Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

DRILL BIT 5.0X145MM 03.010.102

Facility

$1,029.00

Hospital Revenue Code	272
Min. Negotiated Rate	$874.65
Max. Negotiated Rate	$998.13
Rate for Payer: Cash Price	$617.40
Rate for Payer: Health Management Network Commercial	$874.65
Rate for Payer: Kaiser Permanente Commercial	$926.10
Rate for Payer: MDX Hawaii PPO	$998.13

DRILL BIT 5.0X145MM 03.010.102

Facility

$1,029.00

Hospital Revenue Code	272
Min. Negotiated Rate	$514.50
Max. Negotiated Rate	$998.13
Rate for Payer: AlohaCare Medicaid	$514.50
Rate for Payer: AlohaCare Medicare	$782.04
Rate for Payer: Cash Price	$617.40
Rate for Payer: Devoted Health Medicare	$864.36
Rate for Payer: Hawaii Medical Service Association Medicare	$782.04
Rate for Payer: Hawaii Western Management Group Commercial	$977.55
Rate for Payer: Health Management Network Commercial	$874.65
Rate for Payer: Humana Medicare	$782.04
Rate for Payer: Kaiser Permanente Commercial	$926.10
Rate for Payer: Kaiser Permanente Medicaid	$524.79
Rate for Payer: Kaiser Permanente Medicare	$782.04
Rate for Payer: MDX Hawaii PPO	$998.13
Rate for Payer: Ohana Health Plan Medicaid	$782.04
Rate for Payer: Ohana Health Plan Medicare	$782.04
Rate for Payer: UnitedHealthcare Medicare	$782.04
Rate for Payer: University Health Alliance Commercial	$750.04

DRILL BIT 5.0X145MM 03.010.105

Facility

$900.00

Hospital Revenue Code	272
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$873.00
Rate for Payer: Cash Price	$540.00
Rate for Payer: Health Management Network Commercial	$765.00
Rate for Payer: Kaiser Permanente Commercial	$810.00
Rate for Payer: MDX Hawaii PPO	$873.00

DRILL BIT 5.0X145MM 03.010.105

Facility

$900.00

Hospital Revenue Code	272
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$873.00
Rate for Payer: AlohaCare Medicaid	$450.00
Rate for Payer: AlohaCare Medicare	$684.00
Rate for Payer: Cash Price	$540.00
Rate for Payer: Devoted Health Medicare	$756.00
Rate for Payer: Hawaii Medical Service Association Medicare	$684.00
Rate for Payer: Hawaii Western Management Group Commercial	$855.00
Rate for Payer: Health Management Network Commercial	$765.00
Rate for Payer: Humana Medicare	$684.00
Rate for Payer: Kaiser Permanente Commercial	$810.00
Rate for Payer: Kaiser Permanente Medicaid	$459.00
Rate for Payer: Kaiser Permanente Medicare	$684.00
Rate for Payer: MDX Hawaii PPO	$873.00
Rate for Payer: Ohana Health Plan Medicaid	$684.00
Rate for Payer: Ohana Health Plan Medicare	$684.00
Rate for Payer: UnitedHealthcare Medicare	$684.00
Rate for Payer: University Health Alliance Commercial	$656.01

DRILL BIT 5.0X330MM 03.010.062

Facility

$1,260.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,071.00
Max. Negotiated Rate	$1,222.20
Rate for Payer: Cash Price	$756.00
Rate for Payer: Health Management Network Commercial	$1,071.00
Rate for Payer: Kaiser Permanente Commercial	$1,134.00
Rate for Payer: MDX Hawaii PPO	$1,222.20

DRILL BIT 5.0X330MM 03.010.062

Facility

$1,260.00

Hospital Revenue Code	272
Min. Negotiated Rate	$630.00
Max. Negotiated Rate	$1,222.20
Rate for Payer: AlohaCare Medicaid	$630.00
Rate for Payer: AlohaCare Medicare	$957.60
Rate for Payer: Cash Price	$756.00
Rate for Payer: Devoted Health Medicare	$1,058.40
Rate for Payer: Hawaii Medical Service Association Medicare	$957.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,197.00
Rate for Payer: Health Management Network Commercial	$1,071.00
Rate for Payer: Humana Medicare	$957.60
Rate for Payer: Kaiser Permanente Commercial	$1,134.00
Rate for Payer: Kaiser Permanente Medicaid	$642.60
Rate for Payer: Kaiser Permanente Medicare	$957.60
Rate for Payer: MDX Hawaii PPO	$1,222.20
Rate for Payer: Ohana Health Plan Medicaid	$957.60
Rate for Payer: Ohana Health Plan Medicare	$957.60
Rate for Payer: UnitedHealthcare Medicare	$957.60
Rate for Payer: University Health Alliance Commercial	$918.41

DRILL BIT 6.5 CANULATED 702603

Facility

$2,165.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$1,082.50
Max. Negotiated Rate	$2,100.05
Rate for Payer: AlohaCare Medicaid	$1,082.50
Rate for Payer: AlohaCare Medicare	$1,645.40
Rate for Payer: Cash Price	$1,299.00
Rate for Payer: Devoted Health Medicare	$1,818.60
Rate for Payer: Hawaii Medical Service Association Medicare	$1,645.40
Rate for Payer: Hawaii Western Management Group Commercial	$2,056.75
Rate for Payer: Health Management Network Commercial	$1,840.25
Rate for Payer: Humana Medicare	$1,645.40
Rate for Payer: Kaiser Permanente Commercial	$1,948.50
Rate for Payer: Kaiser Permanente Medicaid	$1,104.15
Rate for Payer: Kaiser Permanente Medicare	$1,645.40
Rate for Payer: MDX Hawaii PPO	$2,100.05
Rate for Payer: Ohana Health Plan Medicaid	$1,645.40
Rate for Payer: Ohana Health Plan Medicare	$1,645.40
Rate for Payer: UnitedHealthcare Medicare	$1,645.40
Rate for Payer: University Health Alliance Commercial	$1,578.07

DRILL BIT 6.5 CANULATED 702603

Facility

$2,165.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$1,840.25
Max. Negotiated Rate	$2,100.05
Rate for Payer: Cash Price	$1,299.00
Rate for Payer: Health Management Network Commercial	$1,840.25
Rate for Payer: Kaiser Permanente Commercial	$1,948.50
Rate for Payer: MDX Hawaii PPO	$2,100.05

DRILL BIT 702449

Facility

$1,644.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,397.40
Max. Negotiated Rate	$1,594.68
Rate for Payer: Cash Price	$986.40
Rate for Payer: Health Management Network Commercial	$1,397.40
Rate for Payer: Kaiser Permanente Commercial	$1,479.60
Rate for Payer: MDX Hawaii PPO	$1,594.68

DRILL BIT 702449

Facility

$1,644.00

Hospital Revenue Code	272
Min. Negotiated Rate	$822.00
Max. Negotiated Rate	$1,594.68
Rate for Payer: AlohaCare Medicaid	$822.00
Rate for Payer: AlohaCare Medicare	$1,249.44
Rate for Payer: Cash Price	$986.40
Rate for Payer: Devoted Health Medicare	$1,380.96
Rate for Payer: Hawaii Medical Service Association Medicare	$1,249.44
Rate for Payer: Hawaii Western Management Group Commercial	$1,561.80
Rate for Payer: Health Management Network Commercial	$1,397.40
Rate for Payer: Humana Medicare	$1,249.44
Rate for Payer: Kaiser Permanente Commercial	$1,479.60
Rate for Payer: Kaiser Permanente Medicaid	$838.44
Rate for Payer: Kaiser Permanente Medicare	$1,249.44
Rate for Payer: MDX Hawaii PPO	$1,594.68
Rate for Payer: Ohana Health Plan Medicaid	$1,249.44
Rate for Payer: Ohana Health Plan Medicare	$1,249.44
Rate for Payer: UnitedHealthcare Medicare	$1,249.44
Rate for Payer: University Health Alliance Commercial	$1,198.31

DRILL BIT 702611

Facility

$1,517.00

Hospital Revenue Code	272
Min. Negotiated Rate	$758.50
Max. Negotiated Rate	$1,471.49
Rate for Payer: AlohaCare Medicaid	$758.50
Rate for Payer: AlohaCare Medicare	$1,152.92
Rate for Payer: Cash Price	$910.20
Rate for Payer: Devoted Health Medicare	$1,274.28
Rate for Payer: Hawaii Medical Service Association Medicare	$1,152.92
Rate for Payer: Hawaii Western Management Group Commercial	$1,441.15
Rate for Payer: Health Management Network Commercial	$1,289.45
Rate for Payer: Humana Medicare	$1,152.92
Rate for Payer: Kaiser Permanente Commercial	$1,365.30
Rate for Payer: Kaiser Permanente Medicaid	$773.67
Rate for Payer: Kaiser Permanente Medicare	$1,152.92
Rate for Payer: MDX Hawaii PPO	$1,471.49
Rate for Payer: Ohana Health Plan Medicaid	$1,152.92
Rate for Payer: Ohana Health Plan Medicare	$1,152.92
Rate for Payer: UnitedHealthcare Medicare	$1,152.92
Rate for Payer: University Health Alliance Commercial	$1,105.74

DRILL BIT 702611

Facility

$1,517.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,289.45
Max. Negotiated Rate	$1,471.49
Rate for Payer: Cash Price	$910.20
Rate for Payer: Health Management Network Commercial	$1,289.45
Rate for Payer: Kaiser Permanente Commercial	$1,365.30
Rate for Payer: MDX Hawaii PPO	$1,471.49

DRILL BIT 7.0MM 5820-012-307D

Facility

$530.00

Hospital Revenue Code	272
Min. Negotiated Rate	$265.00
Max. Negotiated Rate	$514.10
Rate for Payer: AlohaCare Medicaid	$265.00
Rate for Payer: AlohaCare Medicare	$402.80
Rate for Payer: Cash Price	$318.00
Rate for Payer: Devoted Health Medicare	$445.20
Rate for Payer: Hawaii Medical Service Association Medicare	$402.80
Rate for Payer: Hawaii Western Management Group Commercial	$503.50
Rate for Payer: Health Management Network Commercial	$450.50
Rate for Payer: Humana Medicare	$402.80
Rate for Payer: Kaiser Permanente Commercial	$477.00
Rate for Payer: Kaiser Permanente Medicaid	$270.30
Rate for Payer: Kaiser Permanente Medicare	$402.80
Rate for Payer: MDX Hawaii PPO	$514.10
Rate for Payer: Ohana Health Plan Medicaid	$402.80
Rate for Payer: Ohana Health Plan Medicare	$402.80
Rate for Payer: UnitedHealthcare Medicare	$402.80
Rate for Payer: University Health Alliance Commercial	$386.32

DRILL BIT 7.0MM 5820-012-307D

Facility

$530.00

Hospital Revenue Code	272
Min. Negotiated Rate	$450.50
Max. Negotiated Rate	$514.10
Rate for Payer: Cash Price	$318.00
Rate for Payer: Health Management Network Commercial	$450.50
Rate for Payer: Kaiser Permanente Commercial	$477.00
Rate for Payer: MDX Hawaii PPO	$514.10

DRILL BIT 8.0MM DHS/DCS 338.10

Facility

$2,139.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,818.15
Max. Negotiated Rate	$2,074.83
Rate for Payer: Cash Price	$1,283.40
Rate for Payer: Health Management Network Commercial	$1,818.15
Rate for Payer: Kaiser Permanente Commercial	$1,925.10
Rate for Payer: MDX Hawaii PPO	$2,074.83

DRILL BIT 8.0MM DHS/DCS 338.10

Facility

$2,139.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,069.50
Max. Negotiated Rate	$2,074.83
Rate for Payer: AlohaCare Medicaid	$1,069.50
Rate for Payer: AlohaCare Medicare	$1,625.64
Rate for Payer: Cash Price	$1,283.40
Rate for Payer: Devoted Health Medicare	$1,796.76
Rate for Payer: Hawaii Medical Service Association Medicare	$1,625.64
Rate for Payer: Hawaii Western Management Group Commercial	$2,032.05
Rate for Payer: Health Management Network Commercial	$1,818.15
Rate for Payer: Humana Medicare	$1,625.64
Rate for Payer: Kaiser Permanente Commercial	$1,925.10
Rate for Payer: Kaiser Permanente Medicaid	$1,090.89
Rate for Payer: Kaiser Permanente Medicare	$1,625.64
Rate for Payer: MDX Hawaii PPO	$2,074.83
Rate for Payer: Ohana Health Plan Medicaid	$1,625.64
Rate for Payer: Ohana Health Plan Medicare	$1,625.64
Rate for Payer: UnitedHealthcare Medicare	$1,625.64
Rate for Payer: University Health Alliance Commercial	$1,559.12

DRILL BIT 95MM 03.113.023

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 95MM 03.113.023

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 AO 2.0X135 703690

Facility

$648.00

Hospital Revenue Code	272
Min. Negotiated Rate	$324.00
Max. Negotiated Rate	$628.56
Rate for Payer: AlohaCare Medicaid	$324.00
Rate for Payer: AlohaCare Medicare	$492.48
Rate for Payer: Cash Price	$388.80
Rate for Payer: Devoted Health Medicare	$544.32
Rate for Payer: Hawaii Medical Service Association Medicare	$492.48
Rate for Payer: Hawaii Western Management Group Commercial	$615.60
Rate for Payer: Health Management Network Commercial	$550.80
Rate for Payer: Humana Medicare	$492.48
Rate for Payer: Kaiser Permanente Commercial	$583.20
Rate for Payer: Kaiser Permanente Medicaid	$330.48
Rate for Payer: Kaiser Permanente Medicare	$492.48
Rate for Payer: MDX Hawaii PPO	$628.56
Rate for Payer: Ohana Health Plan Medicaid	$492.48
Rate for Payer: Ohana Health Plan Medicare	$492.48
Rate for Payer: UnitedHealthcare Medicare	$492.48
Rate for Payer: University Health Alliance Commercial	$472.33

DRILL BIT AO 2.0X135 703690

Facility

$648.00

Hospital Revenue Code	272
Min. Negotiated Rate	$550.80
Max. Negotiated Rate	$628.56
Rate for Payer: Cash Price	$388.80
Rate for Payer: Health Management Network Commercial	$550.80
Rate for Payer: Kaiser Permanente Commercial	$583.20
Rate for Payer: MDX Hawaii PPO	$628.56

DRILL BIT ASNIS 3.2X300 702626

Facility

$804.00

Hospital Revenue Code	272
Min. Negotiated Rate	$402.00
Max. Negotiated Rate	$779.88
Rate for Payer: AlohaCare Medicaid	$402.00
Rate for Payer: AlohaCare Medicare	$611.04
Rate for Payer: Cash Price	$482.40
Rate for Payer: Devoted Health Medicare	$675.36
Rate for Payer: Hawaii Medical Service Association Medicare	$611.04
Rate for Payer: Hawaii Western Management Group Commercial	$763.80
Rate for Payer: Health Management Network Commercial	$683.40
Rate for Payer: Humana Medicare	$611.04
Rate for Payer: Kaiser Permanente Commercial	$723.60
Rate for Payer: Kaiser Permanente Medicaid	$410.04
Rate for Payer: Kaiser Permanente Medicare	$611.04
Rate for Payer: MDX Hawaii PPO	$779.88
Rate for Payer: Ohana Health Plan Medicaid	$611.04
Rate for Payer: Ohana Health Plan Medicare	$611.04
Rate for Payer: UnitedHealthcare Medicare	$611.04
Rate for Payer: University Health Alliance Commercial	$586.04

DRILL BIT ASNIS 3.2X300 702626

Facility

$804.00

Hospital Revenue Code	272
Min. Negotiated Rate	$683.40
Max. Negotiated Rate	$779.88
Rate for Payer: Cash Price	$482.40
Rate for Payer: Health Management Network Commercial	$683.40
Rate for Payer: Kaiser Permanente Commercial	$723.60
Rate for Payer: MDX Hawaii PPO	$779.88

DRILL BIT CAL 2.5MM AR-8916-06

Facility

$428.00

Hospital Revenue Code	272
Min. Negotiated Rate	$214.00
Max. Negotiated Rate	$415.16
Rate for Payer: AlohaCare Medicaid	$214.00
Rate for Payer: AlohaCare Medicare	$325.28
Rate for Payer: Cash Price	$256.80
Rate for Payer: Devoted Health Medicare	$359.52
Rate for Payer: Hawaii Medical Service Association Medicare	$325.28
Rate for Payer: Hawaii Western Management Group Commercial	$406.60
Rate for Payer: Health Management Network Commercial	$363.80
Rate for Payer: Humana Medicare	$325.28
Rate for Payer: Kaiser Permanente Commercial	$385.20
Rate for Payer: Kaiser Permanente Medicaid	$218.28
Rate for Payer: Kaiser Permanente Medicare	$325.28
Rate for Payer: MDX Hawaii PPO	$415.16
Rate for Payer: Ohana Health Plan Medicaid	$325.28
Rate for Payer: Ohana Health Plan Medicare	$325.28
Rate for Payer: UnitedHealthcare Medicare	$325.28
Rate for Payer: University Health Alliance Commercial	$311.97

DRILL BIT CAL 2.5MM AR-8916-06

Facility

$428.00

Hospital Revenue Code	272
Min. Negotiated Rate	$363.80
Max. Negotiated Rate	$415.16
Rate for Payer: Cash Price	$256.80
Rate for Payer: Health Management Network Commercial	$363.80
Rate for Payer: Kaiser Permanente Commercial	$385.20
Rate for Payer: MDX Hawaii PPO	$415.16

DRILL BIT CAL 4.0/180MM 11030A

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

Know your out-of-pocket cost for care.

All Charges