Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

DRILL 3.3X110MM 4806-110-33

Facility

$638.00

Hospital Revenue Code	272
Min. Negotiated Rate	$319.00
Max. Negotiated Rate	$618.86
Rate for Payer: AlohaCare Medicaid	$319.00
Rate for Payer: AlohaCare Medicare	$484.88
Rate for Payer: Cash Price	$382.80
Rate for Payer: Devoted Health Medicare	$535.92
Rate for Payer: Hawaii Medical Service Association Medicare	$484.88
Rate for Payer: Hawaii Western Management Group Commercial	$606.10
Rate for Payer: Health Management Network Commercial	$542.30
Rate for Payer: Humana Medicare	$484.88
Rate for Payer: Kaiser Permanente Commercial	$574.20
Rate for Payer: Kaiser Permanente Medicaid	$325.38
Rate for Payer: Kaiser Permanente Medicare	$484.88
Rate for Payer: MDX Hawaii PPO	$618.86
Rate for Payer: Ohana Health Plan Medicaid	$484.88
Rate for Payer: Ohana Health Plan Medicare	$484.88
Rate for Payer: UnitedHealthcare Medicare	$484.88
Rate for Payer: University Health Alliance Commercial	$465.04

DRILL 3.5 700353

Facility

$1,043.00

Hospital Revenue Code	272
Min. Negotiated Rate	$886.55
Max. Negotiated Rate	$1,011.71
Rate for Payer: Cash Price	$625.80
Rate for Payer: Health Management Network Commercial	$886.55
Rate for Payer: Kaiser Permanente Commercial	$938.70
Rate for Payer: MDX Hawaii PPO	$1,011.71

DRILL 3.5 700353

Facility

$1,043.00

Hospital Revenue Code	272
Min. Negotiated Rate	$521.50
Max. Negotiated Rate	$1,011.71
Rate for Payer: AlohaCare Medicaid	$521.50
Rate for Payer: AlohaCare Medicare	$792.68
Rate for Payer: Cash Price	$625.80
Rate for Payer: Devoted Health Medicare	$876.12
Rate for Payer: Hawaii Medical Service Association Medicare	$792.68
Rate for Payer: Hawaii Western Management Group Commercial	$990.85
Rate for Payer: Health Management Network Commercial	$886.55
Rate for Payer: Humana Medicare	$792.68
Rate for Payer: Kaiser Permanente Commercial	$938.70
Rate for Payer: Kaiser Permanente Medicaid	$531.93
Rate for Payer: Kaiser Permanente Medicare	$792.68
Rate for Payer: MDX Hawaii PPO	$1,011.71
Rate for Payer: Ohana Health Plan Medicaid	$792.68
Rate for Payer: Ohana Health Plan Medicare	$792.68
Rate for Payer: UnitedHealthcare Medicare	$792.68
Rate for Payer: University Health Alliance Commercial	$760.24

DRILL 3.5X130 1806-3550S

Facility

$739.00

Hospital Revenue Code	272
Min. Negotiated Rate	$628.15
Max. Negotiated Rate	$716.83
Rate for Payer: Cash Price	$443.40
Rate for Payer: Health Management Network Commercial	$628.15
Rate for Payer: Kaiser Permanente Commercial	$665.10
Rate for Payer: MDX Hawaii PPO	$716.83

DRILL 3.5X130 1806-3550S

Facility

$739.00

Hospital Revenue Code	272
Min. Negotiated Rate	$369.50
Max. Negotiated Rate	$716.83
Rate for Payer: AlohaCare Medicaid	$369.50
Rate for Payer: AlohaCare Medicare	$561.64
Rate for Payer: Cash Price	$443.40
Rate for Payer: Devoted Health Medicare	$620.76
Rate for Payer: Hawaii Medical Service Association Medicare	$561.64
Rate for Payer: Hawaii Western Management Group Commercial	$702.05
Rate for Payer: Health Management Network Commercial	$628.15
Rate for Payer: Humana Medicare	$561.64
Rate for Payer: Kaiser Permanente Commercial	$665.10
Rate for Payer: Kaiser Permanente Medicaid	$376.89
Rate for Payer: Kaiser Permanente Medicare	$561.64
Rate for Payer: MDX Hawaii PPO	$716.83
Rate for Payer: Ohana Health Plan Medicaid	$561.64
Rate for Payer: Ohana Health Plan Medicare	$561.64
Rate for Payer: UnitedHealthcare Medicare	$561.64
Rate for Payer: University Health Alliance Commercial	$538.66

DRILL 4.0 220MM DRILL-4.0/220C

Facility

$1,278.00

Hospital Revenue Code	272
Min. Negotiated Rate	$639.00
Max. Negotiated Rate	$1,239.66
Rate for Payer: AlohaCare Medicaid	$639.00
Rate for Payer: AlohaCare Medicare	$971.28
Rate for Payer: Cash Price	$766.80
Rate for Payer: Devoted Health Medicare	$1,073.52
Rate for Payer: Hawaii Medical Service Association Medicare	$971.28
Rate for Payer: Hawaii Western Management Group Commercial	$1,214.10
Rate for Payer: Health Management Network Commercial	$1,086.30
Rate for Payer: Humana Medicare	$971.28
Rate for Payer: Kaiser Permanente Commercial	$1,150.20
Rate for Payer: Kaiser Permanente Medicaid	$651.78
Rate for Payer: Kaiser Permanente Medicare	$971.28
Rate for Payer: MDX Hawaii PPO	$1,239.66
Rate for Payer: Ohana Health Plan Medicaid	$971.28
Rate for Payer: Ohana Health Plan Medicare	$971.28
Rate for Payer: UnitedHealthcare Medicare	$971.28
Rate for Payer: University Health Alliance Commercial	$931.53

DRILL 4.0 220MM DRILL-4.0/220C

Facility

$1,278.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,086.30
Max. Negotiated Rate	$1,239.66
Rate for Payer: Cash Price	$766.80
Rate for Payer: Health Management Network Commercial	$1,086.30
Rate for Payer: Kaiser Permanente Commercial	$1,150.20
Rate for Payer: MDX Hawaii PPO	$1,239.66

DRILL 4.2X180MM 1806-4270S

Facility

$1,253.00

Hospital Revenue Code	272
Min. Negotiated Rate	$626.50
Max. Negotiated Rate	$1,215.41
Rate for Payer: AlohaCare Medicaid	$626.50
Rate for Payer: AlohaCare Medicare	$952.28
Rate for Payer: Cash Price	$751.80
Rate for Payer: Devoted Health Medicare	$1,052.52
Rate for Payer: Hawaii Medical Service Association Medicare	$952.28
Rate for Payer: Hawaii Western Management Group Commercial	$1,190.35
Rate for Payer: Health Management Network Commercial	$1,065.05
Rate for Payer: Humana Medicare	$952.28
Rate for Payer: Kaiser Permanente Commercial	$1,127.70
Rate for Payer: Kaiser Permanente Medicaid	$639.03
Rate for Payer: Kaiser Permanente Medicare	$952.28
Rate for Payer: MDX Hawaii PPO	$1,215.41
Rate for Payer: Ohana Health Plan Medicaid	$952.28
Rate for Payer: Ohana Health Plan Medicare	$952.28
Rate for Payer: UnitedHealthcare Medicare	$952.28
Rate for Payer: University Health Alliance Commercial	$913.31

DRILL 4.2X180MM 1806-4270S

Facility

$1,253.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,065.05
Max. Negotiated Rate	$1,215.41
Rate for Payer: Cash Price	$751.80
Rate for Payer: Health Management Network Commercial	$1,065.05
Rate for Payer: Kaiser Permanente Commercial	$1,127.70
Rate for Payer: MDX Hawaii PPO	$1,215.41

DRILL 4.2X230MM 1806-4290S

Facility

$1,257.00

Hospital Revenue Code	272
Min. Negotiated Rate	$628.50
Max. Negotiated Rate	$1,219.29
Rate for Payer: AlohaCare Medicaid	$628.50
Rate for Payer: AlohaCare Medicare	$955.32
Rate for Payer: Cash Price	$754.20
Rate for Payer: Devoted Health Medicare	$1,055.88
Rate for Payer: Hawaii Medical Service Association Medicare	$955.32
Rate for Payer: Hawaii Western Management Group Commercial	$1,194.15
Rate for Payer: Health Management Network Commercial	$1,068.45
Rate for Payer: Humana Medicare	$955.32
Rate for Payer: Kaiser Permanente Commercial	$1,131.30
Rate for Payer: Kaiser Permanente Medicaid	$641.07
Rate for Payer: Kaiser Permanente Medicare	$955.32
Rate for Payer: MDX Hawaii PPO	$1,219.29
Rate for Payer: Ohana Health Plan Medicaid	$955.32
Rate for Payer: Ohana Health Plan Medicare	$955.32
Rate for Payer: UnitedHealthcare Medicare	$955.32
Rate for Payer: University Health Alliance Commercial	$916.23

DRILL 4.2X230MM 1806-4290S

Facility

$1,257.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,068.45
Max. Negotiated Rate	$1,219.29
Rate for Payer: Cash Price	$754.20
Rate for Payer: Health Management Network Commercial	$1,068.45
Rate for Payer: Kaiser Permanente Commercial	$1,131.30
Rate for Payer: MDX Hawaii PPO	$1,219.29

DRILL 4.2X300MM 1320-3042S

Facility

$944.00

Hospital Revenue Code	272
Min. Negotiated Rate	$802.40
Max. Negotiated Rate	$915.68
Rate for Payer: Cash Price	$566.40
Rate for Payer: Health Management Network Commercial	$802.40
Rate for Payer: Kaiser Permanente Commercial	$849.60
Rate for Payer: MDX Hawaii PPO	$915.68

DRILL 4.2X300MM 1320-3042S

Facility

$944.00

Hospital Revenue Code	272
Min. Negotiated Rate	$472.00
Max. Negotiated Rate	$915.68
Rate for Payer: AlohaCare Medicaid	$472.00
Rate for Payer: AlohaCare Medicare	$717.44
Rate for Payer: Cash Price	$566.40
Rate for Payer: Devoted Health Medicare	$792.96
Rate for Payer: Hawaii Medical Service Association Medicare	$717.44
Rate for Payer: Hawaii Western Management Group Commercial	$896.80
Rate for Payer: Health Management Network Commercial	$802.40
Rate for Payer: Humana Medicare	$717.44
Rate for Payer: Kaiser Permanente Commercial	$849.60
Rate for Payer: Kaiser Permanente Medicaid	$481.44
Rate for Payer: Kaiser Permanente Medicare	$717.44
Rate for Payer: MDX Hawaii PPO	$915.68
Rate for Payer: Ohana Health Plan Medicaid	$717.44
Rate for Payer: Ohana Health Plan Medicare	$717.44
Rate for Payer: UnitedHealthcare Medicare	$717.44
Rate for Payer: University Health Alliance Commercial	$688.08

DRILL 4.2X340MM 1806-4260S

Facility

$898.00

Hospital Revenue Code	272
Min. Negotiated Rate	$763.30
Max. Negotiated Rate	$871.06
Rate for Payer: Cash Price	$538.80
Rate for Payer: Health Management Network Commercial	$763.30
Rate for Payer: Kaiser Permanente Commercial	$808.20
Rate for Payer: MDX Hawaii PPO	$871.06

DRILL 4.2X340MM 1806-4260S

Facility

$898.00

Hospital Revenue Code	272
Min. Negotiated Rate	$449.00
Max. Negotiated Rate	$871.06
Rate for Payer: AlohaCare Medicaid	$449.00
Rate for Payer: AlohaCare Medicare	$682.48
Rate for Payer: Cash Price	$538.80
Rate for Payer: Devoted Health Medicare	$754.32
Rate for Payer: Hawaii Medical Service Association Medicare	$682.48
Rate for Payer: Hawaii Western Management Group Commercial	$853.10
Rate for Payer: Health Management Network Commercial	$763.30
Rate for Payer: Humana Medicare	$682.48
Rate for Payer: Kaiser Permanente Commercial	$808.20
Rate for Payer: Kaiser Permanente Medicaid	$457.98
Rate for Payer: Kaiser Permanente Medicare	$682.48
Rate for Payer: MDX Hawaii PPO	$871.06
Rate for Payer: Ohana Health Plan Medicaid	$682.48
Rate for Payer: Ohana Health Plan Medicare	$682.48
Rate for Payer: UnitedHealthcare Medicare	$682.48
Rate for Payer: University Health Alliance Commercial	$654.55

DRILL 4.5/6.5X485MM 03.010.078

Facility

$1,809.00

Hospital Revenue Code	272
Min. Negotiated Rate	$904.50
Max. Negotiated Rate	$1,754.73
Rate for Payer: AlohaCare Medicaid	$904.50
Rate for Payer: AlohaCare Medicare	$1,374.84
Rate for Payer: Cash Price	$1,085.40
Rate for Payer: Devoted Health Medicare	$1,519.56
Rate for Payer: Hawaii Medical Service Association Medicare	$1,374.84
Rate for Payer: Hawaii Western Management Group Commercial	$1,718.55
Rate for Payer: Health Management Network Commercial	$1,537.65
Rate for Payer: Humana Medicare	$1,374.84
Rate for Payer: Kaiser Permanente Commercial	$1,628.10
Rate for Payer: Kaiser Permanente Medicaid	$922.59
Rate for Payer: Kaiser Permanente Medicare	$1,374.84
Rate for Payer: MDX Hawaii PPO	$1,754.73
Rate for Payer: Ohana Health Plan Medicaid	$1,374.84
Rate for Payer: Ohana Health Plan Medicare	$1,374.84
Rate for Payer: UnitedHealthcare Medicare	$1,374.84
Rate for Payer: University Health Alliance Commercial	$1,318.58

DRILL 4.5/6.5X485MM 03.010.078

Facility

$1,809.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,537.65
Max. Negotiated Rate	$1,754.73
Rate for Payer: Cash Price	$1,085.40
Rate for Payer: Health Management Network Commercial	$1,537.65
Rate for Payer: Kaiser Permanente Commercial	$1,628.10
Rate for Payer: MDX Hawaii PPO	$1,754.73

DRILL 4.6X220MM P99-110-4622

Facility

$1,037.00

Hospital Revenue Code	272
Min. Negotiated Rate	$518.50
Max. Negotiated Rate	$1,005.89
Rate for Payer: AlohaCare Medicaid	$518.50
Rate for Payer: AlohaCare Medicare	$788.12
Rate for Payer: Cash Price	$622.20
Rate for Payer: Devoted Health Medicare	$871.08
Rate for Payer: Hawaii Medical Service Association Medicare	$788.12
Rate for Payer: Hawaii Western Management Group Commercial	$985.15
Rate for Payer: Health Management Network Commercial	$881.45
Rate for Payer: Humana Medicare	$788.12
Rate for Payer: Kaiser Permanente Commercial	$933.30
Rate for Payer: Kaiser Permanente Medicaid	$528.87
Rate for Payer: Kaiser Permanente Medicare	$788.12
Rate for Payer: MDX Hawaii PPO	$1,005.89
Rate for Payer: Ohana Health Plan Medicaid	$788.12
Rate for Payer: Ohana Health Plan Medicare	$788.12
Rate for Payer: UnitedHealthcare Medicare	$788.12
Rate for Payer: University Health Alliance Commercial	$755.87

DRILL 4.6X220MM P99-110-4622

Facility

$1,037.00

Hospital Revenue Code	272
Min. Negotiated Rate	$881.45
Max. Negotiated Rate	$1,005.89
Rate for Payer: Cash Price	$622.20
Rate for Payer: Health Management Network Commercial	$881.45
Rate for Payer: Kaiser Permanente Commercial	$933.30
Rate for Payer: MDX Hawaii PPO	$1,005.89

DRILL 4.7MM CANN QR 316-0016

Facility

$1,225.00

Hospital Revenue Code	272
Min. Negotiated Rate	$612.50
Max. Negotiated Rate	$1,188.25
Rate for Payer: AlohaCare Medicaid	$612.50
Rate for Payer: AlohaCare Medicare	$931.00
Rate for Payer: Cash Price	$735.00
Rate for Payer: Devoted Health Medicare	$1,029.00
Rate for Payer: Hawaii Medical Service Association Medicare	$931.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,163.75
Rate for Payer: Health Management Network Commercial	$1,041.25
Rate for Payer: Humana Medicare	$931.00
Rate for Payer: Kaiser Permanente Commercial	$1,102.50
Rate for Payer: Kaiser Permanente Medicaid	$624.75
Rate for Payer: Kaiser Permanente Medicare	$931.00
Rate for Payer: MDX Hawaii PPO	$1,188.25
Rate for Payer: Ohana Health Plan Medicaid	$931.00
Rate for Payer: Ohana Health Plan Medicare	$931.00
Rate for Payer: UnitedHealthcare Medicare	$931.00
Rate for Payer: University Health Alliance Commercial	$892.90

DRILL 4.7MM CANN QR 316-0016

Facility

$1,225.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,041.25
Max. Negotiated Rate	$1,188.25
Rate for Payer: Cash Price	$735.00
Rate for Payer: Health Management Network Commercial	$1,041.25
Rate for Payer: Kaiser Permanente Commercial	$1,102.50
Rate for Payer: MDX Hawaii PPO	$1,188.25

DRILL 5.0X230 1806-5000S

Facility

$898.00

Hospital Revenue Code	272
Min. Negotiated Rate	$449.00
Max. Negotiated Rate	$871.06
Rate for Payer: AlohaCare Medicaid	$449.00
Rate for Payer: AlohaCare Medicare	$682.48
Rate for Payer: Cash Price	$538.80
Rate for Payer: Devoted Health Medicare	$754.32
Rate for Payer: Hawaii Medical Service Association Medicare	$682.48
Rate for Payer: Hawaii Western Management Group Commercial	$853.10
Rate for Payer: Health Management Network Commercial	$763.30
Rate for Payer: Humana Medicare	$682.48
Rate for Payer: Kaiser Permanente Commercial	$808.20
Rate for Payer: Kaiser Permanente Medicaid	$457.98
Rate for Payer: Kaiser Permanente Medicare	$682.48
Rate for Payer: MDX Hawaii PPO	$871.06
Rate for Payer: Ohana Health Plan Medicaid	$682.48
Rate for Payer: Ohana Health Plan Medicare	$682.48
Rate for Payer: UnitedHealthcare Medicare	$682.48
Rate for Payer: University Health Alliance Commercial	$654.55

DRILL 5.0X230 1806-5000S

Facility

$898.00

Hospital Revenue Code	272
Min. Negotiated Rate	$763.30
Max. Negotiated Rate	$871.06
Rate for Payer: Cash Price	$538.80
Rate for Payer: Health Management Network Commercial	$763.30
Rate for Payer: Kaiser Permanente Commercial	$808.20
Rate for Payer: MDX Hawaii PPO	$871.06

DRILL 6/5MM THREADED 395.923

Facility

$896.00

Hospital Revenue Code	272
Min. Negotiated Rate	$761.60
Max. Negotiated Rate	$869.12
Rate for Payer: Cash Price	$537.60
Rate for Payer: Health Management Network Commercial	$761.60
Rate for Payer: Kaiser Permanente Commercial	$806.40
Rate for Payer: MDX Hawaii PPO	$869.12

DRILL 6/5MM THREADED 395.923

Facility

$896.00

Hospital Revenue Code	272
Min. Negotiated Rate	$448.00
Max. Negotiated Rate	$869.12
Rate for Payer: AlohaCare Medicaid	$448.00
Rate for Payer: AlohaCare Medicare	$680.96
Rate for Payer: Cash Price	$537.60
Rate for Payer: Devoted Health Medicare	$752.64
Rate for Payer: Hawaii Medical Service Association Medicare	$680.96
Rate for Payer: Hawaii Western Management Group Commercial	$851.20
Rate for Payer: Health Management Network Commercial	$761.60
Rate for Payer: Humana Medicare	$680.96
Rate for Payer: Kaiser Permanente Commercial	$806.40
Rate for Payer: Kaiser Permanente Medicaid	$456.96
Rate for Payer: Kaiser Permanente Medicare	$680.96
Rate for Payer: MDX Hawaii PPO	$869.12
Rate for Payer: Ohana Health Plan Medicaid	$680.96
Rate for Payer: Ohana Health Plan Medicare	$680.96
Rate for Payer: UnitedHealthcare Medicare	$680.96
Rate for Payer: University Health Alliance Commercial	$653.09

Know your out-of-pocket cost for care.

All Charges