Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

KWIRE 390142

Facility

$92.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$46.00
Max. Negotiated Rate	$89.24
Rate for Payer: AlohaCare Medicaid	$46.00
Rate for Payer: AlohaCare Medicare	$69.92
Rate for Payer: Cash Price	$55.20
Rate for Payer: Devoted Health Medicare	$77.28
Rate for Payer: Hawaii Medical Service Association Medicare	$69.92
Rate for Payer: Hawaii Western Management Group Commercial	$87.40
Rate for Payer: Health Management Network Commercial	$78.20
Rate for Payer: Humana Medicare	$69.92
Rate for Payer: Kaiser Permanente Commercial	$82.80
Rate for Payer: Kaiser Permanente Medicaid	$46.92
Rate for Payer: Kaiser Permanente Medicare	$69.92
Rate for Payer: MDX Hawaii PPO	$89.24
Rate for Payer: Ohana Health Plan Medicaid	$69.92
Rate for Payer: Ohana Health Plan Medicare	$69.92
Rate for Payer: UnitedHealthcare Medicare	$69.92
Rate for Payer: University Health Alliance Commercial	$67.06

KWIRE 390142

Facility

$92.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$78.20
Max. Negotiated Rate	$89.24
Rate for Payer: Cash Price	$55.20
Rate for Payer: Health Management Network Commercial	$78.20
Rate for Payer: Kaiser Permanente Commercial	$82.80
Rate for Payer: MDX Hawaii PPO	$89.24

K-WIRE 3X285MM 1806-0050S

Facility

$489.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$415.65
Max. Negotiated Rate	$474.33
Rate for Payer: Cash Price	$293.40
Rate for Payer: Health Management Network Commercial	$415.65
Rate for Payer: Kaiser Permanente Commercial	$440.10
Rate for Payer: MDX Hawaii PPO	$474.33

K-WIRE 3X285MM 1806-0050S

Facility

$489.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$244.50
Max. Negotiated Rate	$474.33
Rate for Payer: AlohaCare Medicaid	$244.50
Rate for Payer: AlohaCare Medicare	$371.64
Rate for Payer: Cash Price	$293.40
Rate for Payer: Devoted Health Medicare	$410.76
Rate for Payer: Hawaii Medical Service Association Medicare	$371.64
Rate for Payer: Hawaii Western Management Group Commercial	$464.55
Rate for Payer: Health Management Network Commercial	$415.65
Rate for Payer: Humana Medicare	$371.64
Rate for Payer: Kaiser Permanente Commercial	$440.10
Rate for Payer: Kaiser Permanente Medicaid	$249.39
Rate for Payer: Kaiser Permanente Medicare	$371.64
Rate for Payer: MDX Hawaii PPO	$474.33
Rate for Payer: Ohana Health Plan Medicaid	$371.64
Rate for Payer: Ohana Health Plan Medicare	$371.64
Rate for Payer: UnitedHealthcare Medicare	$371.64
Rate for Payer: University Health Alliance Commercial	$356.43

K-WIRE 3X285MM 2351-3028S

Facility

$754.00

Hospital Revenue Code	272
Min. Negotiated Rate	$377.00
Max. Negotiated Rate	$731.38
Rate for Payer: AlohaCare Medicaid	$377.00
Rate for Payer: AlohaCare Medicare	$573.04
Rate for Payer: Cash Price	$452.40
Rate for Payer: Devoted Health Medicare	$633.36
Rate for Payer: Hawaii Medical Service Association Medicare	$573.04
Rate for Payer: Hawaii Western Management Group Commercial	$716.30
Rate for Payer: Health Management Network Commercial	$640.90
Rate for Payer: Humana Medicare	$573.04
Rate for Payer: Kaiser Permanente Commercial	$678.60
Rate for Payer: Kaiser Permanente Medicaid	$384.54
Rate for Payer: Kaiser Permanente Medicare	$573.04
Rate for Payer: MDX Hawaii PPO	$731.38
Rate for Payer: Ohana Health Plan Medicaid	$573.04
Rate for Payer: Ohana Health Plan Medicare	$573.04
Rate for Payer: UnitedHealthcare Medicare	$573.04
Rate for Payer: University Health Alliance Commercial	$549.59

K-WIRE 3X285MM 2351-3028S

Facility

$754.00

Hospital Revenue Code	272
Min. Negotiated Rate	$640.90
Max. Negotiated Rate	$731.38
Rate for Payer: Cash Price	$452.40
Rate for Payer: Health Management Network Commercial	$640.90
Rate for Payer: Kaiser Permanente Commercial	$678.60
Rate for Payer: MDX Hawaii PPO	$731.38

K-WIRE 4.2X185MM 2351-3340S

Facility

$1,343.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,141.55
Max. Negotiated Rate	$1,302.71
Rate for Payer: Cash Price	$805.80
Rate for Payer: Health Management Network Commercial	$1,141.55
Rate for Payer: Kaiser Permanente Commercial	$1,208.70
Rate for Payer: MDX Hawaii PPO	$1,302.71

K-WIRE 4.2X185MM 2351-3340S

Facility

$1,343.00

Hospital Revenue Code	272
Min. Negotiated Rate	$671.50
Max. Negotiated Rate	$1,302.71
Rate for Payer: AlohaCare Medicaid	$671.50
Rate for Payer: AlohaCare Medicare	$1,020.68
Rate for Payer: Cash Price	$805.80
Rate for Payer: Devoted Health Medicare	$1,128.12
Rate for Payer: Hawaii Medical Service Association Medicare	$1,020.68
Rate for Payer: Hawaii Western Management Group Commercial	$1,275.85
Rate for Payer: Health Management Network Commercial	$1,141.55
Rate for Payer: Humana Medicare	$1,020.68
Rate for Payer: Kaiser Permanente Commercial	$1,208.70
Rate for Payer: Kaiser Permanente Medicaid	$684.93
Rate for Payer: Kaiser Permanente Medicare	$1,020.68
Rate for Payer: MDX Hawaii PPO	$1,302.71
Rate for Payer: Ohana Health Plan Medicaid	$1,020.68
Rate for Payer: Ohana Health Plan Medicare	$1,020.68
Rate for Payer: UnitedHealthcare Medicare	$1,020.68
Rate for Payer: University Health Alliance Commercial	$978.91

KWIRE 702459

Facility

$447.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$223.50
Max. Negotiated Rate	$433.59
Rate for Payer: AlohaCare Medicaid	$223.50
Rate for Payer: AlohaCare Medicare	$339.72
Rate for Payer: Cash Price	$268.20
Rate for Payer: Devoted Health Medicare	$375.48
Rate for Payer: Hawaii Medical Service Association Medicare	$339.72
Rate for Payer: Hawaii Western Management Group Commercial	$424.65
Rate for Payer: Health Management Network Commercial	$379.95
Rate for Payer: Humana Medicare	$339.72
Rate for Payer: Kaiser Permanente Commercial	$402.30
Rate for Payer: Kaiser Permanente Medicaid	$227.97
Rate for Payer: Kaiser Permanente Medicare	$339.72
Rate for Payer: MDX Hawaii PPO	$433.59
Rate for Payer: Ohana Health Plan Medicaid	$339.72
Rate for Payer: Ohana Health Plan Medicare	$339.72
Rate for Payer: UnitedHealthcare Medicare	$339.72
Rate for Payer: University Health Alliance Commercial	$325.82

KWIRE 702459

Facility

$447.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$379.95
Max. Negotiated Rate	$433.59
Rate for Payer: Cash Price	$268.20
Rate for Payer: Health Management Network Commercial	$379.95
Rate for Payer: Kaiser Permanente Commercial	$402.30
Rate for Payer: MDX Hawaii PPO	$433.59

K-WIRE DBL END 9" 47-186-46

Facility

$150.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$145.50
Rate for Payer: AlohaCare Medicaid	$75.00
Rate for Payer: AlohaCare Medicare	$114.00
Rate for Payer: Cash Price	$90.00
Rate for Payer: Devoted Health Medicare	$126.00
Rate for Payer: Hawaii Medical Service Association Medicare	$114.00
Rate for Payer: Hawaii Western Management Group Commercial	$142.50
Rate for Payer: Health Management Network Commercial	$127.50
Rate for Payer: Humana Medicare	$114.00
Rate for Payer: Kaiser Permanente Commercial	$135.00
Rate for Payer: Kaiser Permanente Medicaid	$76.50
Rate for Payer: Kaiser Permanente Medicare	$114.00
Rate for Payer: MDX Hawaii PPO	$145.50
Rate for Payer: Ohana Health Plan Medicaid	$114.00
Rate for Payer: Ohana Health Plan Medicare	$114.00
Rate for Payer: UnitedHealthcare Medicare	$114.00
Rate for Payer: University Health Alliance Commercial	$109.33

K-WIRE DBL END 9" 47-186-46

Facility

$150.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$145.50
Rate for Payer: Cash Price	$90.00
Rate for Payer: Health Management Network Commercial	$127.50
Rate for Payer: Kaiser Permanente Commercial	$135.00
Rate for Payer: MDX Hawaii PPO	$145.50

K-WIRE DB TR 045X6 1642-06-045

Facility

$133.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$74.48
Max. Negotiated Rate	$129.01
Rate for Payer: Cash Price	$79.80
Rate for Payer: Hawaii Western Management Group Commercial	$93.10
Rate for Payer: Health Management Network Commercial	$113.05
Rate for Payer: Kaiser Permanente Commercial	$119.70
Rate for Payer: MDX Hawaii PPO	$129.01
Rate for Payer: University Health Alliance Commercial	$74.48

K-WIRE DB TR 045X6 1642-06-045

Facility

$133.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$66.50
Max. Negotiated Rate	$129.01
Rate for Payer: AlohaCare Medicaid	$66.50
Rate for Payer: AlohaCare Medicare	$101.08
Rate for Payer: Cash Price	$79.80
Rate for Payer: Devoted Health Medicare	$111.72
Rate for Payer: Hawaii Medical Service Association Medicare	$101.08
Rate for Payer: Hawaii Western Management Group Commercial	$93.10
Rate for Payer: Health Management Network Commercial	$113.05
Rate for Payer: Humana Medicare	$101.08
Rate for Payer: Kaiser Permanente Commercial	$119.70
Rate for Payer: Kaiser Permanente Medicaid	$67.83
Rate for Payer: Kaiser Permanente Medicare	$101.08
Rate for Payer: MDX Hawaii PPO	$129.01
Rate for Payer: Ohana Health Plan Medicaid	$101.08
Rate for Payer: Ohana Health Plan Medicare	$101.08
Rate for Payer: UnitedHealthcare Medicare	$101.08
Rate for Payer: University Health Alliance Commercial	$74.48

K-WIRE DB TR 062X6 1642-06-062

Facility

$133.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$66.50
Max. Negotiated Rate	$129.01
Rate for Payer: AlohaCare Medicaid	$66.50
Rate for Payer: AlohaCare Medicare	$101.08
Rate for Payer: Cash Price	$79.80
Rate for Payer: Devoted Health Medicare	$111.72
Rate for Payer: Hawaii Medical Service Association Medicare	$101.08
Rate for Payer: Hawaii Western Management Group Commercial	$93.10
Rate for Payer: Health Management Network Commercial	$113.05
Rate for Payer: Humana Medicare	$101.08
Rate for Payer: Kaiser Permanente Commercial	$119.70
Rate for Payer: Kaiser Permanente Medicaid	$67.83
Rate for Payer: Kaiser Permanente Medicare	$101.08
Rate for Payer: MDX Hawaii PPO	$129.01
Rate for Payer: Ohana Health Plan Medicaid	$101.08
Rate for Payer: Ohana Health Plan Medicare	$101.08
Rate for Payer: UnitedHealthcare Medicare	$101.08
Rate for Payer: University Health Alliance Commercial	$74.48

K-WIRE DB TR 062X6 1642-06-062

Facility

$133.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$74.48
Max. Negotiated Rate	$129.01
Rate for Payer: Cash Price	$79.80
Rate for Payer: Hawaii Western Management Group Commercial	$93.10
Rate for Payer: Health Management Network Commercial	$113.05
Rate for Payer: Kaiser Permanente Commercial	$119.70
Rate for Payer: MDX Hawaii PPO	$129.01
Rate for Payer: University Health Alliance Commercial	$74.48

K-WIRE DOUBLE ENDED 47-186-62

Facility

$126.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$107.10
Max. Negotiated Rate	$122.22
Rate for Payer: Cash Price	$75.60
Rate for Payer: Health Management Network Commercial	$107.10
Rate for Payer: Kaiser Permanente Commercial	$113.40
Rate for Payer: MDX Hawaii PPO	$122.22

K-WIRE DOUBLE ENDED 47-186-62

Facility

$126.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$122.22
Rate for Payer: AlohaCare Medicaid	$63.00
Rate for Payer: AlohaCare Medicare	$95.76
Rate for Payer: Cash Price	$75.60
Rate for Payer: Devoted Health Medicare	$105.84
Rate for Payer: Hawaii Medical Service Association Medicare	$95.76
Rate for Payer: Hawaii Western Management Group Commercial	$119.70
Rate for Payer: Health Management Network Commercial	$107.10
Rate for Payer: Humana Medicare	$95.76
Rate for Payer: Kaiser Permanente Commercial	$113.40
Rate for Payer: Kaiser Permanente Medicaid	$64.26
Rate for Payer: Kaiser Permanente Medicare	$95.76
Rate for Payer: MDX Hawaii PPO	$122.22
Rate for Payer: Ohana Health Plan Medicaid	$95.76
Rate for Payer: Ohana Health Plan Medicare	$95.76
Rate for Payer: UnitedHealthcare Medicare	$95.76
Rate for Payer: University Health Alliance Commercial	$91.84

KWIRE DRILL TIP 2.0X315 703561

Facility

$390.00

Hospital Revenue Code	272
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$378.30
Rate for Payer: AlohaCare Medicaid	$195.00
Rate for Payer: AlohaCare Medicare	$296.40
Rate for Payer: Cash Price	$234.00
Rate for Payer: Devoted Health Medicare	$327.60
Rate for Payer: Hawaii Medical Service Association Medicare	$296.40
Rate for Payer: Hawaii Western Management Group Commercial	$370.50
Rate for Payer: Health Management Network Commercial	$331.50
Rate for Payer: Humana Medicare	$296.40
Rate for Payer: Kaiser Permanente Commercial	$351.00
Rate for Payer: Kaiser Permanente Medicaid	$198.90
Rate for Payer: Kaiser Permanente Medicare	$296.40
Rate for Payer: MDX Hawaii PPO	$378.30
Rate for Payer: Ohana Health Plan Medicaid	$296.40
Rate for Payer: Ohana Health Plan Medicare	$296.40
Rate for Payer: UnitedHealthcare Medicare	$296.40
Rate for Payer: University Health Alliance Commercial	$284.27

KWIRE DRILL TIP 2.0X315 703561

Facility

$390.00

Hospital Revenue Code	272
Min. Negotiated Rate	$331.50
Max. Negotiated Rate	$378.30
Rate for Payer: Cash Price	$234.00
Rate for Payer: Health Management Network Commercial	$331.50
Rate for Payer: Kaiser Permanente Commercial	$351.00
Rate for Payer: MDX Hawaii PPO	$378.30

K-WIRE GUIDE .101X2.5 323-1300

Facility

$260.00

Hospital Revenue Code	272
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$252.20
Rate for Payer: AlohaCare Medicaid	$130.00
Rate for Payer: AlohaCare Medicare	$197.60
Rate for Payer: Cash Price	$156.00
Rate for Payer: Devoted Health Medicare	$218.40
Rate for Payer: Hawaii Medical Service Association Medicare	$197.60
Rate for Payer: Hawaii Western Management Group Commercial	$247.00
Rate for Payer: Health Management Network Commercial	$221.00
Rate for Payer: Humana Medicare	$197.60
Rate for Payer: Kaiser Permanente Commercial	$234.00
Rate for Payer: Kaiser Permanente Medicaid	$132.60
Rate for Payer: Kaiser Permanente Medicare	$197.60
Rate for Payer: MDX Hawaii PPO	$252.20
Rate for Payer: Ohana Health Plan Medicaid	$197.60
Rate for Payer: Ohana Health Plan Medicare	$197.60
Rate for Payer: UnitedHealthcare Medicare	$197.60
Rate for Payer: University Health Alliance Commercial	$189.51

K-WIRE GUIDE .101X2.5 323-1300

Facility

$260.00

Hospital Revenue Code	272
Min. Negotiated Rate	$221.00
Max. Negotiated Rate	$252.20
Rate for Payer: Cash Price	$156.00
Rate for Payer: Health Management Network Commercial	$221.00
Rate for Payer: Kaiser Permanente Commercial	$234.00
Rate for Payer: MDX Hawaii PPO	$252.20

K-WIRE KIRSC 2.5X285MM #292.26

Facility

$93.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$52.08
Max. Negotiated Rate	$90.21
Rate for Payer: Cash Price	$55.80
Rate for Payer: Hawaii Western Management Group Commercial	$65.10
Rate for Payer: Health Management Network Commercial	$79.05
Rate for Payer: Kaiser Permanente Commercial	$83.70
Rate for Payer: MDX Hawaii PPO	$90.21
Rate for Payer: University Health Alliance Commercial	$52.08

K-WIRE KIRSC 2.5X285MM #292.26

Facility

$93.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$90.21
Rate for Payer: AlohaCare Medicaid	$46.50
Rate for Payer: AlohaCare Medicare	$70.68
Rate for Payer: Cash Price	$55.80
Rate for Payer: Devoted Health Medicare	$78.12
Rate for Payer: Hawaii Medical Service Association Medicare	$70.68
Rate for Payer: Hawaii Western Management Group Commercial	$65.10
Rate for Payer: Health Management Network Commercial	$79.05
Rate for Payer: Humana Medicare	$70.68
Rate for Payer: Kaiser Permanente Commercial	$83.70
Rate for Payer: Kaiser Permanente Medicaid	$47.43
Rate for Payer: Kaiser Permanente Medicare	$70.68
Rate for Payer: MDX Hawaii PPO	$90.21
Rate for Payer: Ohana Health Plan Medicaid	$70.68
Rate for Payer: Ohana Health Plan Medicare	$70.68
Rate for Payer: UnitedHealthcare Medicare	$70.68
Rate for Payer: University Health Alliance Commercial	$52.08

K-WIRE OLI OLIVE-1.6/100

Facility

$428.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$214.00
Max. Negotiated Rate	$415.16
Rate for Payer: AlohaCare Medicaid	$214.00
Rate for Payer: AlohaCare Medicare	$325.28
Rate for Payer: Cash Price	$256.80
Rate for Payer: Devoted Health Medicare	$359.52
Rate for Payer: Hawaii Medical Service Association Medicare	$325.28
Rate for Payer: Hawaii Western Management Group Commercial	$406.60
Rate for Payer: Health Management Network Commercial	$363.80
Rate for Payer: Humana Medicare	$325.28
Rate for Payer: Kaiser Permanente Commercial	$385.20
Rate for Payer: Kaiser Permanente Medicaid	$218.28
Rate for Payer: Kaiser Permanente Medicare	$325.28
Rate for Payer: MDX Hawaii PPO	$415.16
Rate for Payer: Ohana Health Plan Medicaid	$325.28
Rate for Payer: Ohana Health Plan Medicare	$325.28
Rate for Payer: UnitedHealthcare Medicare	$325.28
Rate for Payer: University Health Alliance Commercial	$311.97

Know your out-of-pocket cost for care.

All Charges