Kauai Veterans Memorial Hospital

All Charges

Charge

Type

Setting

Price

MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES

Facility

$39,671.78

Service Code	MSDRG 483
Min. Negotiated Rate	$39,671.78
Max. Negotiated Rate	$39,671.78
Rate for Payer: Hawaii Medical Service Association Commercial	$39,671.78

MAJOR MALE PELVIC PROCEDURES WITH CC/MCC

Facility

$33,297.78

Service Code	MSDRG 707
Min. Negotiated Rate	$33,297.78
Max. Negotiated Rate	$33,297.78
Rate for Payer: Hawaii Medical Service Association Commercial	$33,297.78

MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC

Facility

$30,263.75

Service Code	MSDRG 708
Min. Negotiated Rate	$30,263.75
Max. Negotiated Rate	$30,263.75
Rate for Payer: Hawaii Medical Service Association Commercial	$30,263.75

MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC

Facility

$24,935.09

Service Code	MSDRG 507
Min. Negotiated Rate	$24,935.09
Max. Negotiated Rate	$24,935.09
Rate for Payer: Hawaii Medical Service Association Commercial	$24,935.09

MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC

Facility

$24,935.09

Service Code	MSDRG 508
Min. Negotiated Rate	$24,935.09
Max. Negotiated Rate	$24,935.09
Rate for Payer: Hawaii Medical Service Association Commercial	$24,935.09

MAJOR SKIN DISORDERS WITH MCC

Facility

$43,572.66

Service Code	MSDRG 595
Min. Negotiated Rate	$43,572.66
Max. Negotiated Rate	$43,572.66
Rate for Payer: Hawaii Medical Service Association Commercial	$43,572.66

MAJOR SKIN DISORDERS WITHOUT MCC

Facility

$34,955.02

Service Code	MSDRG 596
Min. Negotiated Rate	$34,955.02
Max. Negotiated Rate	$34,955.02
Rate for Payer: Hawaii Medical Service Association Commercial	$34,955.02

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$70,164.99

Service Code	MSDRG 330
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$70,164.99
Rate for Payer: Hawaii Medical Service Association Commercial	$70,164.99
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$86,660.90

Service Code	MSDRG 329
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$86,660.90
Rate for Payer: Hawaii Medical Service Association Commercial	$86,660.90
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$39,289.34

Service Code	MSDRG 331
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$39,289.34
Rate for Payer: Hawaii Medical Service Association Commercial	$39,289.34
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR THUMB OR JOINT PROCEDURES

Facility

$37,504.62

Service Code	MSDRG 506
Min. Negotiated Rate	$37,504.62
Max. Negotiated Rate	$37,504.62
Rate for Payer: Hawaii Medical Service Association Commercial	$37,504.62

Malaria Smear, Thick and Thin

Facility

$140.00

Service Code	HCPCS 87015
Hospital Charge Code	12539005
Hospital Revenue Code	306
Min. Negotiated Rate	$6.68
Max. Negotiated Rate	$135.80
Rate for Payer: AlohaCare Medicaid	$70.00
Rate for Payer: AlohaCare Medicare	$70.00
Rate for Payer: Cash Price	$91.00
Rate for Payer: Cash Price	$91.00
Rate for Payer: Devoted Health Medicare	$77.00
Rate for Payer: Hawaii Medical Service Association ABD	$9.23
Rate for Payer: Hawaii Medical Service Association Commercial	$8.35
Rate for Payer: Hawaii Medical Service Association Medicare	$70.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9.69
Rate for Payer: Hawaii Western Management Group Commercial	$6.68
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Humana Medicare	$70.00
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: Kaiser Permanente Medicaid	$71.40
Rate for Payer: Kaiser Permanente Medicare	$70.00
Rate for Payer: MDX Hawaii PPO	$135.80
Rate for Payer: Ohana Health Plan Medicaid	$70.00
Rate for Payer: Ohana Health Plan Medicare	$70.00
Rate for Payer: UnitedHealthcare Medicaid	$9.23
Rate for Payer: UnitedHealthcare Medicare	$70.00
Rate for Payer: University Health Alliance Commercial	$17.26

Malaria Smear, Thick and Thin

Facility

$140.00

Service Code	HCPCS 87015
Hospital Charge Code	12539005
Hospital Revenue Code	306
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$135.80
Rate for Payer: Cash Price	$91.00
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

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC

Facility

$61,725.82

Service Code	MSDRG 755
Min. Negotiated Rate	$61,725.82
Max. Negotiated Rate	$61,725.82
Rate for Payer: Hawaii Medical Service Association Commercial	$61,725.82

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$61,725.82

Service Code	MSDRG 754
Min. Negotiated Rate	$61,725.82
Max. Negotiated Rate	$61,725.82
Rate for Payer: Hawaii Medical Service Association Commercial	$61,725.82

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$23,175.86

Service Code	MSDRG 756
Min. Negotiated Rate	$23,175.86
Max. Negotiated Rate	$23,175.86
Rate for Payer: Hawaii Medical Service Association Commercial	$23,175.86

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC

Facility

$46,632.18

Service Code	MSDRG 723
Min. Negotiated Rate	$46,632.18
Max. Negotiated Rate	$46,632.18
Rate for Payer: Hawaii Medical Service Association Commercial	$46,632.18

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$46,632.18

Service Code	MSDRG 722
Min. Negotiated Rate	$46,632.18
Max. Negotiated Rate	$46,632.18
Rate for Payer: Hawaii Medical Service Association Commercial	$46,632.18

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$32,430.91

Service Code	MSDRG 724
Min. Negotiated Rate	$32,430.91
Max. Negotiated Rate	$32,430.91
Rate for Payer: Hawaii Medical Service Association Commercial	$32,430.91

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC

Facility

$41,558.48

Service Code	MSDRG 436
Min. Negotiated Rate	$41,558.48
Max. Negotiated Rate	$41,558.48
Rate for Payer: Hawaii Medical Service Association Commercial	$41,558.48

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC

Facility

$41,558.48

Service Code	MSDRG 435
Min. Negotiated Rate	$41,558.48
Max. Negotiated Rate	$41,558.48
Rate for Payer: Hawaii Medical Service Association Commercial	$41,558.48

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC

Facility

$41,558.48

Service Code	MSDRG 437
Min. Negotiated Rate	$41,558.48
Max. Negotiated Rate	$41,558.48
Rate for Payer: Hawaii Medical Service Association Commercial	$41,558.48

MALIGNANT BREAST DISORDERS WITH CC

Facility

$55,912.73

Service Code	MSDRG 598
Min. Negotiated Rate	$55,912.73
Max. Negotiated Rate	$55,912.73
Rate for Payer: Hawaii Medical Service Association Commercial	$55,912.73

MALIGNANT BREAST DISORDERS WITH MCC

Facility

$55,912.73

Service Code	MSDRG 597
Min. Negotiated Rate	$55,912.73
Max. Negotiated Rate	$55,912.73
Rate for Payer: Hawaii Medical Service Association Commercial	$55,912.73

MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility

$1,886.70

Service Code	MSDRG 599
Min. Negotiated Rate	$1,886.70
Max. Negotiated Rate	$1,886.70
Rate for Payer: Hawaii Medical Service Association Commercial	$1,886.70

Know your out-of-pocket cost for care.

All Charges