Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

DRILL BIT 17X280MM 03.010.029

Facility

$2,334.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,167.00
Max. Negotiated Rate	$2,263.98
Rate for Payer: AlohaCare Medicaid	$1,167.00
Rate for Payer: AlohaCare Medicare	$1,773.84
Rate for Payer: Cash Price	$1,400.40
Rate for Payer: Devoted Health Medicare	$1,960.56
Rate for Payer: Hawaii Medical Service Association Medicare	$1,773.84
Rate for Payer: Hawaii Western Management Group Commercial	$2,217.30
Rate for Payer: Health Management Network Commercial	$1,983.90
Rate for Payer: Humana Medicare	$1,773.84
Rate for Payer: Kaiser Permanente Commercial	$2,100.60
Rate for Payer: Kaiser Permanente Medicaid	$1,190.34
Rate for Payer: Kaiser Permanente Medicare	$1,773.84
Rate for Payer: MDX Hawaii PPO	$2,263.98
Rate for Payer: Ohana Health Plan Medicaid	$1,773.84
Rate for Payer: Ohana Health Plan Medicare	$1,773.84
Rate for Payer: UnitedHealthcare Medicare	$1,773.84
Rate for Payer: University Health Alliance Commercial	$1,701.25

DRILL BIT 17X280MM 03.010.029

Facility

$2,334.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,983.90
Max. Negotiated Rate	$2,263.98
Rate for Payer: Cash Price	$1,400.40
Rate for Payer: Health Management Network Commercial	$1,983.90
Rate for Payer: Kaiser Permanente Commercial	$2,100.60
Rate for Payer: MDX Hawaii PPO	$2,263.98

DRILL BIT 180X4.8MM 11001

Facility

$473.00

Hospital Revenue Code	272
Min. Negotiated Rate	$402.05
Max. Negotiated Rate	$458.81
Rate for Payer: Cash Price	$283.80
Rate for Payer: Health Management Network Commercial	$402.05
Rate for Payer: Kaiser Permanente Commercial	$425.70
Rate for Payer: MDX Hawaii PPO	$458.81

DRILL BIT 180X4.8MM 11001

Facility

$473.00

Hospital Revenue Code	272
Min. Negotiated Rate	$236.50
Max. Negotiated Rate	$458.81
Rate for Payer: AlohaCare Medicaid	$236.50
Rate for Payer: AlohaCare Medicare	$359.48
Rate for Payer: Cash Price	$283.80
Rate for Payer: Devoted Health Medicare	$397.32
Rate for Payer: Hawaii Medical Service Association Medicare	$359.48
Rate for Payer: Hawaii Western Management Group Commercial	$449.35
Rate for Payer: Health Management Network Commercial	$402.05
Rate for Payer: Humana Medicare	$359.48
Rate for Payer: Kaiser Permanente Commercial	$425.70
Rate for Payer: Kaiser Permanente Medicaid	$241.23
Rate for Payer: Kaiser Permanente Medicare	$359.48
Rate for Payer: MDX Hawaii PPO	$458.81
Rate for Payer: Ohana Health Plan Medicaid	$359.48
Rate for Payer: Ohana Health Plan Medicare	$359.48
Rate for Payer: UnitedHealthcare Medicare	$359.48
Rate for Payer: University Health Alliance Commercial	$344.77

DRILL BIT 180X4.8MM 11001A

Facility

$342.00

Hospital Revenue Code	272
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$331.74
Rate for Payer: AlohaCare Medicaid	$171.00
Rate for Payer: AlohaCare Medicare	$259.92
Rate for Payer: Cash Price	$205.20
Rate for Payer: Devoted Health Medicare	$287.28
Rate for Payer: Hawaii Medical Service Association Medicare	$259.92
Rate for Payer: Hawaii Western Management Group Commercial	$324.90
Rate for Payer: Health Management Network Commercial	$290.70
Rate for Payer: Humana Medicare	$259.92
Rate for Payer: Kaiser Permanente Commercial	$307.80
Rate for Payer: Kaiser Permanente Medicaid	$174.42
Rate for Payer: Kaiser Permanente Medicare	$259.92
Rate for Payer: MDX Hawaii PPO	$331.74
Rate for Payer: Ohana Health Plan Medicaid	$259.92
Rate for Payer: Ohana Health Plan Medicare	$259.92
Rate for Payer: UnitedHealthcare Medicare	$259.92
Rate for Payer: University Health Alliance Commercial	$249.28

DRILL BIT 180X4.8MM 11001A

Facility

$342.00

Hospital Revenue Code	272
Min. Negotiated Rate	$290.70
Max. Negotiated Rate	$331.74
Rate for Payer: Cash Price	$205.20
Rate for Payer: Health Management Network Commercial	$290.70
Rate for Payer: Kaiser Permanente Commercial	$307.80
Rate for Payer: MDX Hawaii PPO	$331.74

DRILL BIT 1.8MM 310.510

Facility

$956.00

Hospital Revenue Code	272
Min. Negotiated Rate	$812.60
Max. Negotiated Rate	$927.32
Rate for Payer: Cash Price	$573.60
Rate for Payer: Health Management Network Commercial	$812.60
Rate for Payer: Kaiser Permanente Commercial	$860.40
Rate for Payer: MDX Hawaii PPO	$927.32

DRILL BIT 1.8MM 310.510

Facility

$956.00

Hospital Revenue Code	272
Min. Negotiated Rate	$478.00
Max. Negotiated Rate	$927.32
Rate for Payer: AlohaCare Medicaid	$478.00
Rate for Payer: AlohaCare Medicare	$726.56
Rate for Payer: Cash Price	$573.60
Rate for Payer: Devoted Health Medicare	$803.04
Rate for Payer: Hawaii Medical Service Association Medicare	$726.56
Rate for Payer: Hawaii Western Management Group Commercial	$908.20
Rate for Payer: Health Management Network Commercial	$812.60
Rate for Payer: Humana Medicare	$726.56
Rate for Payer: Kaiser Permanente Commercial	$860.40
Rate for Payer: Kaiser Permanente Medicaid	$487.56
Rate for Payer: Kaiser Permanente Medicare	$726.56
Rate for Payer: MDX Hawaii PPO	$927.32
Rate for Payer: Ohana Health Plan Medicaid	$726.56
Rate for Payer: Ohana Health Plan Medicare	$726.56
Rate for Payer: UnitedHealthcare Medicare	$726.56
Rate for Payer: University Health Alliance Commercial	$696.83

DRILL BIT 1.9MM 60-19326

Facility

$446.00

Hospital Revenue Code	272
Min. Negotiated Rate	$223.00
Max. Negotiated Rate	$432.62
Rate for Payer: AlohaCare Medicaid	$223.00
Rate for Payer: AlohaCare Medicare	$338.96
Rate for Payer: Cash Price	$267.60
Rate for Payer: Devoted Health Medicare	$374.64
Rate for Payer: Hawaii Medical Service Association Medicare	$338.96
Rate for Payer: Hawaii Western Management Group Commercial	$423.70
Rate for Payer: Health Management Network Commercial	$379.10
Rate for Payer: Humana Medicare	$338.96
Rate for Payer: Kaiser Permanente Commercial	$401.40
Rate for Payer: Kaiser Permanente Medicaid	$227.46
Rate for Payer: Kaiser Permanente Medicare	$338.96
Rate for Payer: MDX Hawaii PPO	$432.62
Rate for Payer: Ohana Health Plan Medicaid	$338.96
Rate for Payer: Ohana Health Plan Medicare	$338.96
Rate for Payer: UnitedHealthcare Medicare	$338.96
Rate for Payer: University Health Alliance Commercial	$325.09

DRILL BIT 1.9MM 60-19326

Facility

$446.00

Hospital Revenue Code	272
Min. Negotiated Rate	$379.10
Max. Negotiated Rate	$432.62
Rate for Payer: Cash Price	$267.60
Rate for Payer: Health Management Network Commercial	$379.10
Rate for Payer: Kaiser Permanente Commercial	$401.40
Rate for Payer: MDX Hawaii PPO	$432.62

DRILL BIT 2.0 03.133.101

Facility

$792.00

Hospital Revenue Code	272
Min. Negotiated Rate	$396.00
Max. Negotiated Rate	$768.24
Rate for Payer: AlohaCare Medicaid	$396.00
Rate for Payer: AlohaCare Medicare	$601.92
Rate for Payer: Cash Price	$475.20
Rate for Payer: Devoted Health Medicare	$665.28
Rate for Payer: Hawaii Medical Service Association Medicare	$601.92
Rate for Payer: Hawaii Western Management Group Commercial	$752.40
Rate for Payer: Health Management Network Commercial	$673.20
Rate for Payer: Humana Medicare	$601.92
Rate for Payer: Kaiser Permanente Commercial	$712.80
Rate for Payer: Kaiser Permanente Medicaid	$403.92
Rate for Payer: Kaiser Permanente Medicare	$601.92
Rate for Payer: MDX Hawaii PPO	$768.24
Rate for Payer: Ohana Health Plan Medicaid	$601.92
Rate for Payer: Ohana Health Plan Medicare	$601.92
Rate for Payer: UnitedHealthcare Medicare	$601.92
Rate for Payer: University Health Alliance Commercial	$577.29

DRILL BIT 2.0 03.133.101

Facility

$792.00

Hospital Revenue Code	272
Min. Negotiated Rate	$673.20
Max. Negotiated Rate	$768.24
Rate for Payer: Cash Price	$475.20
Rate for Payer: Health Management Network Commercial	$673.20
Rate for Payer: Kaiser Permanente Commercial	$712.80
Rate for Payer: MDX Hawaii PPO	$768.24

DRILL BIT 200X3.2MM 11.003

Facility

$473.00

Hospital Revenue Code	272
Min. Negotiated Rate	$236.50
Max. Negotiated Rate	$458.81
Rate for Payer: AlohaCare Medicaid	$236.50
Rate for Payer: AlohaCare Medicare	$359.48
Rate for Payer: Cash Price	$283.80
Rate for Payer: Devoted Health Medicare	$397.32
Rate for Payer: Hawaii Medical Service Association Medicare	$359.48
Rate for Payer: Hawaii Western Management Group Commercial	$449.35
Rate for Payer: Health Management Network Commercial	$402.05
Rate for Payer: Humana Medicare	$359.48
Rate for Payer: Kaiser Permanente Commercial	$425.70
Rate for Payer: Kaiser Permanente Medicaid	$241.23
Rate for Payer: Kaiser Permanente Medicare	$359.48
Rate for Payer: MDX Hawaii PPO	$458.81
Rate for Payer: Ohana Health Plan Medicaid	$359.48
Rate for Payer: Ohana Health Plan Medicare	$359.48
Rate for Payer: UnitedHealthcare Medicare	$359.48
Rate for Payer: University Health Alliance Commercial	$344.77

DRILL BIT 200X3.2MM 11.003

Facility

$473.00

Hospital Revenue Code	272
Min. Negotiated Rate	$402.05
Max. Negotiated Rate	$458.81
Rate for Payer: Cash Price	$283.80
Rate for Payer: Health Management Network Commercial	$402.05
Rate for Payer: Kaiser Permanente Commercial	$425.70
Rate for Payer: MDX Hawaii PPO	$458.81

DRILL BIT 200X3.2MM 11003A

Facility

$342.00

Hospital Revenue Code	272
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$331.74
Rate for Payer: AlohaCare Medicaid	$171.00
Rate for Payer: AlohaCare Medicare	$259.92
Rate for Payer: Cash Price	$205.20
Rate for Payer: Devoted Health Medicare	$287.28
Rate for Payer: Hawaii Medical Service Association Medicare	$259.92
Rate for Payer: Hawaii Western Management Group Commercial	$324.90
Rate for Payer: Health Management Network Commercial	$290.70
Rate for Payer: Humana Medicare	$259.92
Rate for Payer: Kaiser Permanente Commercial	$307.80
Rate for Payer: Kaiser Permanente Medicaid	$174.42
Rate for Payer: Kaiser Permanente Medicare	$259.92
Rate for Payer: MDX Hawaii PPO	$331.74
Rate for Payer: Ohana Health Plan Medicaid	$259.92
Rate for Payer: Ohana Health Plan Medicare	$259.92
Rate for Payer: UnitedHealthcare Medicare	$259.92
Rate for Payer: University Health Alliance Commercial	$249.28

DRILL BIT 200X3.2MM 11003A

Facility

$342.00

Hospital Revenue Code	272
Min. Negotiated Rate	$290.70
Max. Negotiated Rate	$331.74
Rate for Payer: Cash Price	$205.20
Rate for Payer: Health Management Network Commercial	$290.70
Rate for Payer: Kaiser Permanente Commercial	$307.80
Rate for Payer: MDX Hawaii PPO	$331.74

DRILL BIT 200X3.2MM 1-1100301

Facility

$382.00

Hospital Revenue Code	272
Min. Negotiated Rate	$191.00
Max. Negotiated Rate	$370.54
Rate for Payer: AlohaCare Medicaid	$191.00
Rate for Payer: AlohaCare Medicare	$290.32
Rate for Payer: Cash Price	$229.20
Rate for Payer: Devoted Health Medicare	$320.88
Rate for Payer: Hawaii Medical Service Association Medicare	$290.32
Rate for Payer: Hawaii Western Management Group Commercial	$362.90
Rate for Payer: Health Management Network Commercial	$324.70
Rate for Payer: Humana Medicare	$290.32
Rate for Payer: Kaiser Permanente Commercial	$343.80
Rate for Payer: Kaiser Permanente Medicaid	$194.82
Rate for Payer: Kaiser Permanente Medicare	$290.32
Rate for Payer: MDX Hawaii PPO	$370.54
Rate for Payer: Ohana Health Plan Medicaid	$290.32
Rate for Payer: Ohana Health Plan Medicare	$290.32
Rate for Payer: UnitedHealthcare Medicare	$290.32
Rate for Payer: University Health Alliance Commercial	$278.44

DRILL BIT 200X3.2MM 1-1100301

Facility

$382.00

Hospital Revenue Code	272
Min. Negotiated Rate	$324.70
Max. Negotiated Rate	$370.54
Rate for Payer: Cash Price	$229.20
Rate for Payer: Health Management Network Commercial	$324.70
Rate for Payer: Kaiser Permanente Commercial	$343.80
Rate for Payer: MDX Hawaii PPO	$370.54

DRILL BIT 2.0 705134

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

DRILL BIT 2.0 705134

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 BIT 2.0 DB20

Facility

$450.00

Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$436.50
Rate for Payer: AlohaCare Medicaid	$225.00
Rate for Payer: AlohaCare Medicare	$342.00
Rate for Payer: Cash Price	$270.00
Rate for Payer: Devoted Health Medicare	$378.00
Rate for Payer: Hawaii Medical Service Association Medicare	$342.00
Rate for Payer: Hawaii Western Management Group Commercial	$427.50
Rate for Payer: Health Management Network Commercial	$382.50
Rate for Payer: Humana Medicare	$342.00
Rate for Payer: Kaiser Permanente Commercial	$405.00
Rate for Payer: Kaiser Permanente Medicaid	$229.50
Rate for Payer: Kaiser Permanente Medicare	$342.00
Rate for Payer: MDX Hawaii PPO	$436.50
Rate for Payer: Ohana Health Plan Medicaid	$342.00
Rate for Payer: Ohana Health Plan Medicare	$342.00
Rate for Payer: UnitedHealthcare Medicare	$342.00
Rate for Payer: University Health Alliance Commercial	$328.00

DRILL BIT 2.0 DB20

Facility

$450.00

Hospital Revenue Code	272
Min. Negotiated Rate	$382.50
Max. Negotiated Rate	$436.50
Rate for Payer: Cash Price	$270.00
Rate for Payer: Health Management Network Commercial	$382.50
Rate for Payer: Kaiser Permanente Commercial	$405.00
Rate for Payer: MDX Hawaii PPO	$436.50

DRILL BIT 2.0MM 125MM 700346

Facility

$591.00

Hospital Revenue Code	272
Min. Negotiated Rate	$295.50
Max. Negotiated Rate	$573.27
Rate for Payer: AlohaCare Medicaid	$295.50
Rate for Payer: AlohaCare Medicare	$449.16
Rate for Payer: Cash Price	$354.60
Rate for Payer: Devoted Health Medicare	$496.44
Rate for Payer: Hawaii Medical Service Association Medicare	$449.16
Rate for Payer: Hawaii Western Management Group Commercial	$561.45
Rate for Payer: Health Management Network Commercial	$502.35
Rate for Payer: Humana Medicare	$449.16
Rate for Payer: Kaiser Permanente Commercial	$531.90
Rate for Payer: Kaiser Permanente Medicaid	$301.41
Rate for Payer: Kaiser Permanente Medicare	$449.16
Rate for Payer: MDX Hawaii PPO	$573.27
Rate for Payer: Ohana Health Plan Medicaid	$449.16
Rate for Payer: Ohana Health Plan Medicare	$449.16
Rate for Payer: UnitedHealthcare Medicare	$449.16
Rate for Payer: University Health Alliance Commercial	$430.78

DRILL BIT 2.0MM 125MM 700346

Facility

$591.00

Hospital Revenue Code	272
Min. Negotiated Rate	$502.35
Max. Negotiated Rate	$573.27
Rate for Payer: Cash Price	$354.60
Rate for Payer: Health Management Network Commercial	$502.35
Rate for Payer: Kaiser Permanente Commercial	$531.90
Rate for Payer: MDX Hawaii PPO	$573.27

DRILL BIT 2.0MM 13551

Facility

$489.00

Hospital Revenue Code	272
Min. Negotiated Rate	$244.50
Max. Negotiated Rate	$474.33
Rate for Payer: AlohaCare Medicaid	$244.50
Rate for Payer: AlohaCare Medicare	$371.64
Rate for Payer: Cash Price	$293.40
Rate for Payer: Devoted Health Medicare	$410.76
Rate for Payer: Hawaii Medical Service Association Medicare	$371.64
Rate for Payer: Hawaii Western Management Group Commercial	$464.55
Rate for Payer: Health Management Network Commercial	$415.65
Rate for Payer: Humana Medicare	$371.64
Rate for Payer: Kaiser Permanente Commercial	$440.10
Rate for Payer: Kaiser Permanente Medicaid	$249.39
Rate for Payer: Kaiser Permanente Medicare	$371.64
Rate for Payer: MDX Hawaii PPO	$474.33
Rate for Payer: Ohana Health Plan Medicaid	$371.64
Rate for Payer: Ohana Health Plan Medicare	$371.64
Rate for Payer: UnitedHealthcare Medicare	$371.64
Rate for Payer: University Health Alliance Commercial	$356.43

Know your out-of-pocket cost for care.

All Charges