Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

DRESSING LG VERAFLO KIT

Facility

$880.00

Hospital Revenue Code	271
Min. Negotiated Rate	$748.00
Max. Negotiated Rate	$853.60
Rate for Payer: Cash Price	$528.00
Rate for Payer: Health Management Network Commercial	$748.00
Rate for Payer: Kaiser Permanente Commercial	$792.00
Rate for Payer: MDX Hawaii PPO	$853.60

DRESSING LG VERAFLO KIT

Facility

$880.00

Hospital Revenue Code	271
Min. Negotiated Rate	$440.00
Max. Negotiated Rate	$853.60
Rate for Payer: AlohaCare Medicaid	$440.00
Rate for Payer: AlohaCare Medicare	$668.80
Rate for Payer: Cash Price	$528.00
Rate for Payer: Devoted Health Medicare	$739.20
Rate for Payer: Hawaii Medical Service Association Medicare	$668.80
Rate for Payer: Hawaii Western Management Group Commercial	$836.00
Rate for Payer: Health Management Network Commercial	$748.00
Rate for Payer: Humana Medicare	$668.80
Rate for Payer: Kaiser Permanente Commercial	$792.00
Rate for Payer: Kaiser Permanente Medicaid	$448.80
Rate for Payer: Kaiser Permanente Medicare	$668.80
Rate for Payer: MDX Hawaii PPO	$853.60
Rate for Payer: Ohana Health Plan Medicaid	$668.80
Rate for Payer: Ohana Health Plan Medicare	$668.80
Rate for Payer: UnitedHealthcare Medicare	$668.80
Rate for Payer: University Health Alliance Commercial	$641.43

DRESSING MED VERAFLO KIT

Facility

$502.00

Hospital Revenue Code	271
Min. Negotiated Rate	$426.70
Max. Negotiated Rate	$486.94
Rate for Payer: Cash Price	$301.20
Rate for Payer: Health Management Network Commercial	$426.70
Rate for Payer: Kaiser Permanente Commercial	$451.80
Rate for Payer: MDX Hawaii PPO	$486.94

DRESSING MED VERAFLO KIT

Facility

$502.00

Hospital Revenue Code	271
Min. Negotiated Rate	$251.00
Max. Negotiated Rate	$486.94
Rate for Payer: AlohaCare Medicaid	$251.00
Rate for Payer: AlohaCare Medicare	$381.52
Rate for Payer: Cash Price	$301.20
Rate for Payer: Devoted Health Medicare	$421.68
Rate for Payer: Hawaii Medical Service Association Medicare	$381.52
Rate for Payer: Hawaii Western Management Group Commercial	$476.90
Rate for Payer: Health Management Network Commercial	$426.70
Rate for Payer: Humana Medicare	$381.52
Rate for Payer: Kaiser Permanente Commercial	$451.80
Rate for Payer: Kaiser Permanente Medicaid	$256.02
Rate for Payer: Kaiser Permanente Medicare	$381.52
Rate for Payer: MDX Hawaii PPO	$486.94
Rate for Payer: Ohana Health Plan Medicaid	$381.52
Rate for Payer: Ohana Health Plan Medicare	$381.52
Rate for Payer: UnitedHealthcare Medicare	$381.52
Rate for Payer: University Health Alliance Commercial	$365.91

DRILL

Facility

$825.00

Hospital Revenue Code	272
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$800.25
Rate for Payer: AlohaCare Medicaid	$412.50
Rate for Payer: AlohaCare Medicare	$627.00
Rate for Payer: Cash Price	$495.00
Rate for Payer: Devoted Health Medicare	$693.00
Rate for Payer: Hawaii Medical Service Association Medicare	$627.00
Rate for Payer: Hawaii Western Management Group Commercial	$783.75
Rate for Payer: Health Management Network Commercial	$701.25
Rate for Payer: Humana Medicare	$627.00
Rate for Payer: Kaiser Permanente Commercial	$742.50
Rate for Payer: Kaiser Permanente Medicaid	$420.75
Rate for Payer: Kaiser Permanente Medicare	$627.00
Rate for Payer: MDX Hawaii PPO	$800.25
Rate for Payer: Ohana Health Plan Medicaid	$627.00
Rate for Payer: Ohana Health Plan Medicare	$627.00
Rate for Payer: UnitedHealthcare Medicare	$627.00
Rate for Payer: University Health Alliance Commercial	$601.34

DRILL

Facility

$825.00

Hospital Revenue Code	272
Min. Negotiated Rate	$701.25
Max. Negotiated Rate	$800.25
Rate for Payer: Cash Price	$495.00
Rate for Payer: Health Management Network Commercial	$701.25
Rate for Payer: Kaiser Permanente Commercial	$742.50
Rate for Payer: MDX Hawaii PPO	$800.25

DRILL 12MM CANN 03.010.439

Facility

$1,679.00

Hospital Revenue Code	272
Min. Negotiated Rate	$839.50
Max. Negotiated Rate	$1,628.63
Rate for Payer: AlohaCare Medicaid	$839.50
Rate for Payer: AlohaCare Medicare	$1,276.04
Rate for Payer: Cash Price	$1,007.40
Rate for Payer: Devoted Health Medicare	$1,410.36
Rate for Payer: Hawaii Medical Service Association Medicare	$1,276.04
Rate for Payer: Hawaii Western Management Group Commercial	$1,595.05
Rate for Payer: Health Management Network Commercial	$1,427.15
Rate for Payer: Humana Medicare	$1,276.04
Rate for Payer: Kaiser Permanente Commercial	$1,511.10
Rate for Payer: Kaiser Permanente Medicaid	$856.29
Rate for Payer: Kaiser Permanente Medicare	$1,276.04
Rate for Payer: MDX Hawaii PPO	$1,628.63
Rate for Payer: Ohana Health Plan Medicaid	$1,276.04
Rate for Payer: Ohana Health Plan Medicare	$1,276.04
Rate for Payer: UnitedHealthcare Medicare	$1,276.04
Rate for Payer: University Health Alliance Commercial	$1,223.82

DRILL 12MM CANN 03.010.439

Facility

$1,679.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,427.15
Max. Negotiated Rate	$1,628.63
Rate for Payer: Cash Price	$1,007.40
Rate for Payer: Health Management Network Commercial	$1,427.15
Rate for Payer: Kaiser Permanente Commercial	$1,511.10
Rate for Payer: MDX Hawaii PPO	$1,628.63

DRILL 1.3X100MM P99-100-1310

Facility

$872.00

Hospital Revenue Code	272
Min. Negotiated Rate	$436.00
Max. Negotiated Rate	$845.84
Rate for Payer: AlohaCare Medicaid	$436.00
Rate for Payer: AlohaCare Medicare	$662.72
Rate for Payer: Cash Price	$523.20
Rate for Payer: Devoted Health Medicare	$732.48
Rate for Payer: Hawaii Medical Service Association Medicare	$662.72
Rate for Payer: Hawaii Western Management Group Commercial	$828.40
Rate for Payer: Health Management Network Commercial	$741.20
Rate for Payer: Humana Medicare	$662.72
Rate for Payer: Kaiser Permanente Commercial	$784.80
Rate for Payer: Kaiser Permanente Medicaid	$444.72
Rate for Payer: Kaiser Permanente Medicare	$662.72
Rate for Payer: MDX Hawaii PPO	$845.84
Rate for Payer: Ohana Health Plan Medicaid	$662.72
Rate for Payer: Ohana Health Plan Medicare	$662.72
Rate for Payer: UnitedHealthcare Medicare	$662.72
Rate for Payer: University Health Alliance Commercial	$635.60

DRILL 1.3X100MM P99-100-1310

Facility

$872.00

Hospital Revenue Code	272
Min. Negotiated Rate	$741.20
Max. Negotiated Rate	$845.84
Rate for Payer: Cash Price	$523.20
Rate for Payer: Health Management Network Commercial	$741.20
Rate for Payer: Kaiser Permanente Commercial	$784.80
Rate for Payer: MDX Hawaii PPO	$845.84

DRILL 1.6/090

Facility

$630.00

Hospital Revenue Code	272
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$611.10
Rate for Payer: AlohaCare Medicaid	$315.00
Rate for Payer: AlohaCare Medicare	$478.80
Rate for Payer: Cash Price	$378.00
Rate for Payer: Devoted Health Medicare	$529.20
Rate for Payer: Hawaii Medical Service Association Medicare	$478.80
Rate for Payer: Hawaii Western Management Group Commercial	$598.50
Rate for Payer: Health Management Network Commercial	$535.50
Rate for Payer: Humana Medicare	$478.80
Rate for Payer: Kaiser Permanente Commercial	$567.00
Rate for Payer: Kaiser Permanente Medicaid	$321.30
Rate for Payer: Kaiser Permanente Medicare	$478.80
Rate for Payer: MDX Hawaii PPO	$611.10
Rate for Payer: Ohana Health Plan Medicaid	$478.80
Rate for Payer: Ohana Health Plan Medicare	$478.80
Rate for Payer: UnitedHealthcare Medicare	$478.80
Rate for Payer: University Health Alliance Commercial	$459.21

DRILL 1.6/090

Facility

$630.00

Hospital Revenue Code	272
Min. Negotiated Rate	$535.50
Max. Negotiated Rate	$611.10
Rate for Payer: Cash Price	$378.00
Rate for Payer: Health Management Network Commercial	$535.50
Rate for Payer: Kaiser Permanente Commercial	$567.00
Rate for Payer: MDX Hawaii PPO	$611.10

DRILL-1.6/095C

Facility

$825.00

Hospital Revenue Code	272
Min. Negotiated Rate	$701.25
Max. Negotiated Rate	$800.25
Rate for Payer: Cash Price	$495.00
Rate for Payer: Health Management Network Commercial	$701.25
Rate for Payer: Kaiser Permanente Commercial	$742.50
Rate for Payer: MDX Hawaii PPO	$800.25

DRILL-1.6/095C

Facility

$825.00

Hospital Revenue Code	272
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$800.25
Rate for Payer: AlohaCare Medicaid	$412.50
Rate for Payer: AlohaCare Medicare	$627.00
Rate for Payer: Cash Price	$495.00
Rate for Payer: Devoted Health Medicare	$693.00
Rate for Payer: Hawaii Medical Service Association Medicare	$627.00
Rate for Payer: Hawaii Western Management Group Commercial	$783.75
Rate for Payer: Health Management Network Commercial	$701.25
Rate for Payer: Humana Medicare	$627.00
Rate for Payer: Kaiser Permanente Commercial	$742.50
Rate for Payer: Kaiser Permanente Medicaid	$420.75
Rate for Payer: Kaiser Permanente Medicare	$627.00
Rate for Payer: MDX Hawaii PPO	$800.25
Rate for Payer: Ohana Health Plan Medicaid	$627.00
Rate for Payer: Ohana Health Plan Medicare	$627.00
Rate for Payer: UnitedHealthcare Medicare	$627.00
Rate for Payer: University Health Alliance Commercial	$601.34

DRILL 1.7MM CANN QR 316-0013

Facility

$879.00

Hospital Revenue Code	272
Min. Negotiated Rate	$439.50
Max. Negotiated Rate	$852.63
Rate for Payer: AlohaCare Medicaid	$439.50
Rate for Payer: AlohaCare Medicare	$668.04
Rate for Payer: Cash Price	$527.40
Rate for Payer: Devoted Health Medicare	$738.36
Rate for Payer: Hawaii Medical Service Association Medicare	$668.04
Rate for Payer: Hawaii Western Management Group Commercial	$835.05
Rate for Payer: Health Management Network Commercial	$747.15
Rate for Payer: Humana Medicare	$668.04
Rate for Payer: Kaiser Permanente Commercial	$791.10
Rate for Payer: Kaiser Permanente Medicaid	$448.29
Rate for Payer: Kaiser Permanente Medicare	$668.04
Rate for Payer: MDX Hawaii PPO	$852.63
Rate for Payer: Ohana Health Plan Medicaid	$668.04
Rate for Payer: Ohana Health Plan Medicare	$668.04
Rate for Payer: UnitedHealthcare Medicare	$668.04
Rate for Payer: University Health Alliance Commercial	$640.70

DRILL 1.7MM CANN QR 316-0013

Facility

$879.00

Hospital Revenue Code	272
Min. Negotiated Rate	$747.15
Max. Negotiated Rate	$852.63
Rate for Payer: Cash Price	$527.40
Rate for Payer: Health Management Network Commercial	$747.15
Rate for Payer: Kaiser Permanente Commercial	$791.10
Rate for Payer: MDX Hawaii PPO	$852.63

DRILL 1.7MM LONG CANN 316-0014

Facility

$879.00

Hospital Revenue Code	272
Min. Negotiated Rate	$439.50
Max. Negotiated Rate	$852.63
Rate for Payer: AlohaCare Medicaid	$439.50
Rate for Payer: AlohaCare Medicare	$668.04
Rate for Payer: Cash Price	$527.40
Rate for Payer: Devoted Health Medicare	$738.36
Rate for Payer: Hawaii Medical Service Association Medicare	$668.04
Rate for Payer: Hawaii Western Management Group Commercial	$835.05
Rate for Payer: Health Management Network Commercial	$747.15
Rate for Payer: Humana Medicare	$668.04
Rate for Payer: Kaiser Permanente Commercial	$791.10
Rate for Payer: Kaiser Permanente Medicaid	$448.29
Rate for Payer: Kaiser Permanente Medicare	$668.04
Rate for Payer: MDX Hawaii PPO	$852.63
Rate for Payer: Ohana Health Plan Medicaid	$668.04
Rate for Payer: Ohana Health Plan Medicare	$668.04
Rate for Payer: UnitedHealthcare Medicare	$668.04
Rate for Payer: University Health Alliance Commercial	$640.70

DRILL 1.7MM LONG CANN 316-0014

Facility

$879.00

Hospital Revenue Code	272
Min. Negotiated Rate	$747.15
Max. Negotiated Rate	$852.63
Rate for Payer: Cash Price	$527.40
Rate for Payer: Health Management Network Commercial	$747.15
Rate for Payer: Kaiser Permanente Commercial	$791.10
Rate for Payer: MDX Hawaii PPO	$852.63

DRILL 1.7MM MANUAL 316-0105

Facility

$879.00

Hospital Revenue Code	272
Min. Negotiated Rate	$439.50
Max. Negotiated Rate	$852.63
Rate for Payer: AlohaCare Medicaid	$439.50
Rate for Payer: AlohaCare Medicare	$668.04
Rate for Payer: Cash Price	$527.40
Rate for Payer: Devoted Health Medicare	$738.36
Rate for Payer: Hawaii Medical Service Association Medicare	$668.04
Rate for Payer: Hawaii Western Management Group Commercial	$835.05
Rate for Payer: Health Management Network Commercial	$747.15
Rate for Payer: Humana Medicare	$668.04
Rate for Payer: Kaiser Permanente Commercial	$791.10
Rate for Payer: Kaiser Permanente Medicaid	$448.29
Rate for Payer: Kaiser Permanente Medicare	$668.04
Rate for Payer: MDX Hawaii PPO	$852.63
Rate for Payer: Ohana Health Plan Medicaid	$668.04
Rate for Payer: Ohana Health Plan Medicare	$668.04
Rate for Payer: UnitedHealthcare Medicare	$668.04
Rate for Payer: University Health Alliance Commercial	$640.70

DRILL 1.7MM MANUAL 316-0105

Facility

$879.00

Hospital Revenue Code	272
Min. Negotiated Rate	$747.15
Max. Negotiated Rate	$852.63
Rate for Payer: Cash Price	$527.40
Rate for Payer: Health Management Network Commercial	$747.15
Rate for Payer: Kaiser Permanente Commercial	$791.10
Rate for Payer: MDX Hawaii PPO	$852.63

DRILL 1.8MM #DRILL-1.8/090

Facility

$630.00

Hospital Revenue Code	272
Min. Negotiated Rate	$535.50
Max. Negotiated Rate	$611.10
Rate for Payer: Cash Price	$378.00
Rate for Payer: Health Management Network Commercial	$535.50
Rate for Payer: Kaiser Permanente Commercial	$567.00
Rate for Payer: MDX Hawaii PPO	$611.10

DRILL 1.8MM #DRILL-1.8/090

Facility

$630.00

Hospital Revenue Code	272
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$611.10
Rate for Payer: AlohaCare Medicaid	$315.00
Rate for Payer: AlohaCare Medicare	$478.80
Rate for Payer: Cash Price	$378.00
Rate for Payer: Devoted Health Medicare	$529.20
Rate for Payer: Hawaii Medical Service Association Medicare	$478.80
Rate for Payer: Hawaii Western Management Group Commercial	$598.50
Rate for Payer: Health Management Network Commercial	$535.50
Rate for Payer: Humana Medicare	$478.80
Rate for Payer: Kaiser Permanente Commercial	$567.00
Rate for Payer: Kaiser Permanente Medicaid	$321.30
Rate for Payer: Kaiser Permanente Medicare	$478.80
Rate for Payer: MDX Hawaii PPO	$611.10
Rate for Payer: Ohana Health Plan Medicaid	$478.80
Rate for Payer: Ohana Health Plan Medicare	$478.80
Rate for Payer: UnitedHealthcare Medicare	$478.80
Rate for Payer: University Health Alliance Commercial	$459.21

DRILL-2.0/095

Facility

$630.00

Hospital Revenue Code	272
Min. Negotiated Rate	$535.50
Max. Negotiated Rate	$611.10
Rate for Payer: Cash Price	$378.00
Rate for Payer: Health Management Network Commercial	$535.50
Rate for Payer: Kaiser Permanente Commercial	$567.00
Rate for Payer: MDX Hawaii PPO	$611.10

DRILL-2.0/095

Facility

$630.00

Hospital Revenue Code	272
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$611.10
Rate for Payer: AlohaCare Medicaid	$315.00
Rate for Payer: AlohaCare Medicare	$478.80
Rate for Payer: Cash Price	$378.00
Rate for Payer: Devoted Health Medicare	$529.20
Rate for Payer: Hawaii Medical Service Association Medicare	$478.80
Rate for Payer: Hawaii Western Management Group Commercial	$598.50
Rate for Payer: Health Management Network Commercial	$535.50
Rate for Payer: Humana Medicare	$478.80
Rate for Payer: Kaiser Permanente Commercial	$567.00
Rate for Payer: Kaiser Permanente Medicaid	$321.30
Rate for Payer: Kaiser Permanente Medicare	$478.80
Rate for Payer: MDX Hawaii PPO	$611.10
Rate for Payer: Ohana Health Plan Medicaid	$478.80
Rate for Payer: Ohana Health Plan Medicare	$478.80
Rate for Payer: UnitedHealthcare Medicare	$478.80
Rate for Payer: University Health Alliance Commercial	$459.21

DRILL 2.0 703896

Facility

$648.00

Hospital Revenue Code	272
Min. Negotiated Rate	$324.00
Max. Negotiated Rate	$628.56
Rate for Payer: AlohaCare Medicaid	$324.00
Rate for Payer: AlohaCare Medicare	$492.48
Rate for Payer: Cash Price	$388.80
Rate for Payer: Devoted Health Medicare	$544.32
Rate for Payer: Hawaii Medical Service Association Medicare	$492.48
Rate for Payer: Hawaii Western Management Group Commercial	$615.60
Rate for Payer: Health Management Network Commercial	$550.80
Rate for Payer: Humana Medicare	$492.48
Rate for Payer: Kaiser Permanente Commercial	$583.20
Rate for Payer: Kaiser Permanente Medicaid	$330.48
Rate for Payer: Kaiser Permanente Medicare	$492.48
Rate for Payer: MDX Hawaii PPO	$628.56
Rate for Payer: Ohana Health Plan Medicaid	$492.48
Rate for Payer: Ohana Health Plan Medicare	$492.48
Rate for Payer: UnitedHealthcare Medicare	$492.48
Rate for Payer: University Health Alliance Commercial	$472.33

Know your out-of-pocket cost for care.

All Charges