Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

cefTRIAXone 500 mg vial [HHSC]

Facility

IP

$6.34

Service Code	HCPCS J0696
Hospital Charge Code	2500163
Hospital Revenue Code	250
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$6.15
Rate for Payer: Cash Price	$4.12
Rate for Payer: Cash Price	$4.99
Rate for Payer: Health Management Network Commercial	$6.52
Rate for Payer: Health Management Network Commercial	$5.39
Rate for Payer: Kaiser Permanente Commercial	$5.71
Rate for Payer: Kaiser Permanente Commercial	$6.90
Rate for Payer: MDX Hawaii PPO	$6.15
Rate for Payer: MDX Hawaii PPO	$7.44

celecoxib 100 mg capsule [HHSC]

Facility

IP

$25.66

Service Code	NDC 33342015611
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$21.81
Max. Negotiated Rate	$24.89
Rate for Payer: Cash Price	$16.68
Rate for Payer: Health Management Network Commercial	$21.81
Rate for Payer: Kaiser Permanente Commercial	$23.09
Rate for Payer: MDX Hawaii PPO	$24.89

celecoxib 100 mg capsule [HHSC]

Facility

IP

$25.68

Service Code	NDC 68084096901
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$21.83
Max. Negotiated Rate	$24.91
Rate for Payer: Cash Price	$16.69
Rate for Payer: Health Management Network Commercial	$21.83
Rate for Payer: Kaiser Permanente Commercial	$23.11
Rate for Payer: MDX Hawaii PPO	$24.91

celecoxib 100 mg capsule [HHSC]

Facility

IP

$24.28

Service Code	NDC 50268016815
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$20.64
Max. Negotiated Rate	$23.55
Rate for Payer: Cash Price	$15.78
Rate for Payer: Health Management Network Commercial	$20.64
Rate for Payer: Kaiser Permanente Commercial	$21.85
Rate for Payer: MDX Hawaii PPO	$23.55

celecoxib 100 mg capsule [HHSC]

Facility

OP

$25.66

Service Code	NDC 33342015611
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$12.83
Max. Negotiated Rate	$24.89
Rate for Payer: AlohaCare Medicaid	$12.83
Rate for Payer: AlohaCare Medicare	$12.83
Rate for Payer: Cash Price	$16.68
Rate for Payer: Devoted Health Medicare	$14.11
Rate for Payer: Hawaii Medical Service Association Medicare	$12.83
Rate for Payer: Hawaii Western Management Group Commercial	$24.38
Rate for Payer: Health Management Network Commercial	$21.81
Rate for Payer: Humana Medicare	$12.83
Rate for Payer: Kaiser Permanente Commercial	$23.09
Rate for Payer: Kaiser Permanente Medicaid	$13.09
Rate for Payer: Kaiser Permanente Medicare	$12.83
Rate for Payer: MDX Hawaii PPO	$24.89
Rate for Payer: Ohana Health Plan Medicaid	$12.83
Rate for Payer: Ohana Health Plan Medicare	$12.83
Rate for Payer: UnitedHealthcare Medicaid	$15.40
Rate for Payer: UnitedHealthcare Medicare	$12.83
Rate for Payer: University Health Alliance Commercial	$18.70

celecoxib 100 mg capsule [HHSC]

Facility

IP

$25.67

Service Code	NDC 51079019920
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$21.82
Max. Negotiated Rate	$24.90
Rate for Payer: Cash Price	$16.69
Rate for Payer: Health Management Network Commercial	$21.82
Rate for Payer: Kaiser Permanente Commercial	$23.10
Rate for Payer: MDX Hawaii PPO	$24.90

celecoxib 100 mg capsule [HHSC]

Facility

OP

$24.28

Service Code	NDC 50268016815
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$12.14
Max. Negotiated Rate	$23.55
Rate for Payer: AlohaCare Medicaid	$12.14
Rate for Payer: AlohaCare Medicare	$12.14
Rate for Payer: Cash Price	$15.78
Rate for Payer: Devoted Health Medicare	$13.35
Rate for Payer: Hawaii Medical Service Association Medicare	$12.14
Rate for Payer: Hawaii Western Management Group Commercial	$23.07
Rate for Payer: Health Management Network Commercial	$20.64
Rate for Payer: Humana Medicare	$12.14
Rate for Payer: Kaiser Permanente Commercial	$21.85
Rate for Payer: Kaiser Permanente Medicaid	$12.38
Rate for Payer: Kaiser Permanente Medicare	$12.14
Rate for Payer: MDX Hawaii PPO	$23.55
Rate for Payer: Ohana Health Plan Medicaid	$12.14
Rate for Payer: Ohana Health Plan Medicare	$12.14
Rate for Payer: UnitedHealthcare Medicaid	$14.57
Rate for Payer: UnitedHealthcare Medicare	$12.14
Rate for Payer: University Health Alliance Commercial	$17.70

celecoxib 100 mg capsule [HHSC]

Facility

OP

$8.03

Service Code	NDC 00093716501
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$4.01
Max. Negotiated Rate	$7.79
Rate for Payer: AlohaCare Medicaid	$4.01
Rate for Payer: AlohaCare Medicare	$4.01
Rate for Payer: Cash Price	$5.22
Rate for Payer: Devoted Health Medicare	$4.42
Rate for Payer: Hawaii Medical Service Association Medicare	$4.01
Rate for Payer: Hawaii Western Management Group Commercial	$7.63
Rate for Payer: Health Management Network Commercial	$6.83
Rate for Payer: Humana Medicare	$4.01
Rate for Payer: Kaiser Permanente Commercial	$7.23
Rate for Payer: Kaiser Permanente Medicaid	$4.10
Rate for Payer: Kaiser Permanente Medicare	$4.01
Rate for Payer: MDX Hawaii PPO	$7.79
Rate for Payer: Ohana Health Plan Medicaid	$4.01
Rate for Payer: Ohana Health Plan Medicare	$4.01
Rate for Payer: UnitedHealthcare Medicaid	$4.82
Rate for Payer: UnitedHealthcare Medicare	$4.01
Rate for Payer: University Health Alliance Commercial	$5.85

celecoxib 100 mg capsule [HHSC]

Facility

IP

$8.03

Service Code	NDC 00093716501
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$7.79
Rate for Payer: Cash Price	$5.22
Rate for Payer: Health Management Network Commercial	$6.83
Rate for Payer: Kaiser Permanente Commercial	$7.23
Rate for Payer: MDX Hawaii PPO	$7.79

celecoxib 100 mg capsule [HHSC]

Facility

OP

$25.67

Service Code	NDC 62332014131
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$12.84
Max. Negotiated Rate	$24.90
Rate for Payer: AlohaCare Medicaid	$12.84
Rate for Payer: AlohaCare Medicare	$12.84
Rate for Payer: Cash Price	$16.69
Rate for Payer: Devoted Health Medicare	$14.12
Rate for Payer: Hawaii Medical Service Association Medicare	$12.84
Rate for Payer: Hawaii Western Management Group Commercial	$24.39
Rate for Payer: Health Management Network Commercial	$21.82
Rate for Payer: Humana Medicare	$12.84
Rate for Payer: Kaiser Permanente Commercial	$23.10
Rate for Payer: Kaiser Permanente Medicaid	$13.09
Rate for Payer: Kaiser Permanente Medicare	$12.84
Rate for Payer: MDX Hawaii PPO	$24.90
Rate for Payer: Ohana Health Plan Medicaid	$12.84
Rate for Payer: Ohana Health Plan Medicare	$12.84
Rate for Payer: UnitedHealthcare Medicaid	$15.40
Rate for Payer: UnitedHealthcare Medicare	$12.84
Rate for Payer: University Health Alliance Commercial	$18.71

celecoxib 100 mg capsule [HHSC]

Facility

IP

$25.68

Service Code	NDC 60687043601
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$21.83
Max. Negotiated Rate	$24.91
Rate for Payer: Cash Price	$16.69
Rate for Payer: Health Management Network Commercial	$21.83
Rate for Payer: Kaiser Permanente Commercial	$23.11
Rate for Payer: MDX Hawaii PPO	$24.91

celecoxib 100 mg capsule [HHSC]

Facility

OP

$25.68

Service Code	NDC 68084096901
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$12.84
Max. Negotiated Rate	$24.91
Rate for Payer: AlohaCare Medicaid	$12.84
Rate for Payer: AlohaCare Medicare	$12.84
Rate for Payer: Cash Price	$16.69
Rate for Payer: Devoted Health Medicare	$14.12
Rate for Payer: Hawaii Medical Service Association Medicare	$12.84
Rate for Payer: Hawaii Western Management Group Commercial	$24.40
Rate for Payer: Health Management Network Commercial	$21.83
Rate for Payer: Humana Medicare	$12.84
Rate for Payer: Kaiser Permanente Commercial	$23.11
Rate for Payer: Kaiser Permanente Medicaid	$13.10
Rate for Payer: Kaiser Permanente Medicare	$12.84
Rate for Payer: MDX Hawaii PPO	$24.91
Rate for Payer: Ohana Health Plan Medicaid	$12.84
Rate for Payer: Ohana Health Plan Medicare	$12.84
Rate for Payer: UnitedHealthcare Medicaid	$15.41
Rate for Payer: UnitedHealthcare Medicare	$12.84
Rate for Payer: University Health Alliance Commercial	$18.72

celecoxib 100 mg capsule [HHSC]

Facility

IP

$25.67

Service Code	NDC 62332014131
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$21.82
Max. Negotiated Rate	$24.90
Rate for Payer: Cash Price	$16.69
Rate for Payer: Health Management Network Commercial	$21.82
Rate for Payer: Kaiser Permanente Commercial	$23.10
Rate for Payer: MDX Hawaii PPO	$24.90

celecoxib 100 mg capsule [HHSC]

Facility

OP

$25.68

Service Code	NDC 60687043601
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$12.84
Max. Negotiated Rate	$24.91
Rate for Payer: AlohaCare Medicaid	$12.84
Rate for Payer: AlohaCare Medicare	$12.84
Rate for Payer: Cash Price	$16.69
Rate for Payer: Devoted Health Medicare	$14.12
Rate for Payer: Hawaii Medical Service Association Medicare	$12.84
Rate for Payer: Hawaii Western Management Group Commercial	$24.40
Rate for Payer: Health Management Network Commercial	$21.83
Rate for Payer: Humana Medicare	$12.84
Rate for Payer: Kaiser Permanente Commercial	$23.11
Rate for Payer: Kaiser Permanente Medicaid	$13.10
Rate for Payer: Kaiser Permanente Medicare	$12.84
Rate for Payer: MDX Hawaii PPO	$24.91
Rate for Payer: Ohana Health Plan Medicaid	$12.84
Rate for Payer: Ohana Health Plan Medicare	$12.84
Rate for Payer: UnitedHealthcare Medicaid	$15.41
Rate for Payer: UnitedHealthcare Medicare	$12.84
Rate for Payer: University Health Alliance Commercial	$18.72

celecoxib 100 mg capsule [HHSC]

Facility

OP

$25.67

Service Code	NDC 51079019920
Hospital Charge Code	2500166
Hospital Revenue Code	250
Min. Negotiated Rate	$12.84
Max. Negotiated Rate	$24.90
Rate for Payer: AlohaCare Medicaid	$12.84
Rate for Payer: AlohaCare Medicare	$12.84
Rate for Payer: Cash Price	$16.69
Rate for Payer: Devoted Health Medicare	$14.12
Rate for Payer: Hawaii Medical Service Association Medicare	$12.84
Rate for Payer: Hawaii Western Management Group Commercial	$24.39
Rate for Payer: Health Management Network Commercial	$21.82
Rate for Payer: Humana Medicare	$12.84
Rate for Payer: Kaiser Permanente Commercial	$23.10
Rate for Payer: Kaiser Permanente Medicaid	$13.09
Rate for Payer: Kaiser Permanente Medicare	$12.84
Rate for Payer: MDX Hawaii PPO	$24.90
Rate for Payer: Ohana Health Plan Medicaid	$12.84
Rate for Payer: Ohana Health Plan Medicare	$12.84
Rate for Payer: UnitedHealthcare Medicaid	$15.40
Rate for Payer: UnitedHealthcare Medicare	$12.84
Rate for Payer: University Health Alliance Commercial	$18.71

CELERO 12 SPRING LOADED CORE BX DEVICE (US)

Facility

IP

$919.00

Hospital Charge Code	8890533
Hospital Revenue Code	272
Min. Negotiated Rate	$781.15
Max. Negotiated Rate	$891.43
Rate for Payer: Cash Price	$597.35
Rate for Payer: Health Management Network Commercial	$781.15
Rate for Payer: Kaiser Permanente Commercial	$827.10
Rate for Payer: MDX Hawaii PPO	$891.43

CELERO 12 SPRING LOADED CORE BX DEVICE (US)

Facility

OP

$919.00

Hospital Charge Code	8890533
Hospital Revenue Code	272
Min. Negotiated Rate	$459.50
Max. Negotiated Rate	$891.43
Rate for Payer: AlohaCare Medicaid	$459.50
Rate for Payer: AlohaCare Medicare	$459.50
Rate for Payer: Cash Price	$597.35
Rate for Payer: Devoted Health Medicare	$505.45
Rate for Payer: Hawaii Medical Service Association Medicare	$459.50
Rate for Payer: Hawaii Western Management Group Commercial	$873.05
Rate for Payer: Health Management Network Commercial	$781.15
Rate for Payer: Humana Medicare	$459.50
Rate for Payer: Kaiser Permanente Commercial	$827.10
Rate for Payer: Kaiser Permanente Medicaid	$468.69
Rate for Payer: Kaiser Permanente Medicare	$459.50
Rate for Payer: MDX Hawaii PPO	$891.43
Rate for Payer: Ohana Health Plan Medicaid	$459.50
Rate for Payer: Ohana Health Plan Medicare	$459.50
Rate for Payer: UnitedHealthcare Medicare	$459.50
Rate for Payer: University Health Alliance Commercial	$669.86

Cell Count and Diff Fluid FSI

Facility

OP

$86.00

Service Code	HCPCS 89051
Hospital Charge Code	8117878
Hospital Revenue Code	309
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$83.42
Rate for Payer: AlohaCare Medicaid	$43.00
Rate for Payer: AlohaCare Medicare	$43.00
Rate for Payer: Cash Price	$55.90
Rate for Payer: Cash Price	$55.90
Rate for Payer: Devoted Health Medicare	$47.30
Rate for Payer: Hawaii Medical Service Association ABD	$7.61
Rate for Payer: Hawaii Medical Service Association Commercial	$7.00
Rate for Payer: Hawaii Medical Service Association Medicare	$43.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.99
Rate for Payer: Hawaii Western Management Group Commercial	$5.60
Rate for Payer: Health Management Network Commercial	$73.10
Rate for Payer: Humana Medicare	$43.00
Rate for Payer: Kaiser Permanente Commercial	$77.40
Rate for Payer: Kaiser Permanente Medicaid	$43.86
Rate for Payer: Kaiser Permanente Medicare	$43.00
Rate for Payer: MDX Hawaii PPO	$83.42
Rate for Payer: Ohana Health Plan Medicaid	$43.00
Rate for Payer: Ohana Health Plan Medicare	$43.00
Rate for Payer: UnitedHealthcare Medicaid	$7.61
Rate for Payer: UnitedHealthcare Medicare	$43.00
Rate for Payer: University Health Alliance Commercial	$14.24

Cell Count and Diff Fluid FSI

Facility

IP

$86.00

Service Code	HCPCS 89051
Hospital Charge Code	8117878
Hospital Revenue Code	309
Min. Negotiated Rate	$73.10
Max. Negotiated Rate	$83.42
Rate for Payer: Cash Price	$55.90
Rate for Payer: Health Management Network Commercial	$73.10
Rate for Payer: Kaiser Permanente Commercial	$77.40
Rate for Payer: MDX Hawaii PPO	$83.42

Cell Count with Diff CSF FSI

Facility

OP

$86.00

Service Code	HCPCS 89051
Hospital Charge Code	8228850
Hospital Revenue Code	309
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$83.42
Rate for Payer: AlohaCare Medicaid	$43.00
Rate for Payer: AlohaCare Medicare	$43.00
Rate for Payer: Cash Price	$55.90
Rate for Payer: Cash Price	$55.90
Rate for Payer: Devoted Health Medicare	$47.30
Rate for Payer: Hawaii Medical Service Association ABD	$7.61
Rate for Payer: Hawaii Medical Service Association Commercial	$7.00
Rate for Payer: Hawaii Medical Service Association Medicare	$43.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.99
Rate for Payer: Hawaii Western Management Group Commercial	$5.60
Rate for Payer: Health Management Network Commercial	$73.10
Rate for Payer: Humana Medicare	$43.00
Rate for Payer: Kaiser Permanente Commercial	$77.40
Rate for Payer: Kaiser Permanente Medicaid	$43.86
Rate for Payer: Kaiser Permanente Medicare	$43.00
Rate for Payer: MDX Hawaii PPO	$83.42
Rate for Payer: Ohana Health Plan Medicaid	$43.00
Rate for Payer: Ohana Health Plan Medicare	$43.00
Rate for Payer: UnitedHealthcare Medicaid	$7.61
Rate for Payer: UnitedHealthcare Medicare	$43.00
Rate for Payer: University Health Alliance Commercial	$14.24

Cell Count with Diff CSF FSI

Facility

IP

$86.00

Service Code	HCPCS 89051
Hospital Charge Code	8228850
Hospital Revenue Code	309
Min. Negotiated Rate	$73.10
Max. Negotiated Rate	$83.42
Rate for Payer: Cash Price	$55.90
Rate for Payer: Health Management Network Commercial	$73.10
Rate for Payer: Kaiser Permanente Commercial	$77.40
Rate for Payer: MDX Hawaii PPO	$83.42

CELLULITIS WITH MCC

Facility

IP

$25,801.95

Service Code	MSDRG 602
Min. Negotiated Rate	$25,801.95
Max. Negotiated Rate	$25,801.95
Rate for Payer: Hawaii Medical Service Association Commercial	$25,801.95

CELLULITIS WITHOUT MCC

Facility

IP

$17,362.78

Service Code	MSDRG 603
Min. Negotiated Rate	$17,362.78
Max. Negotiated Rate	$17,362.78
Rate for Payer: Hawaii Medical Service Association Commercial	$17,362.78

cephalexin 250 mg/5 mL 100ml [HHSC]

Facility

OP

$138.32

Service Code	NDC 68180044101
Hospital Charge Code	2500167
Hospital Revenue Code	250
Min. Negotiated Rate	$69.16
Max. Negotiated Rate	$134.17
Rate for Payer: AlohaCare Medicaid	$69.16
Rate for Payer: AlohaCare Medicare	$69.16
Rate for Payer: Cash Price	$89.91
Rate for Payer: Devoted Health Medicare	$76.08
Rate for Payer: Hawaii Medical Service Association Medicare	$69.16
Rate for Payer: Hawaii Western Management Group Commercial	$131.40
Rate for Payer: Health Management Network Commercial	$117.57
Rate for Payer: Humana Medicare	$69.16
Rate for Payer: Kaiser Permanente Commercial	$124.49
Rate for Payer: Kaiser Permanente Medicaid	$70.54
Rate for Payer: Kaiser Permanente Medicare	$69.16
Rate for Payer: MDX Hawaii PPO	$134.17
Rate for Payer: Ohana Health Plan Medicaid	$69.16
Rate for Payer: Ohana Health Plan Medicare	$69.16
Rate for Payer: UnitedHealthcare Medicaid	$82.99
Rate for Payer: UnitedHealthcare Medicare	$69.16
Rate for Payer: University Health Alliance Commercial	$100.82

cephalexin 250 mg/5 mL 100ml [HHSC]

Facility

IP

$138.32

Service Code	NDC 68180044101
Hospital Charge Code	2500167
Hospital Revenue Code	250
Min. Negotiated Rate	$117.57
Max. Negotiated Rate	$134.17
Rate for Payer: Cash Price	$89.91
Rate for Payer: Health Management Network Commercial	$117.57
Rate for Payer: Kaiser Permanente Commercial	$124.49
Rate for Payer: MDX Hawaii PPO	$134.17

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