Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

NAIL 12X420MM RT 04.037.262S

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 12X420MM RT 04.037.262S

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 130D LF 11X40 8530-1400S

Facility

$7,092.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,971.52
Max. Negotiated Rate	$6,879.24
Rate for Payer: Cash Price	$4,255.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,964.40
Rate for Payer: Health Management Network Commercial	$6,028.20
Rate for Payer: Kaiser Permanente Commercial	$6,382.80
Rate for Payer: MDX Hawaii PPO	$6,879.24
Rate for Payer: University Health Alliance Commercial	$3,971.52

NAIL 130D LF 11X40 8530-1400S

Facility

$7,092.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,546.00
Max. Negotiated Rate	$6,879.24
Rate for Payer: AlohaCare Medicaid	$3,546.00
Rate for Payer: AlohaCare Medicare	$5,389.92
Rate for Payer: Cash Price	$4,255.20
Rate for Payer: Devoted Health Medicare	$5,957.28
Rate for Payer: Hawaii Medical Service Association Medicare	$5,389.92
Rate for Payer: Hawaii Western Management Group Commercial	$4,964.40
Rate for Payer: Health Management Network Commercial	$6,028.20
Rate for Payer: Humana Medicare	$5,389.92
Rate for Payer: Kaiser Permanente Commercial	$6,382.80
Rate for Payer: Kaiser Permanente Medicaid	$3,616.92
Rate for Payer: Kaiser Permanente Medicare	$5,389.92
Rate for Payer: MDX Hawaii PPO	$6,879.24
Rate for Payer: Ohana Health Plan Medicaid	$5,389.92
Rate for Payer: Ohana Health Plan Medicare	$5,389.92
Rate for Payer: UnitedHealthcare Medicare	$5,389.92
Rate for Payer: University Health Alliance Commercial	$3,971.52

NAIL 13X360MM TI 04.013.752S

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 13X360MM TI 04.013.752S

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 13X380MM TI 04.013.756S

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 13X380MM TI 04.013.756S

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 1.8MM THRD IM TI 38MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,630.00
Max. Negotiated Rate	$3,162.20
Rate for Payer: AlohaCare Medicaid	$1,630.00
Rate for Payer: AlohaCare Medicare	$2,477.60
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Devoted Health Medicare	$2,738.40
Rate for Payer: Hawaii Medical Service Association Medicare	$2,477.60
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: Humana Medicare	$2,477.60
Rate for Payer: Kaiser Permanente Commercial	$2,934.00
Rate for Payer: Kaiser Permanente Medicaid	$1,662.60
Rate for Payer: Kaiser Permanente Medicare	$2,477.60
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: Ohana Health Plan Medicaid	$2,477.60
Rate for Payer: Ohana Health Plan Medicare	$2,477.60
Rate for Payer: UnitedHealthcare Medicare	$2,477.60
Rate for Payer: University Health Alliance Commercial	$1,825.60

NAIL 1.8MM THRD IM TI 38MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,825.60
Max. Negotiated Rate	$3,162.20
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: Kaiser Permanente Commercial	$2,934.00
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: University Health Alliance Commercial	$1,825.60

NAIL 2.0X440MM ELASTC 475.920S

Facility

$1,332.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$745.92
Max. Negotiated Rate	$1,292.04
Rate for Payer: Cash Price	$799.20
Rate for Payer: Hawaii Western Management Group Commercial	$932.40
Rate for Payer: Health Management Network Commercial	$1,132.20
Rate for Payer: Kaiser Permanente Commercial	$1,198.80
Rate for Payer: MDX Hawaii PPO	$1,292.04
Rate for Payer: University Health Alliance Commercial	$745.92

NAIL 2.0X440MM ELASTC 475.920S

Facility

$1,332.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$666.00
Max. Negotiated Rate	$1,292.04
Rate for Payer: AlohaCare Medicaid	$666.00
Rate for Payer: AlohaCare Medicare	$1,012.32
Rate for Payer: Cash Price	$799.20
Rate for Payer: Devoted Health Medicare	$1,118.88
Rate for Payer: Hawaii Medical Service Association Medicare	$1,012.32
Rate for Payer: Hawaii Western Management Group Commercial	$932.40
Rate for Payer: Health Management Network Commercial	$1,132.20
Rate for Payer: Humana Medicare	$1,012.32
Rate for Payer: Kaiser Permanente Commercial	$1,198.80
Rate for Payer: Kaiser Permanente Medicaid	$679.32
Rate for Payer: Kaiser Permanente Medicare	$1,012.32
Rate for Payer: MDX Hawaii PPO	$1,292.04
Rate for Payer: Ohana Health Plan Medicaid	$1,012.32
Rate for Payer: Ohana Health Plan Medicare	$1,012.32
Rate for Payer: UnitedHealthcare Medicare	$1,012.32
Rate for Payer: University Health Alliance Commercial	$745.92

NAIL 2.1 T IM THRD GOLD 45MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,825.60
Max. Negotiated Rate	$3,162.20
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: Kaiser Permanente Commercial	$2,934.00
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: University Health Alliance Commercial	$1,825.60

NAIL 2.1 T IM THRD GOLD 45MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,630.00
Max. Negotiated Rate	$3,162.20
Rate for Payer: AlohaCare Medicaid	$1,630.00
Rate for Payer: AlohaCare Medicare	$2,477.60
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Devoted Health Medicare	$2,738.40
Rate for Payer: Hawaii Medical Service Association Medicare	$2,477.60
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: Humana Medicare	$2,477.60
Rate for Payer: Kaiser Permanente Commercial	$2,934.00
Rate for Payer: Kaiser Permanente Medicaid	$1,662.60
Rate for Payer: Kaiser Permanente Medicare	$2,477.60
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: Ohana Health Plan Medicaid	$2,477.60
Rate for Payer: Ohana Health Plan Medicare	$2,477.60
Rate for Payer: UnitedHealthcare Medicare	$2,477.60
Rate for Payer: University Health Alliance Commercial	$1,825.60

NAIL 2.5X440MM ELASTC 475.925S

Facility

$1,416.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$708.00
Max. Negotiated Rate	$1,373.52
Rate for Payer: AlohaCare Medicaid	$708.00
Rate for Payer: AlohaCare Medicare	$1,076.16
Rate for Payer: Cash Price	$849.60
Rate for Payer: Devoted Health Medicare	$1,189.44
Rate for Payer: Hawaii Medical Service Association Medicare	$1,076.16
Rate for Payer: Hawaii Western Management Group Commercial	$991.20
Rate for Payer: Health Management Network Commercial	$1,203.60
Rate for Payer: Humana Medicare	$1,076.16
Rate for Payer: Kaiser Permanente Commercial	$1,274.40
Rate for Payer: Kaiser Permanente Medicaid	$722.16
Rate for Payer: Kaiser Permanente Medicare	$1,076.16
Rate for Payer: MDX Hawaii PPO	$1,373.52
Rate for Payer: Ohana Health Plan Medicaid	$1,076.16
Rate for Payer: Ohana Health Plan Medicare	$1,076.16
Rate for Payer: UnitedHealthcare Medicare	$1,076.16
Rate for Payer: University Health Alliance Commercial	$792.96

NAIL 2.5X440MM ELASTC 475.925S

Facility

$1,416.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$792.96
Max. Negotiated Rate	$1,373.52
Rate for Payer: Cash Price	$849.60
Rate for Payer: Hawaii Western Management Group Commercial	$991.20
Rate for Payer: Health Management Network Commercial	$1,203.60
Rate for Payer: Kaiser Permanente Commercial	$1,274.40
Rate for Payer: MDX Hawaii PPO	$1,373.52
Rate for Payer: University Health Alliance Commercial	$792.96

NAIL 3.0 T IM THRD LT BLU 40MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,825.60
Max. Negotiated Rate	$3,162.20
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: Kaiser Permanente Commercial	$2,934.00
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: University Health Alliance Commercial	$1,825.60

NAIL 3.0 T IM THRD LT BLU 40MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,630.00
Max. Negotiated Rate	$3,162.20
Rate for Payer: AlohaCare Medicaid	$1,630.00
Rate for Payer: AlohaCare Medicare	$2,477.60
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Devoted Health Medicare	$2,738.40
Rate for Payer: Hawaii Medical Service Association Medicare	$2,477.60
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: Humana Medicare	$2,477.60
Rate for Payer: Kaiser Permanente Commercial	$2,934.00
Rate for Payer: Kaiser Permanente Medicaid	$1,662.60
Rate for Payer: Kaiser Permanente Medicare	$2,477.60
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: Ohana Health Plan Medicaid	$2,477.60
Rate for Payer: Ohana Health Plan Medicare	$2,477.60
Rate for Payer: UnitedHealthcare Medicare	$2,477.60
Rate for Payer: University Health Alliance Commercial	$1,825.60

NAIL 3.5X440MM ELASTC 475.935S

Facility

$1,541.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$770.50
Max. Negotiated Rate	$1,494.77
Rate for Payer: AlohaCare Medicaid	$770.50
Rate for Payer: AlohaCare Medicare	$1,171.16
Rate for Payer: Cash Price	$924.60
Rate for Payer: Devoted Health Medicare	$1,294.44
Rate for Payer: Hawaii Medical Service Association Medicare	$1,171.16
Rate for Payer: Hawaii Western Management Group Commercial	$1,078.70
Rate for Payer: Health Management Network Commercial	$1,309.85
Rate for Payer: Humana Medicare	$1,171.16
Rate for Payer: Kaiser Permanente Commercial	$1,386.90
Rate for Payer: Kaiser Permanente Medicaid	$785.91
Rate for Payer: Kaiser Permanente Medicare	$1,171.16
Rate for Payer: MDX Hawaii PPO	$1,494.77
Rate for Payer: Ohana Health Plan Medicaid	$1,171.16
Rate for Payer: Ohana Health Plan Medicare	$1,171.16
Rate for Payer: UnitedHealthcare Medicare	$1,171.16
Rate for Payer: University Health Alliance Commercial	$862.96

NAIL 3.5X440MM ELASTC 475.935S

Facility

$1,541.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$862.96
Max. Negotiated Rate	$1,494.77
Rate for Payer: Cash Price	$924.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,078.70
Rate for Payer: Health Management Network Commercial	$1,309.85
Rate for Payer: Kaiser Permanente Commercial	$1,386.90
Rate for Payer: MDX Hawaii PPO	$1,494.77
Rate for Payer: University Health Alliance Commercial	$862.96

NAIL 60MM SPIRAL 04.013.044S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,055.50
Max. Negotiated Rate	$2,047.67
Rate for Payer: AlohaCare Medicaid	$1,055.50
Rate for Payer: AlohaCare Medicare	$1,604.36
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Devoted Health Medicare	$1,773.24
Rate for Payer: Hawaii Medical Service Association Medicare	$1,604.36
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: Humana Medicare	$1,604.36
Rate for Payer: Kaiser Permanente Commercial	$1,899.90
Rate for Payer: Kaiser Permanente Medicaid	$1,076.61
Rate for Payer: Kaiser Permanente Medicare	$1,604.36
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: Ohana Health Plan Medicaid	$1,604.36
Rate for Payer: Ohana Health Plan Medicare	$1,604.36
Rate for Payer: UnitedHealthcare Medicare	$1,604.36
Rate for Payer: University Health Alliance Commercial	$1,182.16

NAIL 60MM SPIRAL 04.013.044S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,182.16
Max. Negotiated Rate	$2,047.67
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: Kaiser Permanente Commercial	$1,899.90
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: University Health Alliance Commercial	$1,182.16

NAIL 70MM SPIRAL 04.013.046S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,182.16
Max. Negotiated Rate	$2,047.67
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: Kaiser Permanente Commercial	$1,899.90
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: University Health Alliance Commercial	$1,182.16

NAIL 70MM SPIRAL 04.013.046S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,055.50
Max. Negotiated Rate	$2,047.67
Rate for Payer: AlohaCare Medicaid	$1,055.50
Rate for Payer: AlohaCare Medicare	$1,604.36
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Devoted Health Medicare	$1,773.24
Rate for Payer: Hawaii Medical Service Association Medicare	$1,604.36
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: Humana Medicare	$1,604.36
Rate for Payer: Kaiser Permanente Commercial	$1,899.90
Rate for Payer: Kaiser Permanente Medicaid	$1,076.61
Rate for Payer: Kaiser Permanente Medicare	$1,604.36
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: Ohana Health Plan Medicaid	$1,604.36
Rate for Payer: Ohana Health Plan Medicare	$1,604.36
Rate for Payer: UnitedHealthcare Medicare	$1,604.36
Rate for Payer: University Health Alliance Commercial	$1,182.16

NAIL 75MM SPIRAL 04.013.047S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,182.16
Max. Negotiated Rate	$2,047.67
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: Kaiser Permanente Commercial	$1,899.90
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: University Health Alliance Commercial	$1,182.16

Know your out-of-pocket cost for care.

All Charges