Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

NAIL GAMMA4 LNG RT 8425-0380S

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 GAMMA4 LNG RT 8425-0380S

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 GAMMA4 LNG RT 8425-1320S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,230.00
Max. Negotiated Rate	$6,266.20
Rate for Payer: AlohaCare Medicaid	$3,230.00
Rate for Payer: AlohaCare Medicare	$4,909.60
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Devoted Health Medicare	$5,426.40
Rate for Payer: Hawaii Medical Service Association Medicare	$4,909.60
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Humana Medicare	$4,909.60
Rate for Payer: Kaiser Permanente Commercial	$5,814.00
Rate for Payer: Kaiser Permanente Medicaid	$3,294.60
Rate for Payer: Kaiser Permanente Medicare	$4,909.60
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: Ohana Health Plan Medicaid	$4,909.60
Rate for Payer: Ohana Health Plan Medicare	$4,909.60
Rate for Payer: UnitedHealthcare Medicare	$4,909.60
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LNG RT 8425-1320S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,617.60
Max. Negotiated Rate	$6,266.20
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Kaiser Permanente Commercial	$5,814.00
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LONG LF 8525-1380S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,617.60
Max. Negotiated Rate	$6,266.20
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Kaiser Permanente Commercial	$5,814.00
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LONG LF 8525-1380S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,230.00
Max. Negotiated Rate	$6,266.20
Rate for Payer: AlohaCare Medicaid	$3,230.00
Rate for Payer: AlohaCare Medicare	$4,909.60
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Devoted Health Medicare	$5,426.40
Rate for Payer: Hawaii Medical Service Association Medicare	$4,909.60
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Humana Medicare	$4,909.60
Rate for Payer: Kaiser Permanente Commercial	$5,814.00
Rate for Payer: Kaiser Permanente Medicaid	$3,294.60
Rate for Payer: Kaiser Permanente Medicare	$4,909.60
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: Ohana Health Plan Medicaid	$4,909.60
Rate for Payer: Ohana Health Plan Medicare	$4,909.60
Rate for Payer: UnitedHealthcare Medicare	$4,909.60
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LONG LF 8525-1400S

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: Kaiser Permanente Medicare	$5,389.92
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: 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 GAMMA4 LONG LF 8525-1400S

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 GAMMA4 LONG RT 8425-1380S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,617.60
Max. Negotiated Rate	$6,266.20
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Kaiser Permanente Commercial	$5,814.00
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LONG RT 8425-1380S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,230.00
Max. Negotiated Rate	$6,266.20
Rate for Payer: AlohaCare Medicaid	$3,230.00
Rate for Payer: AlohaCare Medicare	$4,909.60
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Devoted Health Medicare	$5,426.40
Rate for Payer: Hawaii Medical Service Association Medicare	$4,909.60
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Humana Medicare	$4,909.60
Rate for Payer: Kaiser Permanente Commercial	$5,814.00
Rate for Payer: Kaiser Permanente Medicaid	$3,294.60
Rate for Payer: Kaiser Permanente Medicare	$4,909.60
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: Ohana Health Plan Medicaid	$4,909.60
Rate for Payer: Ohana Health Plan Medicare	$4,909.60
Rate for Payer: UnitedHealthcare Medicare	$4,909.60
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LONG RT 8425-2360S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,617.60
Max. Negotiated Rate	$6,266.20
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Kaiser Permanente Commercial	$5,814.00
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LONG RT 8425-2360S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,230.00
Max. Negotiated Rate	$6,266.20
Rate for Payer: AlohaCare Medicaid	$3,230.00
Rate for Payer: AlohaCare Medicare	$4,909.60
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Devoted Health Medicare	$5,426.40
Rate for Payer: Hawaii Medical Service Association Medicare	$4,909.60
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Humana Medicare	$4,909.60
Rate for Payer: Kaiser Permanente Commercial	$5,814.00
Rate for Payer: Kaiser Permanente Medicaid	$3,294.60
Rate for Payer: Kaiser Permanente Medicare	$4,909.60
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: Ohana Health Plan Medicaid	$4,909.60
Rate for Payer: Ohana Health Plan Medicare	$4,909.60
Rate for Payer: UnitedHealthcare Medicare	$4,909.60
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LONG RT 8430-0400S

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 GAMMA4 LONG RT 8430-0400S

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 GAMMA4 LONG RT 8430-1400S

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 GAMMA4 LONG RT 8430-1400S

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 GAMMA4 TROCHAN 8125-9170S

Facility

$4,781.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,390.50
Max. Negotiated Rate	$4,637.57
Rate for Payer: AlohaCare Medicaid	$2,390.50
Rate for Payer: AlohaCare Medicare	$3,633.56
Rate for Payer: Cash Price	$2,868.60
Rate for Payer: Devoted Health Medicare	$4,016.04
Rate for Payer: Hawaii Medical Service Association Medicare	$3,633.56
Rate for Payer: Hawaii Western Management Group Commercial	$3,346.70
Rate for Payer: Health Management Network Commercial	$4,063.85
Rate for Payer: Humana Medicare	$3,633.56
Rate for Payer: Kaiser Permanente Commercial	$4,302.90
Rate for Payer: Kaiser Permanente Medicaid	$2,438.31
Rate for Payer: Kaiser Permanente Medicare	$3,633.56
Rate for Payer: MDX Hawaii PPO	$4,637.57
Rate for Payer: Ohana Health Plan Medicaid	$3,633.56
Rate for Payer: Ohana Health Plan Medicare	$3,633.56
Rate for Payer: UnitedHealthcare Medicare	$3,633.56
Rate for Payer: University Health Alliance Commercial	$2,677.36

NAIL GAMMA4 TROCHAN 8125-9170S

Facility

$4,781.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,677.36
Max. Negotiated Rate	$4,637.57
Rate for Payer: Cash Price	$2,868.60
Rate for Payer: Hawaii Western Management Group Commercial	$3,346.70
Rate for Payer: Health Management Network Commercial	$4,063.85
Rate for Payer: Kaiser Permanente Commercial	$4,302.90
Rate for Payer: MDX Hawaii PPO	$4,637.57
Rate for Payer: University Health Alliance Commercial	$2,677.36

NAIL GAMMA LNG RT 8425-2280S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,617.60
Max. Negotiated Rate	$6,266.20
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Kaiser Permanente Commercial	$5,814.00
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA LNG RT 8425-2280S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,230.00
Max. Negotiated Rate	$6,266.20
Rate for Payer: AlohaCare Medicaid	$3,230.00
Rate for Payer: AlohaCare Medicare	$4,909.60
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Devoted Health Medicare	$5,426.40
Rate for Payer: Hawaii Medical Service Association Medicare	$4,909.60
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Humana Medicare	$4,909.60
Rate for Payer: Kaiser Permanente Commercial	$5,814.00
Rate for Payer: Kaiser Permanente Medicaid	$3,294.60
Rate for Payer: Kaiser Permanente Medicare	$4,909.60
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: Ohana Health Plan Medicaid	$4,909.60
Rate for Payer: Ohana Health Plan Medicare	$4,909.60
Rate for Payer: UnitedHealthcare Medicare	$4,909.60
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL HUMERAL 9X270 1830-0927S

Facility

$3,284.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,839.04
Max. Negotiated Rate	$3,185.48
Rate for Payer: Cash Price	$1,970.40
Rate for Payer: Hawaii Western Management Group Commercial	$2,298.80
Rate for Payer: Health Management Network Commercial	$2,791.40
Rate for Payer: Kaiser Permanente Commercial	$2,955.60
Rate for Payer: MDX Hawaii PPO	$3,185.48
Rate for Payer: University Health Alliance Commercial	$1,839.04

NAIL HUMERAL 9X270 1830-0927S

Facility

$3,284.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,642.00
Max. Negotiated Rate	$3,185.48
Rate for Payer: AlohaCare Medicaid	$1,642.00
Rate for Payer: AlohaCare Medicare	$2,495.84
Rate for Payer: Cash Price	$1,970.40
Rate for Payer: Devoted Health Medicare	$2,758.56
Rate for Payer: Hawaii Medical Service Association Medicare	$2,495.84
Rate for Payer: Hawaii Western Management Group Commercial	$2,298.80
Rate for Payer: Health Management Network Commercial	$2,791.40
Rate for Payer: Humana Medicare	$2,495.84
Rate for Payer: Kaiser Permanente Commercial	$2,955.60
Rate for Payer: Kaiser Permanente Medicaid	$1,674.84
Rate for Payer: Kaiser Permanente Medicare	$2,495.84
Rate for Payer: MDX Hawaii PPO	$3,185.48
Rate for Payer: Ohana Health Plan Medicaid	$2,495.84
Rate for Payer: Ohana Health Plan Medicare	$2,495.84
Rate for Payer: UnitedHealthcare Medicare	$2,495.84
Rate for Payer: University Health Alliance Commercial	$1,839.04

NAIL HUMERAL CANN TI 9X250MM

Facility

$4,128.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,064.00
Max. Negotiated Rate	$4,004.16
Rate for Payer: AlohaCare Medicaid	$2,064.00
Rate for Payer: AlohaCare Medicare	$3,137.28
Rate for Payer: Cash Price	$2,476.80
Rate for Payer: Devoted Health Medicare	$3,467.52
Rate for Payer: Hawaii Medical Service Association Medicare	$3,137.28
Rate for Payer: Hawaii Western Management Group Commercial	$2,889.60
Rate for Payer: Health Management Network Commercial	$3,508.80
Rate for Payer: Humana Medicare	$3,137.28
Rate for Payer: Kaiser Permanente Commercial	$3,715.20
Rate for Payer: Kaiser Permanente Medicaid	$2,105.28
Rate for Payer: Kaiser Permanente Medicare	$3,137.28
Rate for Payer: MDX Hawaii PPO	$4,004.16
Rate for Payer: Ohana Health Plan Medicaid	$3,137.28
Rate for Payer: Ohana Health Plan Medicare	$3,137.28
Rate for Payer: UnitedHealthcare Medicare	$3,137.28
Rate for Payer: University Health Alliance Commercial	$2,311.68

NAIL HUMERAL CANN TI 9X250MM

Facility

$4,128.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,311.68
Max. Negotiated Rate	$4,004.16
Rate for Payer: Cash Price	$2,476.80
Rate for Payer: Hawaii Western Management Group Commercial	$2,889.60
Rate for Payer: Health Management Network Commercial	$3,508.80
Rate for Payer: Kaiser Permanente Commercial	$3,715.20
Rate for Payer: MDX Hawaii PPO	$4,004.16
Rate for Payer: University Health Alliance Commercial	$2,311.68

NAIL HUMERAL LF 1832-1035S

Facility

$5,973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,986.50
Max. Negotiated Rate	$5,793.81
Rate for Payer: AlohaCare Medicaid	$2,986.50
Rate for Payer: AlohaCare Medicare	$4,539.48
Rate for Payer: Cash Price	$3,583.80
Rate for Payer: Devoted Health Medicare	$5,017.32
Rate for Payer: Hawaii Medical Service Association Medicare	$4,539.48
Rate for Payer: Hawaii Western Management Group Commercial	$4,181.10
Rate for Payer: Health Management Network Commercial	$5,077.05
Rate for Payer: Humana Medicare	$4,539.48
Rate for Payer: Kaiser Permanente Commercial	$5,375.70
Rate for Payer: Kaiser Permanente Medicaid	$3,046.23
Rate for Payer: Kaiser Permanente Medicare	$4,539.48
Rate for Payer: MDX Hawaii PPO	$5,793.81
Rate for Payer: Ohana Health Plan Medicaid	$4,539.48
Rate for Payer: Ohana Health Plan Medicare	$4,539.48
Rate for Payer: UnitedHealthcare Medicare	$4,539.48
Rate for Payer: University Health Alliance Commercial	$3,344.88

Know your out-of-pocket cost for care.

All Charges