Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

DRILL 2.0 703896

Facility

$648.00

Hospital Revenue Code	272
Min. Negotiated Rate	$550.80
Max. Negotiated Rate	$628.56
Rate for Payer: Cash Price	$388.80
Rate for Payer: Health Management Network Commercial	$550.80
Rate for Payer: Kaiser Permanente Commercial	$583.20
Rate for Payer: MDX Hawaii PPO	$628.56

DRILL 2.0MM SHORT PILOT DRILL

Facility

$1,005.00

Hospital Revenue Code	272
Min. Negotiated Rate	$502.50
Max. Negotiated Rate	$974.85
Rate for Payer: AlohaCare Medicaid	$502.50
Rate for Payer: AlohaCare Medicare	$763.80
Rate for Payer: Cash Price	$603.00
Rate for Payer: Devoted Health Medicare	$844.20
Rate for Payer: Hawaii Medical Service Association Medicare	$763.80
Rate for Payer: Hawaii Western Management Group Commercial	$954.75
Rate for Payer: Health Management Network Commercial	$854.25
Rate for Payer: Humana Medicare	$763.80
Rate for Payer: Kaiser Permanente Commercial	$904.50
Rate for Payer: Kaiser Permanente Medicaid	$512.55
Rate for Payer: Kaiser Permanente Medicare	$763.80
Rate for Payer: MDX Hawaii PPO	$974.85
Rate for Payer: Ohana Health Plan Medicaid	$763.80
Rate for Payer: Ohana Health Plan Medicare	$763.80
Rate for Payer: UnitedHealthcare Medicare	$763.80
Rate for Payer: University Health Alliance Commercial	$732.54

DRILL 2.0MM SHORT PILOT DRILL

Facility

$1,005.00

Hospital Revenue Code	272
Min. Negotiated Rate	$854.25
Max. Negotiated Rate	$974.85
Rate for Payer: Cash Price	$603.00
Rate for Payer: Health Management Network Commercial	$854.25
Rate for Payer: Kaiser Permanente Commercial	$904.50
Rate for Payer: MDX Hawaii PPO	$974.85

DRILL 2.1 100MM CANN SMTH

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 2.1 100MM CANN SMTH

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 2.1X110MM DRILL-2.1/110C

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 2.1X110MM DRILL-2.1/110C

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 2351-4213S

Facility

$823.00

Hospital Revenue Code	272
Min. Negotiated Rate	$699.55
Max. Negotiated Rate	$798.31
Rate for Payer: Cash Price	$493.80
Rate for Payer: Health Management Network Commercial	$699.55
Rate for Payer: Kaiser Permanente Commercial	$740.70
Rate for Payer: MDX Hawaii PPO	$798.31

DRILL 2351-4213S

Facility

$823.00

Hospital Revenue Code	272
Min. Negotiated Rate	$411.50
Max. Negotiated Rate	$798.31
Rate for Payer: AlohaCare Medicaid	$411.50
Rate for Payer: AlohaCare Medicare	$625.48
Rate for Payer: Cash Price	$493.80
Rate for Payer: Devoted Health Medicare	$691.32
Rate for Payer: Hawaii Medical Service Association Medicare	$625.48
Rate for Payer: Hawaii Western Management Group Commercial	$781.85
Rate for Payer: Health Management Network Commercial	$699.55
Rate for Payer: Humana Medicare	$625.48
Rate for Payer: Kaiser Permanente Commercial	$740.70
Rate for Payer: Kaiser Permanente Medicaid	$419.73
Rate for Payer: Kaiser Permanente Medicare	$625.48
Rate for Payer: MDX Hawaii PPO	$798.31
Rate for Payer: Ohana Health Plan Medicaid	$625.48
Rate for Payer: Ohana Health Plan Medicare	$625.48
Rate for Payer: UnitedHealthcare Medicare	$625.48
Rate for Payer: University Health Alliance Commercial	$599.88

DRILL 2.3 CANN MANUAL 316-0005

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 2.3 CANN MANUAL 316-0005

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 2.3MM, DRILL-2.3/080

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 2.3MM, DRILL-2.3/080

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 2.4/120C

Facility

$619.00

Hospital Revenue Code	272
Min. Negotiated Rate	$526.15
Max. Negotiated Rate	$600.43
Rate for Payer: Cash Price	$371.40
Rate for Payer: Health Management Network Commercial	$526.15
Rate for Payer: Kaiser Permanente Commercial	$557.10
Rate for Payer: MDX Hawaii PPO	$600.43

DRILL 2.4/120C

Facility

$619.00

Hospital Revenue Code	272
Min. Negotiated Rate	$309.50
Max. Negotiated Rate	$600.43
Rate for Payer: AlohaCare Medicaid	$309.50
Rate for Payer: AlohaCare Medicare	$470.44
Rate for Payer: Cash Price	$371.40
Rate for Payer: Devoted Health Medicare	$519.96
Rate for Payer: Hawaii Medical Service Association Medicare	$470.44
Rate for Payer: Hawaii Western Management Group Commercial	$588.05
Rate for Payer: Health Management Network Commercial	$526.15
Rate for Payer: Humana Medicare	$470.44
Rate for Payer: Kaiser Permanente Commercial	$557.10
Rate for Payer: Kaiser Permanente Medicaid	$315.69
Rate for Payer: Kaiser Permanente Medicare	$470.44
Rate for Payer: MDX Hawaii PPO	$600.43
Rate for Payer: Ohana Health Plan Medicaid	$470.44
Rate for Payer: Ohana Health Plan Medicare	$470.44
Rate for Payer: UnitedHealthcare Medicare	$470.44
Rate for Payer: University Health Alliance Commercial	$451.19

DRILL 2.4MM PROXIMAL 316-0322

Facility

$683.00

Hospital Revenue Code	272
Min. Negotiated Rate	$580.55
Max. Negotiated Rate	$662.51
Rate for Payer: Cash Price	$409.80
Rate for Payer: Health Management Network Commercial	$580.55
Rate for Payer: Kaiser Permanente Commercial	$614.70
Rate for Payer: MDX Hawaii PPO	$662.51

DRILL 2.4MM PROXIMAL 316-0322

Facility

$683.00

Hospital Revenue Code	272
Min. Negotiated Rate	$341.50
Max. Negotiated Rate	$662.51
Rate for Payer: AlohaCare Medicaid	$341.50
Rate for Payer: AlohaCare Medicare	$519.08
Rate for Payer: Cash Price	$409.80
Rate for Payer: Devoted Health Medicare	$573.72
Rate for Payer: Hawaii Medical Service Association Medicare	$519.08
Rate for Payer: Hawaii Western Management Group Commercial	$648.85
Rate for Payer: Health Management Network Commercial	$580.55
Rate for Payer: Humana Medicare	$519.08
Rate for Payer: Kaiser Permanente Commercial	$614.70
Rate for Payer: Kaiser Permanente Medicaid	$348.33
Rate for Payer: Kaiser Permanente Medicare	$519.08
Rate for Payer: MDX Hawaii PPO	$662.51
Rate for Payer: Ohana Health Plan Medicaid	$519.08
Rate for Payer: Ohana Health Plan Medicare	$519.08
Rate for Payer: UnitedHealthcare Medicare	$519.08
Rate for Payer: University Health Alliance Commercial	$497.84

DRILL 2.4 QC STERILE

Facility

$242.00

Hospital Revenue Code	272
Min. Negotiated Rate	$205.70
Max. Negotiated Rate	$234.74
Rate for Payer: Cash Price	$145.20
Rate for Payer: Health Management Network Commercial	$205.70
Rate for Payer: Kaiser Permanente Commercial	$217.80
Rate for Payer: MDX Hawaii PPO	$234.74

DRILL 2.4 QC STERILE

Facility

$242.00

Hospital Revenue Code	272
Min. Negotiated Rate	$121.00
Max. Negotiated Rate	$234.74
Rate for Payer: AlohaCare Medicaid	$121.00
Rate for Payer: AlohaCare Medicare	$183.92
Rate for Payer: Cash Price	$145.20
Rate for Payer: Devoted Health Medicare	$203.28
Rate for Payer: Hawaii Medical Service Association Medicare	$183.92
Rate for Payer: Hawaii Western Management Group Commercial	$229.90
Rate for Payer: Health Management Network Commercial	$205.70
Rate for Payer: Humana Medicare	$183.92
Rate for Payer: Kaiser Permanente Commercial	$217.80
Rate for Payer: Kaiser Permanente Medicaid	$123.42
Rate for Payer: Kaiser Permanente Medicare	$183.92
Rate for Payer: MDX Hawaii PPO	$234.74
Rate for Payer: Ohana Health Plan Medicaid	$183.92
Rate for Payer: Ohana Health Plan Medicare	$183.92
Rate for Payer: UnitedHealthcare Medicare	$183.92
Rate for Payer: University Health Alliance Commercial	$176.39

DRILL 2.5 703586

Facility

$856.00

Hospital Revenue Code	272
Min. Negotiated Rate	$428.00
Max. Negotiated Rate	$830.32
Rate for Payer: AlohaCare Medicaid	$428.00
Rate for Payer: AlohaCare Medicare	$650.56
Rate for Payer: Cash Price	$513.60
Rate for Payer: Devoted Health Medicare	$719.04
Rate for Payer: Hawaii Medical Service Association Medicare	$650.56
Rate for Payer: Hawaii Western Management Group Commercial	$813.20
Rate for Payer: Health Management Network Commercial	$727.60
Rate for Payer: Humana Medicare	$650.56
Rate for Payer: Kaiser Permanente Commercial	$770.40
Rate for Payer: Kaiser Permanente Medicaid	$436.56
Rate for Payer: Kaiser Permanente Medicare	$650.56
Rate for Payer: MDX Hawaii PPO	$830.32
Rate for Payer: Ohana Health Plan Medicaid	$650.56
Rate for Payer: Ohana Health Plan Medicare	$650.56
Rate for Payer: UnitedHealthcare Medicare	$650.56
Rate for Payer: University Health Alliance Commercial	$623.94

DRILL 2.5 703586

Facility

$856.00

Hospital Revenue Code	272
Min. Negotiated Rate	$727.60
Max. Negotiated Rate	$830.32
Rate for Payer: Cash Price	$513.60
Rate for Payer: Health Management Network Commercial	$727.60
Rate for Payer: Kaiser Permanente Commercial	$770.40
Rate for Payer: MDX Hawaii PPO	$830.32

DRILL 2.5MM GLENOID AR-9145K

Facility

$675.00

Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$654.75
Rate for Payer: AlohaCare Medicaid	$337.50
Rate for Payer: AlohaCare Medicare	$513.00
Rate for Payer: Cash Price	$405.00
Rate for Payer: Devoted Health Medicare	$567.00
Rate for Payer: Hawaii Medical Service Association Medicare	$513.00
Rate for Payer: Hawaii Western Management Group Commercial	$641.25
Rate for Payer: Health Management Network Commercial	$573.75
Rate for Payer: Humana Medicare	$513.00
Rate for Payer: Kaiser Permanente Commercial	$607.50
Rate for Payer: Kaiser Permanente Medicaid	$344.25
Rate for Payer: Kaiser Permanente Medicare	$513.00
Rate for Payer: MDX Hawaii PPO	$654.75
Rate for Payer: Ohana Health Plan Medicaid	$513.00
Rate for Payer: Ohana Health Plan Medicare	$513.00
Rate for Payer: UnitedHealthcare Medicare	$513.00
Rate for Payer: University Health Alliance Commercial	$492.01

DRILL 2.5MM GLENOID AR-9145K

Facility

$675.00

Hospital Revenue Code	272
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$654.75
Rate for Payer: Cash Price	$405.00
Rate for Payer: Health Management Network Commercial	$573.75
Rate for Payer: Kaiser Permanente Commercial	$607.50
Rate for Payer: MDX Hawaii PPO	$654.75

DRILL 2.6 703691

Facility

$924.00

Hospital Revenue Code	272
Min. Negotiated Rate	$462.00
Max. Negotiated Rate	$896.28
Rate for Payer: AlohaCare Medicaid	$462.00
Rate for Payer: AlohaCare Medicare	$702.24
Rate for Payer: Cash Price	$554.40
Rate for Payer: Devoted Health Medicare	$776.16
Rate for Payer: Hawaii Medical Service Association Medicare	$702.24
Rate for Payer: Hawaii Western Management Group Commercial	$877.80
Rate for Payer: Health Management Network Commercial	$785.40
Rate for Payer: Humana Medicare	$702.24
Rate for Payer: Kaiser Permanente Commercial	$831.60
Rate for Payer: Kaiser Permanente Medicaid	$471.24
Rate for Payer: Kaiser Permanente Medicare	$702.24
Rate for Payer: MDX Hawaii PPO	$896.28
Rate for Payer: Ohana Health Plan Medicaid	$702.24
Rate for Payer: Ohana Health Plan Medicare	$702.24
Rate for Payer: UnitedHealthcare Medicare	$702.24
Rate for Payer: University Health Alliance Commercial	$673.50

DRILL 2.6 703691

Facility

$924.00

Hospital Revenue Code	272
Min. Negotiated Rate	$785.40
Max. Negotiated Rate	$896.28
Rate for Payer: Cash Price	$554.40
Rate for Payer: Health Management Network Commercial	$785.40
Rate for Payer: Kaiser Permanente Commercial	$831.60
Rate for Payer: MDX Hawaii PPO	$896.28

Know your out-of-pocket cost for care.

All Charges