Kauai Veterans Memorial Hospital

All Charges

Charge

Type

Setting

Price

KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC

Facility

$46,555.70

Service Code	MSDRG 658
Min. Negotiated Rate	$46,555.70
Max. Negotiated Rate	$46,555.70
Rate for Payer: Hawaii Medical Service Association Commercial	$46,555.70

KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC

Facility

$49,538.73

Service Code	MSDRG 660
Min. Negotiated Rate	$49,538.73
Max. Negotiated Rate	$49,538.73
Rate for Payer: Hawaii Medical Service Association Commercial	$49,538.73

KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC

Facility

$51,374.44

Service Code	MSDRG 659
Min. Negotiated Rate	$51,374.44
Max. Negotiated Rate	$51,374.44
Rate for Payer: Hawaii Medical Service Association Commercial	$51,374.44

KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC

Facility

$33,501.74

Service Code	MSDRG 661
Min. Negotiated Rate	$33,501.74
Max. Negotiated Rate	$33,501.74
Rate for Payer: Hawaii Medical Service Association Commercial	$33,501.74

KIDNEY AND URINARY TRACT INFECTIONS WITH MCC

Facility

$18,867.04

Service Code	MSDRG 689
Min. Negotiated Rate	$18,867.04
Max. Negotiated Rate	$18,867.04
Rate for Payer: Hawaii Medical Service Association Commercial	$18,867.04

KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC

Facility

$16,113.47

Service Code	MSDRG 690
Min. Negotiated Rate	$16,113.47
Max. Negotiated Rate	$16,113.47
Rate for Payer: Hawaii Medical Service Association Commercial	$16,113.47

KIDNEY AND URINARY TRACT NEOPLASMS WITH CC

Facility

$33,272.28

Service Code	MSDRG 687
Min. Negotiated Rate	$33,272.28
Max. Negotiated Rate	$33,272.28
Rate for Payer: Hawaii Medical Service Association Commercial	$33,272.28

KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC

Facility

$33,272.28

Service Code	MSDRG 686
Min. Negotiated Rate	$33,272.28
Max. Negotiated Rate	$33,272.28
Rate for Payer: Hawaii Medical Service Association Commercial	$33,272.28

KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC

Facility

$33,272.28

Service Code	MSDRG 688
Min. Negotiated Rate	$33,272.28
Max. Negotiated Rate	$33,272.28
Rate for Payer: Hawaii Medical Service Association Commercial	$33,272.28

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC

Facility

$22,079.54

Service Code	MSDRG 695
Min. Negotiated Rate	$22,079.54
Max. Negotiated Rate	$22,079.54
Rate for Payer: Hawaii Medical Service Association Commercial	$22,079.54

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC

Facility

$22,079.54

Service Code	MSDRG 696
Min. Negotiated Rate	$22,079.54
Max. Negotiated Rate	$22,079.54
Rate for Payer: Hawaii Medical Service Association Commercial	$22,079.54

Kidney Stone Risk Profile FSI

Facility

$215.00

Service Code	HCPCS 82365
Hospital Charge Code	10046577
Hospital Revenue Code	300
Min. Negotiated Rate	$11.44
Max. Negotiated Rate	$208.55
Rate for Payer: AlohaCare Medicaid	$107.50
Rate for Payer: AlohaCare Medicare	$107.50
Rate for Payer: Cash Price	$139.75
Rate for Payer: Cash Price	$139.75
Rate for Payer: Devoted Health Medicare	$118.25
Rate for Payer: Hawaii Medical Service Association ABD	$11.44
Rate for Payer: Hawaii Medical Service Association Commercial	$16.12
Rate for Payer: Hawaii Medical Service Association Medicare	$107.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$12.01
Rate for Payer: Hawaii Western Management Group Commercial	$12.90
Rate for Payer: Health Management Network Commercial	$182.75
Rate for Payer: Humana Medicare	$107.50
Rate for Payer: Kaiser Permanente Commercial	$193.50
Rate for Payer: Kaiser Permanente Medicaid	$109.65
Rate for Payer: Kaiser Permanente Medicare	$107.50
Rate for Payer: MDX Hawaii PPO	$208.55
Rate for Payer: Ohana Health Plan Medicaid	$107.50
Rate for Payer: Ohana Health Plan Medicare	$107.50
Rate for Payer: UnitedHealthcare Medicaid	$11.44
Rate for Payer: UnitedHealthcare Medicare	$107.50
Rate for Payer: University Health Alliance Commercial	$21.40

Kidney Stone Risk Profile FSI

Facility

$215.00

Service Code	HCPCS 82365
Hospital Charge Code	10046577
Hospital Revenue Code	300
Min. Negotiated Rate	$182.75
Max. Negotiated Rate	$208.55
Rate for Payer: Cash Price	$139.75
Rate for Payer: Health Management Network Commercial	$182.75
Rate for Payer: Kaiser Permanente Commercial	$193.50
Rate for Payer: MDX Hawaii PPO	$208.55

KIDNEY TRANSPLANT

Facility

$166,437.89

Service Code	MSDRG 652
Min. Negotiated Rate	$166,437.89
Max. Negotiated Rate	$166,437.89
Rate for Payer: Hawaii Medical Service Association Commercial	$166,437.89

KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC

Facility

$166,437.89

Service Code	MSDRG 650
Min. Negotiated Rate	$166,437.89
Max. Negotiated Rate	$166,437.89
Rate for Payer: Hawaii Medical Service Association Commercial	$166,437.89

KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC

Facility

$166,437.89

Service Code	MSDRG 651
Min. Negotiated Rate	$166,437.89
Max. Negotiated Rate	$166,437.89
Rate for Payer: Hawaii Medical Service Association Commercial	$166,437.89

KIT 20G ARTERIAL LINE

Facility

$376.00

Hospital Charge Code	8266520
Hospital Revenue Code	272
Min. Negotiated Rate	$319.60
Max. Negotiated Rate	$364.72
Rate for Payer: Cash Price	$244.40
Rate for Payer: Health Management Network Commercial	$319.60
Rate for Payer: Kaiser Permanente Commercial	$338.40
Rate for Payer: MDX Hawaii PPO	$364.72

KIT 20G ARTERIAL LINE

Facility

$376.00

Hospital Charge Code	8266520
Hospital Revenue Code	272
Min. Negotiated Rate	$188.00
Max. Negotiated Rate	$364.72
Rate for Payer: AlohaCare Medicaid	$188.00
Rate for Payer: AlohaCare Medicare	$188.00
Rate for Payer: Cash Price	$244.40
Rate for Payer: Devoted Health Medicare	$206.80
Rate for Payer: Hawaii Medical Service Association Medicare	$188.00
Rate for Payer: Hawaii Western Management Group Commercial	$357.20
Rate for Payer: Health Management Network Commercial	$319.60
Rate for Payer: Humana Medicare	$188.00
Rate for Payer: Kaiser Permanente Commercial	$338.40
Rate for Payer: Kaiser Permanente Medicaid	$191.76
Rate for Payer: Kaiser Permanente Medicare	$188.00
Rate for Payer: MDX Hawaii PPO	$364.72
Rate for Payer: Ohana Health Plan Medicaid	$188.00
Rate for Payer: Ohana Health Plan Medicare	$188.00
Rate for Payer: UnitedHealthcare Medicare	$188.00
Rate for Payer: University Health Alliance Commercial	$274.07

KIT ARTERIAL LINE 18G X 3

Facility

$250.00

Hospital Charge Code	8266569
Hospital Revenue Code	272
Min. Negotiated Rate	$212.50
Max. Negotiated Rate	$242.50
Rate for Payer: Cash Price	$162.50
Rate for Payer: Health Management Network Commercial	$212.50
Rate for Payer: Kaiser Permanente Commercial	$225.00
Rate for Payer: MDX Hawaii PPO	$242.50

KIT ARTERIAL LINE 18G X 3

Facility

$250.00

Hospital Charge Code	8266569
Hospital Revenue Code	272
Min. Negotiated Rate	$125.00
Max. Negotiated Rate	$242.50
Rate for Payer: AlohaCare Medicaid	$125.00
Rate for Payer: AlohaCare Medicare	$125.00
Rate for Payer: Cash Price	$162.50
Rate for Payer: Devoted Health Medicare	$137.50
Rate for Payer: Hawaii Medical Service Association Medicare	$125.00
Rate for Payer: Hawaii Western Management Group Commercial	$237.50
Rate for Payer: Health Management Network Commercial	$212.50
Rate for Payer: Humana Medicare	$125.00
Rate for Payer: Kaiser Permanente Commercial	$225.00
Rate for Payer: Kaiser Permanente Medicaid	$127.50
Rate for Payer: Kaiser Permanente Medicare	$125.00
Rate for Payer: MDX Hawaii PPO	$242.50
Rate for Payer: Ohana Health Plan Medicaid	$125.00
Rate for Payer: Ohana Health Plan Medicare	$125.00
Rate for Payer: UnitedHealthcare Medicare	$125.00
Rate for Payer: University Health Alliance Commercial	$182.22

KIT CENTRAL LINE DRESSING

Facility

$96.00

Hospital Charge Code	8266496
Hospital Revenue Code	272
Min. Negotiated Rate	$81.60
Max. Negotiated Rate	$93.12
Rate for Payer: Cash Price	$62.40
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

KIT CENTRAL LINE DRESSING

Facility

$96.00

Hospital Charge Code	8266496
Hospital Revenue Code	272
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$93.12
Rate for Payer: AlohaCare Medicaid	$48.00
Rate for Payer: AlohaCare Medicare	$48.00
Rate for Payer: Cash Price	$62.40
Rate for Payer: Devoted Health Medicare	$52.80
Rate for Payer: Hawaii Medical Service Association Medicare	$48.00
Rate for Payer: Hawaii Western Management Group Commercial	$91.20
Rate for Payer: Health Management Network Commercial	$81.60
Rate for Payer: Humana Medicare	$48.00
Rate for Payer: Kaiser Permanente Commercial	$86.40
Rate for Payer: Kaiser Permanente Medicaid	$48.96
Rate for Payer: Kaiser Permanente Medicare	$48.00
Rate for Payer: MDX Hawaii PPO	$93.12
Rate for Payer: Ohana Health Plan Medicaid	$48.00
Rate for Payer: Ohana Health Plan Medicare	$48.00
Rate for Payer: UnitedHealthcare Medicare	$48.00
Rate for Payer: University Health Alliance Commercial	$69.97

KIT EZ-IO 25MM 15G NEEDLE+STABLIZER

Facility

$577.00

Hospital Charge Code	8500827
Hospital Revenue Code	272
Min. Negotiated Rate	$490.45
Max. Negotiated Rate	$559.69
Rate for Payer: Cash Price	$375.05
Rate for Payer: Health Management Network Commercial	$490.45
Rate for Payer: Kaiser Permanente Commercial	$519.30
Rate for Payer: MDX Hawaii PPO	$559.69

KIT EZ-IO 25MM 15G NEEDLE+STABLIZER

Facility

$577.00

Hospital Charge Code	8500827
Hospital Revenue Code	272
Min. Negotiated Rate	$288.50
Max. Negotiated Rate	$559.69
Rate for Payer: AlohaCare Medicaid	$288.50
Rate for Payer: AlohaCare Medicare	$288.50
Rate for Payer: Cash Price	$375.05
Rate for Payer: Devoted Health Medicare	$317.35
Rate for Payer: Hawaii Medical Service Association Medicare	$288.50
Rate for Payer: Hawaii Western Management Group Commercial	$548.15
Rate for Payer: Health Management Network Commercial	$490.45
Rate for Payer: Humana Medicare	$288.50
Rate for Payer: Kaiser Permanente Commercial	$519.30
Rate for Payer: Kaiser Permanente Medicaid	$294.27
Rate for Payer: Kaiser Permanente Medicare	$288.50
Rate for Payer: MDX Hawaii PPO	$559.69
Rate for Payer: Ohana Health Plan Medicaid	$288.50
Rate for Payer: Ohana Health Plan Medicare	$288.50
Rate for Payer: UnitedHealthcare Medicare	$288.50
Rate for Payer: University Health Alliance Commercial	$420.58

KIT EZ-IO 45MM NEEDLE+STABILIZER

Facility

$535.00

Hospital Charge Code	8500828
Hospital Revenue Code	272
Min. Negotiated Rate	$267.50
Max. Negotiated Rate	$518.95
Rate for Payer: AlohaCare Medicaid	$267.50
Rate for Payer: AlohaCare Medicare	$267.50
Rate for Payer: Cash Price	$347.75
Rate for Payer: Devoted Health Medicare	$294.25
Rate for Payer: Hawaii Medical Service Association Medicare	$267.50
Rate for Payer: Hawaii Western Management Group Commercial	$508.25
Rate for Payer: Health Management Network Commercial	$454.75
Rate for Payer: Humana Medicare	$267.50
Rate for Payer: Kaiser Permanente Commercial	$481.50
Rate for Payer: Kaiser Permanente Medicaid	$272.85
Rate for Payer: Kaiser Permanente Medicare	$267.50
Rate for Payer: MDX Hawaii PPO	$518.95
Rate for Payer: Ohana Health Plan Medicaid	$267.50
Rate for Payer: Ohana Health Plan Medicare	$267.50
Rate for Payer: UnitedHealthcare Medicare	$267.50
Rate for Payer: University Health Alliance Commercial	$389.96

Know your out-of-pocket cost for care.

All Charges