Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

EXCLUDER 14.5/10CM PLC141000

Facility

$11,204.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,602.00
Max. Negotiated Rate	$10,867.88
Rate for Payer: AlohaCare Medicaid	$5,602.00
Rate for Payer: AlohaCare Medicare	$8,515.04
Rate for Payer: Cash Price	$6,722.40
Rate for Payer: Devoted Health Medicare	$9,411.36
Rate for Payer: Hawaii Medical Service Association Medicare	$8,515.04
Rate for Payer: Hawaii Western Management Group Commercial	$7,842.80
Rate for Payer: Health Management Network Commercial	$9,523.40
Rate for Payer: Humana Medicare	$8,515.04
Rate for Payer: Kaiser Permanente Commercial	$10,083.60
Rate for Payer: Kaiser Permanente Medicaid	$5,714.04
Rate for Payer: Kaiser Permanente Medicare	$8,515.04
Rate for Payer: MDX Hawaii PPO	$10,867.88
Rate for Payer: Ohana Health Plan Medicaid	$8,515.04
Rate for Payer: Ohana Health Plan Medicare	$8,515.04
Rate for Payer: UnitedHealthcare Medicare	$8,515.04
Rate for Payer: University Health Alliance Commercial	$6,274.24

EXCLUDER 14.5X14 PLC141400

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,770.00
Max. Negotiated Rate	$11,193.80
Rate for Payer: AlohaCare Medicaid	$5,770.00
Rate for Payer: AlohaCare Medicare	$8,770.40
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Devoted Health Medicare	$9,693.60
Rate for Payer: Hawaii Medical Service Association Medicare	$8,770.40
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Humana Medicare	$8,770.40
Rate for Payer: Kaiser Permanente Commercial	$10,386.00
Rate for Payer: Kaiser Permanente Medicaid	$5,885.40
Rate for Payer: Kaiser Permanente Medicare	$8,770.40
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: Ohana Health Plan Medicaid	$8,770.40
Rate for Payer: Ohana Health Plan Medicare	$8,770.40
Rate for Payer: UnitedHealthcare Medicare	$8,770.40
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER 14.5X14 PLC141400

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,462.40
Max. Negotiated Rate	$11,193.80
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Kaiser Permanente Commercial	$10,386.00
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER 15FR 23X4.5 CXA280005

Facility

$11,074.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,537.00
Max. Negotiated Rate	$10,741.78
Rate for Payer: AlohaCare Medicaid	$5,537.00
Rate for Payer: AlohaCare Medicare	$8,416.24
Rate for Payer: Cash Price	$6,644.40
Rate for Payer: Devoted Health Medicare	$9,302.16
Rate for Payer: Hawaii Medical Service Association Medicare	$8,416.24
Rate for Payer: Hawaii Western Management Group Commercial	$7,751.80
Rate for Payer: Health Management Network Commercial	$9,412.90
Rate for Payer: Humana Medicare	$8,416.24
Rate for Payer: Kaiser Permanente Commercial	$9,966.60
Rate for Payer: Kaiser Permanente Medicaid	$5,647.74
Rate for Payer: Kaiser Permanente Medicare	$8,416.24
Rate for Payer: MDX Hawaii PPO	$10,741.78
Rate for Payer: Ohana Health Plan Medicaid	$8,416.24
Rate for Payer: Ohana Health Plan Medicare	$8,416.24
Rate for Payer: UnitedHealthcare Medicare	$8,416.24
Rate for Payer: University Health Alliance Commercial	$6,201.44

EXCLUDER 15FR 23X4.5 CXA280005

Facility

$11,074.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,201.44
Max. Negotiated Rate	$10,741.78
Rate for Payer: Cash Price	$6,644.40
Rate for Payer: Hawaii Western Management Group Commercial	$7,751.80
Rate for Payer: Health Management Network Commercial	$9,412.90
Rate for Payer: Kaiser Permanente Commercial	$9,966.60
Rate for Payer: MDX Hawaii PPO	$10,741.78
Rate for Payer: University Health Alliance Commercial	$6,201.44

EXCLUDER 23X4.5 15FR CXA230005

Facility

$10,004.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,602.24
Max. Negotiated Rate	$9,703.88
Rate for Payer: Cash Price	$6,002.40
Rate for Payer: Hawaii Western Management Group Commercial	$7,002.80
Rate for Payer: Health Management Network Commercial	$8,503.40
Rate for Payer: Kaiser Permanente Commercial	$9,003.60
Rate for Payer: MDX Hawaii PPO	$9,703.88
Rate for Payer: University Health Alliance Commercial	$5,602.24

EXCLUDER 23X4.5 15FR CXA230005

Facility

$10,004.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,002.00
Max. Negotiated Rate	$9,703.88
Rate for Payer: AlohaCare Medicaid	$5,002.00
Rate for Payer: AlohaCare Medicare	$7,603.04
Rate for Payer: Cash Price	$6,002.40
Rate for Payer: Devoted Health Medicare	$8,403.36
Rate for Payer: Hawaii Medical Service Association Medicare	$7,603.04
Rate for Payer: Hawaii Western Management Group Commercial	$7,002.80
Rate for Payer: Health Management Network Commercial	$8,503.40
Rate for Payer: Humana Medicare	$7,603.04
Rate for Payer: Kaiser Permanente Commercial	$9,003.60
Rate for Payer: Kaiser Permanente Medicaid	$5,102.04
Rate for Payer: Kaiser Permanente Medicare	$7,603.04
Rate for Payer: MDX Hawaii PPO	$9,703.88
Rate for Payer: Ohana Health Plan Medicaid	$7,603.04
Rate for Payer: Ohana Health Plan Medicare	$7,603.04
Rate for Payer: UnitedHealthcare Medicare	$7,603.04
Rate for Payer: University Health Alliance Commercial	$5,602.24

EXCLUDER AAA 12X10 PLC121000

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,770.00
Max. Negotiated Rate	$11,193.80
Rate for Payer: AlohaCare Medicaid	$5,770.00
Rate for Payer: AlohaCare Medicare	$8,770.40
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Devoted Health Medicare	$9,693.60
Rate for Payer: Hawaii Medical Service Association Medicare	$8,770.40
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Humana Medicare	$8,770.40
Rate for Payer: Kaiser Permanente Commercial	$10,386.00
Rate for Payer: Kaiser Permanente Medicaid	$5,885.40
Rate for Payer: Kaiser Permanente Medicare	$8,770.40
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: Ohana Health Plan Medicaid	$8,770.40
Rate for Payer: Ohana Health Plan Medicare	$8,770.40
Rate for Payer: UnitedHealthcare Medicare	$8,770.40
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER AAA 12X10 PLC121000

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,462.40
Max. Negotiated Rate	$11,193.80
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Kaiser Permanente Commercial	$10,386.00
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER AAA 12X12 PLC121200

Facility

$11,204.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,602.00
Max. Negotiated Rate	$10,867.88
Rate for Payer: AlohaCare Medicaid	$5,602.00
Rate for Payer: AlohaCare Medicare	$8,515.04
Rate for Payer: Cash Price	$6,722.40
Rate for Payer: Devoted Health Medicare	$9,411.36
Rate for Payer: Hawaii Medical Service Association Medicare	$8,515.04
Rate for Payer: Hawaii Western Management Group Commercial	$7,842.80
Rate for Payer: Health Management Network Commercial	$9,523.40
Rate for Payer: Humana Medicare	$8,515.04
Rate for Payer: Kaiser Permanente Commercial	$10,083.60
Rate for Payer: Kaiser Permanente Medicaid	$5,714.04
Rate for Payer: Kaiser Permanente Medicare	$8,515.04
Rate for Payer: MDX Hawaii PPO	$10,867.88
Rate for Payer: Ohana Health Plan Medicaid	$8,515.04
Rate for Payer: Ohana Health Plan Medicare	$8,515.04
Rate for Payer: UnitedHealthcare Medicare	$8,515.04
Rate for Payer: University Health Alliance Commercial	$6,274.24

EXCLUDER AAA 12X12 PLC121200

Facility

$11,204.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,274.24
Max. Negotiated Rate	$10,867.88
Rate for Payer: Cash Price	$6,722.40
Rate for Payer: Hawaii Western Management Group Commercial	$7,842.80
Rate for Payer: Health Management Network Commercial	$9,523.40
Rate for Payer: Kaiser Permanente Commercial	$10,083.60
Rate for Payer: MDX Hawaii PPO	$10,867.88
Rate for Payer: University Health Alliance Commercial	$6,274.24

EXCLUDER AAA 16X10X7 PLL161007

Facility

$7,506.00

Hospital Revenue Code	278
Min. Negotiated Rate	$4,203.36
Max. Negotiated Rate	$7,280.82
Rate for Payer: Cash Price	$4,503.60
Rate for Payer: Hawaii Western Management Group Commercial	$5,254.20
Rate for Payer: Health Management Network Commercial	$6,380.10
Rate for Payer: Kaiser Permanente Commercial	$6,755.40
Rate for Payer: MDX Hawaii PPO	$7,280.82
Rate for Payer: University Health Alliance Commercial	$4,203.36

EXCLUDER AAA 16X10X7 PLL161007

Facility

$7,506.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,753.00
Max. Negotiated Rate	$7,280.82
Rate for Payer: AlohaCare Medicaid	$3,753.00
Rate for Payer: AlohaCare Medicare	$5,704.56
Rate for Payer: Cash Price	$4,503.60
Rate for Payer: Devoted Health Medicare	$6,305.04
Rate for Payer: Hawaii Medical Service Association Medicare	$5,704.56
Rate for Payer: Hawaii Western Management Group Commercial	$5,254.20
Rate for Payer: Health Management Network Commercial	$6,380.10
Rate for Payer: Humana Medicare	$5,704.56
Rate for Payer: Kaiser Permanente Commercial	$6,755.40
Rate for Payer: Kaiser Permanente Medicaid	$3,828.06
Rate for Payer: Kaiser Permanente Medicare	$5,704.56
Rate for Payer: MDX Hawaii PPO	$7,280.82
Rate for Payer: Ohana Health Plan Medicaid	$5,704.56
Rate for Payer: Ohana Health Plan Medicare	$5,704.56
Rate for Payer: UnitedHealthcare Medicare	$5,704.56
Rate for Payer: University Health Alliance Commercial	$4,203.36

EXCLUDER AAA 23MM CXT231412

Facility

$31,656.00

Hospital Revenue Code	278
Min. Negotiated Rate	$17,727.36
Max. Negotiated Rate	$30,706.32
Rate for Payer: Cash Price	$18,993.60
Rate for Payer: Hawaii Western Management Group Commercial	$22,159.20
Rate for Payer: Health Management Network Commercial	$26,907.60
Rate for Payer: Kaiser Permanente Commercial	$28,490.40
Rate for Payer: MDX Hawaii PPO	$30,706.32
Rate for Payer: University Health Alliance Commercial	$17,727.36

EXCLUDER AAA 23MM CXT231412

Facility

$31,656.00

Hospital Revenue Code	278
Min. Negotiated Rate	$15,828.00
Max. Negotiated Rate	$30,706.32
Rate for Payer: AlohaCare Medicaid	$15,828.00
Rate for Payer: AlohaCare Medicare	$24,058.56
Rate for Payer: Cash Price	$18,993.60
Rate for Payer: Devoted Health Medicare	$26,591.04
Rate for Payer: Hawaii Medical Service Association Medicare	$24,058.56
Rate for Payer: Hawaii Western Management Group Commercial	$22,159.20
Rate for Payer: Health Management Network Commercial	$26,907.60
Rate for Payer: Humana Medicare	$24,058.56
Rate for Payer: Kaiser Permanente Commercial	$28,490.40
Rate for Payer: Kaiser Permanente Medicaid	$16,144.56
Rate for Payer: Kaiser Permanente Medicare	$24,058.56
Rate for Payer: MDX Hawaii PPO	$30,706.32
Rate for Payer: Ohana Health Plan Medicaid	$24,058.56
Rate for Payer: Ohana Health Plan Medicare	$24,058.56
Rate for Payer: UnitedHealthcare Medicare	$24,058.56
Rate for Payer: University Health Alliance Commercial	$17,727.36

EXCLUDER AAA CXA200005

Facility

$10,004.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,002.00
Max. Negotiated Rate	$9,703.88
Rate for Payer: AlohaCare Medicaid	$5,002.00
Rate for Payer: AlohaCare Medicare	$7,603.04
Rate for Payer: Cash Price	$6,002.40
Rate for Payer: Devoted Health Medicare	$8,403.36
Rate for Payer: Hawaii Medical Service Association Medicare	$7,603.04
Rate for Payer: Hawaii Western Management Group Commercial	$7,002.80
Rate for Payer: Health Management Network Commercial	$8,503.40
Rate for Payer: Humana Medicare	$7,603.04
Rate for Payer: Kaiser Permanente Commercial	$9,003.60
Rate for Payer: Kaiser Permanente Medicaid	$5,102.04
Rate for Payer: Kaiser Permanente Medicare	$7,603.04
Rate for Payer: MDX Hawaii PPO	$9,703.88
Rate for Payer: Ohana Health Plan Medicaid	$7,603.04
Rate for Payer: Ohana Health Plan Medicare	$7,603.04
Rate for Payer: UnitedHealthcare Medicare	$7,603.04
Rate for Payer: University Health Alliance Commercial	$5,602.24

EXCLUDER AAA CXA200005

Facility

$10,004.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,602.24
Max. Negotiated Rate	$9,703.88
Rate for Payer: Cash Price	$6,002.40
Rate for Payer: Hawaii Western Management Group Commercial	$7,002.80
Rate for Payer: Health Management Network Commercial	$8,503.40
Rate for Payer: Kaiser Permanente Commercial	$9,003.60
Rate for Payer: MDX Hawaii PPO	$9,703.88
Rate for Payer: University Health Alliance Commercial	$5,602.24

EXCLUDER AAA ENDOPRO PLC121400

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,770.00
Max. Negotiated Rate	$11,193.80
Rate for Payer: AlohaCare Medicaid	$5,770.00
Rate for Payer: AlohaCare Medicare	$8,770.40
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Devoted Health Medicare	$9,693.60
Rate for Payer: Hawaii Medical Service Association Medicare	$8,770.40
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Humana Medicare	$8,770.40
Rate for Payer: Kaiser Permanente Commercial	$10,386.00
Rate for Payer: Kaiser Permanente Medicaid	$5,885.40
Rate for Payer: Kaiser Permanente Medicare	$8,770.40
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: Ohana Health Plan Medicaid	$8,770.40
Rate for Payer: Ohana Health Plan Medicare	$8,770.40
Rate for Payer: UnitedHealthcare Medicare	$8,770.40
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER AAA ENDOPRO PLC121400

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,462.40
Max. Negotiated Rate	$11,193.80
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Kaiser Permanente Commercial	$10,386.00
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER AAA PLL161200

Facility

$10,360.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,180.00
Max. Negotiated Rate	$10,049.20
Rate for Payer: AlohaCare Medicaid	$5,180.00
Rate for Payer: AlohaCare Medicare	$7,873.60
Rate for Payer: Cash Price	$6,216.00
Rate for Payer: Devoted Health Medicare	$8,702.40
Rate for Payer: Hawaii Medical Service Association Medicare	$7,873.60
Rate for Payer: Hawaii Western Management Group Commercial	$7,252.00
Rate for Payer: Health Management Network Commercial	$8,806.00
Rate for Payer: Humana Medicare	$7,873.60
Rate for Payer: Kaiser Permanente Commercial	$9,324.00
Rate for Payer: Kaiser Permanente Medicaid	$5,283.60
Rate for Payer: Kaiser Permanente Medicare	$7,873.60
Rate for Payer: MDX Hawaii PPO	$10,049.20
Rate for Payer: Ohana Health Plan Medicaid	$7,873.60
Rate for Payer: Ohana Health Plan Medicare	$7,873.60
Rate for Payer: UnitedHealthcare Medicare	$7,873.60
Rate for Payer: University Health Alliance Commercial	$5,801.60

EXCLUDER AAA PLL161200

Facility

$10,360.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,801.60
Max. Negotiated Rate	$10,049.20
Rate for Payer: Cash Price	$6,216.00
Rate for Payer: Hawaii Western Management Group Commercial	$7,252.00
Rate for Payer: Health Management Network Commercial	$8,806.00
Rate for Payer: Kaiser Permanente Commercial	$9,324.00
Rate for Payer: MDX Hawaii PPO	$10,049.20
Rate for Payer: University Health Alliance Commercial	$5,801.60

EXCLUDER AAA PLL161407

Facility

$7,986.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,993.00
Max. Negotiated Rate	$7,746.42
Rate for Payer: AlohaCare Medicaid	$3,993.00
Rate for Payer: AlohaCare Medicare	$6,069.36
Rate for Payer: Cash Price	$4,791.60
Rate for Payer: Devoted Health Medicare	$6,708.24
Rate for Payer: Hawaii Medical Service Association Medicare	$6,069.36
Rate for Payer: Hawaii Western Management Group Commercial	$5,590.20
Rate for Payer: Health Management Network Commercial	$6,788.10
Rate for Payer: Humana Medicare	$6,069.36
Rate for Payer: Kaiser Permanente Commercial	$7,187.40
Rate for Payer: Kaiser Permanente Medicaid	$4,072.86
Rate for Payer: Kaiser Permanente Medicare	$6,069.36
Rate for Payer: MDX Hawaii PPO	$7,746.42
Rate for Payer: Ohana Health Plan Medicaid	$6,069.36
Rate for Payer: Ohana Health Plan Medicare	$6,069.36
Rate for Payer: UnitedHealthcare Medicare	$6,069.36
Rate for Payer: University Health Alliance Commercial	$4,472.16

EXCLUDER AAA PLL161407

Facility

$7,986.00

Hospital Revenue Code	278
Min. Negotiated Rate	$4,472.16
Max. Negotiated Rate	$7,746.42
Rate for Payer: Cash Price	$4,791.60
Rate for Payer: Hawaii Western Management Group Commercial	$5,590.20
Rate for Payer: Health Management Network Commercial	$6,788.10
Rate for Payer: Kaiser Permanente Commercial	$7,187.40
Rate for Payer: MDX Hawaii PPO	$7,746.42
Rate for Payer: University Health Alliance Commercial	$4,472.16

EXCLUDER BIFURCATED ENDOPROSTH

Facility

$6,200.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,100.00
Max. Negotiated Rate	$6,014.00
Rate for Payer: AlohaCare Medicaid	$3,100.00
Rate for Payer: AlohaCare Medicare	$4,712.00
Rate for Payer: Cash Price	$3,720.00
Rate for Payer: Devoted Health Medicare	$5,208.00
Rate for Payer: Hawaii Medical Service Association Medicare	$4,712.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,340.00
Rate for Payer: Health Management Network Commercial	$5,270.00
Rate for Payer: Humana Medicare	$4,712.00
Rate for Payer: Kaiser Permanente Commercial	$5,580.00
Rate for Payer: Kaiser Permanente Medicaid	$3,162.00
Rate for Payer: Kaiser Permanente Medicare	$4,712.00
Rate for Payer: MDX Hawaii PPO	$6,014.00
Rate for Payer: Ohana Health Plan Medicaid	$4,712.00
Rate for Payer: Ohana Health Plan Medicare	$4,712.00
Rate for Payer: UnitedHealthcare Medicare	$4,712.00
Rate for Payer: University Health Alliance Commercial	$3,472.00

EXCLUDER BIFURCATED ENDOPROSTH

Facility

$6,200.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,472.00
Max. Negotiated Rate	$6,014.00
Rate for Payer: Cash Price	$3,720.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,340.00
Rate for Payer: Health Management Network Commercial	$5,270.00
Rate for Payer: Kaiser Permanente Commercial	$5,580.00
Rate for Payer: MDX Hawaii PPO	$6,014.00
Rate for Payer: University Health Alliance Commercial	$3,472.00

Know your out-of-pocket cost for care.

All Charges