Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

DRILL BIT FAST 2.0 231220204

Facility

$563.00

Hospital Revenue Code	272
Min. Negotiated Rate	$478.55
Max. Negotiated Rate	$546.11
Rate for Payer: Cash Price	$337.80
Rate for Payer: Health Management Network Commercial	$478.55
Rate for Payer: Kaiser Permanente Commercial	$506.70
Rate for Payer: MDX Hawaii PPO	$546.11

DRILL BIT FAST 2.0 231220204

Facility

$563.00

Hospital Revenue Code	272
Min. Negotiated Rate	$281.50
Max. Negotiated Rate	$546.11
Rate for Payer: AlohaCare Medicaid	$281.50
Rate for Payer: AlohaCare Medicare	$427.88
Rate for Payer: Cash Price	$337.80
Rate for Payer: Devoted Health Medicare	$472.92
Rate for Payer: Hawaii Medical Service Association Medicare	$427.88
Rate for Payer: Hawaii Western Management Group Commercial	$534.85
Rate for Payer: Health Management Network Commercial	$478.55
Rate for Payer: Humana Medicare	$427.88
Rate for Payer: Kaiser Permanente Commercial	$506.70
Rate for Payer: Kaiser Permanente Medicaid	$287.13
Rate for Payer: Kaiser Permanente Medicare	$427.88
Rate for Payer: MDX Hawaii PPO	$546.11
Rate for Payer: Ohana Health Plan Medicaid	$427.88
Rate for Payer: Ohana Health Plan Medicare	$427.88
Rate for Payer: UnitedHealthcare Medicare	$427.88
Rate for Payer: University Health Alliance Commercial	$410.37

DRILL BIT HOLLOW 10.0MM

Facility

$1,610.00

Hospital Revenue Code	272
Min. Negotiated Rate	$805.00
Max. Negotiated Rate	$1,561.70
Rate for Payer: AlohaCare Medicaid	$805.00
Rate for Payer: AlohaCare Medicare	$1,223.60
Rate for Payer: Cash Price	$966.00
Rate for Payer: Devoted Health Medicare	$1,352.40
Rate for Payer: Hawaii Medical Service Association Medicare	$1,223.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,529.50
Rate for Payer: Health Management Network Commercial	$1,368.50
Rate for Payer: Humana Medicare	$1,223.60
Rate for Payer: Kaiser Permanente Commercial	$1,449.00
Rate for Payer: Kaiser Permanente Medicaid	$821.10
Rate for Payer: Kaiser Permanente Medicare	$1,223.60
Rate for Payer: MDX Hawaii PPO	$1,561.70
Rate for Payer: Ohana Health Plan Medicaid	$1,223.60
Rate for Payer: Ohana Health Plan Medicare	$1,223.60
Rate for Payer: UnitedHealthcare Medicare	$1,223.60
Rate for Payer: University Health Alliance Commercial	$1,173.53

DRILL BIT HOLLOW 10.0MM

Facility

$1,610.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,368.50
Max. Negotiated Rate	$1,561.70
Rate for Payer: Cash Price	$966.00
Rate for Payer: Health Management Network Commercial	$1,368.50
Rate for Payer: Kaiser Permanente Commercial	$1,449.00
Rate for Payer: MDX Hawaii PPO	$1,561.70

DRILL BIT JC 2.0X85MM 310.20

Facility

$372.00

Hospital Revenue Code	272
Min. Negotiated Rate	$316.20
Max. Negotiated Rate	$360.84
Rate for Payer: Cash Price	$223.20
Rate for Payer: Health Management Network Commercial	$316.20
Rate for Payer: Kaiser Permanente Commercial	$334.80
Rate for Payer: MDX Hawaii PPO	$360.84

DRILL BIT JC 2.0X85MM 310.20

Facility

$372.00

Hospital Revenue Code	272
Min. Negotiated Rate	$186.00
Max. Negotiated Rate	$360.84
Rate for Payer: AlohaCare Medicaid	$186.00
Rate for Payer: AlohaCare Medicare	$282.72
Rate for Payer: Cash Price	$223.20
Rate for Payer: Devoted Health Medicare	$312.48
Rate for Payer: Hawaii Medical Service Association Medicare	$282.72
Rate for Payer: Hawaii Western Management Group Commercial	$353.40
Rate for Payer: Health Management Network Commercial	$316.20
Rate for Payer: Humana Medicare	$282.72
Rate for Payer: Kaiser Permanente Commercial	$334.80
Rate for Payer: Kaiser Permanente Medicaid	$189.72
Rate for Payer: Kaiser Permanente Medicare	$282.72
Rate for Payer: MDX Hawaii PPO	$360.84
Rate for Payer: Ohana Health Plan Medicaid	$282.72
Rate for Payer: Ohana Health Plan Medicare	$282.72
Rate for Payer: UnitedHealthcare Medicare	$282.72
Rate for Payer: University Health Alliance Commercial	$271.15

DRILL BIT JC 2.5MM 4805-95-25

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 JC 2.5MM 4805-95-25

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 JC 4.5MM #03.010.089

Facility

$1,584.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,346.40
Max. Negotiated Rate	$1,536.48
Rate for Payer: Cash Price	$950.40
Rate for Payer: Health Management Network Commercial	$1,346.40
Rate for Payer: Kaiser Permanente Commercial	$1,425.60
Rate for Payer: MDX Hawaii PPO	$1,536.48

DRILL BIT JC 4.5MM #03.010.089

Facility

$1,584.00

Hospital Revenue Code	272
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$1,536.48
Rate for Payer: AlohaCare Medicaid	$792.00
Rate for Payer: AlohaCare Medicare	$1,203.84
Rate for Payer: Cash Price	$950.40
Rate for Payer: Devoted Health Medicare	$1,330.56
Rate for Payer: Hawaii Medical Service Association Medicare	$1,203.84
Rate for Payer: Hawaii Western Management Group Commercial	$1,504.80
Rate for Payer: Health Management Network Commercial	$1,346.40
Rate for Payer: Humana Medicare	$1,203.84
Rate for Payer: Kaiser Permanente Commercial	$1,425.60
Rate for Payer: Kaiser Permanente Medicaid	$807.84
Rate for Payer: Kaiser Permanente Medicare	$1,203.84
Rate for Payer: MDX Hawaii PPO	$1,536.48
Rate for Payer: Ohana Health Plan Medicaid	$1,203.84
Rate for Payer: Ohana Health Plan Medicare	$1,203.84
Rate for Payer: UnitedHealthcare Medicare	$1,203.84
Rate for Payer: University Health Alliance Commercial	$1,154.58

DRILL BIT L 122 DIA 3.5 703694

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 L 122 DIA 3.5 703694

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 LCKNG MED 3.1 705077

Facility

$986.00

Hospital Revenue Code	272
Min. Negotiated Rate	$493.00
Max. Negotiated Rate	$956.42
Rate for Payer: AlohaCare Medicaid	$493.00
Rate for Payer: AlohaCare Medicare	$749.36
Rate for Payer: Cash Price	$591.60
Rate for Payer: Devoted Health Medicare	$828.24
Rate for Payer: Hawaii Medical Service Association Medicare	$749.36
Rate for Payer: Hawaii Western Management Group Commercial	$936.70
Rate for Payer: Health Management Network Commercial	$838.10
Rate for Payer: Humana Medicare	$749.36
Rate for Payer: Kaiser Permanente Commercial	$887.40
Rate for Payer: Kaiser Permanente Medicaid	$502.86
Rate for Payer: Kaiser Permanente Medicare	$749.36
Rate for Payer: MDX Hawaii PPO	$956.42
Rate for Payer: Ohana Health Plan Medicaid	$749.36
Rate for Payer: Ohana Health Plan Medicare	$749.36
Rate for Payer: UnitedHealthcare Medicare	$749.36
Rate for Payer: University Health Alliance Commercial	$718.70

DRILL BIT LCKNG MED 3.1 705077

Facility

$986.00

Hospital Revenue Code	272
Min. Negotiated Rate	$838.10
Max. Negotiated Rate	$956.42
Rate for Payer: Cash Price	$591.60
Rate for Payer: Health Management Network Commercial	$838.10
Rate for Payer: Kaiser Permanente Commercial	$887.40
Rate for Payer: MDX Hawaii PPO	$956.42

DRILL BIT LCKNG SHR 2.5 705025

Facility

$1,039.00

Hospital Revenue Code	272
Min. Negotiated Rate	$519.50
Max. Negotiated Rate	$1,007.83
Rate for Payer: AlohaCare Medicaid	$519.50
Rate for Payer: AlohaCare Medicare	$789.64
Rate for Payer: Cash Price	$623.40
Rate for Payer: Devoted Health Medicare	$872.76
Rate for Payer: Hawaii Medical Service Association Medicare	$789.64
Rate for Payer: Hawaii Western Management Group Commercial	$987.05
Rate for Payer: Health Management Network Commercial	$883.15
Rate for Payer: Humana Medicare	$789.64
Rate for Payer: Kaiser Permanente Commercial	$935.10
Rate for Payer: Kaiser Permanente Medicaid	$529.89
Rate for Payer: Kaiser Permanente Medicare	$789.64
Rate for Payer: MDX Hawaii PPO	$1,007.83
Rate for Payer: Ohana Health Plan Medicaid	$789.64
Rate for Payer: Ohana Health Plan Medicare	$789.64
Rate for Payer: UnitedHealthcare Medicare	$789.64
Rate for Payer: University Health Alliance Commercial	$757.33

DRILL BIT LCKNG SHR 2.5 705025

Facility

$1,039.00

Hospital Revenue Code	272
Min. Negotiated Rate	$883.15
Max. Negotiated Rate	$1,007.83
Rate for Payer: Cash Price	$623.40
Rate for Payer: Health Management Network Commercial	$883.15
Rate for Payer: Kaiser Permanente Commercial	$935.10
Rate for Payer: MDX Hawaii PPO	$1,007.83

DRILL BIT LONG 2.5

Facility

$600.00

Hospital Revenue Code	272
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$582.00
Rate for Payer: AlohaCare Medicaid	$300.00
Rate for Payer: AlohaCare Medicare	$456.00
Rate for Payer: Cash Price	$360.00
Rate for Payer: Devoted Health Medicare	$504.00
Rate for Payer: Hawaii Medical Service Association Medicare	$456.00
Rate for Payer: Hawaii Western Management Group Commercial	$570.00
Rate for Payer: Health Management Network Commercial	$510.00
Rate for Payer: Humana Medicare	$456.00
Rate for Payer: Kaiser Permanente Commercial	$540.00
Rate for Payer: Kaiser Permanente Medicaid	$306.00
Rate for Payer: Kaiser Permanente Medicare	$456.00
Rate for Payer: MDX Hawaii PPO	$582.00
Rate for Payer: Ohana Health Plan Medicaid	$456.00
Rate for Payer: Ohana Health Plan Medicare	$456.00
Rate for Payer: UnitedHealthcare Medicare	$456.00
Rate for Payer: University Health Alliance Commercial	$437.34

DRILL BIT LONG 2.5

Facility

$600.00

Hospital Revenue Code	272
Min. Negotiated Rate	$510.00
Max. Negotiated Rate	$582.00
Rate for Payer: Cash Price	$360.00
Rate for Payer: Health Management Network Commercial	$510.00
Rate for Payer: Kaiser Permanente Commercial	$540.00
Rate for Payer: MDX Hawaii PPO	$582.00

DRILL BIT QC 1.0X160MM 310.401

Facility

$488.00

Hospital Revenue Code	272
Min. Negotiated Rate	$244.00
Max. Negotiated Rate	$473.36
Rate for Payer: AlohaCare Medicaid	$244.00
Rate for Payer: AlohaCare Medicare	$370.88
Rate for Payer: Cash Price	$292.80
Rate for Payer: Devoted Health Medicare	$409.92
Rate for Payer: Hawaii Medical Service Association Medicare	$370.88
Rate for Payer: Hawaii Western Management Group Commercial	$463.60
Rate for Payer: Health Management Network Commercial	$414.80
Rate for Payer: Humana Medicare	$370.88
Rate for Payer: Kaiser Permanente Commercial	$439.20
Rate for Payer: Kaiser Permanente Medicaid	$248.88
Rate for Payer: Kaiser Permanente Medicare	$370.88
Rate for Payer: MDX Hawaii PPO	$473.36
Rate for Payer: Ohana Health Plan Medicaid	$370.88
Rate for Payer: Ohana Health Plan Medicare	$370.88
Rate for Payer: UnitedHealthcare Medicare	$370.88
Rate for Payer: University Health Alliance Commercial	$355.70

DRILL BIT QC 1.0X160MM 310.401

Facility

$488.00

Hospital Revenue Code	272
Min. Negotiated Rate	$414.80
Max. Negotiated Rate	$473.36
Rate for Payer: Cash Price	$292.80
Rate for Payer: Health Management Network Commercial	$414.80
Rate for Payer: Kaiser Permanente Commercial	$439.20
Rate for Payer: MDX Hawaii PPO	$473.36

DRILL BIT QC 1.8X110MM 310.509

Facility

$670.00

Hospital Revenue Code	272
Min. Negotiated Rate	$569.50
Max. Negotiated Rate	$649.90
Rate for Payer: Cash Price	$402.00
Rate for Payer: Health Management Network Commercial	$569.50
Rate for Payer: Kaiser Permanente Commercial	$603.00
Rate for Payer: MDX Hawaii PPO	$649.90

DRILL BIT QC 1.8X110MM 310.509

Facility

$670.00

Hospital Revenue Code	272
Min. Negotiated Rate	$335.00
Max. Negotiated Rate	$649.90
Rate for Payer: AlohaCare Medicaid	$335.00
Rate for Payer: AlohaCare Medicare	$509.20
Rate for Payer: Cash Price	$402.00
Rate for Payer: Devoted Health Medicare	$562.80
Rate for Payer: Hawaii Medical Service Association Medicare	$509.20
Rate for Payer: Hawaii Western Management Group Commercial	$636.50
Rate for Payer: Health Management Network Commercial	$569.50
Rate for Payer: Humana Medicare	$509.20
Rate for Payer: Kaiser Permanente Commercial	$603.00
Rate for Payer: Kaiser Permanente Medicaid	$341.70
Rate for Payer: Kaiser Permanente Medicare	$509.20
Rate for Payer: MDX Hawaii PPO	$649.90
Rate for Payer: Ohana Health Plan Medicaid	$509.20
Rate for Payer: Ohana Health Plan Medicare	$509.20
Rate for Payer: UnitedHealthcare Medicare	$509.20
Rate for Payer: University Health Alliance Commercial	$488.36

DRILL BIT QC 2.0/65MM 310.201

Facility

$356.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$178.00
Max. Negotiated Rate	$345.32
Rate for Payer: AlohaCare Medicaid	$178.00
Rate for Payer: AlohaCare Medicare	$270.56
Rate for Payer: Cash Price	$213.60
Rate for Payer: Devoted Health Medicare	$299.04
Rate for Payer: Hawaii Medical Service Association Medicare	$270.56
Rate for Payer: Hawaii Western Management Group Commercial	$338.20
Rate for Payer: Health Management Network Commercial	$302.60
Rate for Payer: Humana Medicare	$270.56
Rate for Payer: Kaiser Permanente Commercial	$320.40
Rate for Payer: Kaiser Permanente Medicaid	$181.56
Rate for Payer: Kaiser Permanente Medicare	$270.56
Rate for Payer: MDX Hawaii PPO	$345.32
Rate for Payer: Ohana Health Plan Medicaid	$270.56
Rate for Payer: Ohana Health Plan Medicare	$270.56
Rate for Payer: UnitedHealthcare Medicare	$270.56
Rate for Payer: University Health Alliance Commercial	$259.49

DRILL BIT QC 2.0/65MM 310.201

Facility

$356.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$302.60
Max. Negotiated Rate	$345.32
Rate for Payer: Cash Price	$213.60
Rate for Payer: Health Management Network Commercial	$302.60
Rate for Payer: Kaiser Permanente Commercial	$320.40
Rate for Payer: MDX Hawaii PPO	$345.32

DRILL BIT QC 2.0X100MM 310.19

Facility

$361.00

Hospital Revenue Code	272
Min. Negotiated Rate	$306.85
Max. Negotiated Rate	$350.17
Rate for Payer: Cash Price	$216.60
Rate for Payer: Health Management Network Commercial	$306.85
Rate for Payer: Kaiser Permanente Commercial	$324.90
Rate for Payer: MDX Hawaii PPO	$350.17

Know your out-of-pocket cost for care.

All Charges