Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

NAIL TI CAN 10X375 04.004.455S

Facility

$3,635.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,817.50
Max. Negotiated Rate	$3,525.95
Rate for Payer: AlohaCare Medicaid	$1,817.50
Rate for Payer: AlohaCare Medicare	$2,762.60
Rate for Payer: Cash Price	$2,181.00
Rate for Payer: Devoted Health Medicare	$3,053.40
Rate for Payer: Hawaii Medical Service Association Medicare	$2,762.60
Rate for Payer: Hawaii Western Management Group Commercial	$2,544.50
Rate for Payer: Health Management Network Commercial	$3,089.75
Rate for Payer: Humana Medicare	$2,762.60
Rate for Payer: Kaiser Permanente Commercial	$3,271.50
Rate for Payer: Kaiser Permanente Medicaid	$1,853.85
Rate for Payer: Kaiser Permanente Medicare	$2,762.60
Rate for Payer: MDX Hawaii PPO	$3,525.95
Rate for Payer: Ohana Health Plan Medicaid	$2,762.60
Rate for Payer: Ohana Health Plan Medicare	$2,762.60
Rate for Payer: UnitedHealthcare Medicare	$2,762.60
Rate for Payer: University Health Alliance Commercial	$2,035.60

NAIL TI CAN 10X375 04.004.455S

Facility

$3,635.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,035.60
Max. Negotiated Rate	$3,525.95
Rate for Payer: Cash Price	$2,181.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,544.50
Rate for Payer: Health Management Network Commercial	$3,089.75
Rate for Payer: Kaiser Permanente Commercial	$3,271.50
Rate for Payer: MDX Hawaii PPO	$3,525.95
Rate for Payer: University Health Alliance Commercial	$2,035.60

NAIL TI CANN FIXTION 10MM

Facility

$5,208.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,604.00
Max. Negotiated Rate	$5,051.76
Rate for Payer: AlohaCare Medicaid	$2,604.00
Rate for Payer: AlohaCare Medicare	$3,958.08
Rate for Payer: Cash Price	$3,124.80
Rate for Payer: Devoted Health Medicare	$4,374.72
Rate for Payer: Hawaii Medical Service Association Medicare	$3,958.08
Rate for Payer: Hawaii Western Management Group Commercial	$3,645.60
Rate for Payer: Health Management Network Commercial	$4,426.80
Rate for Payer: Humana Medicare	$3,958.08
Rate for Payer: Kaiser Permanente Commercial	$4,687.20
Rate for Payer: Kaiser Permanente Medicaid	$2,656.08
Rate for Payer: Kaiser Permanente Medicare	$3,958.08
Rate for Payer: MDX Hawaii PPO	$5,051.76
Rate for Payer: Ohana Health Plan Medicaid	$3,958.08
Rate for Payer: Ohana Health Plan Medicare	$3,958.08
Rate for Payer: UnitedHealthcare Medicare	$3,958.08
Rate for Payer: University Health Alliance Commercial	$2,916.48

NAIL TI CANN FIXTION 10MM

Facility

$5,208.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,916.48
Max. Negotiated Rate	$5,051.76
Rate for Payer: Cash Price	$3,124.80
Rate for Payer: Hawaii Western Management Group Commercial	$3,645.60
Rate for Payer: Health Management Network Commercial	$4,426.80
Rate for Payer: Kaiser Permanente Commercial	$4,687.20
Rate for Payer: MDX Hawaii PPO	$5,051.76
Rate for Payer: University Health Alliance Commercial	$2,916.48

NAIL TI CANN HUMERAL 7X150MM

Facility

$5,806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,251.36
Max. Negotiated Rate	$5,631.82
Rate for Payer: Cash Price	$3,483.60
Rate for Payer: Hawaii Western Management Group Commercial	$4,064.20
Rate for Payer: Health Management Network Commercial	$4,935.10
Rate for Payer: Kaiser Permanente Commercial	$5,225.40
Rate for Payer: MDX Hawaii PPO	$5,631.82
Rate for Payer: University Health Alliance Commercial	$3,251.36

NAIL TI CANN HUMERAL 7X150MM

Facility

$5,806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,903.00
Max. Negotiated Rate	$5,631.82
Rate for Payer: AlohaCare Medicaid	$2,903.00
Rate for Payer: AlohaCare Medicare	$4,412.56
Rate for Payer: Cash Price	$3,483.60
Rate for Payer: Devoted Health Medicare	$4,877.04
Rate for Payer: Hawaii Medical Service Association Medicare	$4,412.56
Rate for Payer: Hawaii Western Management Group Commercial	$4,064.20
Rate for Payer: Health Management Network Commercial	$4,935.10
Rate for Payer: Humana Medicare	$4,412.56
Rate for Payer: Kaiser Permanente Commercial	$5,225.40
Rate for Payer: Kaiser Permanente Medicaid	$2,961.06
Rate for Payer: Kaiser Permanente Medicare	$4,412.56
Rate for Payer: MDX Hawaii PPO	$5,631.82
Rate for Payer: Ohana Health Plan Medicaid	$4,412.56
Rate for Payer: Ohana Health Plan Medicare	$4,412.56
Rate for Payer: UnitedHealthcare Medicare	$4,412.56
Rate for Payer: University Health Alliance Commercial	$3,251.36

NAIL TI CANN HUMERAL 7X200MM

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 TI CANN HUMERAL 7X200MM

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 TI CANN HUMERAL 7X210MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X210MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,991.00
Max. Negotiated Rate	$5,802.54
Rate for Payer: AlohaCare Medicaid	$2,991.00
Rate for Payer: AlohaCare Medicare	$4,546.32
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Devoted Health Medicare	$5,024.88
Rate for Payer: Hawaii Medical Service Association Medicare	$4,546.32
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Humana Medicare	$4,546.32
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: Kaiser Permanente Medicare	$4,546.32
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: Ohana Health Plan Medicaid	$4,546.32
Rate for Payer: Ohana Health Plan Medicare	$4,546.32
Rate for Payer: UnitedHealthcare Medicare	$4,546.32
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X220MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,991.00
Max. Negotiated Rate	$5,802.54
Rate for Payer: AlohaCare Medicaid	$2,991.00
Rate for Payer: AlohaCare Medicare	$4,546.32
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Devoted Health Medicare	$5,024.88
Rate for Payer: Hawaii Medical Service Association Medicare	$4,546.32
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Humana Medicare	$4,546.32
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: Kaiser Permanente Medicare	$4,546.32
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: Ohana Health Plan Medicaid	$4,546.32
Rate for Payer: Ohana Health Plan Medicare	$4,546.32
Rate for Payer: UnitedHealthcare Medicare	$4,546.32
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X220MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X230MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X230MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,991.00
Max. Negotiated Rate	$5,802.54
Rate for Payer: Kaiser Permanente Medicare	$4,546.32
Rate for Payer: AlohaCare Medicaid	$2,991.00
Rate for Payer: AlohaCare Medicare	$4,546.32
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Devoted Health Medicare	$5,024.88
Rate for Payer: Hawaii Medical Service Association Medicare	$4,546.32
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Humana Medicare	$4,546.32
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: Ohana Health Plan Medicaid	$4,546.32
Rate for Payer: Ohana Health Plan Medicare	$4,546.32
Rate for Payer: UnitedHealthcare Medicare	$4,546.32
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X240MM

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 TI CANN HUMERAL 7X240MM

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 TI CANN HUMERAL 7X250MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X250MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,991.00
Max. Negotiated Rate	$5,802.54
Rate for Payer: AlohaCare Medicaid	$2,991.00
Rate for Payer: AlohaCare Medicare	$4,546.32
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Devoted Health Medicare	$5,024.88
Rate for Payer: Hawaii Medical Service Association Medicare	$4,546.32
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Humana Medicare	$4,546.32
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: Kaiser Permanente Medicare	$4,546.32
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: Ohana Health Plan Medicaid	$4,546.32
Rate for Payer: Ohana Health Plan Medicare	$4,546.32
Rate for Payer: UnitedHealthcare Medicare	$4,546.32
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X260MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,991.00
Max. Negotiated Rate	$5,802.54
Rate for Payer: AlohaCare Medicaid	$2,991.00
Rate for Payer: AlohaCare Medicare	$4,546.32
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Devoted Health Medicare	$5,024.88
Rate for Payer: Hawaii Medical Service Association Medicare	$4,546.32
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Humana Medicare	$4,546.32
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: Kaiser Permanente Medicare	$4,546.32
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: Ohana Health Plan Medicaid	$4,546.32
Rate for Payer: Ohana Health Plan Medicare	$4,546.32
Rate for Payer: UnitedHealthcare Medicare	$4,546.32
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X260MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X270MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X270MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,991.00
Max. Negotiated Rate	$5,802.54
Rate for Payer: AlohaCare Medicaid	$2,991.00
Rate for Payer: AlohaCare Medicare	$4,546.32
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Devoted Health Medicare	$5,024.88
Rate for Payer: Hawaii Medical Service Association Medicare	$4,546.32
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Humana Medicare	$4,546.32
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: Kaiser Permanente Medicare	$4,546.32
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: Ohana Health Plan Medicaid	$4,546.32
Rate for Payer: Ohana Health Plan Medicare	$4,546.32
Rate for Payer: UnitedHealthcare Medicare	$4,546.32
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X280MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X280MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,991.00
Max. Negotiated Rate	$5,802.54
Rate for Payer: AlohaCare Medicaid	$2,991.00
Rate for Payer: AlohaCare Medicare	$4,546.32
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Devoted Health Medicare	$5,024.88
Rate for Payer: Hawaii Medical Service Association Medicare	$4,546.32
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Humana Medicare	$4,546.32
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: Kaiser Permanente Medicare	$4,546.32
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: Ohana Health Plan Medicaid	$4,546.32
Rate for Payer: Ohana Health Plan Medicare	$4,546.32
Rate for Payer: UnitedHealthcare Medicare	$4,546.32
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X290MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

Know your out-of-pocket cost for care.

All Charges