Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

DRILL CANN 3.2MMX170MM 310.65

Facility

$1,565.00

Hospital Revenue Code	272
Min. Negotiated Rate	$782.50
Max. Negotiated Rate	$1,518.05
Rate for Payer: AlohaCare Medicaid	$782.50
Rate for Payer: AlohaCare Medicare	$1,189.40
Rate for Payer: Cash Price	$939.00
Rate for Payer: Devoted Health Medicare	$1,314.60
Rate for Payer: Hawaii Medical Service Association Medicare	$1,189.40
Rate for Payer: Hawaii Western Management Group Commercial	$1,486.75
Rate for Payer: Health Management Network Commercial	$1,330.25
Rate for Payer: Humana Medicare	$1,189.40
Rate for Payer: Kaiser Permanente Commercial	$1,408.50
Rate for Payer: Kaiser Permanente Medicaid	$798.15
Rate for Payer: Kaiser Permanente Medicare	$1,189.40
Rate for Payer: MDX Hawaii PPO	$1,518.05
Rate for Payer: Ohana Health Plan Medicaid	$1,189.40
Rate for Payer: Ohana Health Plan Medicare	$1,189.40
Rate for Payer: UnitedHealthcare Medicare	$1,189.40
Rate for Payer: University Health Alliance Commercial	$1,140.73

DRILL CANN QR 2.3MM 316-0015

Facility

$879.00

Hospital Revenue Code	272
Min. Negotiated Rate	$747.15
Max. Negotiated Rate	$852.63
Rate for Payer: Cash Price	$527.40
Rate for Payer: Health Management Network Commercial	$747.15
Rate for Payer: Kaiser Permanente Commercial	$791.10
Rate for Payer: MDX Hawaii PPO	$852.63

DRILL CANN QR 2.3MM 316-0015

Facility

$879.00

Hospital Revenue Code	272
Min. Negotiated Rate	$439.50
Max. Negotiated Rate	$852.63
Rate for Payer: AlohaCare Medicaid	$439.50
Rate for Payer: AlohaCare Medicare	$668.04
Rate for Payer: Cash Price	$527.40
Rate for Payer: Devoted Health Medicare	$738.36
Rate for Payer: Hawaii Medical Service Association Medicare	$668.04
Rate for Payer: Hawaii Western Management Group Commercial	$835.05
Rate for Payer: Health Management Network Commercial	$747.15
Rate for Payer: Humana Medicare	$668.04
Rate for Payer: Kaiser Permanente Commercial	$791.10
Rate for Payer: Kaiser Permanente Medicaid	$448.29
Rate for Payer: Kaiser Permanente Medicare	$668.04
Rate for Payer: MDX Hawaii PPO	$852.63
Rate for Payer: Ohana Health Plan Medicaid	$668.04
Rate for Payer: Ohana Health Plan Medicare	$668.04
Rate for Payer: UnitedHealthcare Medicare	$668.04
Rate for Payer: University Health Alliance Commercial	$640.70

DRILL CANNULATED 2.5MM

Facility

$1,022.00

Hospital Revenue Code	272
Min. Negotiated Rate	$511.00
Max. Negotiated Rate	$991.34
Rate for Payer: AlohaCare Medicaid	$511.00
Rate for Payer: AlohaCare Medicare	$776.72
Rate for Payer: Cash Price	$613.20
Rate for Payer: Devoted Health Medicare	$858.48
Rate for Payer: Hawaii Medical Service Association Medicare	$776.72
Rate for Payer: Hawaii Western Management Group Commercial	$970.90
Rate for Payer: Health Management Network Commercial	$868.70
Rate for Payer: Humana Medicare	$776.72
Rate for Payer: Kaiser Permanente Commercial	$919.80
Rate for Payer: Kaiser Permanente Medicaid	$521.22
Rate for Payer: Kaiser Permanente Medicare	$776.72
Rate for Payer: MDX Hawaii PPO	$991.34
Rate for Payer: Ohana Health Plan Medicaid	$776.72
Rate for Payer: Ohana Health Plan Medicare	$776.72
Rate for Payer: UnitedHealthcare Medicare	$776.72
Rate for Payer: University Health Alliance Commercial	$744.94

DRILL CANNULATED 2.5MM

Facility

$1,022.00

Hospital Revenue Code	272
Min. Negotiated Rate	$868.70
Max. Negotiated Rate	$991.34
Rate for Payer: Cash Price	$613.20
Rate for Payer: Health Management Network Commercial	$868.70
Rate for Payer: Kaiser Permanente Commercial	$919.80
Rate for Payer: MDX Hawaii PPO	$991.34

DRILL CANNULATED DRILL-2.0/110

Facility

$825.00

Hospital Revenue Code	272
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$800.25
Rate for Payer: AlohaCare Medicaid	$412.50
Rate for Payer: AlohaCare Medicare	$627.00
Rate for Payer: Cash Price	$495.00
Rate for Payer: Devoted Health Medicare	$693.00
Rate for Payer: Hawaii Medical Service Association Medicare	$627.00
Rate for Payer: Hawaii Western Management Group Commercial	$783.75
Rate for Payer: Health Management Network Commercial	$701.25
Rate for Payer: Humana Medicare	$627.00
Rate for Payer: Kaiser Permanente Commercial	$742.50
Rate for Payer: Kaiser Permanente Medicaid	$420.75
Rate for Payer: Kaiser Permanente Medicare	$627.00
Rate for Payer: MDX Hawaii PPO	$800.25
Rate for Payer: Ohana Health Plan Medicaid	$627.00
Rate for Payer: Ohana Health Plan Medicare	$627.00
Rate for Payer: UnitedHealthcare Medicare	$627.00
Rate for Payer: University Health Alliance Commercial	$601.34

DRILL CANNULATED DRILL-2.0/110

Facility

$825.00

Hospital Revenue Code	272
Min. Negotiated Rate	$701.25
Max. Negotiated Rate	$800.25
Rate for Payer: Cash Price	$495.00
Rate for Payer: Health Management Network Commercial	$701.25
Rate for Payer: Kaiser Permanente Commercial	$742.50
Rate for Payer: MDX Hawaii PPO	$800.25

DRILL COUNTERSINK 2.7MM 706200

Facility

$826.00

Hospital Revenue Code	272
Min. Negotiated Rate	$413.00
Max. Negotiated Rate	$801.22
Rate for Payer: AlohaCare Medicaid	$413.00
Rate for Payer: AlohaCare Medicare	$627.76
Rate for Payer: Cash Price	$495.60
Rate for Payer: Devoted Health Medicare	$693.84
Rate for Payer: Hawaii Medical Service Association Medicare	$627.76
Rate for Payer: Hawaii Western Management Group Commercial	$784.70
Rate for Payer: Health Management Network Commercial	$702.10
Rate for Payer: Humana Medicare	$627.76
Rate for Payer: Kaiser Permanente Commercial	$743.40
Rate for Payer: Kaiser Permanente Medicaid	$421.26
Rate for Payer: Kaiser Permanente Medicare	$627.76
Rate for Payer: MDX Hawaii PPO	$801.22
Rate for Payer: Ohana Health Plan Medicaid	$627.76
Rate for Payer: Ohana Health Plan Medicare	$627.76
Rate for Payer: UnitedHealthcare Medicare	$627.76
Rate for Payer: University Health Alliance Commercial	$602.07

DRILL COUNTERSINK 2.7MM 706200

Facility

$826.00

Hospital Revenue Code	272
Min. Negotiated Rate	$702.10
Max. Negotiated Rate	$801.22
Rate for Payer: Cash Price	$495.60
Rate for Payer: Health Management Network Commercial	$702.10
Rate for Payer: Kaiser Permanente Commercial	$743.40
Rate for Payer: MDX Hawaii PPO	$801.22

DRILL FREEHAND 2351-4218S

Facility

$1,096.00

Hospital Revenue Code	272
Min. Negotiated Rate	$548.00
Max. Negotiated Rate	$1,063.12
Rate for Payer: AlohaCare Medicaid	$548.00
Rate for Payer: AlohaCare Medicare	$832.96
Rate for Payer: Cash Price	$657.60
Rate for Payer: Devoted Health Medicare	$920.64
Rate for Payer: Hawaii Medical Service Association Medicare	$832.96
Rate for Payer: Hawaii Western Management Group Commercial	$1,041.20
Rate for Payer: Health Management Network Commercial	$931.60
Rate for Payer: Humana Medicare	$832.96
Rate for Payer: Kaiser Permanente Commercial	$986.40
Rate for Payer: Kaiser Permanente Medicaid	$558.96
Rate for Payer: Kaiser Permanente Medicare	$832.96
Rate for Payer: MDX Hawaii PPO	$1,063.12
Rate for Payer: Ohana Health Plan Medicaid	$832.96
Rate for Payer: Ohana Health Plan Medicare	$832.96
Rate for Payer: UnitedHealthcare Medicare	$832.96
Rate for Payer: University Health Alliance Commercial	$798.87

DRILL FREEHAND 2351-4218S

Facility

$1,096.00

Hospital Revenue Code	272
Min. Negotiated Rate	$931.60
Max. Negotiated Rate	$1,063.12
Rate for Payer: Cash Price	$657.60
Rate for Payer: Health Management Network Commercial	$931.60
Rate for Payer: Kaiser Permanente Commercial	$986.40
Rate for Payer: MDX Hawaii PPO	$1,063.12

DRILL FREEHAND 4.2X130MM

Facility

$1,274.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,082.90
Max. Negotiated Rate	$1,235.78
Rate for Payer: Cash Price	$764.40
Rate for Payer: Health Management Network Commercial	$1,082.90
Rate for Payer: Kaiser Permanente Commercial	$1,146.60
Rate for Payer: MDX Hawaii PPO	$1,235.78

DRILL FREEHAND 4.2X130MM

Facility

$1,274.00

Hospital Revenue Code	272
Min. Negotiated Rate	$637.00
Max. Negotiated Rate	$1,235.78
Rate for Payer: AlohaCare Medicaid	$637.00
Rate for Payer: AlohaCare Medicare	$968.24
Rate for Payer: Cash Price	$764.40
Rate for Payer: Devoted Health Medicare	$1,070.16
Rate for Payer: Hawaii Medical Service Association Medicare	$968.24
Rate for Payer: Hawaii Western Management Group Commercial	$1,210.30
Rate for Payer: Health Management Network Commercial	$1,082.90
Rate for Payer: Humana Medicare	$968.24
Rate for Payer: Kaiser Permanente Commercial	$1,146.60
Rate for Payer: Kaiser Permanente Medicaid	$649.74
Rate for Payer: Kaiser Permanente Medicare	$968.24
Rate for Payer: MDX Hawaii PPO	$1,235.78
Rate for Payer: Ohana Health Plan Medicaid	$968.24
Rate for Payer: Ohana Health Plan Medicare	$968.24
Rate for Payer: UnitedHealthcare Medicare	$968.24
Rate for Payer: University Health Alliance Commercial	$928.62

DRILL GUIDE 2.0MM LCP 313.353

Facility

$735.00

Hospital Revenue Code	272
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$712.95
Rate for Payer: AlohaCare Medicaid	$367.50
Rate for Payer: AlohaCare Medicare	$558.60
Rate for Payer: Cash Price	$441.00
Rate for Payer: Devoted Health Medicare	$617.40
Rate for Payer: Hawaii Medical Service Association Medicare	$558.60
Rate for Payer: Hawaii Western Management Group Commercial	$698.25
Rate for Payer: Health Management Network Commercial	$624.75
Rate for Payer: Humana Medicare	$558.60
Rate for Payer: Kaiser Permanente Commercial	$661.50
Rate for Payer: Kaiser Permanente Medicaid	$374.85
Rate for Payer: Kaiser Permanente Medicare	$558.60
Rate for Payer: MDX Hawaii PPO	$712.95
Rate for Payer: Ohana Health Plan Medicaid	$558.60
Rate for Payer: Ohana Health Plan Medicare	$558.60
Rate for Payer: UnitedHealthcare Medicare	$558.60
Rate for Payer: University Health Alliance Commercial	$535.74

DRILL GUIDE 2.0MM LCP 313.353

Facility

$735.00

Hospital Revenue Code	272
Min. Negotiated Rate	$624.75
Max. Negotiated Rate	$712.95
Rate for Payer: Cash Price	$441.00
Rate for Payer: Health Management Network Commercial	$624.75
Rate for Payer: Kaiser Permanente Commercial	$661.50
Rate for Payer: MDX Hawaii PPO	$712.95

DRILL GUIDE 2.3 GUIDELCBS-2.3

Facility

$562.50

Hospital Revenue Code	272
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$545.62
Rate for Payer: AlohaCare Medicaid	$281.25
Rate for Payer: AlohaCare Medicare	$427.50
Rate for Payer: Cash Price	$337.50
Rate for Payer: Devoted Health Medicare	$472.50
Rate for Payer: Hawaii Medical Service Association Medicare	$427.50
Rate for Payer: Hawaii Western Management Group Commercial	$534.38
Rate for Payer: Health Management Network Commercial	$478.12
Rate for Payer: Humana Medicare	$427.50
Rate for Payer: Kaiser Permanente Commercial	$506.25
Rate for Payer: Kaiser Permanente Medicaid	$286.88
Rate for Payer: Kaiser Permanente Medicare	$427.50
Rate for Payer: MDX Hawaii PPO	$545.62
Rate for Payer: Ohana Health Plan Medicaid	$427.50
Rate for Payer: Ohana Health Plan Medicare	$427.50
Rate for Payer: UnitedHealthcare Medicare	$427.50
Rate for Payer: University Health Alliance Commercial	$410.01

DRILL GUIDE 2.3 GUIDELCBS-2.3

Facility

$562.50

Hospital Revenue Code	272
Min. Negotiated Rate	$478.12
Max. Negotiated Rate	$545.62
Rate for Payer: Cash Price	$337.50
Rate for Payer: Health Management Network Commercial	$478.12
Rate for Payer: Kaiser Permanente Commercial	$506.25
Rate for Payer: MDX Hawaii PPO	$545.62

DRILL GUIDE 3.5MM UNIV 323.36

Facility

$1,586.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,348.10
Max. Negotiated Rate	$1,538.42
Rate for Payer: Cash Price	$951.60
Rate for Payer: Health Management Network Commercial	$1,348.10
Rate for Payer: Kaiser Permanente Commercial	$1,427.40
Rate for Payer: MDX Hawaii PPO	$1,538.42

DRILL GUIDE 3.5MM UNIV 323.36

Facility

$1,586.00

Hospital Revenue Code	272
Min. Negotiated Rate	$793.00
Max. Negotiated Rate	$1,538.42
Rate for Payer: AlohaCare Medicaid	$793.00
Rate for Payer: AlohaCare Medicare	$1,205.36
Rate for Payer: Cash Price	$951.60
Rate for Payer: Devoted Health Medicare	$1,332.24
Rate for Payer: Hawaii Medical Service Association Medicare	$1,205.36
Rate for Payer: Hawaii Western Management Group Commercial	$1,506.70
Rate for Payer: Health Management Network Commercial	$1,348.10
Rate for Payer: Humana Medicare	$1,205.36
Rate for Payer: Kaiser Permanente Commercial	$1,427.40
Rate for Payer: Kaiser Permanente Medicaid	$808.86
Rate for Payer: Kaiser Permanente Medicare	$1,205.36
Rate for Payer: MDX Hawaii PPO	$1,538.42
Rate for Payer: Ohana Health Plan Medicaid	$1,205.36
Rate for Payer: Ohana Health Plan Medicare	$1,205.36
Rate for Payer: UnitedHealthcare Medicare	$1,205.36
Rate for Payer: University Health Alliance Commercial	$1,156.04

DRILL ICONX 1.4MM 3910-500-568

Facility

$870.00

Hospital Revenue Code	272
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$843.90
Rate for Payer: AlohaCare Medicaid	$435.00
Rate for Payer: AlohaCare Medicare	$661.20
Rate for Payer: Cash Price	$522.00
Rate for Payer: Devoted Health Medicare	$730.80
Rate for Payer: Hawaii Medical Service Association Medicare	$661.20
Rate for Payer: Hawaii Western Management Group Commercial	$826.50
Rate for Payer: Health Management Network Commercial	$739.50
Rate for Payer: Humana Medicare	$661.20
Rate for Payer: Kaiser Permanente Commercial	$783.00
Rate for Payer: Kaiser Permanente Medicaid	$443.70
Rate for Payer: Kaiser Permanente Medicare	$661.20
Rate for Payer: MDX Hawaii PPO	$843.90
Rate for Payer: Ohana Health Plan Medicaid	$661.20
Rate for Payer: Ohana Health Plan Medicare	$661.20
Rate for Payer: UnitedHealthcare Medicare	$661.20
Rate for Payer: University Health Alliance Commercial	$634.14

DRILL ICONX 1.4MM 3910-500-568

Facility

$870.00

Hospital Revenue Code	272
Min. Negotiated Rate	$739.50
Max. Negotiated Rate	$843.90
Rate for Payer: Cash Price	$522.00
Rate for Payer: Health Management Network Commercial	$739.50
Rate for Payer: Kaiser Permanente Commercial	$783.00
Rate for Payer: MDX Hawaii PPO	$843.90

DRILL LCK 2351-4236S

Facility

$891.00

Hospital Revenue Code	272
Min. Negotiated Rate	$445.50
Max. Negotiated Rate	$864.27
Rate for Payer: AlohaCare Medicaid	$445.50
Rate for Payer: AlohaCare Medicare	$677.16
Rate for Payer: Cash Price	$534.60
Rate for Payer: Devoted Health Medicare	$748.44
Rate for Payer: Hawaii Medical Service Association Medicare	$677.16
Rate for Payer: Hawaii Western Management Group Commercial	$846.45
Rate for Payer: Health Management Network Commercial	$757.35
Rate for Payer: Humana Medicare	$677.16
Rate for Payer: Kaiser Permanente Commercial	$801.90
Rate for Payer: Kaiser Permanente Medicaid	$454.41
Rate for Payer: Kaiser Permanente Medicare	$677.16
Rate for Payer: MDX Hawaii PPO	$864.27
Rate for Payer: Ohana Health Plan Medicaid	$677.16
Rate for Payer: Ohana Health Plan Medicare	$677.16
Rate for Payer: UnitedHealthcare Medicare	$677.16
Rate for Payer: University Health Alliance Commercial	$649.45

DRILL LCK 2351-4236S

Facility

$891.00

Hospital Revenue Code	272
Min. Negotiated Rate	$757.35
Max. Negotiated Rate	$864.27
Rate for Payer: Cash Price	$534.60
Rate for Payer: Health Management Network Commercial	$757.35
Rate for Payer: Kaiser Permanente Commercial	$801.90
Rate for Payer: MDX Hawaii PPO	$864.27

DRILL LCK 4.2X360MM

Facility

$891.00

Hospital Revenue Code	272
Min. Negotiated Rate	$445.50
Max. Negotiated Rate	$864.27
Rate for Payer: AlohaCare Medicaid	$445.50
Rate for Payer: AlohaCare Medicare	$677.16
Rate for Payer: Cash Price	$534.60
Rate for Payer: Devoted Health Medicare	$748.44
Rate for Payer: Hawaii Medical Service Association Medicare	$677.16
Rate for Payer: Hawaii Western Management Group Commercial	$846.45
Rate for Payer: Health Management Network Commercial	$757.35
Rate for Payer: Humana Medicare	$677.16
Rate for Payer: Kaiser Permanente Commercial	$801.90
Rate for Payer: Kaiser Permanente Medicaid	$454.41
Rate for Payer: Kaiser Permanente Medicare	$677.16
Rate for Payer: MDX Hawaii PPO	$864.27
Rate for Payer: Ohana Health Plan Medicaid	$677.16
Rate for Payer: Ohana Health Plan Medicare	$677.16
Rate for Payer: UnitedHealthcare Medicare	$677.16
Rate for Payer: University Health Alliance Commercial	$649.45

DRILL LCK 4.2X360MM

Facility

$891.00

Hospital Revenue Code	272
Min. Negotiated Rate	$757.35
Max. Negotiated Rate	$864.27
Rate for Payer: Cash Price	$534.60
Rate for Payer: Health Management Network Commercial	$757.35
Rate for Payer: Kaiser Permanente Commercial	$801.90
Rate for Payer: MDX Hawaii PPO	$864.27

Know your out-of-pocket cost for care.

All Charges