Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

DRILL BIT CAL 4.0/180MM 11030A

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 CAL 4.8/180MM 11021A

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 CAL 4.8/180MM 11021A

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 CAL 4.8/280MM 11027A

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 CAL 4.8/280MM 11027A

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 CAN 3.2/150MM 11013A

Facility

$506.00

Hospital Revenue Code	272
Min. Negotiated Rate	$430.10
Max. Negotiated Rate	$490.82
Rate for Payer: Cash Price	$303.60
Rate for Payer: Health Management Network Commercial	$430.10
Rate for Payer: Kaiser Permanente Commercial	$455.40
Rate for Payer: MDX Hawaii PPO	$490.82

DRILL BIT CAN 3.2/150MM 11013A

Facility

$506.00

Hospital Revenue Code	272
Min. Negotiated Rate	$253.00
Max. Negotiated Rate	$490.82
Rate for Payer: AlohaCare Medicaid	$253.00
Rate for Payer: AlohaCare Medicare	$384.56
Rate for Payer: Cash Price	$303.60
Rate for Payer: Devoted Health Medicare	$425.04
Rate for Payer: Hawaii Medical Service Association Medicare	$384.56
Rate for Payer: Hawaii Western Management Group Commercial	$480.70
Rate for Payer: Health Management Network Commercial	$430.10
Rate for Payer: Humana Medicare	$384.56
Rate for Payer: Kaiser Permanente Commercial	$455.40
Rate for Payer: Kaiser Permanente Medicaid	$258.06
Rate for Payer: Kaiser Permanente Medicare	$384.56
Rate for Payer: MDX Hawaii PPO	$490.82
Rate for Payer: Ohana Health Plan Medicaid	$384.56
Rate for Payer: Ohana Health Plan Medicare	$384.56
Rate for Payer: UnitedHealthcare Medicare	$384.56
Rate for Payer: University Health Alliance Commercial	$368.82

DRILL BIT CAN 3.2/200MM 11011A

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 CAN 3.2/200MM 11011A

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 CAN 4.8/280MM 11.012

Facility

$624.00

Hospital Revenue Code	272
Min. Negotiated Rate	$312.00
Max. Negotiated Rate	$605.28
Rate for Payer: AlohaCare Medicaid	$312.00
Rate for Payer: AlohaCare Medicare	$474.24
Rate for Payer: Cash Price	$374.40
Rate for Payer: Devoted Health Medicare	$524.16
Rate for Payer: Hawaii Medical Service Association Medicare	$474.24
Rate for Payer: Hawaii Western Management Group Commercial	$592.80
Rate for Payer: Health Management Network Commercial	$530.40
Rate for Payer: Humana Medicare	$474.24
Rate for Payer: Kaiser Permanente Commercial	$561.60
Rate for Payer: Kaiser Permanente Medicaid	$318.24
Rate for Payer: Kaiser Permanente Medicare	$474.24
Rate for Payer: MDX Hawaii PPO	$605.28
Rate for Payer: Ohana Health Plan Medicaid	$474.24
Rate for Payer: Ohana Health Plan Medicare	$474.24
Rate for Payer: UnitedHealthcare Medicare	$474.24
Rate for Payer: University Health Alliance Commercial	$454.83

DRILL BIT CAN 4.8/280MM 11.012

Facility

$624.00

Hospital Revenue Code	272
Min. Negotiated Rate	$530.40
Max. Negotiated Rate	$605.28
Rate for Payer: Cash Price	$374.40
Rate for Payer: Health Management Network Commercial	$530.40
Rate for Payer: Kaiser Permanente Commercial	$561.60
Rate for Payer: MDX Hawaii PPO	$605.28

DRILL BIT CAN 4.8/280MM 11012A

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 CAN 4.8/280MM 11012A

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 CANN 14MM 03.033.004

Facility

$2,081.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,040.50
Max. Negotiated Rate	$2,018.57
Rate for Payer: AlohaCare Medicaid	$1,040.50
Rate for Payer: AlohaCare Medicare	$1,581.56
Rate for Payer: Cash Price	$1,248.60
Rate for Payer: Devoted Health Medicare	$1,748.04
Rate for Payer: Hawaii Medical Service Association Medicare	$1,581.56
Rate for Payer: Hawaii Western Management Group Commercial	$1,976.95
Rate for Payer: Health Management Network Commercial	$1,768.85
Rate for Payer: Humana Medicare	$1,581.56
Rate for Payer: Kaiser Permanente Commercial	$1,872.90
Rate for Payer: Kaiser Permanente Medicaid	$1,061.31
Rate for Payer: Kaiser Permanente Medicare	$1,581.56
Rate for Payer: MDX Hawaii PPO	$2,018.57
Rate for Payer: Ohana Health Plan Medicaid	$1,581.56
Rate for Payer: Ohana Health Plan Medicare	$1,581.56
Rate for Payer: UnitedHealthcare Medicare	$1,581.56
Rate for Payer: University Health Alliance Commercial	$1,516.84

DRILL BIT CANN 14MM 03.033.004

Facility

$2,081.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,768.85
Max. Negotiated Rate	$2,018.57
Rate for Payer: Cash Price	$1,248.60
Rate for Payer: Health Management Network Commercial	$1,768.85
Rate for Payer: Kaiser Permanente Commercial	$1,872.90
Rate for Payer: MDX Hawaii PPO	$2,018.57

DRILL BIT CANN 14MM 03.033.005

Facility

$1,920.00

Hospital Revenue Code	272
Min. Negotiated Rate	$960.00
Max. Negotiated Rate	$1,862.40
Rate for Payer: AlohaCare Medicaid	$960.00
Rate for Payer: AlohaCare Medicare	$1,459.20
Rate for Payer: Cash Price	$1,152.00
Rate for Payer: Devoted Health Medicare	$1,612.80
Rate for Payer: Hawaii Medical Service Association Medicare	$1,459.20
Rate for Payer: Hawaii Western Management Group Commercial	$1,824.00
Rate for Payer: Health Management Network Commercial	$1,632.00
Rate for Payer: Humana Medicare	$1,459.20
Rate for Payer: Kaiser Permanente Commercial	$1,728.00
Rate for Payer: Kaiser Permanente Medicaid	$979.20
Rate for Payer: Kaiser Permanente Medicare	$1,459.20
Rate for Payer: MDX Hawaii PPO	$1,862.40
Rate for Payer: Ohana Health Plan Medicaid	$1,459.20
Rate for Payer: Ohana Health Plan Medicare	$1,459.20
Rate for Payer: UnitedHealthcare Medicare	$1,459.20
Rate for Payer: University Health Alliance Commercial	$1,399.49

DRILL BIT CANN 14MM 03.033.005

Facility

$1,920.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,632.00
Max. Negotiated Rate	$1,862.40
Rate for Payer: Cash Price	$1,152.00
Rate for Payer: Health Management Network Commercial	$1,632.00
Rate for Payer: Kaiser Permanente Commercial	$1,728.00
Rate for Payer: MDX Hawaii PPO	$1,862.40

DRILL BIT CANN 2.7MM 320-2627

Facility

$882.00

Hospital Revenue Code	272
Min. Negotiated Rate	$749.70
Max. Negotiated Rate	$855.54
Rate for Payer: Cash Price	$529.20
Rate for Payer: Health Management Network Commercial	$749.70
Rate for Payer: Kaiser Permanente Commercial	$793.80
Rate for Payer: MDX Hawaii PPO	$855.54

DRILL BIT CANN 2.7MM 320-2627

Facility

$882.00

Hospital Revenue Code	272
Min. Negotiated Rate	$441.00
Max. Negotiated Rate	$855.54
Rate for Payer: AlohaCare Medicaid	$441.00
Rate for Payer: AlohaCare Medicare	$670.32
Rate for Payer: Cash Price	$529.20
Rate for Payer: Devoted Health Medicare	$740.88
Rate for Payer: Hawaii Medical Service Association Medicare	$670.32
Rate for Payer: Hawaii Western Management Group Commercial	$837.90
Rate for Payer: Health Management Network Commercial	$749.70
Rate for Payer: Humana Medicare	$670.32
Rate for Payer: Kaiser Permanente Commercial	$793.80
Rate for Payer: Kaiser Permanente Medicaid	$449.82
Rate for Payer: Kaiser Permanente Medicare	$670.32
Rate for Payer: MDX Hawaii PPO	$855.54
Rate for Payer: Ohana Health Plan Medicaid	$670.32
Rate for Payer: Ohana Health Plan Medicare	$670.32
Rate for Payer: UnitedHealthcare Medicare	$670.32
Rate for Payer: University Health Alliance Commercial	$642.89

DRILL BIT CANN 3.2/200MM 11011

Facility

$624.00

Hospital Revenue Code	272
Min. Negotiated Rate	$530.40
Max. Negotiated Rate	$605.28
Rate for Payer: Cash Price	$374.40
Rate for Payer: Health Management Network Commercial	$530.40
Rate for Payer: Kaiser Permanente Commercial	$561.60
Rate for Payer: MDX Hawaii PPO	$605.28

DRILL BIT CANN 3.2/200MM 11011

Facility

$624.00

Hospital Revenue Code	272
Min. Negotiated Rate	$312.00
Max. Negotiated Rate	$605.28
Rate for Payer: AlohaCare Medicaid	$312.00
Rate for Payer: AlohaCare Medicare	$474.24
Rate for Payer: Cash Price	$374.40
Rate for Payer: Devoted Health Medicare	$524.16
Rate for Payer: Hawaii Medical Service Association Medicare	$474.24
Rate for Payer: Hawaii Western Management Group Commercial	$592.80
Rate for Payer: Health Management Network Commercial	$530.40
Rate for Payer: Humana Medicare	$474.24
Rate for Payer: Kaiser Permanente Commercial	$561.60
Rate for Payer: Kaiser Permanente Medicaid	$318.24
Rate for Payer: Kaiser Permanente Medicare	$474.24
Rate for Payer: MDX Hawaii PPO	$605.28
Rate for Payer: Ohana Health Plan Medicaid	$474.24
Rate for Payer: Ohana Health Plan Medicare	$474.24
Rate for Payer: UnitedHealthcare Medicare	$474.24
Rate for Payer: University Health Alliance Commercial	$454.83

DRILL BIT CANNULATED, 11.0MM

Facility

$2,238.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,119.00
Max. Negotiated Rate	$2,170.86
Rate for Payer: AlohaCare Medicaid	$1,119.00
Rate for Payer: AlohaCare Medicare	$1,700.88
Rate for Payer: Cash Price	$1,342.80
Rate for Payer: Devoted Health Medicare	$1,879.92
Rate for Payer: Hawaii Medical Service Association Medicare	$1,700.88
Rate for Payer: Hawaii Western Management Group Commercial	$2,126.10
Rate for Payer: Health Management Network Commercial	$1,902.30
Rate for Payer: Humana Medicare	$1,700.88
Rate for Payer: Kaiser Permanente Commercial	$2,014.20
Rate for Payer: Kaiser Permanente Medicaid	$1,141.38
Rate for Payer: Kaiser Permanente Medicare	$1,700.88
Rate for Payer: MDX Hawaii PPO	$2,170.86
Rate for Payer: Ohana Health Plan Medicaid	$1,700.88
Rate for Payer: Ohana Health Plan Medicare	$1,700.88
Rate for Payer: UnitedHealthcare Medicare	$1,700.88
Rate for Payer: University Health Alliance Commercial	$1,631.28

DRILL BIT CANNULATED, 11.0MM

Facility

$2,238.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,902.30
Max. Negotiated Rate	$2,170.86
Rate for Payer: Cash Price	$1,342.80
Rate for Payer: Health Management Network Commercial	$1,902.30
Rate for Payer: Kaiser Permanente Commercial	$2,014.20
Rate for Payer: MDX Hawaii PPO	$2,170.86

DRILL BIT DRILL-2.4CL

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 DRILL-2.4CL

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

Know your out-of-pocket cost for care.

All Charges