Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

NAIL 12MM/340MM LF 04.033.265S

Facility

$5,002.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,801.12
Max. Negotiated Rate	$4,851.94
Rate for Payer: Cash Price	$3,001.20
Rate for Payer: Hawaii Western Management Group Commercial	$3,501.40
Rate for Payer: Health Management Network Commercial	$4,251.70
Rate for Payer: Kaiser Permanente Commercial	$4,501.80
Rate for Payer: MDX Hawaii PPO	$4,851.94
Rate for Payer: University Health Alliance Commercial	$2,801.12

NAIL 12X170MM/130° 04.037.242S

Facility

$4,045.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,265.20
Max. Negotiated Rate	$3,923.65
Rate for Payer: Cash Price	$2,427.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,831.50
Rate for Payer: Health Management Network Commercial	$3,438.25
Rate for Payer: Kaiser Permanente Commercial	$3,640.50
Rate for Payer: MDX Hawaii PPO	$3,923.65
Rate for Payer: University Health Alliance Commercial	$2,265.20

NAIL 12X170MM/130° 04.037.242S

Facility

$4,045.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,022.50
Max. Negotiated Rate	$3,923.65
Rate for Payer: AlohaCare Medicaid	$2,022.50
Rate for Payer: AlohaCare Medicare	$3,074.20
Rate for Payer: Cash Price	$2,427.00
Rate for Payer: Devoted Health Medicare	$3,397.80
Rate for Payer: Hawaii Medical Service Association Medicare	$3,074.20
Rate for Payer: Hawaii Western Management Group Commercial	$2,831.50
Rate for Payer: Health Management Network Commercial	$3,438.25
Rate for Payer: Humana Medicare	$3,074.20
Rate for Payer: Kaiser Permanente Commercial	$3,640.50
Rate for Payer: Kaiser Permanente Medicaid	$2,062.95
Rate for Payer: Kaiser Permanente Medicare	$3,074.20
Rate for Payer: MDX Hawaii PPO	$3,923.65
Rate for Payer: Ohana Health Plan Medicaid	$3,074.20
Rate for Payer: Ohana Health Plan Medicare	$3,074.20
Rate for Payer: UnitedHealthcare Medicare	$3,074.20
Rate for Payer: University Health Alliance Commercial	$2,265.20

NAIL 12X320MM RT 04.037.252S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,832.50
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$4,305.40
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$4,758.60
Rate for Payer: Hawaii Medical Service Association Medicare	$4,305.40
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$4,305.40
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$4,305.40
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$4,305.40
Rate for Payer: Ohana Health Plan Medicare	$4,305.40
Rate for Payer: UnitedHealthcare Medicare	$4,305.40
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X320MM RT 04.037.252S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X340MM LEFT 04.037.255S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X340MM LEFT 04.037.255S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,832.50
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$4,305.40
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$4,758.60
Rate for Payer: Hawaii Medical Service Association Medicare	$4,305.40
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$4,305.40
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$4,305.40
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$4,305.40
Rate for Payer: Ohana Health Plan Medicare	$4,305.40
Rate for Payer: UnitedHealthcare Medicare	$4,305.40
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X360MM LEFT 04.037.257S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X360MM LEFT 04.037.257S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,832.50
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$4,305.40
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$4,758.60
Rate for Payer: Hawaii Medical Service Association Medicare	$4,305.40
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$4,305.40
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$4,305.40
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$4,305.40
Rate for Payer: Ohana Health Plan Medicare	$4,305.40
Rate for Payer: UnitedHealthcare Medicare	$4,305.40
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X360MM RT 04.037.256S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,832.50
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$4,305.40
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$4,758.60
Rate for Payer: Hawaii Medical Service Association Medicare	$4,305.40
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$4,305.40
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$4,305.40
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$4,305.40
Rate for Payer: Ohana Health Plan Medicare	$4,305.40
Rate for Payer: UnitedHealthcare Medicare	$4,305.40
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X360MM RT 04.037.256S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X360MM TI 04.013.652S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,223.20
Max. Negotiated Rate	$3,850.90
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Kaiser Permanente Commercial	$3,573.00
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 12X360MM TI 04.013.652S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,985.00
Max. Negotiated Rate	$3,850.90
Rate for Payer: AlohaCare Medicaid	$1,985.00
Rate for Payer: AlohaCare Medicare	$3,017.20
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Devoted Health Medicare	$3,334.80
Rate for Payer: Hawaii Medical Service Association Medicare	$3,017.20
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Humana Medicare	$3,017.20
Rate for Payer: Kaiser Permanente Commercial	$3,573.00
Rate for Payer: Kaiser Permanente Medicaid	$2,024.70
Rate for Payer: Kaiser Permanente Medicare	$3,017.20
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: Ohana Health Plan Medicaid	$3,017.20
Rate for Payer: Ohana Health Plan Medicare	$3,017.20
Rate for Payer: UnitedHealthcare Medicare	$3,017.20
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 12X380MM LEFT 04.037.259S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,832.50
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$4,305.40
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$4,758.60
Rate for Payer: Hawaii Medical Service Association Medicare	$4,305.40
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$4,305.40
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$4,305.40
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$4,305.40
Rate for Payer: Ohana Health Plan Medicare	$4,305.40
Rate for Payer: UnitedHealthcare Medicare	$4,305.40
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X380MM LEFT 04.037.259S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X380MM RT 04.037.258S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,832.50
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$4,305.40
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$4,758.60
Rate for Payer: Hawaii Medical Service Association Medicare	$4,305.40
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$4,305.40
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$4,305.40
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$4,305.40
Rate for Payer: Ohana Health Plan Medicare	$4,305.40
Rate for Payer: UnitedHealthcare Medicare	$4,305.40
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X380MM RT 04.037.258S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X380MM TI 04.013.656S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,223.20
Max. Negotiated Rate	$3,850.90
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Kaiser Permanente Commercial	$3,573.00
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 12X380MM TI 04.013.656S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,985.00
Max. Negotiated Rate	$3,850.90
Rate for Payer: AlohaCare Medicaid	$1,985.00
Rate for Payer: AlohaCare Medicare	$3,017.20
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Devoted Health Medicare	$3,334.80
Rate for Payer: Hawaii Medical Service Association Medicare	$3,017.20
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Humana Medicare	$3,017.20
Rate for Payer: Kaiser Permanente Commercial	$3,573.00
Rate for Payer: Kaiser Permanente Medicaid	$2,024.70
Rate for Payer: Kaiser Permanente Medicare	$3,017.20
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: Ohana Health Plan Medicaid	$3,017.20
Rate for Payer: Ohana Health Plan Medicare	$3,017.20
Rate for Payer: UnitedHealthcare Medicare	$3,017.20
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 12X400MM LEFT 04.037.261S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,832.50
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$4,305.40
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$4,758.60
Rate for Payer: Hawaii Medical Service Association Medicare	$4,305.40
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$4,305.40
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$4,305.40
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$4,305.40
Rate for Payer: Ohana Health Plan Medicare	$4,305.40
Rate for Payer: UnitedHealthcare Medicare	$4,305.40
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X400MM LEFT 04.037.261S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X400MM RT 04.037.260S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,832.50
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$4,305.40
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$4,758.60
Rate for Payer: Hawaii Medical Service Association Medicare	$4,305.40
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$4,305.40
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$4,305.40
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$4,305.40
Rate for Payer: Ohana Health Plan Medicare	$4,305.40
Rate for Payer: UnitedHealthcare Medicare	$4,305.40
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X400MM RT 04.037.260S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X420MM LEFT 04.037.263S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X420MM LEFT 04.037.263S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,832.50
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$4,305.40
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$4,758.60
Rate for Payer: Hawaii Medical Service Association Medicare	$4,305.40
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$4,305.40
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$4,305.40
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$4,305.40
Rate for Payer: Ohana Health Plan Medicare	$4,305.40
Rate for Payer: UnitedHealthcare Medicare	$4,305.40
Rate for Payer: University Health Alliance Commercial	$3,172.40

Know your out-of-pocket cost for care.

All Charges