Kauai Veterans Memorial Hospital

All Charges

Charge

Type

Setting

Price

32405 XA Biopsy Lung Mediastinum Charges

Facility

$7,195.00

Service Code	HCPCS 32408
Hospital Charge Code	8221515
Hospital Revenue Code	761
Min. Negotiated Rate	$456.03
Max. Negotiated Rate	$6,979.15
Rate for Payer: AlohaCare Medicaid	$3,597.50
Rate for Payer: AlohaCare Medicare	$3,597.50
Rate for Payer: Cash Price	$4,676.75
Rate for Payer: Cash Price	$4,676.75
Rate for Payer: Devoted Health Medicare	$3,957.25
Rate for Payer: Hawaii Medical Service Association ABD	$695.00
Rate for Payer: Hawaii Medical Service Association Commercial	$5,655.00
Rate for Payer: Hawaii Medical Service Association Medicare	$3,597.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$700.72
Rate for Payer: Hawaii Western Management Group Commercial	$6,835.25
Rate for Payer: Health Management Network Commercial	$6,115.75
Rate for Payer: Humana Medicare	$3,597.50
Rate for Payer: Kaiser Permanente Commercial	$6,475.50
Rate for Payer: Kaiser Permanente Medicaid	$3,669.45
Rate for Payer: Kaiser Permanente Medicare	$3,597.50
Rate for Payer: MDX Hawaii PPO	$6,979.15
Rate for Payer: Ohana Health Plan Medicaid	$3,597.50
Rate for Payer: Ohana Health Plan Medicare	$3,597.50
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$3,597.50
Rate for Payer: University Health Alliance Commercial	$5,160.40

32550-Insertion Tunneled Pleural Cath

Facility

$14,669.00

Service Code	HCPCS 32550
Hospital Charge Code	8080185
Hospital Revenue Code	450
Min. Negotiated Rate	$393.00
Max. Negotiated Rate	$14,228.93
Rate for Payer: AlohaCare Medicaid	$525.09
Rate for Payer: AlohaCare Medicare	$7,334.50
Rate for Payer: Cash Price	$9,534.85
Rate for Payer: Cash Price	$9,534.85
Rate for Payer: Cash Price	$9,534.85
Rate for Payer: Devoted Health Medicare	$8,067.95
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,389.00
Rate for Payer: Hawaii Medical Service Association Medicare	$7,334.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Hawaii Western Management Group Commercial	$13,935.55
Rate for Payer: Health Management Network Commercial	$12,468.65
Rate for Payer: Humana Medicare	$7,334.50
Rate for Payer: Kaiser Permanente Commercial	$13,202.10
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$7,334.50
Rate for Payer: MDX Hawaii PPO	$14,228.93
Rate for Payer: Ohana Health Plan Medicaid	$7,334.50
Rate for Payer: Ohana Health Plan Medicare	$7,334.50
Rate for Payer: UnitedHealthcare Medicaid	$456.03
Rate for Payer: UnitedHealthcare Medicare	$7,334.50
Rate for Payer: University Health Alliance Commercial	$4,035.20

32550-Insertion Tunneled Pleural Cath

Facility

$14,669.00

Service Code	HCPCS 32550
Hospital Charge Code	8080185
Hospital Revenue Code	450
Min. Negotiated Rate	$12,468.65
Max. Negotiated Rate	$14,228.93
Rate for Payer: Cash Price	$9,534.85
Rate for Payer: Health Management Network Commercial	$12,468.65
Rate for Payer: Kaiser Permanente Commercial	$13,202.10
Rate for Payer: MDX Hawaii PPO	$14,228.93

32551-Insertion Chest Tube

Facility

$2,672.00

Service Code	HCPCS 32551
Hospital Charge Code	8080171
Hospital Revenue Code	450
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$2,591.84
Rate for Payer: AlohaCare Medicaid	$525.09
Rate for Payer: AlohaCare Medicare	$1,336.00
Rate for Payer: Cash Price	$1,736.80
Rate for Payer: Cash Price	$1,736.80
Rate for Payer: Cash Price	$1,736.80
Rate for Payer: Devoted Health Medicare	$1,469.60
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,389.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,336.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Hawaii Western Management Group Commercial	$2,538.40
Rate for Payer: Health Management Network Commercial	$2,271.20
Rate for Payer: Humana Medicare	$1,336.00
Rate for Payer: Kaiser Permanente Commercial	$2,404.80
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$1,336.00
Rate for Payer: MDX Hawaii PPO	$2,591.84
Rate for Payer: Ohana Health Plan Medicaid	$1,336.00
Rate for Payer: Ohana Health Plan Medicare	$1,336.00
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$1,336.00
Rate for Payer: University Health Alliance Commercial	$1,947.62

32551-Insertion Chest Tube

Facility

$2,672.00

Service Code	HCPCS 32551
Hospital Charge Code	8080171
Hospital Revenue Code	450
Min. Negotiated Rate	$2,271.20
Max. Negotiated Rate	$2,591.84
Rate for Payer: Cash Price	$1,736.80
Rate for Payer: Health Management Network Commercial	$2,271.20
Rate for Payer: Kaiser Permanente Commercial	$2,404.80
Rate for Payer: MDX Hawaii PPO	$2,591.84

32551 INSERTION OF CHEST TUBE BILAT CHARGE

Facility

$2,632.00

Service Code	HCPCS 32551 50
Hospital Charge Code	8408895
Hospital Revenue Code	761
Min. Negotiated Rate	$2,237.20
Max. Negotiated Rate	$2,553.04
Rate for Payer: Cash Price	$1,710.80
Rate for Payer: Health Management Network Commercial	$2,237.20
Rate for Payer: Kaiser Permanente Commercial	$2,368.80
Rate for Payer: MDX Hawaii PPO	$2,553.04

32551 INSERTION OF CHEST TUBE BILAT CHARGE

Facility

$2,632.00

Service Code	HCPCS 32551 50
Hospital Charge Code	8408895
Hospital Revenue Code	761
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$2,553.04
Rate for Payer: AlohaCare Medicaid	$1,316.00
Rate for Payer: AlohaCare Medicare	$1,316.00
Rate for Payer: Cash Price	$1,710.80
Rate for Payer: Cash Price	$1,710.80
Rate for Payer: Devoted Health Medicare	$1,447.60
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,389.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,316.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Hawaii Western Management Group Commercial	$2,500.40
Rate for Payer: Health Management Network Commercial	$2,237.20
Rate for Payer: Humana Medicare	$1,316.00
Rate for Payer: Kaiser Permanente Commercial	$2,368.80
Rate for Payer: Kaiser Permanente Medicaid	$1,342.32
Rate for Payer: Kaiser Permanente Medicare	$1,316.00
Rate for Payer: MDX Hawaii PPO	$2,553.04
Rate for Payer: Ohana Health Plan Medicaid	$1,316.00
Rate for Payer: Ohana Health Plan Medicare	$1,316.00
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$1,316.00
Rate for Payer: University Health Alliance Commercial	$1,918.46

32551 INSERTION OF CHEST TUBE LT CHARGE

Facility

$2,632.00

Service Code	HCPCS 32551 LT
Hospital Charge Code	8408902
Hospital Revenue Code	761
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$2,553.04
Rate for Payer: AlohaCare Medicaid	$1,316.00
Rate for Payer: AlohaCare Medicare	$1,316.00
Rate for Payer: Cash Price	$1,710.80
Rate for Payer: Cash Price	$1,710.80
Rate for Payer: Devoted Health Medicare	$1,447.60
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,389.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,316.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Hawaii Western Management Group Commercial	$2,500.40
Rate for Payer: Health Management Network Commercial	$2,237.20
Rate for Payer: Humana Medicare	$1,316.00
Rate for Payer: Kaiser Permanente Commercial	$2,368.80
Rate for Payer: Kaiser Permanente Medicaid	$1,342.32
Rate for Payer: Kaiser Permanente Medicare	$1,316.00
Rate for Payer: MDX Hawaii PPO	$2,553.04
Rate for Payer: Ohana Health Plan Medicaid	$1,316.00
Rate for Payer: Ohana Health Plan Medicare	$1,316.00
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$1,316.00
Rate for Payer: University Health Alliance Commercial	$1,918.46

32551 INSERTION OF CHEST TUBE LT CHARGE

Facility

$2,632.00

Service Code	HCPCS 32551 LT
Hospital Charge Code	8408902
Hospital Revenue Code	761
Min. Negotiated Rate	$2,237.20
Max. Negotiated Rate	$2,553.04
Rate for Payer: Cash Price	$1,710.80
Rate for Payer: Health Management Network Commercial	$2,237.20
Rate for Payer: Kaiser Permanente Commercial	$2,368.80
Rate for Payer: MDX Hawaii PPO	$2,553.04

32551 INSERTION OF CHEST TUBE RT CHARGE

Facility

$2,632.00

Service Code	HCPCS 32551 RT
Hospital Charge Code	8408916
Hospital Revenue Code	761
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$2,553.04
Rate for Payer: AlohaCare Medicaid	$1,316.00
Rate for Payer: AlohaCare Medicare	$1,316.00
Rate for Payer: Cash Price	$1,710.80
Rate for Payer: Cash Price	$1,710.80
Rate for Payer: Devoted Health Medicare	$1,447.60
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,389.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,316.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Hawaii Western Management Group Commercial	$2,500.40
Rate for Payer: Health Management Network Commercial	$2,237.20
Rate for Payer: Humana Medicare	$1,316.00
Rate for Payer: Kaiser Permanente Commercial	$2,368.80
Rate for Payer: Kaiser Permanente Medicaid	$1,342.32
Rate for Payer: Kaiser Permanente Medicare	$1,316.00
Rate for Payer: MDX Hawaii PPO	$2,553.04
Rate for Payer: Ohana Health Plan Medicaid	$1,316.00
Rate for Payer: Ohana Health Plan Medicare	$1,316.00
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$1,316.00
Rate for Payer: University Health Alliance Commercial	$1,918.46

32551 INSERTION OF CHEST TUBE RT CHARGE

Facility

$2,632.00

Service Code	HCPCS 32551 RT
Hospital Charge Code	8408916
Hospital Revenue Code	761
Min. Negotiated Rate	$2,237.20
Max. Negotiated Rate	$2,553.04
Rate for Payer: Cash Price	$1,710.80
Rate for Payer: Health Management Network Commercial	$2,237.20
Rate for Payer: Kaiser Permanente Commercial	$2,368.80
Rate for Payer: MDX Hawaii PPO	$2,553.04

32551 TUBE THORACOSTOMY, INCLUDES CONNECTION TO DRAINAGE SYSTEM (EG, WATER SEAL), WHEN PERFO ProFee

Professional

Both

$2,191.00

Service Code	HCPCS 32551
Hospital Charge Code	8018681
Hospital Revenue Code	960
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$1,862.35
Rate for Payer: AlohaCare Medicaid	$150.10
Rate for Payer: AlohaCare Medicare	$138.75
Rate for Payer: Cash Price	$1,424.15
Rate for Payer: Cash Price	$1,424.15
Rate for Payer: Devoted Health Medicare	$152.62
Rate for Payer: Hawaii Medical Service Association Medicare	$138.75
Rate for Payer: Hawaii Western Management Group Commercial	$160.16
Rate for Payer: Health Management Network Commercial	$1,862.35
Rate for Payer: Kaiser Permanente Commercial	$152.62
Rate for Payer: Kaiser Permanente Medicaid	$152.62
Rate for Payer: Kaiser Permanente Medicare	$152.62
Rate for Payer: Ohana Health Plan Medicaid	$150.10
Rate for Payer: Ohana Health Plan Medicare	$138.75
Rate for Payer: UnitedHealthcare Medicaid	$150.10
Rate for Payer: UnitedHealthcare Medicare	$138.75

32551 TUBE THORACOSTOMY INCLUDES WATER SEAL TechFee

Facility

$3,190.00

Service Code	HCPCS 32551
Hospital Charge Code	8211298
Hospital Revenue Code	450
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$3,094.30
Rate for Payer: AlohaCare Medicaid	$525.09
Rate for Payer: AlohaCare Medicare	$1,595.00
Rate for Payer: Cash Price	$2,073.50
Rate for Payer: Cash Price	$2,073.50
Rate for Payer: Cash Price	$2,073.50
Rate for Payer: Devoted Health Medicare	$1,754.50
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,389.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,595.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Hawaii Western Management Group Commercial	$3,030.50
Rate for Payer: Health Management Network Commercial	$2,711.50
Rate for Payer: Humana Medicare	$1,595.00
Rate for Payer: Kaiser Permanente Commercial	$2,871.00
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$1,595.00
Rate for Payer: MDX Hawaii PPO	$3,094.30
Rate for Payer: Ohana Health Plan Medicaid	$1,595.00
Rate for Payer: Ohana Health Plan Medicare	$1,595.00
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$1,595.00
Rate for Payer: University Health Alliance Commercial	$2,325.19

32551 TUBE THORACOSTOMY INCLUDES WATER SEAL TechFee

Facility

$3,190.00

Service Code	HCPCS 32551
Hospital Charge Code	8211298
Hospital Revenue Code	450
Min. Negotiated Rate	$2,711.50
Max. Negotiated Rate	$3,094.30
Rate for Payer: Cash Price	$2,073.50
Rate for Payer: Health Management Network Commercial	$2,711.50
Rate for Payer: Kaiser Permanente Commercial	$2,871.00
Rate for Payer: MDX Hawaii PPO	$3,094.30

32554 Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance

Professional

Both

$873.00

Service Code	HCPCS 32554
Hospital Charge Code	8038699
Hospital Revenue Code	975
Min. Negotiated Rate	$77.99
Max. Negotiated Rate	$742.05
Rate for Payer: AlohaCare Medicaid	$86.69
Rate for Payer: AlohaCare Medicare	$77.99
Rate for Payer: Cash Price	$567.45
Rate for Payer: Cash Price	$567.45
Rate for Payer: Devoted Health Medicare	$85.79
Rate for Payer: Hawaii Medical Service Association ABD	$86.69
Rate for Payer: Hawaii Medical Service Association Commercial	$145.57
Rate for Payer: Hawaii Medical Service Association Medicare	$77.99
Rate for Payer: Hawaii Medical Service Association Non-ABD	$86.69
Rate for Payer: Health Management Network Commercial	$742.05
Rate for Payer: Kaiser Permanente Commercial	$85.79
Rate for Payer: Kaiser Permanente Medicaid	$85.79
Rate for Payer: Kaiser Permanente Medicare	$85.79
Rate for Payer: Ohana Health Plan Medicaid	$86.69
Rate for Payer: Ohana Health Plan Medicare	$77.99
Rate for Payer: UnitedHealthcare Medicaid	$86.69
Rate for Payer: UnitedHealthcare Medicare	$77.99
Rate for Payer: University Health Alliance Commercial	$116.87

32554 Thoracentesis w/o Imaging

Facility

$1,652.00

Service Code	HCPCS 32554
Hospital Charge Code	11464803
Hospital Revenue Code	450
Min. Negotiated Rate	$1,404.20
Max. Negotiated Rate	$1,602.44
Rate for Payer: Cash Price	$1,073.80
Rate for Payer: Health Management Network Commercial	$1,404.20
Rate for Payer: Kaiser Permanente Commercial	$1,486.80
Rate for Payer: MDX Hawaii PPO	$1,602.44

32554 Thoracentesis w/o Imaging

Facility

$1,652.00

Service Code	HCPCS 32554
Hospital Charge Code	11464803
Hospital Revenue Code	450
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$4,035.20
Rate for Payer: AlohaCare Medicaid	$525.09
Rate for Payer: AlohaCare Medicare	$826.00
Rate for Payer: Cash Price	$1,073.80
Rate for Payer: Cash Price	$1,073.80
Rate for Payer: Cash Price	$1,073.80
Rate for Payer: Devoted Health Medicare	$908.60
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,389.00
Rate for Payer: Hawaii Medical Service Association Medicare	$826.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,569.40
Rate for Payer: Health Management Network Commercial	$1,404.20
Rate for Payer: Humana Medicare	$826.00
Rate for Payer: Kaiser Permanente Commercial	$1,486.80
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$826.00
Rate for Payer: MDX Hawaii PPO	$1,602.44
Rate for Payer: Ohana Health Plan Medicaid	$826.00
Rate for Payer: Ohana Health Plan Medicare	$826.00
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$826.00
Rate for Payer: University Health Alliance Commercial	$4,035.20

32554-Thoracentesis w/o Imaging Guidance

Facility

$1,832.00

Service Code	HCPCS 32554
Hospital Charge Code	8080187
Hospital Revenue Code	450
Min. Negotiated Rate	$1,557.20
Max. Negotiated Rate	$1,777.04
Rate for Payer: Cash Price	$1,190.80
Rate for Payer: Health Management Network Commercial	$1,557.20
Rate for Payer: Kaiser Permanente Commercial	$1,648.80
Rate for Payer: MDX Hawaii PPO	$1,777.04

32554-Thoracentesis w/o Imaging Guidance

Facility

$1,832.00

Service Code	HCPCS 32554
Hospital Charge Code	8080187
Hospital Revenue Code	450
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$4,035.20
Rate for Payer: AlohaCare Medicaid	$525.09
Rate for Payer: AlohaCare Medicare	$916.00
Rate for Payer: Cash Price	$1,190.80
Rate for Payer: Cash Price	$1,190.80
Rate for Payer: Cash Price	$1,190.80
Rate for Payer: Devoted Health Medicare	$1,007.60
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,389.00
Rate for Payer: Hawaii Medical Service Association Medicare	$916.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,740.40
Rate for Payer: Health Management Network Commercial	$1,557.20
Rate for Payer: Humana Medicare	$916.00
Rate for Payer: Kaiser Permanente Commercial	$1,648.80
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$916.00
Rate for Payer: MDX Hawaii PPO	$1,777.04
Rate for Payer: Ohana Health Plan Medicaid	$916.00
Rate for Payer: Ohana Health Plan Medicare	$916.00
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$916.00
Rate for Payer: University Health Alliance Commercial	$4,035.20

32554 THORACENTESIS w/o IMAGING LT CHARGE

Facility

$1,402.00

Service Code	HCPCS 32554 LT
Hospital Charge Code	8408927
Hospital Revenue Code	761
Min. Negotiated Rate	$1,191.70
Max. Negotiated Rate	$1,359.94
Rate for Payer: Cash Price	$911.30
Rate for Payer: Health Management Network Commercial	$1,191.70
Rate for Payer: Kaiser Permanente Commercial	$1,261.80
Rate for Payer: MDX Hawaii PPO	$1,359.94

32554 THORACENTESIS w/o IMAGING LT CHARGE

Facility

$1,402.00

Service Code	HCPCS 32554 LT
Hospital Charge Code	8408927
Hospital Revenue Code	761
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$4,035.20
Rate for Payer: AlohaCare Medicaid	$701.00
Rate for Payer: AlohaCare Medicare	$701.00
Rate for Payer: Cash Price	$911.30
Rate for Payer: Cash Price	$911.30
Rate for Payer: Devoted Health Medicare	$771.10
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,389.00
Rate for Payer: Hawaii Medical Service Association Medicare	$701.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,331.90
Rate for Payer: Health Management Network Commercial	$1,191.70
Rate for Payer: Humana Medicare	$701.00
Rate for Payer: Kaiser Permanente Commercial	$1,261.80
Rate for Payer: Kaiser Permanente Medicaid	$715.02
Rate for Payer: Kaiser Permanente Medicare	$701.00
Rate for Payer: MDX Hawaii PPO	$1,359.94
Rate for Payer: Ohana Health Plan Medicaid	$701.00
Rate for Payer: Ohana Health Plan Medicare	$701.00
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$701.00
Rate for Payer: University Health Alliance Commercial	$4,035.20

32554 THORACENTESIS w/o IMAGING RT CHARGE

Facility

$1,402.00

Service Code	HCPCS 32554 RT
Hospital Charge Code	8408928
Hospital Revenue Code	761
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$4,035.20
Rate for Payer: AlohaCare Medicaid	$701.00
Rate for Payer: AlohaCare Medicare	$701.00
Rate for Payer: Cash Price	$911.30
Rate for Payer: Cash Price	$911.30
Rate for Payer: Devoted Health Medicare	$771.10
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,389.00
Rate for Payer: Hawaii Medical Service Association Medicare	$701.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,331.90
Rate for Payer: Health Management Network Commercial	$1,191.70
Rate for Payer: Humana Medicare	$701.00
Rate for Payer: Kaiser Permanente Commercial	$1,261.80
Rate for Payer: Kaiser Permanente Medicaid	$715.02
Rate for Payer: Kaiser Permanente Medicare	$701.00
Rate for Payer: MDX Hawaii PPO	$1,359.94
Rate for Payer: Ohana Health Plan Medicaid	$701.00
Rate for Payer: Ohana Health Plan Medicare	$701.00
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$701.00
Rate for Payer: University Health Alliance Commercial	$4,035.20

32554 THORACENTESIS w/o IMAGING RT CHARGE

Facility

$1,402.00

Service Code	HCPCS 32554 RT
Hospital Charge Code	8408928
Hospital Revenue Code	761
Min. Negotiated Rate	$1,191.70
Max. Negotiated Rate	$1,359.94
Rate for Payer: Cash Price	$911.30
Rate for Payer: Health Management Network Commercial	$1,191.70
Rate for Payer: Kaiser Permanente Commercial	$1,261.80
Rate for Payer: MDX Hawaii PPO	$1,359.94

32555 THORACENTESIS, NEEDLE OR CATHETER, ASPIRATION OF THE PLEURAL SPACE; WITH IMAGING GUIDA ProFee

Professional

Both

$873.00

Service Code	HCPCS 32555
Hospital Charge Code	8018685
Hospital Revenue Code	972
Min. Negotiated Rate	$92.50
Max. Negotiated Rate	$742.05
Rate for Payer: AlohaCare Medicaid	$106.83
Rate for Payer: AlohaCare Medicare	$92.50
Rate for Payer: Cash Price	$567.45
Rate for Payer: Cash Price	$567.45
Rate for Payer: Devoted Health Medicare	$101.75
Rate for Payer: Hawaii Medical Service Association ABD	$106.83
Rate for Payer: Hawaii Medical Service Association Commercial	$182.66
Rate for Payer: Hawaii Medical Service Association Medicare	$92.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$106.83
Rate for Payer: Health Management Network Commercial	$742.05
Rate for Payer: Kaiser Permanente Commercial	$101.75
Rate for Payer: Kaiser Permanente Medicaid	$101.75
Rate for Payer: Kaiser Permanente Medicare	$101.75
Rate for Payer: Ohana Health Plan Medicaid	$106.83
Rate for Payer: Ohana Health Plan Medicare	$92.50
Rate for Payer: UnitedHealthcare Medicaid	$106.83
Rate for Payer: UnitedHealthcare Medicare	$92.50
Rate for Payer: University Health Alliance Commercial	$132.55

32555 Thoracentesis w/ Imaging

Facility

$2,140.00

Service Code	HCPCS 32555
Hospital Charge Code	8705582
Hospital Revenue Code	450
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$4,035.20
Rate for Payer: AlohaCare Medicaid	$525.09
Rate for Payer: AlohaCare Medicare	$1,070.00
Rate for Payer: Cash Price	$1,391.00
Rate for Payer: Cash Price	$1,391.00
Rate for Payer: Cash Price	$1,391.00
Rate for Payer: Devoted Health Medicare	$1,177.00
Rate for Payer: Hawaii Medical Service Association ABD	$393.00
Rate for Payer: Hawaii Medical Service Association Commercial	$2,389.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,070.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$407.95
Rate for Payer: Hawaii Western Management Group Commercial	$2,033.00
Rate for Payer: Health Management Network Commercial	$1,819.00
Rate for Payer: Humana Medicare	$1,070.00
Rate for Payer: Kaiser Permanente Commercial	$1,926.00
Rate for Payer: Kaiser Permanente Medicaid	$937.50
Rate for Payer: Kaiser Permanente Medicare	$1,070.00
Rate for Payer: MDX Hawaii PPO	$2,075.80
Rate for Payer: Ohana Health Plan Medicaid	$1,070.00
Rate for Payer: Ohana Health Plan Medicare	$1,070.00
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$1,070.00
Rate for Payer: University Health Alliance Commercial	$4,035.20

Know your out-of-pocket cost for care.

All Charges