Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

DRILL BIT 3.5X6MM 210451

Facility

$431.00

Hospital Revenue Code	272
Min. Negotiated Rate	$366.35
Max. Negotiated Rate	$418.07
Rate for Payer: Cash Price	$258.60
Rate for Payer: Health Management Network Commercial	$366.35
Rate for Payer: Kaiser Permanente Commercial	$387.90
Rate for Payer: MDX Hawaii PPO	$418.07

DRILL BIT 3.5X6MM 210451

Facility

$431.00

Hospital Revenue Code	272
Min. Negotiated Rate	$215.50
Max. Negotiated Rate	$418.07
Rate for Payer: AlohaCare Medicaid	$215.50
Rate for Payer: AlohaCare Medicare	$327.56
Rate for Payer: Cash Price	$258.60
Rate for Payer: Devoted Health Medicare	$362.04
Rate for Payer: Hawaii Medical Service Association Medicare	$327.56
Rate for Payer: Hawaii Western Management Group Commercial	$409.45
Rate for Payer: Health Management Network Commercial	$366.35
Rate for Payer: Humana Medicare	$327.56
Rate for Payer: Kaiser Permanente Commercial	$387.90
Rate for Payer: Kaiser Permanente Medicaid	$219.81
Rate for Payer: Kaiser Permanente Medicare	$327.56
Rate for Payer: MDX Hawaii PPO	$418.07
Rate for Payer: Ohana Health Plan Medicaid	$327.56
Rate for Payer: Ohana Health Plan Medicare	$327.56
Rate for Payer: UnitedHealthcare Medicare	$327.56
Rate for Payer: University Health Alliance Commercial	$314.16

DRILL BIT 3.5X95MM JC 310.36

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 3.5X95MM JC 310.36

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 4.0/180MM 1-1103001

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 4.0/180MM 1-1103001

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 4.0 200MM 5085-2-040

Facility

$438.00

Hospital Revenue Code	272
Min. Negotiated Rate	$372.30
Max. Negotiated Rate	$424.86
Rate for Payer: Cash Price	$262.80
Rate for Payer: Health Management Network Commercial	$372.30
Rate for Payer: Kaiser Permanente Commercial	$394.20
Rate for Payer: MDX Hawaii PPO	$424.86

DRILL BIT 4.0 200MM 5085-2-040

Facility

$438.00

Hospital Revenue Code	272
Min. Negotiated Rate	$219.00
Max. Negotiated Rate	$424.86
Rate for Payer: AlohaCare Medicaid	$219.00
Rate for Payer: AlohaCare Medicare	$332.88
Rate for Payer: Cash Price	$262.80
Rate for Payer: Devoted Health Medicare	$367.92
Rate for Payer: Hawaii Medical Service Association Medicare	$332.88
Rate for Payer: Hawaii Western Management Group Commercial	$416.10
Rate for Payer: Health Management Network Commercial	$372.30
Rate for Payer: Humana Medicare	$332.88
Rate for Payer: Kaiser Permanente Commercial	$394.20
Rate for Payer: Kaiser Permanente Medicaid	$223.38
Rate for Payer: Kaiser Permanente Medicare	$332.88
Rate for Payer: MDX Hawaii PPO	$424.86
Rate for Payer: Ohana Health Plan Medicaid	$332.88
Rate for Payer: Ohana Health Plan Medicare	$332.88
Rate for Payer: UnitedHealthcare Medicare	$332.88
Rate for Payer: University Health Alliance Commercial	$319.26

DRILL BIT 4.0MM 2129-57-014

Facility

$394.00

Hospital Revenue Code	272
Min. Negotiated Rate	$334.90
Max. Negotiated Rate	$382.18
Rate for Payer: Cash Price	$236.40
Rate for Payer: Health Management Network Commercial	$334.90
Rate for Payer: Kaiser Permanente Commercial	$354.60
Rate for Payer: MDX Hawaii PPO	$382.18

DRILL BIT 4.0MM 2129-57-014

Facility

$394.00

Hospital Revenue Code	272
Min. Negotiated Rate	$197.00
Max. Negotiated Rate	$382.18
Rate for Payer: AlohaCare Medicaid	$197.00
Rate for Payer: AlohaCare Medicare	$299.44
Rate for Payer: Cash Price	$236.40
Rate for Payer: Devoted Health Medicare	$330.96
Rate for Payer: Hawaii Medical Service Association Medicare	$299.44
Rate for Payer: Hawaii Western Management Group Commercial	$374.30
Rate for Payer: Health Management Network Commercial	$334.90
Rate for Payer: Humana Medicare	$299.44
Rate for Payer: Kaiser Permanente Commercial	$354.60
Rate for Payer: Kaiser Permanente Medicaid	$200.94
Rate for Payer: Kaiser Permanente Medicare	$299.44
Rate for Payer: MDX Hawaii PPO	$382.18
Rate for Payer: Ohana Health Plan Medicaid	$299.44
Rate for Payer: Ohana Health Plan Medicare	$299.44
Rate for Payer: UnitedHealthcare Medicare	$299.44
Rate for Payer: University Health Alliance Commercial	$287.19

DRILL BIT 4.2MM X 145MM

Facility

$938.00

Hospital Revenue Code	272
Min. Negotiated Rate	$469.00
Max. Negotiated Rate	$909.86
Rate for Payer: AlohaCare Medicaid	$469.00
Rate for Payer: AlohaCare Medicare	$712.88
Rate for Payer: Cash Price	$562.80
Rate for Payer: Devoted Health Medicare	$787.92
Rate for Payer: Hawaii Medical Service Association Medicare	$712.88
Rate for Payer: Hawaii Western Management Group Commercial	$891.10
Rate for Payer: Health Management Network Commercial	$797.30
Rate for Payer: Humana Medicare	$712.88
Rate for Payer: Kaiser Permanente Commercial	$844.20
Rate for Payer: Kaiser Permanente Medicaid	$478.38
Rate for Payer: Kaiser Permanente Medicare	$712.88
Rate for Payer: MDX Hawaii PPO	$909.86
Rate for Payer: Ohana Health Plan Medicaid	$712.88
Rate for Payer: Ohana Health Plan Medicare	$712.88
Rate for Payer: UnitedHealthcare Medicare	$712.88
Rate for Payer: University Health Alliance Commercial	$683.71

DRILL BIT 4.2MM X 145MM

Facility

$938.00

Hospital Revenue Code	272
Min. Negotiated Rate	$797.30
Max. Negotiated Rate	$909.86
Rate for Payer: Cash Price	$562.80
Rate for Payer: Health Management Network Commercial	$797.30
Rate for Payer: Kaiser Permanente Commercial	$844.20
Rate for Payer: MDX Hawaii PPO	$909.86

DRILL BIT 4.2X145MM 03.010.101

Facility

$993.00

Hospital Revenue Code	272
Min. Negotiated Rate	$844.05
Max. Negotiated Rate	$963.21
Rate for Payer: Cash Price	$595.80
Rate for Payer: Health Management Network Commercial	$844.05
Rate for Payer: Kaiser Permanente Commercial	$893.70
Rate for Payer: MDX Hawaii PPO	$963.21

DRILL BIT 4.2X145MM 03.010.101

Facility

$993.00

Hospital Revenue Code	272
Min. Negotiated Rate	$496.50
Max. Negotiated Rate	$963.21
Rate for Payer: AlohaCare Medicaid	$496.50
Rate for Payer: AlohaCare Medicare	$754.68
Rate for Payer: Cash Price	$595.80
Rate for Payer: Devoted Health Medicare	$834.12
Rate for Payer: Hawaii Medical Service Association Medicare	$754.68
Rate for Payer: Hawaii Western Management Group Commercial	$943.35
Rate for Payer: Health Management Network Commercial	$844.05
Rate for Payer: Humana Medicare	$754.68
Rate for Payer: Kaiser Permanente Commercial	$893.70
Rate for Payer: Kaiser Permanente Medicaid	$506.43
Rate for Payer: Kaiser Permanente Medicare	$754.68
Rate for Payer: MDX Hawaii PPO	$963.21
Rate for Payer: Ohana Health Plan Medicaid	$754.68
Rate for Payer: Ohana Health Plan Medicare	$754.68
Rate for Payer: UnitedHealthcare Medicare	$754.68
Rate for Payer: University Health Alliance Commercial	$723.80

DRILL BIT 4.2X145MM 03.010.104

Facility

$880.00

Hospital Revenue Code	272
Min. Negotiated Rate	$440.00
Max. Negotiated Rate	$853.60
Rate for Payer: AlohaCare Medicaid	$440.00
Rate for Payer: AlohaCare Medicare	$668.80
Rate for Payer: Cash Price	$528.00
Rate for Payer: Devoted Health Medicare	$739.20
Rate for Payer: Hawaii Medical Service Association Medicare	$668.80
Rate for Payer: Hawaii Western Management Group Commercial	$836.00
Rate for Payer: Health Management Network Commercial	$748.00
Rate for Payer: Humana Medicare	$668.80
Rate for Payer: Kaiser Permanente Commercial	$792.00
Rate for Payer: Kaiser Permanente Medicaid	$448.80
Rate for Payer: Kaiser Permanente Medicare	$668.80
Rate for Payer: MDX Hawaii PPO	$853.60
Rate for Payer: Ohana Health Plan Medicaid	$668.80
Rate for Payer: Ohana Health Plan Medicare	$668.80
Rate for Payer: UnitedHealthcare Medicare	$668.80
Rate for Payer: University Health Alliance Commercial	$641.43

DRILL BIT 4.2X145MM 03.010.104

Facility

$880.00

Hospital Revenue Code	272
Min. Negotiated Rate	$748.00
Max. Negotiated Rate	$853.60
Rate for Payer: Cash Price	$528.00
Rate for Payer: Health Management Network Commercial	$748.00
Rate for Payer: Kaiser Permanente Commercial	$792.00
Rate for Payer: MDX Hawaii PPO	$853.60

DRILL BIT 4.2X330MM 03.010.061

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

DRILL BIT 4.2X330MM 03.010.061

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 4.3MM 02.00024.002

Facility

$980.00

Hospital Revenue Code	272
Min. Negotiated Rate	$490.00
Max. Negotiated Rate	$950.60
Rate for Payer: AlohaCare Medicaid	$490.00
Rate for Payer: AlohaCare Medicare	$744.80
Rate for Payer: Cash Price	$588.00
Rate for Payer: Devoted Health Medicare	$823.20
Rate for Payer: Hawaii Medical Service Association Medicare	$744.80
Rate for Payer: Hawaii Western Management Group Commercial	$931.00
Rate for Payer: Health Management Network Commercial	$833.00
Rate for Payer: Humana Medicare	$744.80
Rate for Payer: Kaiser Permanente Commercial	$882.00
Rate for Payer: Kaiser Permanente Medicaid	$499.80
Rate for Payer: Kaiser Permanente Medicare	$744.80
Rate for Payer: MDX Hawaii PPO	$950.60
Rate for Payer: Ohana Health Plan Medicaid	$744.80
Rate for Payer: Ohana Health Plan Medicare	$744.80
Rate for Payer: UnitedHealthcare Medicare	$744.80
Rate for Payer: University Health Alliance Commercial	$714.32

DRILL BIT 4.3MM 02.00024.002

Facility

$980.00

Hospital Revenue Code	272
Min. Negotiated Rate	$833.00
Max. Negotiated Rate	$950.60
Rate for Payer: Cash Price	$588.00
Rate for Payer: Health Management Network Commercial	$833.00
Rate for Payer: Kaiser Permanente Commercial	$882.00
Rate for Payer: MDX Hawaii PPO	$950.60

DRILL BIT 4.3MM 02.00024.346

Facility

$840.00

Hospital Revenue Code	272
Min. Negotiated Rate	$714.00
Max. Negotiated Rate	$814.80
Rate for Payer: Cash Price	$504.00
Rate for Payer: Health Management Network Commercial	$714.00
Rate for Payer: Kaiser Permanente Commercial	$756.00
Rate for Payer: MDX Hawaii PPO	$814.80

DRILL BIT 4.3MM 02.00024.346

Facility

$840.00

Hospital Revenue Code	272
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$814.80
Rate for Payer: AlohaCare Medicaid	$420.00
Rate for Payer: AlohaCare Medicare	$638.40
Rate for Payer: Cash Price	$504.00
Rate for Payer: Devoted Health Medicare	$705.60
Rate for Payer: Hawaii Medical Service Association Medicare	$638.40
Rate for Payer: Hawaii Western Management Group Commercial	$798.00
Rate for Payer: Health Management Network Commercial	$714.00
Rate for Payer: Humana Medicare	$638.40
Rate for Payer: Kaiser Permanente Commercial	$756.00
Rate for Payer: Kaiser Permanente Medicaid	$428.40
Rate for Payer: Kaiser Permanente Medicare	$638.40
Rate for Payer: MDX Hawaii PPO	$814.80
Rate for Payer: Ohana Health Plan Medicaid	$638.40
Rate for Payer: Ohana Health Plan Medicare	$638.40
Rate for Payer: UnitedHealthcare Medicare	$638.40
Rate for Payer: University Health Alliance Commercial	$612.28

DRILL BIT 4.3MMX300MM 324.213

Facility

$841.00

Hospital Revenue Code	272
Min. Negotiated Rate	$420.50
Max. Negotiated Rate	$815.77
Rate for Payer: AlohaCare Medicaid	$420.50
Rate for Payer: AlohaCare Medicare	$639.16
Rate for Payer: Cash Price	$504.60
Rate for Payer: Devoted Health Medicare	$706.44
Rate for Payer: Hawaii Medical Service Association Medicare	$639.16
Rate for Payer: Hawaii Western Management Group Commercial	$798.95
Rate for Payer: Health Management Network Commercial	$714.85
Rate for Payer: Humana Medicare	$639.16
Rate for Payer: Kaiser Permanente Commercial	$756.90
Rate for Payer: Kaiser Permanente Medicaid	$428.91
Rate for Payer: Kaiser Permanente Medicare	$639.16
Rate for Payer: MDX Hawaii PPO	$815.77
Rate for Payer: Ohana Health Plan Medicaid	$639.16
Rate for Payer: Ohana Health Plan Medicare	$639.16
Rate for Payer: UnitedHealthcare Medicare	$639.16
Rate for Payer: University Health Alliance Commercial	$613.00

DRILL BIT 4.3MMX300MM 324.213

Facility

$841.00

Hospital Revenue Code	272
Min. Negotiated Rate	$714.85
Max. Negotiated Rate	$815.77
Rate for Payer: Cash Price	$504.60
Rate for Payer: Health Management Network Commercial	$714.85
Rate for Payer: Kaiser Permanente Commercial	$756.90
Rate for Payer: MDX Hawaii PPO	$815.77

DRILL BIT 4.3X196 705078

Facility

$1,013.00

Hospital Revenue Code	272
Min. Negotiated Rate	$506.50
Max. Negotiated Rate	$982.61
Rate for Payer: AlohaCare Medicaid	$506.50
Rate for Payer: AlohaCare Medicare	$769.88
Rate for Payer: Cash Price	$607.80
Rate for Payer: Devoted Health Medicare	$850.92
Rate for Payer: Hawaii Medical Service Association Medicare	$769.88
Rate for Payer: Hawaii Western Management Group Commercial	$962.35
Rate for Payer: Health Management Network Commercial	$861.05
Rate for Payer: Humana Medicare	$769.88
Rate for Payer: Kaiser Permanente Commercial	$911.70
Rate for Payer: Kaiser Permanente Medicaid	$516.63
Rate for Payer: Kaiser Permanente Medicare	$769.88
Rate for Payer: MDX Hawaii PPO	$982.61
Rate for Payer: Ohana Health Plan Medicaid	$769.88
Rate for Payer: Ohana Health Plan Medicare	$769.88
Rate for Payer: UnitedHealthcare Medicare	$769.88
Rate for Payer: University Health Alliance Commercial	$738.38

Know your out-of-pocket cost for care.

All Charges