Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

DRILL BIT 140X2.9MM 13001

Facility

$483.00

Hospital Revenue Code	272
Min. Negotiated Rate	$410.55
Max. Negotiated Rate	$468.51
Rate for Payer: Cash Price	$289.80
Rate for Payer: Health Management Network Commercial	$410.55
Rate for Payer: Kaiser Permanente Commercial	$434.70
Rate for Payer: MDX Hawaii PPO	$468.51

DRILL BIT 140X2.9MM 13001A

Facility

$360.00

Hospital Revenue Code	272
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$349.20
Rate for Payer: AlohaCare Medicaid	$180.00
Rate for Payer: AlohaCare Medicare	$273.60
Rate for Payer: Cash Price	$216.00
Rate for Payer: Devoted Health Medicare	$302.40
Rate for Payer: Hawaii Medical Service Association Medicare	$273.60
Rate for Payer: Hawaii Western Management Group Commercial	$342.00
Rate for Payer: Health Management Network Commercial	$306.00
Rate for Payer: Humana Medicare	$273.60
Rate for Payer: Kaiser Permanente Commercial	$324.00
Rate for Payer: Kaiser Permanente Medicaid	$183.60
Rate for Payer: Kaiser Permanente Medicare	$273.60
Rate for Payer: MDX Hawaii PPO	$349.20
Rate for Payer: Ohana Health Plan Medicaid	$273.60
Rate for Payer: Ohana Health Plan Medicare	$273.60
Rate for Payer: UnitedHealthcare Medicare	$273.60
Rate for Payer: University Health Alliance Commercial	$262.40

DRILL BIT 140X2.9MM 13001A

Facility

$360.00

Hospital Revenue Code	272
Min. Negotiated Rate	$306.00
Max. Negotiated Rate	$349.20
Rate for Payer: Cash Price	$216.00
Rate for Payer: Health Management Network Commercial	$306.00
Rate for Payer: Kaiser Permanente Commercial	$324.00
Rate for Payer: MDX Hawaii PPO	$349.20

DRILL BIT 1.4MM 60-14326

Facility

$606.00

Hospital Revenue Code	272
Min. Negotiated Rate	$515.10
Max. Negotiated Rate	$587.82
Rate for Payer: Cash Price	$363.60
Rate for Payer: Health Management Network Commercial	$515.10
Rate for Payer: Kaiser Permanente Commercial	$545.40
Rate for Payer: MDX Hawaii PPO	$587.82

DRILL BIT 1.4MM 60-14326

Facility

$606.00

Hospital Revenue Code	272
Min. Negotiated Rate	$303.00
Max. Negotiated Rate	$587.82
Rate for Payer: AlohaCare Medicaid	$303.00
Rate for Payer: AlohaCare Medicare	$460.56
Rate for Payer: Cash Price	$363.60
Rate for Payer: Devoted Health Medicare	$509.04
Rate for Payer: Hawaii Medical Service Association Medicare	$460.56
Rate for Payer: Hawaii Western Management Group Commercial	$575.70
Rate for Payer: Health Management Network Commercial	$515.10
Rate for Payer: Humana Medicare	$460.56
Rate for Payer: Kaiser Permanente Commercial	$545.40
Rate for Payer: Kaiser Permanente Medicaid	$309.06
Rate for Payer: Kaiser Permanente Medicare	$460.56
Rate for Payer: MDX Hawaii PPO	$587.82
Rate for Payer: Ohana Health Plan Medicaid	$460.56
Rate for Payer: Ohana Health Plan Medicare	$460.56
Rate for Payer: UnitedHealthcare Medicare	$460.56
Rate for Payer: University Health Alliance Commercial	$441.71

DRILLBIT 15.0X310MM 03.010.165

Facility

$2,463.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,231.50
Max. Negotiated Rate	$2,389.11
Rate for Payer: AlohaCare Medicaid	$1,231.50
Rate for Payer: AlohaCare Medicare	$1,871.88
Rate for Payer: Cash Price	$1,477.80
Rate for Payer: Devoted Health Medicare	$2,068.92
Rate for Payer: Hawaii Medical Service Association Medicare	$1,871.88
Rate for Payer: Hawaii Western Management Group Commercial	$2,339.85
Rate for Payer: Health Management Network Commercial	$2,093.55
Rate for Payer: Humana Medicare	$1,871.88
Rate for Payer: Kaiser Permanente Commercial	$2,216.70
Rate for Payer: Kaiser Permanente Medicaid	$1,256.13
Rate for Payer: Kaiser Permanente Medicare	$1,871.88
Rate for Payer: MDX Hawaii PPO	$2,389.11
Rate for Payer: Ohana Health Plan Medicaid	$1,871.88
Rate for Payer: Ohana Health Plan Medicare	$1,871.88
Rate for Payer: UnitedHealthcare Medicare	$1,871.88
Rate for Payer: University Health Alliance Commercial	$1,795.28

DRILLBIT 15.0X310MM 03.010.165

Facility

$2,463.00

Hospital Revenue Code	272
Min. Negotiated Rate	$2,093.55
Max. Negotiated Rate	$2,389.11
Rate for Payer: Cash Price	$1,477.80
Rate for Payer: Health Management Network Commercial	$2,093.55
Rate for Payer: Kaiser Permanente Commercial	$2,216.70
Rate for Payer: MDX Hawaii PPO	$2,389.11

DRILL BIT 1.5 125MM 03.503.476

Facility

$1,712.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,455.20
Max. Negotiated Rate	$1,660.64
Rate for Payer: Cash Price	$1,027.20
Rate for Payer: Health Management Network Commercial	$1,455.20
Rate for Payer: Kaiser Permanente Commercial	$1,540.80
Rate for Payer: MDX Hawaii PPO	$1,660.64

DRILL BIT 1.5 125MM 03.503.476

Facility

$1,712.00

Hospital Revenue Code	272
Min. Negotiated Rate	$856.00
Max. Negotiated Rate	$1,660.64
Rate for Payer: AlohaCare Medicaid	$856.00
Rate for Payer: AlohaCare Medicare	$1,301.12
Rate for Payer: Cash Price	$1,027.20
Rate for Payer: Devoted Health Medicare	$1,438.08
Rate for Payer: Hawaii Medical Service Association Medicare	$1,301.12
Rate for Payer: Hawaii Western Management Group Commercial	$1,626.40
Rate for Payer: Health Management Network Commercial	$1,455.20
Rate for Payer: Humana Medicare	$1,301.12
Rate for Payer: Kaiser Permanente Commercial	$1,540.80
Rate for Payer: Kaiser Permanente Medicaid	$873.12
Rate for Payer: Kaiser Permanente Medicare	$1,301.12
Rate for Payer: MDX Hawaii PPO	$1,660.64
Rate for Payer: Ohana Health Plan Medicaid	$1,301.12
Rate for Payer: Ohana Health Plan Medicare	$1,301.12
Rate for Payer: UnitedHealthcare Medicare	$1,301.12
Rate for Payer: University Health Alliance Commercial	$1,247.88

DRILL BIT 1.5 12MM 03.503.412

Facility

$952.00

Hospital Revenue Code	272
Min. Negotiated Rate	$809.20
Max. Negotiated Rate	$923.44
Rate for Payer: Cash Price	$571.20
Rate for Payer: Health Management Network Commercial	$809.20
Rate for Payer: Kaiser Permanente Commercial	$856.80
Rate for Payer: MDX Hawaii PPO	$923.44

DRILL BIT 1.5 12MM 03.503.412

Facility

$952.00

Hospital Revenue Code	272
Min. Negotiated Rate	$476.00
Max. Negotiated Rate	$923.44
Rate for Payer: AlohaCare Medicaid	$476.00
Rate for Payer: AlohaCare Medicare	$723.52
Rate for Payer: Cash Price	$571.20
Rate for Payer: Devoted Health Medicare	$799.68
Rate for Payer: Hawaii Medical Service Association Medicare	$723.52
Rate for Payer: Hawaii Western Management Group Commercial	$904.40
Rate for Payer: Health Management Network Commercial	$809.20
Rate for Payer: Humana Medicare	$723.52
Rate for Payer: Kaiser Permanente Commercial	$856.80
Rate for Payer: Kaiser Permanente Medicaid	$485.52
Rate for Payer: Kaiser Permanente Medicare	$723.52
Rate for Payer: MDX Hawaii PPO	$923.44
Rate for Payer: Ohana Health Plan Medicaid	$723.52
Rate for Payer: Ohana Health Plan Medicare	$723.52
Rate for Payer: UnitedHealthcare Medicare	$723.52
Rate for Payer: University Health Alliance Commercial	$693.91

DRILL BIT 1.5 6MM 03.503.406

Facility

$1,390.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,181.50
Max. Negotiated Rate	$1,348.30
Rate for Payer: Cash Price	$834.00
Rate for Payer: Health Management Network Commercial	$1,181.50
Rate for Payer: Kaiser Permanente Commercial	$1,251.00
Rate for Payer: MDX Hawaii PPO	$1,348.30

DRILL BIT 1.5 6MM 03.503.406

Facility

$1,390.00

Hospital Revenue Code	272
Min. Negotiated Rate	$695.00
Max. Negotiated Rate	$1,348.30
Rate for Payer: AlohaCare Medicaid	$695.00
Rate for Payer: AlohaCare Medicare	$1,056.40
Rate for Payer: Cash Price	$834.00
Rate for Payer: Devoted Health Medicare	$1,167.60
Rate for Payer: Hawaii Medical Service Association Medicare	$1,056.40
Rate for Payer: Hawaii Western Management Group Commercial	$1,320.50
Rate for Payer: Health Management Network Commercial	$1,181.50
Rate for Payer: Humana Medicare	$1,056.40
Rate for Payer: Kaiser Permanente Commercial	$1,251.00
Rate for Payer: Kaiser Permanente Medicaid	$708.90
Rate for Payer: Kaiser Permanente Medicare	$1,056.40
Rate for Payer: MDX Hawaii PPO	$1,348.30
Rate for Payer: Ohana Health Plan Medicaid	$1,056.40
Rate for Payer: Ohana Health Plan Medicare	$1,056.40
Rate for Payer: UnitedHealthcare Medicare	$1,056.40
Rate for Payer: University Health Alliance Commercial	$1,013.17

DRILL BIT 1.5/70MM JC 310.14

Facility

$348.00

Hospital Revenue Code	272
Min. Negotiated Rate	$174.00
Max. Negotiated Rate	$337.56
Rate for Payer: AlohaCare Medicaid	$174.00
Rate for Payer: AlohaCare Medicare	$264.48
Rate for Payer: Cash Price	$208.80
Rate for Payer: Devoted Health Medicare	$292.32
Rate for Payer: Hawaii Medical Service Association Medicare	$264.48
Rate for Payer: Hawaii Western Management Group Commercial	$330.60
Rate for Payer: Health Management Network Commercial	$295.80
Rate for Payer: Humana Medicare	$264.48
Rate for Payer: Kaiser Permanente Commercial	$313.20
Rate for Payer: Kaiser Permanente Medicaid	$177.48
Rate for Payer: Kaiser Permanente Medicare	$264.48
Rate for Payer: MDX Hawaii PPO	$337.56
Rate for Payer: Ohana Health Plan Medicaid	$264.48
Rate for Payer: Ohana Health Plan Medicare	$264.48
Rate for Payer: UnitedHealthcare Medicare	$264.48
Rate for Payer: University Health Alliance Commercial	$253.66

DRILL BIT 1.5/70MM JC 310.14

Facility

$348.00

Hospital Revenue Code	272
Min. Negotiated Rate	$295.80
Max. Negotiated Rate	$337.56
Rate for Payer: Cash Price	$208.80
Rate for Payer: Health Management Network Commercial	$295.80
Rate for Payer: Kaiser Permanente Commercial	$313.20
Rate for Payer: MDX Hawaii PPO	$337.56

DRILL BIT 1.5MM, QC 86MM

Facility

$700.00

Hospital Revenue Code	272
Min. Negotiated Rate	$350.00
Max. Negotiated Rate	$679.00
Rate for Payer: AlohaCare Medicaid	$350.00
Rate for Payer: AlohaCare Medicare	$532.00
Rate for Payer: Cash Price	$420.00
Rate for Payer: Devoted Health Medicare	$588.00
Rate for Payer: Hawaii Medical Service Association Medicare	$532.00
Rate for Payer: Hawaii Western Management Group Commercial	$665.00
Rate for Payer: Health Management Network Commercial	$595.00
Rate for Payer: Humana Medicare	$532.00
Rate for Payer: Kaiser Permanente Commercial	$630.00
Rate for Payer: Kaiser Permanente Medicaid	$357.00
Rate for Payer: Kaiser Permanente Medicare	$532.00
Rate for Payer: MDX Hawaii PPO	$679.00
Rate for Payer: Ohana Health Plan Medicaid	$532.00
Rate for Payer: Ohana Health Plan Medicare	$532.00
Rate for Payer: UnitedHealthcare Medicare	$532.00
Rate for Payer: University Health Alliance Commercial	$510.23

DRILL BIT 1.5MM, QC 86MM

Facility

$700.00

Hospital Revenue Code	272
Min. Negotiated Rate	$595.00
Max. Negotiated Rate	$679.00
Rate for Payer: Cash Price	$420.00
Rate for Payer: Health Management Network Commercial	$595.00
Rate for Payer: Kaiser Permanente Commercial	$630.00
Rate for Payer: MDX Hawaii PPO	$679.00

DRILL BIT 1.5X96MM 310.16

Facility

$348.00

Hospital Revenue Code	272
Min. Negotiated Rate	$174.00
Max. Negotiated Rate	$337.56
Rate for Payer: AlohaCare Medicaid	$174.00
Rate for Payer: AlohaCare Medicare	$264.48
Rate for Payer: Cash Price	$208.80
Rate for Payer: Devoted Health Medicare	$292.32
Rate for Payer: Hawaii Medical Service Association Medicare	$264.48
Rate for Payer: Hawaii Western Management Group Commercial	$330.60
Rate for Payer: Health Management Network Commercial	$295.80
Rate for Payer: Humana Medicare	$264.48
Rate for Payer: Kaiser Permanente Commercial	$313.20
Rate for Payer: Kaiser Permanente Medicaid	$177.48
Rate for Payer: Kaiser Permanente Medicare	$264.48
Rate for Payer: MDX Hawaii PPO	$337.56
Rate for Payer: Ohana Health Plan Medicaid	$264.48
Rate for Payer: Ohana Health Plan Medicare	$264.48
Rate for Payer: UnitedHealthcare Medicare	$264.48
Rate for Payer: University Health Alliance Commercial	$253.66

DRILL BIT 1.5X96MM 310.16

Facility

$348.00

Hospital Revenue Code	272
Min. Negotiated Rate	$295.80
Max. Negotiated Rate	$337.56
Rate for Payer: Cash Price	$208.80
Rate for Payer: Health Management Network Commercial	$295.80
Rate for Payer: Kaiser Permanente Commercial	$313.20
Rate for Payer: MDX Hawaii PPO	$337.56

DRILL BIT 1.6 705133

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 BIT 1.6 705133

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 BIT 1.7MM AR-8916-14

Facility

$495.00

Hospital Revenue Code	272
Min. Negotiated Rate	$420.75
Max. Negotiated Rate	$480.15
Rate for Payer: Cash Price	$297.00
Rate for Payer: Health Management Network Commercial	$420.75
Rate for Payer: Kaiser Permanente Commercial	$445.50
Rate for Payer: MDX Hawaii PPO	$480.15

DRILL BIT 1.7MM AR-8916-14

Facility

$495.00

Hospital Revenue Code	272
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$480.15
Rate for Payer: AlohaCare Medicaid	$247.50
Rate for Payer: AlohaCare Medicare	$376.20
Rate for Payer: Cash Price	$297.00
Rate for Payer: Devoted Health Medicare	$415.80
Rate for Payer: Hawaii Medical Service Association Medicare	$376.20
Rate for Payer: Hawaii Western Management Group Commercial	$470.25
Rate for Payer: Health Management Network Commercial	$420.75
Rate for Payer: Humana Medicare	$376.20
Rate for Payer: Kaiser Permanente Commercial	$445.50
Rate for Payer: Kaiser Permanente Medicaid	$252.45
Rate for Payer: Kaiser Permanente Medicare	$376.20
Rate for Payer: MDX Hawaii PPO	$480.15
Rate for Payer: Ohana Health Plan Medicaid	$376.20
Rate for Payer: Ohana Health Plan Medicare	$376.20
Rate for Payer: UnitedHealthcare Medicare	$376.20
Rate for Payer: University Health Alliance Commercial	$360.81

DRILL BIT 1.7NN

Facility

$890.00

Hospital Revenue Code	272
Min. Negotiated Rate	$756.50
Max. Negotiated Rate	$863.30
Rate for Payer: Cash Price	$534.00
Rate for Payer: Health Management Network Commercial	$756.50
Rate for Payer: Kaiser Permanente Commercial	$801.00
Rate for Payer: MDX Hawaii PPO	$863.30

DRILL BIT 1.7NN

Facility

$890.00

Hospital Revenue Code	272
Min. Negotiated Rate	$445.00
Max. Negotiated Rate	$863.30
Rate for Payer: AlohaCare Medicaid	$445.00
Rate for Payer: AlohaCare Medicare	$676.40
Rate for Payer: Cash Price	$534.00
Rate for Payer: Devoted Health Medicare	$747.60
Rate for Payer: Hawaii Medical Service Association Medicare	$676.40
Rate for Payer: Hawaii Western Management Group Commercial	$845.50
Rate for Payer: Health Management Network Commercial	$756.50
Rate for Payer: Humana Medicare	$676.40
Rate for Payer: Kaiser Permanente Commercial	$801.00
Rate for Payer: Kaiser Permanente Medicaid	$453.90
Rate for Payer: Kaiser Permanente Medicare	$676.40
Rate for Payer: MDX Hawaii PPO	$863.30
Rate for Payer: Ohana Health Plan Medicaid	$676.40
Rate for Payer: Ohana Health Plan Medicare	$676.40
Rate for Payer: UnitedHealthcare Medicare	$676.40
Rate for Payer: University Health Alliance Commercial	$648.72

Know your out-of-pocket cost for care.

All Charges