Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

DRILL BIT QC 4.3X180MM 310.431

Facility

$554.00

Hospital Revenue Code	272
Min. Negotiated Rate	$277.00
Max. Negotiated Rate	$537.38
Rate for Payer: AlohaCare Medicaid	$277.00
Rate for Payer: AlohaCare Medicare	$421.04
Rate for Payer: Cash Price	$332.40
Rate for Payer: Devoted Health Medicare	$465.36
Rate for Payer: Hawaii Medical Service Association Medicare	$421.04
Rate for Payer: Hawaii Western Management Group Commercial	$526.30
Rate for Payer: Health Management Network Commercial	$470.90
Rate for Payer: Humana Medicare	$421.04
Rate for Payer: Kaiser Permanente Commercial	$498.60
Rate for Payer: Kaiser Permanente Medicaid	$282.54
Rate for Payer: Kaiser Permanente Medicare	$421.04
Rate for Payer: MDX Hawaii PPO	$537.38
Rate for Payer: Ohana Health Plan Medicaid	$421.04
Rate for Payer: Ohana Health Plan Medicare	$421.04
Rate for Payer: UnitedHealthcare Medicare	$421.04
Rate for Payer: University Health Alliance Commercial	$403.81

DRILL BIT QC 4.3X180MM 310.431

Facility

$554.00

Hospital Revenue Code	272
Min. Negotiated Rate	$470.90
Max. Negotiated Rate	$537.38
Rate for Payer: Cash Price	$332.40
Rate for Payer: Health Management Network Commercial	$470.90
Rate for Payer: Kaiser Permanente Commercial	$498.60
Rate for Payer: MDX Hawaii PPO	$537.38

DRILL BIT QC 4.3X200MM 310.634

Facility

$1,471.00

Hospital Revenue Code	272
Min. Negotiated Rate	$735.50
Max. Negotiated Rate	$1,426.87
Rate for Payer: AlohaCare Medicaid	$735.50
Rate for Payer: AlohaCare Medicare	$1,117.96
Rate for Payer: Cash Price	$882.60
Rate for Payer: Devoted Health Medicare	$1,235.64
Rate for Payer: Hawaii Medical Service Association Medicare	$1,117.96
Rate for Payer: Hawaii Western Management Group Commercial	$1,397.45
Rate for Payer: Health Management Network Commercial	$1,250.35
Rate for Payer: Humana Medicare	$1,117.96
Rate for Payer: Kaiser Permanente Commercial	$1,323.90
Rate for Payer: Kaiser Permanente Medicaid	$750.21
Rate for Payer: Kaiser Permanente Medicare	$1,117.96
Rate for Payer: MDX Hawaii PPO	$1,426.87
Rate for Payer: Ohana Health Plan Medicaid	$1,117.96
Rate for Payer: Ohana Health Plan Medicare	$1,117.96
Rate for Payer: UnitedHealthcare Medicare	$1,117.96
Rate for Payer: University Health Alliance Commercial	$1,072.21

DRILL BIT QC 4.3X200MM 310.634

Facility

$1,471.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,250.35
Max. Negotiated Rate	$1,426.87
Rate for Payer: Cash Price	$882.60
Rate for Payer: Health Management Network Commercial	$1,250.35
Rate for Payer: Kaiser Permanente Commercial	$1,323.90
Rate for Payer: MDX Hawaii PPO	$1,426.87

DRILL BIT QC 5.0X200MM 310.632

Facility

$1,471.00

Hospital Revenue Code	272
Min. Negotiated Rate	$735.50
Max. Negotiated Rate	$1,426.87
Rate for Payer: AlohaCare Medicaid	$735.50
Rate for Payer: AlohaCare Medicare	$1,117.96
Rate for Payer: Cash Price	$882.60
Rate for Payer: Devoted Health Medicare	$1,235.64
Rate for Payer: Hawaii Medical Service Association Medicare	$1,117.96
Rate for Payer: Hawaii Western Management Group Commercial	$1,397.45
Rate for Payer: Health Management Network Commercial	$1,250.35
Rate for Payer: Humana Medicare	$1,117.96
Rate for Payer: Kaiser Permanente Commercial	$1,323.90
Rate for Payer: Kaiser Permanente Medicaid	$750.21
Rate for Payer: Kaiser Permanente Medicare	$1,117.96
Rate for Payer: MDX Hawaii PPO	$1,426.87
Rate for Payer: Ohana Health Plan Medicaid	$1,117.96
Rate for Payer: Ohana Health Plan Medicare	$1,117.96
Rate for Payer: UnitedHealthcare Medicare	$1,117.96
Rate for Payer: University Health Alliance Commercial	$1,072.21

DRILL BIT QC 5.0X200MM 310.632

Facility

$1,471.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,250.35
Max. Negotiated Rate	$1,426.87
Rate for Payer: Cash Price	$882.60
Rate for Payer: Health Management Network Commercial	$1,250.35
Rate for Payer: Kaiser Permanente Commercial	$1,323.90
Rate for Payer: MDX Hawaii PPO	$1,426.87

DRILL BIT QC 5.0X300MM 310.63

Facility

$1,575.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,338.75
Max. Negotiated Rate	$1,527.75
Rate for Payer: Cash Price	$945.00
Rate for Payer: Health Management Network Commercial	$1,338.75
Rate for Payer: Kaiser Permanente Commercial	$1,417.50
Rate for Payer: MDX Hawaii PPO	$1,527.75

DRILL BIT QC 5.0X300MM 310.63

Facility

$1,575.00

Hospital Revenue Code	272
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,527.75
Rate for Payer: AlohaCare Medicaid	$787.50
Rate for Payer: AlohaCare Medicare	$1,197.00
Rate for Payer: Cash Price	$945.00
Rate for Payer: Devoted Health Medicare	$1,323.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,197.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,496.25
Rate for Payer: Health Management Network Commercial	$1,338.75
Rate for Payer: Humana Medicare	$1,197.00
Rate for Payer: Kaiser Permanente Commercial	$1,417.50
Rate for Payer: Kaiser Permanente Medicaid	$803.25
Rate for Payer: Kaiser Permanente Medicare	$1,197.00
Rate for Payer: MDX Hawaii PPO	$1,527.75
Rate for Payer: Ohana Health Plan Medicaid	$1,197.00
Rate for Payer: Ohana Health Plan Medicare	$1,197.00
Rate for Payer: UnitedHealthcare Medicare	$1,197.00
Rate for Payer: University Health Alliance Commercial	$1,148.02

DRILL BIT, STRGHT SHANK 2.5X10

Facility

$202.00

Hospital Revenue Code	272
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$195.94
Rate for Payer: AlohaCare Medicaid	$101.00
Rate for Payer: AlohaCare Medicare	$153.52
Rate for Payer: Cash Price	$121.20
Rate for Payer: Devoted Health Medicare	$169.68
Rate for Payer: Hawaii Medical Service Association Medicare	$153.52
Rate for Payer: Hawaii Western Management Group Commercial	$191.90
Rate for Payer: Health Management Network Commercial	$171.70
Rate for Payer: Humana Medicare	$153.52
Rate for Payer: Kaiser Permanente Commercial	$181.80
Rate for Payer: Kaiser Permanente Medicaid	$103.02
Rate for Payer: Kaiser Permanente Medicare	$153.52
Rate for Payer: MDX Hawaii PPO	$195.94
Rate for Payer: Ohana Health Plan Medicaid	$153.52
Rate for Payer: Ohana Health Plan Medicare	$153.52
Rate for Payer: UnitedHealthcare Medicare	$153.52
Rate for Payer: University Health Alliance Commercial	$147.24

DRILL BIT, STRGHT SHANK 2.5X10

Facility

$202.00

Hospital Revenue Code	272
Min. Negotiated Rate	$171.70
Max. Negotiated Rate	$195.94
Rate for Payer: Cash Price	$121.20
Rate for Payer: Health Management Network Commercial	$171.70
Rate for Payer: Kaiser Permanente Commercial	$181.80
Rate for Payer: MDX Hawaii PPO	$195.94

DRILL BIT STRGHT SHANK 3.2X10

Facility

$202.00

Hospital Revenue Code	272
Min. Negotiated Rate	$171.70
Max. Negotiated Rate	$195.94
Rate for Payer: Cash Price	$121.20
Rate for Payer: Health Management Network Commercial	$171.70
Rate for Payer: Kaiser Permanente Commercial	$181.80
Rate for Payer: MDX Hawaii PPO	$195.94

DRILL BIT STRGHT SHANK 3.2X10

Facility

$202.00

Hospital Revenue Code	272
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$195.94
Rate for Payer: AlohaCare Medicaid	$101.00
Rate for Payer: AlohaCare Medicare	$153.52
Rate for Payer: Cash Price	$121.20
Rate for Payer: Devoted Health Medicare	$169.68
Rate for Payer: Hawaii Medical Service Association Medicare	$153.52
Rate for Payer: Hawaii Western Management Group Commercial	$191.90
Rate for Payer: Health Management Network Commercial	$171.70
Rate for Payer: Humana Medicare	$153.52
Rate for Payer: Kaiser Permanente Commercial	$181.80
Rate for Payer: Kaiser Permanente Medicaid	$103.02
Rate for Payer: Kaiser Permanente Medicare	$153.52
Rate for Payer: MDX Hawaii PPO	$195.94
Rate for Payer: Ohana Health Plan Medicaid	$153.52
Rate for Payer: Ohana Health Plan Medicare	$153.52
Rate for Payer: UnitedHealthcare Medicare	$153.52
Rate for Payer: University Health Alliance Commercial	$147.24

DRILL BIT STRGHT SHANK 3.5X10

Facility

$202.00

Hospital Revenue Code	272
Min. Negotiated Rate	$171.70
Max. Negotiated Rate	$195.94
Rate for Payer: Cash Price	$121.20
Rate for Payer: Health Management Network Commercial	$171.70
Rate for Payer: Kaiser Permanente Commercial	$181.80
Rate for Payer: MDX Hawaii PPO	$195.94

DRILL BIT STRGHT SHANK 3.5X10

Facility

$202.00

Hospital Revenue Code	272
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$195.94
Rate for Payer: AlohaCare Medicaid	$101.00
Rate for Payer: AlohaCare Medicare	$153.52
Rate for Payer: Cash Price	$121.20
Rate for Payer: Devoted Health Medicare	$169.68
Rate for Payer: Hawaii Medical Service Association Medicare	$153.52
Rate for Payer: Hawaii Western Management Group Commercial	$191.90
Rate for Payer: Health Management Network Commercial	$171.70
Rate for Payer: Humana Medicare	$153.52
Rate for Payer: Kaiser Permanente Commercial	$181.80
Rate for Payer: Kaiser Permanente Medicaid	$103.02
Rate for Payer: Kaiser Permanente Medicare	$153.52
Rate for Payer: MDX Hawaii PPO	$195.94
Rate for Payer: Ohana Health Plan Medicaid	$153.52
Rate for Payer: Ohana Health Plan Medicare	$153.52
Rate for Payer: UnitedHealthcare Medicare	$153.52
Rate for Payer: University Health Alliance Commercial	$147.24

DRILL BIT T-F 2.5MM 103.25.180

Facility

$1,050.00

Hospital Revenue Code	272
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,018.50
Rate for Payer: AlohaCare Medicaid	$525.00
Rate for Payer: AlohaCare Medicare	$798.00
Rate for Payer: Cash Price	$630.00
Rate for Payer: Devoted Health Medicare	$882.00
Rate for Payer: Hawaii Medical Service Association Medicare	$798.00
Rate for Payer: Hawaii Western Management Group Commercial	$997.50
Rate for Payer: Health Management Network Commercial	$892.50
Rate for Payer: Humana Medicare	$798.00
Rate for Payer: Kaiser Permanente Commercial	$945.00
Rate for Payer: Kaiser Permanente Medicaid	$535.50
Rate for Payer: Kaiser Permanente Medicare	$798.00
Rate for Payer: MDX Hawaii PPO	$1,018.50
Rate for Payer: Ohana Health Plan Medicaid	$798.00
Rate for Payer: Ohana Health Plan Medicare	$798.00
Rate for Payer: UnitedHealthcare Medicare	$798.00
Rate for Payer: University Health Alliance Commercial	$765.35

DRILL BIT T-F 2.5MM 103.25.180

Facility

$1,050.00

Hospital Revenue Code	272
Min. Negotiated Rate	$892.50
Max. Negotiated Rate	$1,018.50
Rate for Payer: Cash Price	$630.00
Rate for Payer: Health Management Network Commercial	$892.50
Rate for Payer: Kaiser Permanente Commercial	$945.00
Rate for Payer: MDX Hawaii PPO	$1,018.50

DRILL CANN 13.0MM BIT 351.27

Facility

$2,058.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,749.30
Max. Negotiated Rate	$1,996.26
Rate for Payer: Cash Price	$1,234.80
Rate for Payer: Health Management Network Commercial	$1,749.30
Rate for Payer: Kaiser Permanente Commercial	$1,852.20
Rate for Payer: MDX Hawaii PPO	$1,996.26

DRILL CANN 13.0MM BIT 351.27

Facility

$2,058.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,029.00
Max. Negotiated Rate	$1,996.26
Rate for Payer: AlohaCare Medicaid	$1,029.00
Rate for Payer: AlohaCare Medicare	$1,564.08
Rate for Payer: Cash Price	$1,234.80
Rate for Payer: Devoted Health Medicare	$1,728.72
Rate for Payer: Hawaii Medical Service Association Medicare	$1,564.08
Rate for Payer: Hawaii Western Management Group Commercial	$1,955.10
Rate for Payer: Health Management Network Commercial	$1,749.30
Rate for Payer: Humana Medicare	$1,564.08
Rate for Payer: Kaiser Permanente Commercial	$1,852.20
Rate for Payer: Kaiser Permanente Medicaid	$1,049.58
Rate for Payer: Kaiser Permanente Medicare	$1,564.08
Rate for Payer: MDX Hawaii PPO	$1,996.26
Rate for Payer: Ohana Health Plan Medicaid	$1,564.08
Rate for Payer: Ohana Health Plan Medicare	$1,564.08
Rate for Payer: UnitedHealthcare Medicare	$1,564.08
Rate for Payer: University Health Alliance Commercial	$1,500.08

DRILL CANN 15GA 60MM 308.151

Facility

$1,470.00

Hospital Revenue Code	272
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$1,425.90
Rate for Payer: AlohaCare Medicaid	$735.00
Rate for Payer: AlohaCare Medicare	$1,117.20
Rate for Payer: Cash Price	$882.00
Rate for Payer: Devoted Health Medicare	$1,234.80
Rate for Payer: Hawaii Medical Service Association Medicare	$1,117.20
Rate for Payer: Hawaii Western Management Group Commercial	$1,396.50
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: Humana Medicare	$1,117.20
Rate for Payer: Kaiser Permanente Commercial	$1,323.00
Rate for Payer: Kaiser Permanente Medicaid	$749.70
Rate for Payer: Kaiser Permanente Medicare	$1,117.20
Rate for Payer: MDX Hawaii PPO	$1,425.90
Rate for Payer: Ohana Health Plan Medicaid	$1,117.20
Rate for Payer: Ohana Health Plan Medicare	$1,117.20
Rate for Payer: UnitedHealthcare Medicare	$1,117.20
Rate for Payer: University Health Alliance Commercial	$1,071.48

DRILL CANN 15GA 60MM 308.151

Facility

$1,470.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,249.50
Max. Negotiated Rate	$1,425.90
Rate for Payer: Cash Price	$882.00
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: Kaiser Permanente Commercial	$1,323.00
Rate for Payer: MDX Hawaii PPO	$1,425.90

DRILL CANN 2.0MM DRILL-2.00CL

Facility

$581.00

Hospital Revenue Code	272
Min. Negotiated Rate	$290.50
Max. Negotiated Rate	$563.57
Rate for Payer: AlohaCare Medicaid	$290.50
Rate for Payer: AlohaCare Medicare	$441.56
Rate for Payer: Cash Price	$348.60
Rate for Payer: Devoted Health Medicare	$488.04
Rate for Payer: Hawaii Medical Service Association Medicare	$441.56
Rate for Payer: Hawaii Western Management Group Commercial	$551.95
Rate for Payer: Health Management Network Commercial	$493.85
Rate for Payer: Humana Medicare	$441.56
Rate for Payer: Kaiser Permanente Commercial	$522.90
Rate for Payer: Kaiser Permanente Medicaid	$296.31
Rate for Payer: Kaiser Permanente Medicare	$441.56
Rate for Payer: MDX Hawaii PPO	$563.57
Rate for Payer: Ohana Health Plan Medicaid	$441.56
Rate for Payer: Ohana Health Plan Medicare	$441.56
Rate for Payer: UnitedHealthcare Medicare	$441.56
Rate for Payer: University Health Alliance Commercial	$423.49

DRILL CANN 2.0MM DRILL-2.00CL

Facility

$581.00

Hospital Revenue Code	272
Min. Negotiated Rate	$493.85
Max. Negotiated Rate	$563.57
Rate for Payer: Cash Price	$348.60
Rate for Payer: Health Management Network Commercial	$493.85
Rate for Payer: Kaiser Permanente Commercial	$522.90
Rate for Payer: MDX Hawaii PPO	$563.57

DRILL CANN 3.20MM DRILL-3.20CL

Facility

$630.00

Hospital Revenue Code	272
Min. Negotiated Rate	$535.50
Max. Negotiated Rate	$611.10
Rate for Payer: Cash Price	$378.00
Rate for Payer: Health Management Network Commercial	$535.50
Rate for Payer: Kaiser Permanente Commercial	$567.00
Rate for Payer: MDX Hawaii PPO	$611.10

DRILL CANN 3.20MM DRILL-3.20CL

Facility

$630.00

Hospital Revenue Code	272
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$611.10
Rate for Payer: AlohaCare Medicaid	$315.00
Rate for Payer: AlohaCare Medicare	$478.80
Rate for Payer: Cash Price	$378.00
Rate for Payer: Devoted Health Medicare	$529.20
Rate for Payer: Hawaii Medical Service Association Medicare	$478.80
Rate for Payer: Hawaii Western Management Group Commercial	$598.50
Rate for Payer: Health Management Network Commercial	$535.50
Rate for Payer: Humana Medicare	$478.80
Rate for Payer: Kaiser Permanente Commercial	$567.00
Rate for Payer: Kaiser Permanente Medicaid	$321.30
Rate for Payer: Kaiser Permanente Medicare	$478.80
Rate for Payer: MDX Hawaii PPO	$611.10
Rate for Payer: Ohana Health Plan Medicaid	$478.80
Rate for Payer: Ohana Health Plan Medicare	$478.80
Rate for Payer: UnitedHealthcare Medicare	$478.80
Rate for Payer: University Health Alliance Commercial	$459.21

DRILL CANN 3.2MMX170MM 310.65

Facility

$1,565.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,330.25
Max. Negotiated Rate	$1,518.05
Rate for Payer: Cash Price	$939.00
Rate for Payer: Health Management Network Commercial	$1,330.25
Rate for Payer: Kaiser Permanente Commercial	$1,408.50
Rate for Payer: MDX Hawaii PPO	$1,518.05

Know your out-of-pocket cost for care.

All Charges