KAHUKU MEDICAL CENTER — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J2997	alteplase 100 mg IV [KMC]	$42,242	$27,457	—	—	16
74334603	leuprolide 22.5 mg/3 months Kit	$26,699	$17,354	—	—	16
50458060701	paliperidone 410 mg/1.315 mL ER	$20,199	$13,129	—	—	16
50242012001	tenecteplase 50 mg IV Inj [KMC]	$16,778	$10,906	—	—	16
42367054032	dantrolene 250 mg REC	$14,041	$9,127	—	—	15
59148007280	ARIPiprazole 400 mg PWD	$11,465	$7,452	—	—	16
59148004580	ARIPiprazole 300 mg PWD	$8,599	$5,589	—	—	16
50458056401	paliperidone 234 mg/1.5 mL ER	$8,558	$5,563	—	—	16
55513073001	denosumab 120 mg/1.7 mL Sol	$7,672	$4,987	—	—	16
50458056301	paliperidone 156 mg/mL ER	$7,278	$4,731	—	—	16
55513071001	denosumab 60 mg/mL Sol	$7,091	$4,609	—	—	16
50458056201	paliperidone 117 mg/0.75 mL ER	$6,684	$4,345	—	—	16
50242021501	omalizumab 150 mg/mL Sol	$5,862	$3,810	—	—	16
G0378	OBS CARE BY FAC EA HR	$5,687	$3,697	—	—	17
25021018467	fluconazole 400 mg Soln	$4,231	$2,750	—	—	16
55513084101	erenumab 70 mg/mL Sol	$3,247	$2,111	—	—	15
11704037001	hydroxocobalamin 5 g REC [KMC]	$3,118	$2,027	—	—	15
2237711	galcanezumab 120 mg/mL Sol	$2,898	$1,884	—	—	15
69018921	palbociclib 125 mg Cap	$2,846	$1,850	—	—	15
36556	ED INSERT NON TUNNEL CV CATH 5+	$2,811	$1,827	—	—	15
99291	99291 - Critical Care	$2,801	$1,821	—	—	19
78056751	everolimus 10 mg Tab	$2,693	$1,750	—	—	16
62847000101	telavancin 750 mg REC	$2,396	$1,557	—	—	16
74178	CT ABD AND PELVIS WOW CON	$2,320	$1,508	—	—	30
74177	CT Abdomen/Pelvis w/ Contrast	$2,320	$1,508	—	—	19
74174	CT Angiography Abdomen/Pelvis	$2,320	$1,508	—	—	38
73201	CT UPP XTR W CON	$2,320	$1,508	—	—	19
72132	CT LUMBAR SPINE W CON	$2,209	$1,436	—	—	22
5197102	pneumococcal 13-valent conjugate vaccine - Sus	$2,173	$1,412	—	—	15
71288001615	DAPTOmycin 500 mg REC	$2,139	$1,390	—	—	16
781325089	glatiramer 40 mg/mL Sol	$2,098	$1,364	—	—	16
0111	ROOM/BED: Swing	$2,069	$1,345	—	—	19
169413602	semaglutide 2 mg/1.5 mL Sol	$2,044	$1,329	—	—	15
76329339905	procainamide 100 mg/mL Sol	$2,040	$1,326	—	—	16
99285	ER VISIT LEVEL 5	$2,011	$1,307	—	—	19
27810	CLOSD TRT BIMALL ANK W MAN	$1,886	$1,226	—	—	15
25605	CLTX DS RD FX INC ULN ST W MAN	$1,886	$1,226	—	—	15
78066815	trametinib 2 mg Tab	$1,812	$1,178	—	—	15
87633	Respiratory Panel by FilmArray DLS	$1,632	$1,061	—	—	18
73202	CT UPP XTR WO W CON FS	$1,617	$1,051	—	—	19
74170	CT ABD WO W CON FS	$1,617	$1,051	—	—	29
45802015194	fluocinonide topical 0.1% Cre	$1,615	$1,050	—	—	15
32551	ED TUBE THRCSTMY INC WATR SEAL SEP	$1,606	$1,044	—	—	15
173087306	umeclidinium 62.5 mcg (0.0625 mg)/inh Pow	$1,556	$1,011	—	—	15
92960	ED CARDIOVERSION EXTERNAL	$1,461	$950	—	—	15
74176	CT Abdomen/Pelvis w/o Contrast	$1,451	$943	—	—	19
73701	CT LOW XTR W CON	$1,427	$928	—	—	71
70481	CT ORB SLLREAR W CON	$1,427	$928	—	—	22
72193	CT PELVIS W CON	$1,427	$928	—	—	29
70491	CT SOFT TISSUE NECK W CON	$1,427	$928	—	—	33

Showing top 50 of 15,971 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.