Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

NAIL LONG GAMMA4 RT 8425-1340S

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 LONG LEFT 8525-2360S

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 LONG LEFT 8525-2360S

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 LONG LF

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 LONG LF

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 LONG LF 12X400 8525-2400S

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 LONG LF 12X400 8525-2400S

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 LONG LF GAMMA4 8525-1360S

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 LONG LF GAMMA4 8525-1360S

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 LONG RIGHT 8425-2320S

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 LONG RIGHT 8425-2320S

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 LONG RT 10X 60MMX12

Facility

$6,160.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,080.00
Max. Negotiated Rate	$5,975.20
Rate for Payer: AlohaCare Medicaid	$3,080.00
Rate for Payer: AlohaCare Medicare	$4,681.60
Rate for Payer: Cash Price	$3,696.00
Rate for Payer: Devoted Health Medicare	$5,174.40
Rate for Payer: Hawaii Medical Service Association Medicare	$4,681.60
Rate for Payer: Hawaii Western Management Group Commercial	$4,312.00
Rate for Payer: Health Management Network Commercial	$5,236.00
Rate for Payer: Humana Medicare	$4,681.60
Rate for Payer: Kaiser Permanente Commercial	$5,544.00
Rate for Payer: Kaiser Permanente Medicaid	$3,141.60
Rate for Payer: Kaiser Permanente Medicare	$4,681.60
Rate for Payer: MDX Hawaii PPO	$5,975.20
Rate for Payer: Ohana Health Plan Medicaid	$4,681.60
Rate for Payer: Ohana Health Plan Medicare	$4,681.60
Rate for Payer: UnitedHealthcare Medicare	$4,681.60
Rate for Payer: University Health Alliance Commercial	$3,449.60

NAIL LONG RT 10X 60MMX12

Facility

$6,160.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,449.60
Max. Negotiated Rate	$5,975.20
Rate for Payer: Cash Price	$3,696.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,312.00
Rate for Payer: Health Management Network Commercial	$5,236.00
Rate for Payer: Kaiser Permanente Commercial	$5,544.00
Rate for Payer: MDX Hawaii PPO	$5,975.20
Rate for Payer: University Health Alliance Commercial	$3,449.60

NAIL LONG RT 12X340 8425-2340S

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 LONG RT 12X340 8425-2340S

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 LONG RT 12X420 8425-2420S

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 LONG RT 12X420 8425-2420S

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 LONG RT 9X34MM 8430-9340S

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 LONG RT 9X34MM 8430-9340S

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 LONG RT 9X360 130 DEGREE

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 LONG RT 9X360 130 DEGREE

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 L R 11X360X125 8425-1360S

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 L R 11X360X125 8425-1360S

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 PROX HEM 8X240 1832-2824S

Facility

$4,070.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,035.00
Max. Negotiated Rate	$3,947.90
Rate for Payer: AlohaCare Medicaid	$2,035.00
Rate for Payer: AlohaCare Medicare	$3,093.20
Rate for Payer: Cash Price	$2,442.00
Rate for Payer: Devoted Health Medicare	$3,418.80
Rate for Payer: Hawaii Medical Service Association Medicare	$3,093.20
Rate for Payer: Hawaii Western Management Group Commercial	$2,849.00
Rate for Payer: Health Management Network Commercial	$3,459.50
Rate for Payer: Humana Medicare	$3,093.20
Rate for Payer: Kaiser Permanente Commercial	$3,663.00
Rate for Payer: Kaiser Permanente Medicaid	$2,075.70
Rate for Payer: Kaiser Permanente Medicare	$3,093.20
Rate for Payer: MDX Hawaii PPO	$3,947.90
Rate for Payer: Ohana Health Plan Medicaid	$3,093.20
Rate for Payer: Ohana Health Plan Medicare	$3,093.20
Rate for Payer: UnitedHealthcare Medicare	$3,093.20
Rate for Payer: University Health Alliance Commercial	$2,279.20

NAIL PROX HEM 8X240 1832-2824S

Facility

$4,070.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,279.20
Max. Negotiated Rate	$3,947.90
Rate for Payer: Cash Price	$2,442.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,849.00
Rate for Payer: Health Management Network Commercial	$3,459.50
Rate for Payer: Kaiser Permanente Commercial	$3,663.00
Rate for Payer: MDX Hawaii PPO	$3,947.90
Rate for Payer: University Health Alliance Commercial	$2,279.20

Know your out-of-pocket cost for care.

All Charges