Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

NAIL PROXI HUME RT 1832-1045S

Facility

$5,973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,344.88
Max. Negotiated Rate	$5,793.81
Rate for Payer: Cash Price	$3,583.80
Rate for Payer: Hawaii Western Management Group Commercial	$4,181.10
Rate for Payer: Health Management Network Commercial	$5,077.05
Rate for Payer: Kaiser Permanente Commercial	$5,375.70
Rate for Payer: MDX Hawaii PPO	$5,793.81
Rate for Payer: University Health Alliance Commercial	$3,344.88

NAIL PROXI HUME RT 1832-1045S

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

NAIL RECON SYS ST 04.033.967S

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 RECON SYS ST 04.033.967S

Facility

$5,002.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,501.00
Max. Negotiated Rate	$4,851.94
Rate for Payer: AlohaCare Medicaid	$2,501.00
Rate for Payer: AlohaCare Medicare	$3,801.52
Rate for Payer: Cash Price	$3,001.20
Rate for Payer: Devoted Health Medicare	$4,201.68
Rate for Payer: Hawaii Medical Service Association Medicare	$3,801.52
Rate for Payer: Hawaii Western Management Group Commercial	$3,501.40
Rate for Payer: Health Management Network Commercial	$4,251.70
Rate for Payer: Humana Medicare	$3,801.52
Rate for Payer: Kaiser Permanente Commercial	$4,501.80
Rate for Payer: Kaiser Permanente Medicaid	$2,551.02
Rate for Payer: Kaiser Permanente Medicare	$3,801.52
Rate for Payer: MDX Hawaii PPO	$4,851.94
Rate for Payer: Ohana Health Plan Medicaid	$3,801.52
Rate for Payer: Ohana Health Plan Medicare	$3,801.52
Rate for Payer: UnitedHealthcare Medicare	$3,801.52
Rate for Payer: University Health Alliance Commercial	$2,801.12

NAIL T2 FE RETRO 2339-1020S

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,059.28
Max. Negotiated Rate	$5,299.11
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Kaiser Permanente Commercial	$4,916.70
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL T2 FE RETRO 2339-1020S

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,731.50
Max. Negotiated Rate	$5,299.11
Rate for Payer: AlohaCare Medicaid	$2,731.50
Rate for Payer: AlohaCare Medicare	$4,151.88
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Devoted Health Medicare	$4,588.92
Rate for Payer: Hawaii Medical Service Association Medicare	$4,151.88
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Humana Medicare	$4,151.88
Rate for Payer: Kaiser Permanente Commercial	$4,916.70
Rate for Payer: Kaiser Permanente Medicaid	$2,786.13
Rate for Payer: Kaiser Permanente Medicare	$4,151.88
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: Ohana Health Plan Medicaid	$4,151.88
Rate for Payer: Ohana Health Plan Medicare	$4,151.88
Rate for Payer: UnitedHealthcare Medicare	$4,151.88
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL TFNA 9X320 L 04.037.953S

Facility

$5,973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,344.88
Max. Negotiated Rate	$5,793.81
Rate for Payer: Cash Price	$3,583.80
Rate for Payer: Hawaii Western Management Group Commercial	$4,181.10
Rate for Payer: Health Management Network Commercial	$5,077.05
Rate for Payer: Kaiser Permanente Commercial	$5,375.70
Rate for Payer: MDX Hawaii PPO	$5,793.81
Rate for Payer: University Health Alliance Commercial	$3,344.88

NAIL TFNA 9X320 L 04.037.953S

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

NAIL TFNA 9X320 R 04.037.952S

Facility

$5,973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,344.88
Max. Negotiated Rate	$5,793.81
Rate for Payer: Cash Price	$3,583.80
Rate for Payer: Hawaii Western Management Group Commercial	$4,181.10
Rate for Payer: Health Management Network Commercial	$5,077.05
Rate for Payer: Kaiser Permanente Commercial	$5,375.70
Rate for Payer: MDX Hawaii PPO	$5,793.81
Rate for Payer: University Health Alliance Commercial	$3,344.88

NAIL TFNA 9X320 R 04.037.952S

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

NAIL TFNA 9X340 L 04.037.955S

Facility

$5,973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,344.88
Max. Negotiated Rate	$5,793.81
Rate for Payer: Cash Price	$3,583.80
Rate for Payer: Hawaii Western Management Group Commercial	$4,181.10
Rate for Payer: Health Management Network Commercial	$5,077.05
Rate for Payer: Kaiser Permanente Commercial	$5,375.70
Rate for Payer: MDX Hawaii PPO	$5,793.81
Rate for Payer: University Health Alliance Commercial	$3,344.88

NAIL TFNA 9X340 L 04.037.955S

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

NAIL TFNA 9X360 L 04.037.957S

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

NAIL TFNA 9X360 L 04.037.957S

Facility

$5,973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,344.88
Max. Negotiated Rate	$5,793.81
Rate for Payer: Cash Price	$3,583.80
Rate for Payer: Hawaii Western Management Group Commercial	$4,181.10
Rate for Payer: Health Management Network Commercial	$5,077.05
Rate for Payer: Kaiser Permanente Commercial	$5,375.70
Rate for Payer: MDX Hawaii PPO	$5,793.81
Rate for Payer: University Health Alliance Commercial	$3,344.88

NAIL TFNA 9X360 R 04.037.956S

Facility

$5,973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,344.88
Max. Negotiated Rate	$5,793.81
Rate for Payer: Cash Price	$3,583.80
Rate for Payer: Hawaii Western Management Group Commercial	$4,181.10
Rate for Payer: Health Management Network Commercial	$5,077.05
Rate for Payer: Kaiser Permanente Commercial	$5,375.70
Rate for Payer: MDX Hawaii PPO	$5,793.81
Rate for Payer: University Health Alliance Commercial	$3,344.88

NAIL TFNA 9X360 R 04.037.956S

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

NAIL TFNA 9X380 L 04.037.959S

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

NAIL TFNA 9X380 L 04.037.959S

Facility

$5,973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,344.88
Max. Negotiated Rate	$5,793.81
Rate for Payer: Cash Price	$3,583.80
Rate for Payer: Hawaii Western Management Group Commercial	$4,181.10
Rate for Payer: Health Management Network Commercial	$5,077.05
Rate for Payer: Kaiser Permanente Commercial	$5,375.70
Rate for Payer: MDX Hawaii PPO	$5,793.81
Rate for Payer: University Health Alliance Commercial	$3,344.88

NAIL TFNA 9X380 R 04.037.958S

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

NAIL TFNA 9X380 R 04.037.958S

Facility

$5,973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,344.88
Max. Negotiated Rate	$5,793.81
Rate for Payer: Cash Price	$3,583.80
Rate for Payer: Hawaii Western Management Group Commercial	$4,181.10
Rate for Payer: Health Management Network Commercial	$5,077.05
Rate for Payer: Kaiser Permanente Commercial	$5,375.70
Rate for Payer: MDX Hawaii PPO	$5,793.81
Rate for Payer: University Health Alliance Commercial	$3,344.88

NAIL TFNA 9X400 L 04.037.961S

Facility

$5,973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,344.88
Max. Negotiated Rate	$5,793.81
Rate for Payer: Cash Price	$3,583.80
Rate for Payer: Hawaii Western Management Group Commercial	$4,181.10
Rate for Payer: Health Management Network Commercial	$5,077.05
Rate for Payer: Kaiser Permanente Commercial	$5,375.70
Rate for Payer: MDX Hawaii PPO	$5,793.81
Rate for Payer: University Health Alliance Commercial	$3,344.88

NAIL TFNA 9X400 L 04.037.961S

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

NAIL TFNA 9X400 R 04.037.960S

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

NAIL TFNA 9X400 R 04.037.960S

Facility

$5,973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,344.88
Max. Negotiated Rate	$5,793.81
Rate for Payer: Cash Price	$3,583.80
Rate for Payer: Hawaii Western Management Group Commercial	$4,181.10
Rate for Payer: Health Management Network Commercial	$5,077.05
Rate for Payer: Kaiser Permanente Commercial	$5,375.70
Rate for Payer: MDX Hawaii PPO	$5,793.81
Rate for Payer: University Health Alliance Commercial	$3,344.88

NAIL TFNA 9X420 L 04.037.963S

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.

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