|
DRILL STEP AR-2752
|
Facility
|
IP
|
$394.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$334.90 |
| Max. Negotiated Rate |
$382.18 |
| Rate for Payer: Cash Price |
$236.40
|
| Rate for Payer: Health Management Network Commercial |
$334.90
|
| Rate for Payer: Kaiser Permanente Commercial |
$354.60
|
| Rate for Payer: MDX Hawaii PPO |
$382.18
|
|
|
DRILL STEP AR-2752
|
Facility
|
OP
|
$394.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$197.00 |
| Max. Negotiated Rate |
$382.18 |
| Rate for Payer: AlohaCare Medicaid |
$197.00
|
| Rate for Payer: AlohaCare Medicare |
$299.44
|
| Rate for Payer: Cash Price |
$236.40
|
| Rate for Payer: Devoted Health Medicare |
$330.96
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$299.44
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$374.30
|
| Rate for Payer: Health Management Network Commercial |
$334.90
|
| Rate for Payer: Humana Medicare |
$299.44
|
| Rate for Payer: Kaiser Permanente Commercial |
$354.60
|
| Rate for Payer: Kaiser Permanente Medicaid |
$200.94
|
| Rate for Payer: Kaiser Permanente Medicare |
$299.44
|
| Rate for Payer: MDX Hawaii PPO |
$382.18
|
| Rate for Payer: Ohana Health Plan Medicaid |
$299.44
|
| Rate for Payer: Ohana Health Plan Medicare |
$299.44
|
| Rate for Payer: UnitedHealthcare Medicare |
$299.44
|
| Rate for Payer: University Health Alliance Commercial |
$287.19
|
|
|
DRILL TWIST 1.0X22 60-10422
|
Facility
|
OP
|
$606.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.00 |
| Max. Negotiated Rate |
$587.82 |
| Rate for Payer: AlohaCare Medicaid |
$303.00
|
| Rate for Payer: AlohaCare Medicare |
$460.56
|
| Rate for Payer: Cash Price |
$363.60
|
| Rate for Payer: Devoted Health Medicare |
$509.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$460.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$575.70
|
| Rate for Payer: Health Management Network Commercial |
$515.10
|
| Rate for Payer: Humana Medicare |
$460.56
|
| Rate for Payer: Kaiser Permanente Commercial |
$545.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$309.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$460.56
|
| Rate for Payer: MDX Hawaii PPO |
$587.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$460.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$460.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$460.56
|
| Rate for Payer: University Health Alliance Commercial |
$441.71
|
|
|
DRILL TWIST 1.0X22 60-10422
|
Facility
|
IP
|
$606.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$515.10 |
| Max. Negotiated Rate |
$587.82 |
| Rate for Payer: Cash Price |
$363.60
|
| Rate for Payer: Health Management Network Commercial |
$515.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$545.40
|
| Rate for Payer: MDX Hawaii PPO |
$587.82
|
|
|
DRILL TWIST 1.0X22MM 60-10322
|
Facility
|
IP
|
$571.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$485.35 |
| Max. Negotiated Rate |
$553.87 |
| Rate for Payer: Cash Price |
$342.60
|
| Rate for Payer: Health Management Network Commercial |
$485.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$513.90
|
| Rate for Payer: MDX Hawaii PPO |
$553.87
|
|
|
DRILL TWIST 1.0X22MM 60-10322
|
Facility
|
OP
|
$571.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$285.50 |
| Max. Negotiated Rate |
$553.87 |
| Rate for Payer: AlohaCare Medicaid |
$285.50
|
| Rate for Payer: AlohaCare Medicare |
$433.96
|
| Rate for Payer: Cash Price |
$342.60
|
| Rate for Payer: Devoted Health Medicare |
$479.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$433.96
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$542.45
|
| Rate for Payer: Health Management Network Commercial |
$485.35
|
| Rate for Payer: Humana Medicare |
$433.96
|
| Rate for Payer: Kaiser Permanente Commercial |
$513.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$291.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$433.96
|
| Rate for Payer: MDX Hawaii PPO |
$553.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$433.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$433.96
|
| Rate for Payer: UnitedHealthcare Medicare |
$433.96
|
| Rate for Payer: University Health Alliance Commercial |
$416.20
|
|
|
DRILL TWIST 1.4X27 60-14426
|
Facility
|
IP
|
$606.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$515.10 |
| Max. Negotiated Rate |
$587.82 |
| Rate for Payer: Cash Price |
$363.60
|
| Rate for Payer: Health Management Network Commercial |
$515.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$545.40
|
| Rate for Payer: MDX Hawaii PPO |
$587.82
|
|
|
DRILL TWIST 1.4X27 60-14426
|
Facility
|
OP
|
$606.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.00 |
| Max. Negotiated Rate |
$587.82 |
| Rate for Payer: AlohaCare Medicaid |
$303.00
|
| Rate for Payer: AlohaCare Medicare |
$460.56
|
| Rate for Payer: Cash Price |
$363.60
|
| Rate for Payer: Devoted Health Medicare |
$509.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$460.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$575.70
|
| Rate for Payer: Health Management Network Commercial |
$515.10
|
| Rate for Payer: Humana Medicare |
$460.56
|
| Rate for Payer: Kaiser Permanente Commercial |
$545.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$309.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$460.56
|
| Rate for Payer: MDX Hawaii PPO |
$587.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$460.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$460.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$460.56
|
| Rate for Payer: University Health Alliance Commercial |
$441.71
|
|
|
DRILL TWIST 1.60MM DRILL-1.60
|
Facility
|
OP
|
$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
|
|
|
DRILL TWIST 1.60MM DRILL-1.60
|
Facility
|
IP
|
$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 TWIST 1.9X27 60-19426
|
Facility
|
OP
|
$606.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.00 |
| Max. Negotiated Rate |
$587.82 |
| Rate for Payer: AlohaCare Medicaid |
$303.00
|
| Rate for Payer: AlohaCare Medicare |
$460.56
|
| Rate for Payer: Cash Price |
$363.60
|
| Rate for Payer: Devoted Health Medicare |
$509.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$460.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$575.70
|
| Rate for Payer: Health Management Network Commercial |
$515.10
|
| Rate for Payer: Humana Medicare |
$460.56
|
| Rate for Payer: Kaiser Permanente Commercial |
$545.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$309.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$460.56
|
| Rate for Payer: MDX Hawaii PPO |
$587.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$460.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$460.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$460.56
|
| Rate for Payer: University Health Alliance Commercial |
$441.71
|
|
|
DRILL TWIST 1.9X27 60-19426
|
Facility
|
IP
|
$606.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$515.10 |
| Max. Negotiated Rate |
$587.82 |
| Rate for Payer: Cash Price |
$363.60
|
| Rate for Payer: Health Management Network Commercial |
$515.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$545.40
|
| Rate for Payer: MDX Hawaii PPO |
$587.82
|
|
|
DRILL TWIST 1.9X27MM 60-19126
|
Facility
|
OP
|
$571.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$285.50 |
| Max. Negotiated Rate |
$553.87 |
| Rate for Payer: Kaiser Permanente Commercial |
$513.90
|
| Rate for Payer: AlohaCare Medicaid |
$285.50
|
| Rate for Payer: AlohaCare Medicare |
$433.96
|
| Rate for Payer: Cash Price |
$342.60
|
| Rate for Payer: Devoted Health Medicare |
$479.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$433.96
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$542.45
|
| Rate for Payer: Health Management Network Commercial |
$485.35
|
| Rate for Payer: Humana Medicare |
$433.96
|
| Rate for Payer: Kaiser Permanente Medicaid |
$291.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$433.96
|
| Rate for Payer: MDX Hawaii PPO |
$553.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$433.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$433.96
|
| Rate for Payer: UnitedHealthcare Medicare |
$433.96
|
| Rate for Payer: University Health Alliance Commercial |
$416.20
|
|
|
DRILL TWIST 1.9X27MM 60-19126
|
Facility
|
IP
|
$571.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$485.35 |
| Max. Negotiated Rate |
$553.87 |
| Rate for Payer: Cash Price |
$342.60
|
| Rate for Payer: Health Management Network Commercial |
$485.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$513.90
|
| Rate for Payer: MDX Hawaii PPO |
$553.87
|
|
|
DRILL TWIST 1.9X41MM 60-19340
|
Facility
|
IP
|
$571.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$485.35 |
| Max. Negotiated Rate |
$553.87 |
| Rate for Payer: Cash Price |
$342.60
|
| Rate for Payer: Health Management Network Commercial |
$485.35
|
| Rate for Payer: Kaiser Permanente Commercial |
$513.90
|
| Rate for Payer: MDX Hawaii PPO |
$553.87
|
|
|
DRILL TWIST 1.9X41MM 60-19340
|
Facility
|
OP
|
$571.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$285.50 |
| Max. Negotiated Rate |
$553.87 |
| Rate for Payer: AlohaCare Medicaid |
$285.50
|
| Rate for Payer: AlohaCare Medicare |
$433.96
|
| Rate for Payer: Cash Price |
$342.60
|
| Rate for Payer: Devoted Health Medicare |
$479.64
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$433.96
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$542.45
|
| Rate for Payer: Health Management Network Commercial |
$485.35
|
| Rate for Payer: Humana Medicare |
$433.96
|
| Rate for Payer: Kaiser Permanente Commercial |
$513.90
|
| Rate for Payer: Kaiser Permanente Medicaid |
$291.21
|
| Rate for Payer: Kaiser Permanente Medicare |
$433.96
|
| Rate for Payer: MDX Hawaii PPO |
$553.87
|
| Rate for Payer: Ohana Health Plan Medicaid |
$433.96
|
| Rate for Payer: Ohana Health Plan Medicare |
$433.96
|
| Rate for Payer: UnitedHealthcare Medicare |
$433.96
|
| Rate for Payer: University Health Alliance Commercial |
$416.20
|
|
|
DRILL TWIST 2.0MM DRILL-2.00L
|
Facility
|
IP
|
$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 TWIST 2.0MM DRILL-2.00L
|
Facility
|
OP
|
$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 TWIST 2.5X2 AO 60-25326
|
Facility
|
OP
|
$606.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.00 |
| Max. Negotiated Rate |
$587.82 |
| Rate for Payer: AlohaCare Medicaid |
$303.00
|
| Rate for Payer: AlohaCare Medicare |
$460.56
|
| Rate for Payer: Cash Price |
$363.60
|
| Rate for Payer: Devoted Health Medicare |
$509.04
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$460.56
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$575.70
|
| Rate for Payer: Health Management Network Commercial |
$515.10
|
| Rate for Payer: Humana Medicare |
$460.56
|
| Rate for Payer: Kaiser Permanente Commercial |
$545.40
|
| Rate for Payer: Kaiser Permanente Medicaid |
$309.06
|
| Rate for Payer: Kaiser Permanente Medicare |
$460.56
|
| Rate for Payer: MDX Hawaii PPO |
$587.82
|
| Rate for Payer: Ohana Health Plan Medicaid |
$460.56
|
| Rate for Payer: Ohana Health Plan Medicare |
$460.56
|
| Rate for Payer: UnitedHealthcare Medicare |
$460.56
|
| Rate for Payer: University Health Alliance Commercial |
$441.71
|
|
|
DRILL TWIST 2.5X2 AO 60-25326
|
Facility
|
IP
|
$606.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$515.10 |
| Max. Negotiated Rate |
$587.82 |
| Rate for Payer: Cash Price |
$363.60
|
| Rate for Payer: Health Management Network Commercial |
$515.10
|
| Rate for Payer: Kaiser Permanente Commercial |
$545.40
|
| Rate for Payer: MDX Hawaii PPO |
$587.82
|
|
|
DRILL TWIST 2.7X125 502015217
|
Facility
|
IP
|
$320.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$272.00 |
| Max. Negotiated Rate |
$310.40 |
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Health Management Network Commercial |
$272.00
|
| Rate for Payer: Kaiser Permanente Commercial |
$288.00
|
| Rate for Payer: MDX Hawaii PPO |
$310.40
|
|
|
DRILL TWIST 2.7X125 502015217
|
Facility
|
OP
|
$320.00
|
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$310.40 |
| Rate for Payer: AlohaCare Medicaid |
$160.00
|
| Rate for Payer: AlohaCare Medicare |
$243.20
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Devoted Health Medicare |
$268.80
|
| Rate for Payer: Hawaii Medical Service Association Medicare |
$243.20
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$304.00
|
| Rate for Payer: Health Management Network Commercial |
$272.00
|
| Rate for Payer: Humana Medicare |
$243.20
|
| Rate for Payer: Kaiser Permanente Commercial |
$288.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$163.20
|
| Rate for Payer: Kaiser Permanente Medicare |
$243.20
|
| Rate for Payer: MDX Hawaii PPO |
$310.40
|
| Rate for Payer: Ohana Health Plan Medicaid |
$243.20
|
| Rate for Payer: Ohana Health Plan Medicare |
$243.20
|
| Rate for Payer: UnitedHealthcare Medicare |
$243.20
|
| Rate for Payer: University Health Alliance Commercial |
$233.25
|
|
|
DRILL TWIST 3.20MM DRILL-3.20L
|
Facility
|
IP
|
$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 TWIST 3.20MM DRILL-3.20L
|
Facility
|
OP
|
$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
|
|
|
DRILL TWIST 4.00MM DRILL-4.00L
|
Facility
|
OP
|
$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
|
|