Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

ANCHOR SUTURE #AR-1927BCFT

Facility

$1,726.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$966.56
Max. Negotiated Rate	$1,674.22
Rate for Payer: Cash Price	$1,035.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,208.20
Rate for Payer: Health Management Network Commercial	$1,467.10
Rate for Payer: Kaiser Permanente Commercial	$1,553.40
Rate for Payer: MDX Hawaii PPO	$1,674.22
Rate for Payer: University Health Alliance Commercial	$966.56

ANCHOR SUTURE #AR-1927BCFT

Facility

$1,726.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$863.00
Max. Negotiated Rate	$1,674.22
Rate for Payer: AlohaCare Medicaid	$863.00
Rate for Payer: AlohaCare Medicare	$1,311.76
Rate for Payer: Cash Price	$1,035.60
Rate for Payer: Devoted Health Medicare	$1,449.84
Rate for Payer: Hawaii Medical Service Association Medicare	$1,311.76
Rate for Payer: Hawaii Western Management Group Commercial	$1,208.20
Rate for Payer: Health Management Network Commercial	$1,467.10
Rate for Payer: Humana Medicare	$1,311.76
Rate for Payer: Kaiser Permanente Commercial	$1,553.40
Rate for Payer: Kaiser Permanente Medicaid	$880.26
Rate for Payer: Kaiser Permanente Medicare	$1,311.76
Rate for Payer: MDX Hawaii PPO	$1,674.22
Rate for Payer: Ohana Health Plan Medicaid	$1,311.76
Rate for Payer: Ohana Health Plan Medicare	$1,311.76
Rate for Payer: UnitedHealthcare Medicare	$1,311.76
Rate for Payer: University Health Alliance Commercial	$966.56

ANCHOR SUTURE #AR-1927BCNF

Facility

$1,677.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$838.50
Max. Negotiated Rate	$1,626.69
Rate for Payer: AlohaCare Medicaid	$838.50
Rate for Payer: AlohaCare Medicare	$1,274.52
Rate for Payer: Cash Price	$1,006.20
Rate for Payer: Devoted Health Medicare	$1,408.68
Rate for Payer: Hawaii Medical Service Association Medicare	$1,274.52
Rate for Payer: Hawaii Western Management Group Commercial	$1,173.90
Rate for Payer: Health Management Network Commercial	$1,425.45
Rate for Payer: Humana Medicare	$1,274.52
Rate for Payer: Kaiser Permanente Commercial	$1,509.30
Rate for Payer: Kaiser Permanente Medicaid	$855.27
Rate for Payer: Kaiser Permanente Medicare	$1,274.52
Rate for Payer: MDX Hawaii PPO	$1,626.69
Rate for Payer: Ohana Health Plan Medicaid	$1,274.52
Rate for Payer: Ohana Health Plan Medicare	$1,274.52
Rate for Payer: UnitedHealthcare Medicare	$1,274.52
Rate for Payer: University Health Alliance Commercial	$939.12

ANCHOR SUTURE #AR-1927BCNF

Facility

$1,677.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$939.12
Max. Negotiated Rate	$1,626.69
Rate for Payer: Cash Price	$1,006.20
Rate for Payer: Hawaii Western Management Group Commercial	$1,173.90
Rate for Payer: Health Management Network Commercial	$1,425.45
Rate for Payer: Kaiser Permanente Commercial	$1,509.30
Rate for Payer: MDX Hawaii PPO	$1,626.69
Rate for Payer: University Health Alliance Commercial	$939.12

ANCHOR SUTURE #AR-1928SF-3

Facility

$1,225.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$686.00
Max. Negotiated Rate	$1,188.25
Rate for Payer: Cash Price	$735.00
Rate for Payer: Hawaii Western Management Group Commercial	$857.50
Rate for Payer: Health Management Network Commercial	$1,041.25
Rate for Payer: Kaiser Permanente Commercial	$1,102.50
Rate for Payer: MDX Hawaii PPO	$1,188.25
Rate for Payer: University Health Alliance Commercial	$686.00

ANCHOR SUTURE #AR-1928SF-3

Facility

$1,225.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$612.50
Max. Negotiated Rate	$1,188.25
Rate for Payer: AlohaCare Medicaid	$612.50
Rate for Payer: AlohaCare Medicare	$931.00
Rate for Payer: Cash Price	$735.00
Rate for Payer: Devoted Health Medicare	$1,029.00
Rate for Payer: Hawaii Medical Service Association Medicare	$931.00
Rate for Payer: Hawaii Western Management Group Commercial	$857.50
Rate for Payer: Health Management Network Commercial	$1,041.25
Rate for Payer: Humana Medicare	$931.00
Rate for Payer: Kaiser Permanente Commercial	$1,102.50
Rate for Payer: Kaiser Permanente Medicaid	$624.75
Rate for Payer: Kaiser Permanente Medicare	$931.00
Rate for Payer: MDX Hawaii PPO	$1,188.25
Rate for Payer: Ohana Health Plan Medicaid	$931.00
Rate for Payer: Ohana Health Plan Medicare	$931.00
Rate for Payer: UnitedHealthcare Medicare	$931.00
Rate for Payer: University Health Alliance Commercial	$686.00

ANCHOR SUTURE #AR-1934BCF-24

Facility

$1,526.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$763.00
Max. Negotiated Rate	$1,480.22
Rate for Payer: AlohaCare Medicaid	$763.00
Rate for Payer: AlohaCare Medicare	$1,159.76
Rate for Payer: Cash Price	$915.60
Rate for Payer: Devoted Health Medicare	$1,281.84
Rate for Payer: Hawaii Medical Service Association Medicare	$1,159.76
Rate for Payer: Hawaii Western Management Group Commercial	$1,068.20
Rate for Payer: Health Management Network Commercial	$1,297.10
Rate for Payer: Humana Medicare	$1,159.76
Rate for Payer: Kaiser Permanente Commercial	$1,373.40
Rate for Payer: Kaiser Permanente Medicaid	$778.26
Rate for Payer: Kaiser Permanente Medicare	$1,159.76
Rate for Payer: MDX Hawaii PPO	$1,480.22
Rate for Payer: Ohana Health Plan Medicaid	$1,159.76
Rate for Payer: Ohana Health Plan Medicare	$1,159.76
Rate for Payer: UnitedHealthcare Medicare	$1,159.76
Rate for Payer: University Health Alliance Commercial	$854.56

ANCHOR SUTURE #AR-1934BCF-24

Facility

$1,526.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$854.56
Max. Negotiated Rate	$1,480.22
Rate for Payer: Cash Price	$915.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,068.20
Rate for Payer: Health Management Network Commercial	$1,297.10
Rate for Payer: Kaiser Permanente Commercial	$1,373.40
Rate for Payer: MDX Hawaii PPO	$1,480.22
Rate for Payer: University Health Alliance Commercial	$854.56

ANCHOR SUTURE #AR-1934BCF-24-2

Facility

$1,603.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$897.68
Max. Negotiated Rate	$1,554.91
Rate for Payer: Cash Price	$961.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,122.10
Rate for Payer: Health Management Network Commercial	$1,362.55
Rate for Payer: Kaiser Permanente Commercial	$1,442.70
Rate for Payer: MDX Hawaii PPO	$1,554.91
Rate for Payer: University Health Alliance Commercial	$897.68

ANCHOR SUTURE #AR-1934BCF-24-2

Facility

$1,603.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$801.50
Max. Negotiated Rate	$1,554.91
Rate for Payer: AlohaCare Medicaid	$801.50
Rate for Payer: AlohaCare Medicare	$1,218.28
Rate for Payer: Cash Price	$961.80
Rate for Payer: Devoted Health Medicare	$1,346.52
Rate for Payer: Hawaii Medical Service Association Medicare	$1,218.28
Rate for Payer: Hawaii Western Management Group Commercial	$1,122.10
Rate for Payer: Health Management Network Commercial	$1,362.55
Rate for Payer: Humana Medicare	$1,218.28
Rate for Payer: Kaiser Permanente Commercial	$1,442.70
Rate for Payer: Kaiser Permanente Medicaid	$817.53
Rate for Payer: Kaiser Permanente Medicare	$1,218.28
Rate for Payer: MDX Hawaii PPO	$1,554.91
Rate for Payer: Ohana Health Plan Medicaid	$1,218.28
Rate for Payer: Ohana Health Plan Medicare	$1,218.28
Rate for Payer: UnitedHealthcare Medicare	$1,218.28
Rate for Payer: University Health Alliance Commercial	$897.68

ANCHOR SUTURE #AR-2324BSLM

Facility

$1,629.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$912.24
Max. Negotiated Rate	$1,580.13
Rate for Payer: Cash Price	$977.40
Rate for Payer: Hawaii Western Management Group Commercial	$1,140.30
Rate for Payer: Health Management Network Commercial	$1,384.65
Rate for Payer: Kaiser Permanente Commercial	$1,466.10
Rate for Payer: MDX Hawaii PPO	$1,580.13
Rate for Payer: University Health Alliance Commercial	$912.24

ANCHOR SUTURE #AR-2324BSLM

Facility

$1,629.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$814.50
Max. Negotiated Rate	$1,580.13
Rate for Payer: AlohaCare Medicaid	$814.50
Rate for Payer: AlohaCare Medicare	$1,238.04
Rate for Payer: Cash Price	$977.40
Rate for Payer: Devoted Health Medicare	$1,368.36
Rate for Payer: Hawaii Medical Service Association Medicare	$1,238.04
Rate for Payer: Hawaii Western Management Group Commercial	$1,140.30
Rate for Payer: Health Management Network Commercial	$1,384.65
Rate for Payer: Humana Medicare	$1,238.04
Rate for Payer: Kaiser Permanente Commercial	$1,466.10
Rate for Payer: Kaiser Permanente Medicaid	$830.79
Rate for Payer: Kaiser Permanente Medicare	$1,238.04
Rate for Payer: MDX Hawaii PPO	$1,580.13
Rate for Payer: Ohana Health Plan Medicaid	$1,238.04
Rate for Payer: Ohana Health Plan Medicare	$1,238.04
Rate for Payer: UnitedHealthcare Medicare	$1,238.04
Rate for Payer: University Health Alliance Commercial	$912.24

ANCHOR SUTURE #AR-2324SLM

Facility

$1,603.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$897.68
Max. Negotiated Rate	$1,554.91
Rate for Payer: Cash Price	$961.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,122.10
Rate for Payer: Health Management Network Commercial	$1,362.55
Rate for Payer: Kaiser Permanente Commercial	$1,442.70
Rate for Payer: MDX Hawaii PPO	$1,554.91
Rate for Payer: University Health Alliance Commercial	$897.68

ANCHOR SUTURE #AR-2324SLM

Facility

$1,603.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$801.50
Max. Negotiated Rate	$1,554.91
Rate for Payer: AlohaCare Medicaid	$801.50
Rate for Payer: AlohaCare Medicare	$1,218.28
Rate for Payer: Cash Price	$961.80
Rate for Payer: Devoted Health Medicare	$1,346.52
Rate for Payer: Hawaii Medical Service Association Medicare	$1,218.28
Rate for Payer: Hawaii Western Management Group Commercial	$1,122.10
Rate for Payer: Health Management Network Commercial	$1,362.55
Rate for Payer: Humana Medicare	$1,218.28
Rate for Payer: Kaiser Permanente Commercial	$1,442.70
Rate for Payer: Kaiser Permanente Medicaid	$817.53
Rate for Payer: Kaiser Permanente Medicare	$1,218.28
Rate for Payer: MDX Hawaii PPO	$1,554.91
Rate for Payer: Ohana Health Plan Medicaid	$1,218.28
Rate for Payer: Ohana Health Plan Medicare	$1,218.28
Rate for Payer: UnitedHealthcare Medicare	$1,218.28
Rate for Payer: University Health Alliance Commercial	$897.68

ANCHOR SUTURE AR-8990ST

Facility

$1,995.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$997.50
Max. Negotiated Rate	$1,935.15
Rate for Payer: AlohaCare Medicaid	$997.50
Rate for Payer: AlohaCare Medicare	$1,516.20
Rate for Payer: Cash Price	$1,197.00
Rate for Payer: Devoted Health Medicare	$1,675.80
Rate for Payer: Hawaii Medical Service Association Medicare	$1,516.20
Rate for Payer: Hawaii Western Management Group Commercial	$1,396.50
Rate for Payer: Health Management Network Commercial	$1,695.75
Rate for Payer: Humana Medicare	$1,516.20
Rate for Payer: Kaiser Permanente Commercial	$1,795.50
Rate for Payer: Kaiser Permanente Medicaid	$1,017.45
Rate for Payer: Kaiser Permanente Medicare	$1,516.20
Rate for Payer: MDX Hawaii PPO	$1,935.15
Rate for Payer: Ohana Health Plan Medicaid	$1,516.20
Rate for Payer: Ohana Health Plan Medicare	$1,516.20
Rate for Payer: UnitedHealthcare Medicare	$1,516.20
Rate for Payer: University Health Alliance Commercial	$1,117.20

ANCHOR SUTURE AR-8990ST

Facility

$1,995.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,117.20
Max. Negotiated Rate	$1,935.15
Rate for Payer: Cash Price	$1,197.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,396.50
Rate for Payer: Health Management Network Commercial	$1,695.75
Rate for Payer: Kaiser Permanente Commercial	$1,795.50
Rate for Payer: MDX Hawaii PPO	$1,935.15
Rate for Payer: University Health Alliance Commercial	$1,117.20

ANCHOR SUTURE PUSHLOCK

Facility

$2,001.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$1,940.97
Rate for Payer: AlohaCare Medicaid	$1,000.50
Rate for Payer: AlohaCare Medicare	$1,520.76
Rate for Payer: Cash Price	$1,200.60
Rate for Payer: Devoted Health Medicare	$1,680.84
Rate for Payer: Hawaii Medical Service Association Medicare	$1,520.76
Rate for Payer: Hawaii Western Management Group Commercial	$1,400.70
Rate for Payer: Health Management Network Commercial	$1,700.85
Rate for Payer: Humana Medicare	$1,520.76
Rate for Payer: Kaiser Permanente Commercial	$1,800.90
Rate for Payer: Kaiser Permanente Medicaid	$1,020.51
Rate for Payer: Kaiser Permanente Medicare	$1,520.76
Rate for Payer: MDX Hawaii PPO	$1,940.97
Rate for Payer: Ohana Health Plan Medicaid	$1,520.76
Rate for Payer: Ohana Health Plan Medicare	$1,520.76
Rate for Payer: UnitedHealthcare Medicare	$1,520.76
Rate for Payer: University Health Alliance Commercial	$1,120.56

ANCHOR SUTURE PUSHLOCK

Facility

$2,001.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,120.56
Max. Negotiated Rate	$1,940.97
Rate for Payer: Cash Price	$1,200.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,400.70
Rate for Payer: Health Management Network Commercial	$1,700.85
Rate for Payer: Kaiser Permanente Commercial	$1,800.90
Rate for Payer: MDX Hawaii PPO	$1,940.97
Rate for Payer: University Health Alliance Commercial	$1,120.56

ANCHOR SWIVELOCK AR-1593-BC

Facility

$2,284.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,279.04
Max. Negotiated Rate	$2,215.48
Rate for Payer: Cash Price	$1,370.40
Rate for Payer: Hawaii Western Management Group Commercial	$1,598.80
Rate for Payer: Health Management Network Commercial	$1,941.40
Rate for Payer: Kaiser Permanente Commercial	$2,055.60
Rate for Payer: MDX Hawaii PPO	$2,215.48
Rate for Payer: University Health Alliance Commercial	$1,279.04

ANCHOR SWIVELOCK AR-1593-BC

Facility

$2,284.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,142.00
Max. Negotiated Rate	$2,215.48
Rate for Payer: AlohaCare Medicaid	$1,142.00
Rate for Payer: AlohaCare Medicare	$1,735.84
Rate for Payer: Cash Price	$1,370.40
Rate for Payer: Devoted Health Medicare	$1,918.56
Rate for Payer: Hawaii Medical Service Association Medicare	$1,735.84
Rate for Payer: Hawaii Western Management Group Commercial	$1,598.80
Rate for Payer: Health Management Network Commercial	$1,941.40
Rate for Payer: Humana Medicare	$1,735.84
Rate for Payer: Kaiser Permanente Commercial	$2,055.60
Rate for Payer: Kaiser Permanente Medicaid	$1,164.84
Rate for Payer: Kaiser Permanente Medicare	$1,735.84
Rate for Payer: MDX Hawaii PPO	$2,215.48
Rate for Payer: Ohana Health Plan Medicaid	$1,735.84
Rate for Payer: Ohana Health Plan Medicare	$1,735.84
Rate for Payer: UnitedHealthcare Medicare	$1,735.84
Rate for Payer: University Health Alliance Commercial	$1,279.04

ANCHOR TISS. RET SYS TRS100SB2

Facility

$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

ANCHOR TISS. RET SYS TRS100SB2

Facility

$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

ANCHOR W/SUTURE #AR-1927BCF

Facility

$1,524.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$853.44
Max. Negotiated Rate	$1,478.28
Rate for Payer: Cash Price	$914.40
Rate for Payer: Hawaii Western Management Group Commercial	$1,066.80
Rate for Payer: Health Management Network Commercial	$1,295.40
Rate for Payer: Kaiser Permanente Commercial	$1,371.60
Rate for Payer: MDX Hawaii PPO	$1,478.28
Rate for Payer: University Health Alliance Commercial	$853.44

ANCHOR W/SUTURE #AR-1927BCF

Facility

$1,524.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$762.00
Max. Negotiated Rate	$1,478.28
Rate for Payer: AlohaCare Medicaid	$762.00
Rate for Payer: AlohaCare Medicare	$1,158.24
Rate for Payer: Cash Price	$914.40
Rate for Payer: Devoted Health Medicare	$1,280.16
Rate for Payer: Hawaii Medical Service Association Medicare	$1,158.24
Rate for Payer: Hawaii Western Management Group Commercial	$1,066.80
Rate for Payer: Health Management Network Commercial	$1,295.40
Rate for Payer: Humana Medicare	$1,158.24
Rate for Payer: Kaiser Permanente Commercial	$1,371.60
Rate for Payer: Kaiser Permanente Medicaid	$777.24
Rate for Payer: Kaiser Permanente Medicare	$1,158.24
Rate for Payer: MDX Hawaii PPO	$1,478.28
Rate for Payer: Ohana Health Plan Medicaid	$1,158.24
Rate for Payer: Ohana Health Plan Medicare	$1,158.24
Rate for Payer: UnitedHealthcare Medicare	$1,158.24
Rate for Payer: University Health Alliance Commercial	$853.44

ANCHR FOOTPRINT 4.5MM 72202901

Facility

$1,384.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$692.00
Max. Negotiated Rate	$1,342.48
Rate for Payer: AlohaCare Medicaid	$692.00
Rate for Payer: AlohaCare Medicare	$1,051.84
Rate for Payer: Cash Price	$830.40
Rate for Payer: Devoted Health Medicare	$1,162.56
Rate for Payer: Hawaii Medical Service Association Medicare	$1,051.84
Rate for Payer: Hawaii Western Management Group Commercial	$968.80
Rate for Payer: Health Management Network Commercial	$1,176.40
Rate for Payer: Humana Medicare	$1,051.84
Rate for Payer: Kaiser Permanente Commercial	$1,245.60
Rate for Payer: Kaiser Permanente Medicaid	$705.84
Rate for Payer: Kaiser Permanente Medicare	$1,051.84
Rate for Payer: MDX Hawaii PPO	$1,342.48
Rate for Payer: Ohana Health Plan Medicaid	$1,051.84
Rate for Payer: Ohana Health Plan Medicare	$1,051.84
Rate for Payer: UnitedHealthcare Medicare	$1,051.84
Rate for Payer: University Health Alliance Commercial	$775.04

Know your out-of-pocket cost for care.

All Charges