08
Rate for Payer: Ohana Health Plan Medicare	$1,633.08
Rate for Payer: UnitedHealthcare Medicare	$1,633.08
Rate for Payer: University Health Alliance Commercial	$2,950.08

VENTRALIGHT MESH 7X9 5991525

Facility

$4,580.00

Service Code	HCPCS C1781
Hospital Revenue Code	278
Min. Negotiated Rate	$2,564.80
Max. Negotiated Rate	$4,442.60
Rate for Payer: Cash Price	$2,748.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,206.00
Rate for Payer: Health Management Network Commercial	$3,893.00
Rate for Payer: Kaiser Permanente Commercial	$4,122.00
Rate for Payer: MDX Hawaii PPO	$4,442.60
Rate for Payer: University Health Alliance Commercial	$2,564.80

VENTRALIGHT MESH 7X9 5991525

Facility

$4,580.00

Service Code	HCPCS C1781
Hospital Revenue Code	278
Min. Negotiated Rate	$1,419.80
Max. Negotiated Rate	$4,442.60
Rate for Payer: AlohaCare Medicaid	$2,290.00
Rate for Payer: AlohaCare Medicare	$1,419.80
Rate for Payer: Cash Price	$2,748.00
Rate for Payer: Devoted Health Medicare	$1,557.20
Rate for Payer: Hawaii Medical Service Association Medicare	$1,419.80
Rate for Payer: Hawaii Western Management Group Commercial	$3,206.00
Rate for Payer: Health Management Network Commercial	$3,893.00
Rate for Payer: Humana Medicare	$1,419.80
Rate for Payer: Kaiser Permanente Commercial	$4,122.00
Rate for Payer: Kaiser Permanente Medicaid	$2,335.80
Rate for Payer: Kaiser Permanente Medicare	$1,419.80
Rate for Payer: MDX Hawaii PPO	$4,442.60
Rate for Payer: Ohana Health Plan Medicaid	$1,419.80
Rate for Payer: Ohana Health Plan Medicare	$1,419.80
Rate for Payer: UnitedHealthcare Medicare	$1,419.80
Rate for Payer: University Health Alliance Commercial	$2,564.80

VENTRICULAR SHUNT PROCEDURES WITH CC

Facility

$53,827.24

Service Code	MSDRG 032
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$53,827.24
Rate for Payer: Hawaii Medical Service Association Commercial	$53,827.24
Rate for Payer: University Health Alliance Commercial	$10,400.00

VENTRICULAR SHUNT PROCEDURES WITH MCC

Facility

$53,827.24

Service Code	MSDRG 031
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$53,827.24
Rate for Payer: Hawaii Medical Service Association Commercial	$53,827.24
Rate for Payer: University Health Alliance Commercial	$10,400.00

VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC

Facility

$37,401.76

Service Code	MSDRG 033
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$37,401.76
Rate for Payer: Hawaii Medical Service Association Commercial	$37,401.76
Rate for Payer: University Health Alliance Commercial	$10,400.00

VENTRIO ST HERNIA PATCH OVAL

Facility

$3,260.00

Service Code	HCPCS C1781
Hospital Revenue Code	278
Min. Negotiated Rate	$1,825.60
Max. Negotiated Rate	$3,162.20
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: Kaiser Permanente Commercial	$2,934.00
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: University Health Alliance Commercial	$1,825.60

VENTRIO ST HERNIA PATCH OVAL

Facility

$3,260.00

Service Code	HCPCS C1781
Hospital Revenue Code	278
Min. Negotiated Rate	$1,010.60
Max. Negotiated Rate	$3,162.20
Rate for Payer: AlohaCare Medicaid	$1,630.00
Rate for Payer: AlohaCare Medicare	$1,010.60
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Devoted Health Medicare	$1,108.40
Rate for Payer: Hawaii Medical Service Association Medicare	$1,010.60
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: Humana Medicare	$1,010.60
Rate for Payer: Kaiser Permanente Commercial	$2,934.00
Rate for Payer: Kaiser Permanente Medicaid	$1,662.60
Rate for Payer: Kaiser Permanente Medicare	$1,010.60
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: Ohana Health Plan Medicaid	$1,010.60
Rate for Payer: Ohana Health Plan Medicare	$1,010.60
Rate for Payer: UnitedHealthcare Medicare	$1,010.60
Rate for Payer: University Health Alliance Commercial	$1,825.60

VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION [8527]

Facility

$38.00

Service Code	NDC 70710164307
Hospital Revenue Code	250
Min. Negotiated Rate	$32.30
Max. Negotiated Rate	$36.86
Rate for Payer: Cash Price	$22.80
Rate for Payer: Health Management Network Commercial	$32.30
Rate for Payer: Kaiser Permanente Commercial	$34.20
Rate for Payer: MDX Hawaii PPO	$36.86

VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION [8527]

Facility

$38.00

Service Code	NDC 70710164301
Hospital Revenue Code	250
Min. Negotiated Rate	$32.30
Max. Negotiated Rate	$36.86
Rate for Payer: Cash Price	$22.80
Rate for Payer: Health Management Network Commercial	$32.30
Rate for Payer: Kaiser Permanente Commercial	$34.20
Rate for Payer: MDX Hawaii PPO	$36.86

VERAPAMIL 40 MG TABLET [8529]

Facility

$1.00

Service Code	NDC 00591040401
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

VERAPAMIL 40 MG TABLET [8529]

Facility

$1.00

Service Code	NDC 00591040401
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

VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE [14626]

Facility

$6.00

Service Code	NDC 75834015801
Hospital Revenue Code	637
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$5.82
Rate for Payer: AlohaCare Medicaid	$3.00
Rate for Payer: AlohaCare Medicare	$1.86
Rate for Payer: Cash Price	$3.60
Rate for Payer: Devoted Health Medicare	$2.04
Rate for Payer: Hawaii Medical Service Association Medicare	$1.86
Rate for Payer: Hawaii Western Management Group Commercial	$5.70
Rate for Payer: Health Management Network Commercial	$5.10
Rate for Payer: Humana Medicare	$1.86
Rate for Payer: Kaiser Permanente Commercial	$5.40
Rate for Payer: Kaiser Permanente Medicaid	$3.06
Rate for Payer: Kaiser Permanente Medicare	$1.86
Rate for Payer: MDX Hawaii PPO	$5.82
Rate for Payer: Ohana Health Plan Medicaid	$1.86
Rate for Payer: Ohana Health Plan Medicare	$1.86
Rate for Payer: UnitedHealthcare Medicare	$1.86
Rate for Payer: University Health Alliance Commercial	$4.37

VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE [14626]

Facility

$6.00

Service Code	NDC 75834015801
Hospital Revenue Code	250
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$3.60
Rate for Payer: Health Management Network Commercial	$5.10
Rate for Payer: Kaiser Permanente Commercial	$5.40
Rate for Payer: MDX Hawaii PPO	$5.82

VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE [14626]

Facility

$7.00

Service Code	NDC 60687050411
Hospital Revenue Code	637
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$6.79
Rate for Payer: AlohaCare Medicaid	$3.50
Rate for Payer: AlohaCare Medicare	$2.17
Rate for Payer: Cash Price	$4.20
Rate for Payer: Devoted Health Medicare	$2.38
Rate for Payer: Hawaii Medical Service Association Medicare	$2.17
Rate for Payer: Hawaii Western Management Group Commercial	$6.65
Rate for Payer: Health Management Network Commercial	$5.95
Rate for Payer: Humana Medicare	$2.17
Rate for Payer: Kaiser Permanente Commercial	$6.30
Rate for Payer: Kaiser Permanente Medicaid	$3.57
Rate for Payer: Kaiser Permanente Medicare	$2.17
Rate for Payer: MDX Hawaii PPO	$6.79
Rate for Payer: Ohana Health Plan Medicaid	$2.17
Rate for Payer: Ohana Health Plan Medicare	$2.17
Rate for Payer: UnitedHealthcare Medicare	$2.17
Rate for Payer: University Health Alliance Commercial	$5.10

VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE [14626]

Facility

$7.00

Service Code	NDC 60687050401
Hospital Revenue Code	637
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$6.79
Rate for Payer: AlohaCare Medicaid	$3.50
Rate for Payer: AlohaCare Medicare	$2.17
Rate for Payer: Cash Price	$4.20
Rate for Payer: Devoted Health Medicare	$2.38
Rate for Payer: Hawaii Medical Service Association Medicare	$2.17
Rate for Payer: Hawaii Western Management Group Commercial	$6.65
Rate for Payer: Health Management Network Commercial	$5.95
Rate for Payer: Humana Medicare	$2.17
Rate for Payer: Kaiser Permanente Commercial	$6.30
Rate for Payer: Kaiser Permanente Medicaid	$3.57
Rate for Payer: Kaiser Permanente Medicare	$2.17
Rate for Payer: MDX Hawaii PPO	$6.79
Rate for Payer: Ohana Health Plan Medicaid	$2.17
Rate for Payer: Ohana Health Plan Medicare	$2.17
Rate for Payer: UnitedHealthcare Medicare	$2.17
Rate for Payer: University Health Alliance Commercial	$5.10

VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE [14626]

Facility

$7.00

Service Code	NDC 60687050411
Hospital Revenue Code	250
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$4.20
Rate for Payer: Health Management Network Commercial	$5.95
Rate for Payer: Kaiser Permanente Commercial	$6.30
Rate for Payer: MDX Hawaii PPO	$6.79

VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE [14626]

Facility

$7.00

Service Code	NDC 60687050401
Hospital Revenue Code	250
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$4.20
Rate for Payer: Health Management Network Commercial	$5.95
Rate for Payer: Kaiser Permanente Commercial	$6.30
Rate for Payer: MDX Hawaii PPO	$6.79

VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE [13073]

Facility

$6.00

Service Code	NDC 75834015901
Hospital Revenue Code	637
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$5.82
Rate for Payer: AlohaCare Medicaid	$3.00
Rate for Payer: AlohaCare Medicare	$1.86
Rate for Payer: Cash Price	$3.60
Rate for Payer: Devoted Health Medicare	$2.04
Rate for Payer: Hawaii Medical Service Association Medicare	$1.86
Rate for Payer: Hawaii Western Management Group Commercial	$5.70
Rate for Payer: Health Management Network Commercial	$5.10
Rate for Payer: Humana Medicare	$1.86
Rate for Payer: Kaiser Permanente Commercial	$5.40
Rate for Payer: Kaiser Permanente Medicaid	$3.06
Rate for Payer: Kaiser Permanente Medicare	$1.86
Rate for Payer: MDX Hawaii PPO	$5.82
Rate for Payer: Ohana Health Plan Medicaid	$1.86
Rate for Payer: Ohana Health Plan Medicare	$1.86
Rate for Payer: UnitedHealthcare Medicare	$1.86
Rate for Payer: University Health Alliance Commercial	$4.37

VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE [13073]

Facility

$6.00

Service Code	NDC 75834015901
Hospital Revenue Code	250
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$3.60
Rate for Payer: Health Management Network Commercial	$5.10
Rate for Payer: Kaiser Permanente Commercial	$5.40
Rate for Payer: MDX Hawaii PPO	$5.82

VERSA-DIAL TI TAPER 118001

Facility

$563.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$315.28
Max. Negotiated Rate	$546.11
Rate for Payer: Cash Price	$337.80
Rate for Payer: Hawaii Western Management Group Commercial	$394.10
Rate for Payer: Health Management Network Commercial	$478.55
Rate for Payer: Kaiser Permanente Commercial	$506.70
Rate for Payer: MDX Hawaii PPO	$546.11
Rate for Payer: University Health Alliance Commercial	$315.28

VERSA-DIAL TI TAPER 118001

Facility

$563.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$174.53
Max. Negotiated Rate	$546.11
Rate for Payer: AlohaCare Medicaid	$281.50
Rate for Payer: AlohaCare Medicare	$174.53
Rate for Payer: Cash Price	$337.80
Rate for Payer: Devoted Health Medicare	$191.42
Rate for Payer: Hawaii Medical Service Association Medicare	$174.53
Rate for Payer: Hawaii Western Management Group Commercial	$394.10
Rate for Payer: Health Management Network Commercial	$478.55
Rate for Payer: Humana Medicare	$174.53
Rate for Payer: Kaiser Permanente Commercial	$506.70
Rate for Payer: Kaiser Permanente Medicaid	$287.13
Rate for Payer: Kaiser Permanente Medicare	$174.53
Rate for Payer: MDX Hawaii PPO	$546.11
Rate for Payer: Ohana Health Plan Medicaid	$174.53
Rate for Payer: Ohana Health Plan Medicare	$174.53
Rate for Payer: UnitedHealthcare Medicare	$174.53
Rate for Payer: University Health Alliance Commercial	$315.28

VERSAJET II HANDSET 45DEG/14MM

Facility

$1,587.00

Hospital Revenue Code	272
Min. Negotiated Rate	$491.97
Max. Negotiated Rate	$1,539.39
Rate for Payer: AlohaCare Medicaid	$793.50
Rate for Payer: AlohaCare Medicare	$491.97
Rate for Payer: Cash Price	$952.20
Rate for Payer: Devoted Health Medicare	$539.58
Rate for Payer: Hawaii Medical Service Association Medicare	$491.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,507.65
Rate for Payer: Health Management Network Commercial	$1,348.95
Rate for Payer: Humana Medicare	$491.97
Rate for Payer: Kaiser Permanente Commercial	$1,428.30
Rate for Payer: Kaiser Permanente Medicaid	$809.37
Rate for Payer: Kaiser Permanente Medicare	$491.97
Rate for Payer: MDX Hawaii PPO	$1,539.39
Rate for Payer: Ohana Health Plan Medicaid	$491.97
Rate for Payer: Ohana Health Plan Medicare	$491.97
Rate for Payer: UnitedHealthcare Medicare	$491.97
Rate for Payer: University Health Alliance Commercial	$1,156.76

VERSAJET II HANDSET 45DEG/14MM

Facility

$1,587.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,348.95
Max. Negotiated Rate	$1,539.39
Rate for Payer: Cash Price	$952.20
Rate for Payer: Health Management Network Commercial	$1,348.95
Rate for Payer: Kaiser Permanente Commercial	$1,428.30
Rate for Payer: MDX Hawaii PPO	$1,539.39

Know your out-of-pocket cost for care.

All Charges