Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

DRILL BIT 2.7MM 214227070

Facility

$713.00

Hospital Revenue Code	272
Min. Negotiated Rate	$606.05
Max. Negotiated Rate	$691.61
Rate for Payer: Cash Price	$427.80
Rate for Payer: Health Management Network Commercial	$606.05
Rate for Payer: Kaiser Permanente Commercial	$641.70
Rate for Payer: MDX Hawaii PPO	$691.61

DRILL BIT 2.7MM AR-8827D-01

Facility

$340.00

Hospital Revenue Code	272
Min. Negotiated Rate	$289.00
Max. Negotiated Rate	$329.80
Rate for Payer: Cash Price	$204.00
Rate for Payer: Health Management Network Commercial	$289.00
Rate for Payer: Kaiser Permanente Commercial	$306.00
Rate for Payer: MDX Hawaii PPO	$329.80

DRILL BIT 2.7MM AR-8827D-01

Facility

$340.00

Hospital Revenue Code	272
Min. Negotiated Rate	$170.00
Max. Negotiated Rate	$329.80
Rate for Payer: AlohaCare Medicaid	$170.00
Rate for Payer: AlohaCare Medicare	$258.40
Rate for Payer: Cash Price	$204.00
Rate for Payer: Devoted Health Medicare	$285.60
Rate for Payer: Hawaii Medical Service Association Medicare	$258.40
Rate for Payer: Hawaii Western Management Group Commercial	$323.00
Rate for Payer: Health Management Network Commercial	$289.00
Rate for Payer: Humana Medicare	$258.40
Rate for Payer: Kaiser Permanente Commercial	$306.00
Rate for Payer: Kaiser Permanente Medicaid	$173.40
Rate for Payer: Kaiser Permanente Medicare	$258.40
Rate for Payer: MDX Hawaii PPO	$329.80
Rate for Payer: Ohana Health Plan Medicaid	$258.40
Rate for Payer: Ohana Health Plan Medicare	$258.40
Rate for Payer: UnitedHealthcare Medicare	$258.40
Rate for Payer: University Health Alliance Commercial	$247.83

DRILL BIT 2.7MM CORTEX 310.87

Facility

$672.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$571.20
Max. Negotiated Rate	$651.84
Rate for Payer: Cash Price	$403.20
Rate for Payer: Health Management Network Commercial	$571.20
Rate for Payer: Kaiser Permanente Commercial	$604.80
Rate for Payer: MDX Hawaii PPO	$651.84

DRILL BIT 2.7MM CORTEX 310.87

Facility

$672.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$336.00
Max. Negotiated Rate	$651.84
Rate for Payer: AlohaCare Medicaid	$336.00
Rate for Payer: AlohaCare Medicare	$510.72
Rate for Payer: Cash Price	$403.20
Rate for Payer: Devoted Health Medicare	$564.48
Rate for Payer: Hawaii Medical Service Association Medicare	$510.72
Rate for Payer: Hawaii Western Management Group Commercial	$638.40
Rate for Payer: Health Management Network Commercial	$571.20
Rate for Payer: Humana Medicare	$510.72
Rate for Payer: Kaiser Permanente Commercial	$604.80
Rate for Payer: Kaiser Permanente Medicaid	$342.72
Rate for Payer: Kaiser Permanente Medicare	$510.72
Rate for Payer: MDX Hawaii PPO	$651.84
Rate for Payer: Ohana Health Plan Medicaid	$510.72
Rate for Payer: Ohana Health Plan Medicare	$510.72
Rate for Payer: UnitedHealthcare Medicare	$510.72
Rate for Payer: University Health Alliance Commercial	$489.82

DRILL BIT 2.7X155MM 7117-3581

Facility

$2,529.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,264.50
Max. Negotiated Rate	$2,453.13
Rate for Payer: AlohaCare Medicaid	$1,264.50
Rate for Payer: AlohaCare Medicare	$1,922.04
Rate for Payer: Cash Price	$1,517.40
Rate for Payer: Devoted Health Medicare	$2,124.36
Rate for Payer: Hawaii Medical Service Association Medicare	$1,922.04
Rate for Payer: Hawaii Western Management Group Commercial	$2,402.55
Rate for Payer: Health Management Network Commercial	$2,149.65
Rate for Payer: Humana Medicare	$1,922.04
Rate for Payer: Kaiser Permanente Commercial	$2,276.10
Rate for Payer: Kaiser Permanente Medicaid	$1,289.79
Rate for Payer: Kaiser Permanente Medicare	$1,922.04
Rate for Payer: MDX Hawaii PPO	$2,453.13
Rate for Payer: Ohana Health Plan Medicaid	$1,922.04
Rate for Payer: Ohana Health Plan Medicare	$1,922.04
Rate for Payer: UnitedHealthcare Medicare	$1,922.04
Rate for Payer: University Health Alliance Commercial	$1,843.39

DRILL BIT 2.7X155MM 7117-3581

Facility

$2,529.00

Hospital Revenue Code	272
Min. Negotiated Rate	$2,149.65
Max. Negotiated Rate	$2,453.13
Rate for Payer: Cash Price	$1,517.40
Rate for Payer: Health Management Network Commercial	$2,149.65
Rate for Payer: Kaiser Permanente Commercial	$2,276.10
Rate for Payer: MDX Hawaii PPO	$2,453.13

DRILL BIT 2.7X205 2360-205-27

Facility

$622.00

Hospital Revenue Code	272
Min. Negotiated Rate	$311.00
Max. Negotiated Rate	$603.34
Rate for Payer: AlohaCare Medicaid	$311.00
Rate for Payer: AlohaCare Medicare	$472.72
Rate for Payer: Cash Price	$373.20
Rate for Payer: Devoted Health Medicare	$522.48
Rate for Payer: Hawaii Medical Service Association Medicare	$472.72
Rate for Payer: Hawaii Western Management Group Commercial	$590.90
Rate for Payer: Health Management Network Commercial	$528.70
Rate for Payer: Humana Medicare	$472.72
Rate for Payer: Kaiser Permanente Commercial	$559.80
Rate for Payer: Kaiser Permanente Medicaid	$317.22
Rate for Payer: Kaiser Permanente Medicare	$472.72
Rate for Payer: MDX Hawaii PPO	$603.34
Rate for Payer: Ohana Health Plan Medicaid	$472.72
Rate for Payer: Ohana Health Plan Medicare	$472.72
Rate for Payer: UnitedHealthcare Medicare	$472.72
Rate for Payer: University Health Alliance Commercial	$453.38

DRILL BIT 2.7X205 2360-205-27

Facility

$622.00

Hospital Revenue Code	272
Min. Negotiated Rate	$528.70
Max. Negotiated Rate	$603.34
Rate for Payer: Cash Price	$373.20
Rate for Payer: Health Management Network Commercial	$528.70
Rate for Payer: Kaiser Permanente Commercial	$559.80
Rate for Payer: MDX Hawaii PPO	$603.34

DRILL BIT 280X4.8MM 11007

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 280X4.8MM 11007

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 280X4.8MM 11007A

Facility

$380.00

Hospital Revenue Code	272
Min. Negotiated Rate	$190.00
Max. Negotiated Rate	$368.60
Rate for Payer: AlohaCare Medicaid	$190.00
Rate for Payer: AlohaCare Medicare	$288.80
Rate for Payer: Cash Price	$228.00
Rate for Payer: Devoted Health Medicare	$319.20
Rate for Payer: Hawaii Medical Service Association Medicare	$288.80
Rate for Payer: Hawaii Western Management Group Commercial	$361.00
Rate for Payer: Health Management Network Commercial	$323.00
Rate for Payer: Humana Medicare	$288.80
Rate for Payer: Kaiser Permanente Commercial	$342.00
Rate for Payer: Kaiser Permanente Medicaid	$193.80
Rate for Payer: Kaiser Permanente Medicare	$288.80
Rate for Payer: MDX Hawaii PPO	$368.60
Rate for Payer: Ohana Health Plan Medicaid	$288.80
Rate for Payer: Ohana Health Plan Medicare	$288.80
Rate for Payer: UnitedHealthcare Medicare	$288.80
Rate for Payer: University Health Alliance Commercial	$276.98

DRILL BIT 280X4.8MM 11007A

Facility

$380.00

Hospital Revenue Code	272
Min. Negotiated Rate	$323.00
Max. Negotiated Rate	$368.60
Rate for Payer: Cash Price	$228.00
Rate for Payer: Health Management Network Commercial	$323.00
Rate for Payer: Kaiser Permanente Commercial	$342.00
Rate for Payer: MDX Hawaii PPO	$368.60

DRILL BIT 280X4.8MM 1-1100701

Facility

$527.00

Hospital Revenue Code	272
Min. Negotiated Rate	$263.50
Max. Negotiated Rate	$511.19
Rate for Payer: AlohaCare Medicaid	$263.50
Rate for Payer: AlohaCare Medicare	$400.52
Rate for Payer: Cash Price	$316.20
Rate for Payer: Devoted Health Medicare	$442.68
Rate for Payer: Hawaii Medical Service Association Medicare	$400.52
Rate for Payer: Hawaii Western Management Group Commercial	$500.65
Rate for Payer: Health Management Network Commercial	$447.95
Rate for Payer: Humana Medicare	$400.52
Rate for Payer: Kaiser Permanente Commercial	$474.30
Rate for Payer: Kaiser Permanente Medicaid	$268.77
Rate for Payer: Kaiser Permanente Medicare	$400.52
Rate for Payer: MDX Hawaii PPO	$511.19
Rate for Payer: Ohana Health Plan Medicaid	$400.52
Rate for Payer: Ohana Health Plan Medicare	$400.52
Rate for Payer: UnitedHealthcare Medicare	$400.52
Rate for Payer: University Health Alliance Commercial	$384.13

DRILL BIT 280X4.8MM 1-1100701

Facility

$527.00

Hospital Revenue Code	272
Min. Negotiated Rate	$447.95
Max. Negotiated Rate	$511.19
Rate for Payer: Cash Price	$316.20
Rate for Payer: Health Management Network Commercial	$447.95
Rate for Payer: Kaiser Permanente Commercial	$474.30
Rate for Payer: MDX Hawaii PPO	$511.19

DRILL BIT 2.8MM 03.122.002

Facility

$712.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$605.20
Max. Negotiated Rate	$690.64
Rate for Payer: Cash Price	$427.20
Rate for Payer: Health Management Network Commercial	$605.20
Rate for Payer: Kaiser Permanente Commercial	$640.80
Rate for Payer: MDX Hawaii PPO	$690.64

DRILL BIT 2.8MM 03.122.002

Facility

$712.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$356.00
Max. Negotiated Rate	$690.64
Rate for Payer: AlohaCare Medicaid	$356.00
Rate for Payer: AlohaCare Medicare	$541.12
Rate for Payer: Cash Price	$427.20
Rate for Payer: Devoted Health Medicare	$598.08
Rate for Payer: Hawaii Medical Service Association Medicare	$541.12
Rate for Payer: Hawaii Western Management Group Commercial	$676.40
Rate for Payer: Health Management Network Commercial	$605.20
Rate for Payer: Humana Medicare	$541.12
Rate for Payer: Kaiser Permanente Commercial	$640.80
Rate for Payer: Kaiser Permanente Medicaid	$363.12
Rate for Payer: Kaiser Permanente Medicare	$541.12
Rate for Payer: MDX Hawaii PPO	$690.64
Rate for Payer: Ohana Health Plan Medicaid	$541.12
Rate for Payer: Ohana Health Plan Medicare	$541.12
Rate for Payer: UnitedHealthcare Medicare	$541.12
Rate for Payer: University Health Alliance Commercial	$518.98

DRILL BIT 2.8MM STERILE

Facility

$375.00

Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$363.75
Rate for Payer: AlohaCare Medicaid	$187.50
Rate for Payer: AlohaCare Medicare	$285.00
Rate for Payer: Cash Price	$225.00
Rate for Payer: Devoted Health Medicare	$315.00
Rate for Payer: Hawaii Medical Service Association Medicare	$285.00
Rate for Payer: Hawaii Western Management Group Commercial	$356.25
Rate for Payer: Health Management Network Commercial	$318.75
Rate for Payer: Humana Medicare	$285.00
Rate for Payer: Kaiser Permanente Commercial	$337.50
Rate for Payer: Kaiser Permanente Medicaid	$191.25
Rate for Payer: Kaiser Permanente Medicare	$285.00
Rate for Payer: MDX Hawaii PPO	$363.75
Rate for Payer: Ohana Health Plan Medicaid	$285.00
Rate for Payer: Ohana Health Plan Medicare	$285.00
Rate for Payer: UnitedHealthcare Medicare	$285.00
Rate for Payer: University Health Alliance Commercial	$273.34

DRILL BIT 2.8MM STERILE

Facility

$375.00

Hospital Revenue Code	272
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$363.75
Rate for Payer: Cash Price	$225.00
Rate for Payer: Health Management Network Commercial	$318.75
Rate for Payer: Kaiser Permanente Commercial	$337.50
Rate for Payer: MDX Hawaii PPO	$363.75

DRILL BIT 2.8X250MM 03.113.024

Facility

$546.00

Hospital Revenue Code	272
Min. Negotiated Rate	$464.10
Max. Negotiated Rate	$529.62
Rate for Payer: Cash Price	$327.60
Rate for Payer: Health Management Network Commercial	$464.10
Rate for Payer: Kaiser Permanente Commercial	$491.40
Rate for Payer: MDX Hawaii PPO	$529.62

DRILL BIT 2.8X250MM 03.113.024

Facility

$546.00

Hospital Revenue Code	272
Min. Negotiated Rate	$273.00
Max. Negotiated Rate	$529.62
Rate for Payer: AlohaCare Medicaid	$273.00
Rate for Payer: AlohaCare Medicare	$414.96
Rate for Payer: Cash Price	$327.60
Rate for Payer: Devoted Health Medicare	$458.64
Rate for Payer: Hawaii Medical Service Association Medicare	$414.96
Rate for Payer: Hawaii Western Management Group Commercial	$518.70
Rate for Payer: Health Management Network Commercial	$464.10
Rate for Payer: Humana Medicare	$414.96
Rate for Payer: Kaiser Permanente Commercial	$491.40
Rate for Payer: Kaiser Permanente Medicaid	$278.46
Rate for Payer: Kaiser Permanente Medicare	$414.96
Rate for Payer: MDX Hawaii PPO	$529.62
Rate for Payer: Ohana Health Plan Medicaid	$414.96
Rate for Payer: Ohana Health Plan Medicare	$414.96
Rate for Payer: UnitedHealthcare Medicare	$414.96
Rate for Payer: University Health Alliance Commercial	$397.98

DRILL BIT 2MM AR-8944-22

Facility

$357.00

Hospital Revenue Code	272
Min. Negotiated Rate	$303.45
Max. Negotiated Rate	$346.29
Rate for Payer: Cash Price	$214.20
Rate for Payer: Health Management Network Commercial	$303.45
Rate for Payer: Kaiser Permanente Commercial	$321.30
Rate for Payer: MDX Hawaii PPO	$346.29

DRILL BIT 2MM AR-8944-22

Facility

$357.00

Hospital Revenue Code	272
Min. Negotiated Rate	$178.50
Max. Negotiated Rate	$346.29
Rate for Payer: AlohaCare Medicaid	$178.50
Rate for Payer: AlohaCare Medicare	$271.32
Rate for Payer: Cash Price	$214.20
Rate for Payer: Devoted Health Medicare	$299.88
Rate for Payer: Hawaii Medical Service Association Medicare	$271.32
Rate for Payer: Hawaii Western Management Group Commercial	$339.15
Rate for Payer: Health Management Network Commercial	$303.45
Rate for Payer: Humana Medicare	$271.32
Rate for Payer: Kaiser Permanente Commercial	$321.30
Rate for Payer: Kaiser Permanente Medicaid	$182.07
Rate for Payer: Kaiser Permanente Medicare	$271.32
Rate for Payer: MDX Hawaii PPO	$346.29
Rate for Payer: Ohana Health Plan Medicaid	$271.32
Rate for Payer: Ohana Health Plan Medicare	$271.32
Rate for Payer: UnitedHealthcare Medicare	$271.32
Rate for Payer: University Health Alliance Commercial	$260.22

DRILL BIT 2MMX135MM 542000

Facility

$1,148.00

Hospital Revenue Code	272
Min. Negotiated Rate	$975.80
Max. Negotiated Rate	$1,113.56
Rate for Payer: Cash Price	$688.80
Rate for Payer: Health Management Network Commercial	$975.80
Rate for Payer: Kaiser Permanente Commercial	$1,033.20
Rate for Payer: MDX Hawaii PPO	$1,113.56

DRILL BIT 2MMX135MM 542000

Facility

$1,148.00

Hospital Revenue Code	272
Min. Negotiated Rate	$574.00
Max. Negotiated Rate	$1,113.56
Rate for Payer: AlohaCare Medicaid	$574.00
Rate for Payer: AlohaCare Medicare	$872.48
Rate for Payer: Cash Price	$688.80
Rate for Payer: Devoted Health Medicare	$964.32
Rate for Payer: Hawaii Medical Service Association Medicare	$872.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,090.60
Rate for Payer: Health Management Network Commercial	$975.80
Rate for Payer: Humana Medicare	$872.48
Rate for Payer: Kaiser Permanente Commercial	$1,033.20
Rate for Payer: Kaiser Permanente Medicaid	$585.48
Rate for Payer: Kaiser Permanente Medicare	$872.48
Rate for Payer: MDX Hawaii PPO	$1,113.56
Rate for Payer: Ohana Health Plan Medicaid	$872.48
Rate for Payer: Ohana Health Plan Medicare	$872.48
Rate for Payer: UnitedHealthcare Medicare	$872.48
Rate for Payer: University Health Alliance Commercial	$836.78

Know your out-of-pocket cost for care.

All Charges