Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

NEEDLE 150MM INSUFFLATION

Facility

$89.00

Hospital Revenue Code	272
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$86.33
Rate for Payer: AlohaCare Medicaid	$44.50
Rate for Payer: AlohaCare Medicare	$67.64
Rate for Payer: Cash Price	$53.40
Rate for Payer: Devoted Health Medicare	$74.76
Rate for Payer: Hawaii Medical Service Association Medicare	$67.64
Rate for Payer: Hawaii Western Management Group Commercial	$84.55
Rate for Payer: Health Management Network Commercial	$75.65
Rate for Payer: Humana Medicare	$67.64
Rate for Payer: Kaiser Permanente Commercial	$80.10
Rate for Payer: Kaiser Permanente Medicaid	$45.39
Rate for Payer: Kaiser Permanente Medicare	$67.64
Rate for Payer: MDX Hawaii PPO	$86.33
Rate for Payer: Ohana Health Plan Medicaid	$67.64
Rate for Payer: Ohana Health Plan Medicare	$67.64
Rate for Payer: UnitedHealthcare Medicare	$67.64
Rate for Payer: University Health Alliance Commercial	$64.87

NEEDLE 15GX70MM BONE MARROW

Facility

$90.00

Hospital Revenue Code	272
Min. Negotiated Rate	$76.50
Max. Negotiated Rate	$87.30
Rate for Payer: Cash Price	$54.00
Rate for Payer: Health Management Network Commercial	$76.50
Rate for Payer: Kaiser Permanente Commercial	$81.00
Rate for Payer: MDX Hawaii PPO	$87.30

NEEDLE 15GX70MM BONE MARROW

Facility

$90.00

Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$87.30
Rate for Payer: AlohaCare Medicaid	$45.00
Rate for Payer: AlohaCare Medicare	$68.40
Rate for Payer: Cash Price	$54.00
Rate for Payer: Devoted Health Medicare	$75.60
Rate for Payer: Hawaii Medical Service Association Medicare	$68.40
Rate for Payer: Hawaii Western Management Group Commercial	$85.50
Rate for Payer: Health Management Network Commercial	$76.50
Rate for Payer: Humana Medicare	$68.40
Rate for Payer: Kaiser Permanente Commercial	$81.00
Rate for Payer: Kaiser Permanente Medicaid	$45.90
Rate for Payer: Kaiser Permanente Medicare	$68.40
Rate for Payer: MDX Hawaii PPO	$87.30
Rate for Payer: Ohana Health Plan Medicaid	$68.40
Rate for Payer: Ohana Health Plan Medicare	$68.40
Rate for Payer: UnitedHealthcare Medicare	$68.40
Rate for Payer: University Health Alliance Commercial	$65.60

NEEDLE 15X13 8CM TRUGUIDE

Facility

$94.00

Hospital Revenue Code	272
Min. Negotiated Rate	$47.00
Max. Negotiated Rate	$91.18
Rate for Payer: AlohaCare Medicaid	$47.00
Rate for Payer: AlohaCare Medicare	$71.44
Rate for Payer: Cash Price	$56.40
Rate for Payer: Devoted Health Medicare	$78.96
Rate for Payer: Hawaii Medical Service Association Medicare	$71.44
Rate for Payer: Hawaii Western Management Group Commercial	$89.30
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: Humana Medicare	$71.44
Rate for Payer: Kaiser Permanente Commercial	$84.60
Rate for Payer: Kaiser Permanente Medicaid	$47.94
Rate for Payer: Kaiser Permanente Medicare	$71.44
Rate for Payer: MDX Hawaii PPO	$91.18
Rate for Payer: Ohana Health Plan Medicaid	$71.44
Rate for Payer: Ohana Health Plan Medicare	$71.44
Rate for Payer: UnitedHealthcare Medicare	$71.44
Rate for Payer: University Health Alliance Commercial	$68.52

NEEDLE 15X13 8CM TRUGUIDE

Facility

$94.00

Hospital Revenue Code	272
Min. Negotiated Rate	$79.90
Max. Negotiated Rate	$91.18
Rate for Payer: Cash Price	$56.40
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: Kaiser Permanente Commercial	$84.60
Rate for Payer: MDX Hawaii PPO	$91.18

NEEDLE 18X16 MONOPTY CORE

Facility

$141.00

Hospital Revenue Code	272
Min. Negotiated Rate	$119.85
Max. Negotiated Rate	$136.77
Rate for Payer: Cash Price	$84.60
Rate for Payer: Health Management Network Commercial	$119.85
Rate for Payer: Kaiser Permanente Commercial	$126.90
Rate for Payer: MDX Hawaii PPO	$136.77

NEEDLE 18X16 MONOPTY CORE

Facility

$141.00

Hospital Revenue Code	272
Min. Negotiated Rate	$70.50
Max. Negotiated Rate	$136.77
Rate for Payer: AlohaCare Medicaid	$70.50
Rate for Payer: AlohaCare Medicare	$107.16
Rate for Payer: Cash Price	$84.60
Rate for Payer: Devoted Health Medicare	$118.44
Rate for Payer: Hawaii Medical Service Association Medicare	$107.16
Rate for Payer: Hawaii Western Management Group Commercial	$133.95
Rate for Payer: Health Management Network Commercial	$119.85
Rate for Payer: Humana Medicare	$107.16
Rate for Payer: Kaiser Permanente Commercial	$126.90
Rate for Payer: Kaiser Permanente Medicaid	$71.91
Rate for Payer: Kaiser Permanente Medicare	$107.16
Rate for Payer: MDX Hawaii PPO	$136.77
Rate for Payer: Ohana Health Plan Medicaid	$107.16
Rate for Payer: Ohana Health Plan Medicare	$107.16
Rate for Payer: UnitedHealthcare Medicare	$107.16
Rate for Payer: University Health Alliance Commercial	$102.77

NEEDLE 20G TRANSBRONCH ASP

Facility

$328.00

Service Code	HCPCS C1889
Hospital Revenue Code	272
Min. Negotiated Rate	$278.80
Max. Negotiated Rate	$318.16
Rate for Payer: Cash Price	$196.80
Rate for Payer: Health Management Network Commercial	$278.80
Rate for Payer: Kaiser Permanente Commercial	$295.20
Rate for Payer: MDX Hawaii PPO	$318.16

NEEDLE 20G TRANSBRONCH ASP

Facility

$328.00

Service Code	HCPCS C1889
Hospital Revenue Code	272
Min. Negotiated Rate	$164.00
Max. Negotiated Rate	$318.16
Rate for Payer: AlohaCare Medicaid	$164.00
Rate for Payer: AlohaCare Medicare	$249.28
Rate for Payer: Cash Price	$196.80
Rate for Payer: Devoted Health Medicare	$275.52
Rate for Payer: Hawaii Medical Service Association Medicare	$249.28
Rate for Payer: Hawaii Western Management Group Commercial	$311.60
Rate for Payer: Health Management Network Commercial	$278.80
Rate for Payer: Humana Medicare	$249.28
Rate for Payer: Kaiser Permanente Commercial	$295.20
Rate for Payer: Kaiser Permanente Medicaid	$167.28
Rate for Payer: Kaiser Permanente Medicare	$249.28
Rate for Payer: MDX Hawaii PPO	$318.16
Rate for Payer: Ohana Health Plan Medicaid	$249.28
Rate for Payer: Ohana Health Plan Medicare	$249.28
Rate for Payer: UnitedHealthcare Medicare	$249.28
Rate for Payer: University Health Alliance Commercial	$239.08

NEEDLE ACCESS PERC 18X12

Facility

$379.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$322.15
Max. Negotiated Rate	$367.63
Rate for Payer: Cash Price	$227.40
Rate for Payer: Health Management Network Commercial	$322.15
Rate for Payer: Kaiser Permanente Commercial	$341.10
Rate for Payer: MDX Hawaii PPO	$367.63

NEEDLE ACCESS PERC 18X12

Facility

$379.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$189.50
Max. Negotiated Rate	$367.63
Rate for Payer: AlohaCare Medicaid	$189.50
Rate for Payer: AlohaCare Medicare	$288.04
Rate for Payer: Cash Price	$227.40
Rate for Payer: Devoted Health Medicare	$318.36
Rate for Payer: Hawaii Medical Service Association Medicare	$288.04
Rate for Payer: Hawaii Western Management Group Commercial	$360.05
Rate for Payer: Health Management Network Commercial	$322.15
Rate for Payer: Humana Medicare	$288.04
Rate for Payer: Kaiser Permanente Commercial	$341.10
Rate for Payer: Kaiser Permanente Medicaid	$193.29
Rate for Payer: Kaiser Permanente Medicare	$288.04
Rate for Payer: MDX Hawaii PPO	$367.63
Rate for Payer: Ohana Health Plan Medicaid	$288.04
Rate for Payer: Ohana Health Plan Medicare	$288.04
Rate for Payer: UnitedHealthcare Medicare	$288.04
Rate for Payer: University Health Alliance Commercial	$276.25

NEEDLE ACCESS PERC 18X20

Facility

$155.00

Service Code	HCPCS C1889
Hospital Revenue Code	272
Min. Negotiated Rate	$131.75
Max. Negotiated Rate	$150.35
Rate for Payer: Cash Price	$93.00
Rate for Payer: Health Management Network Commercial	$131.75
Rate for Payer: Kaiser Permanente Commercial	$139.50
Rate for Payer: MDX Hawaii PPO	$150.35

NEEDLE ACCESS PERC 18X20

Facility

$155.00

Service Code	HCPCS C1889
Hospital Revenue Code	272
Min. Negotiated Rate	$77.50
Max. Negotiated Rate	$150.35
Rate for Payer: AlohaCare Medicaid	$77.50
Rate for Payer: AlohaCare Medicare	$117.80
Rate for Payer: Cash Price	$93.00
Rate for Payer: Devoted Health Medicare	$130.20
Rate for Payer: Hawaii Medical Service Association Medicare	$117.80
Rate for Payer: Hawaii Western Management Group Commercial	$147.25
Rate for Payer: Health Management Network Commercial	$131.75
Rate for Payer: Humana Medicare	$117.80
Rate for Payer: Kaiser Permanente Commercial	$139.50
Rate for Payer: Kaiser Permanente Medicaid	$79.05
Rate for Payer: Kaiser Permanente Medicare	$117.80
Rate for Payer: MDX Hawaii PPO	$150.35
Rate for Payer: Ohana Health Plan Medicaid	$117.80
Rate for Payer: Ohana Health Plan Medicare	$117.80
Rate for Payer: UnitedHealthcare Medicare	$117.80
Rate for Payer: University Health Alliance Commercial	$112.98

NEEDLE BIOPSY 18GX11

Facility

$214.00

Hospital Revenue Code	270
Min. Negotiated Rate	$107.00
Max. Negotiated Rate	$207.58
Rate for Payer: AlohaCare Medicaid	$107.00
Rate for Payer: AlohaCare Medicare	$162.64
Rate for Payer: Cash Price	$128.40
Rate for Payer: Devoted Health Medicare	$179.76
Rate for Payer: Hawaii Medical Service Association Medicare	$162.64
Rate for Payer: Hawaii Western Management Group Commercial	$203.30
Rate for Payer: Health Management Network Commercial	$181.90
Rate for Payer: Humana Medicare	$162.64
Rate for Payer: Kaiser Permanente Commercial	$192.60
Rate for Payer: Kaiser Permanente Medicaid	$109.14
Rate for Payer: Kaiser Permanente Medicare	$162.64
Rate for Payer: MDX Hawaii PPO	$207.58
Rate for Payer: Ohana Health Plan Medicaid	$162.64
Rate for Payer: Ohana Health Plan Medicare	$162.64
Rate for Payer: UnitedHealthcare Medicare	$162.64
Rate for Payer: University Health Alliance Commercial	$155.98

NEEDLE BIOPSY 18GX11

Facility

$214.00

Hospital Revenue Code	270
Min. Negotiated Rate	$181.90
Max. Negotiated Rate	$207.58
Rate for Payer: Cash Price	$128.40
Rate for Payer: Health Management Network Commercial	$181.90
Rate for Payer: Kaiser Permanente Commercial	$192.60
Rate for Payer: MDX Hawaii PPO	$207.58

NEEDLE BIOPSY 18GX15

Facility

$243.00

Hospital Revenue Code	270
Min. Negotiated Rate	$121.50
Max. Negotiated Rate	$235.71
Rate for Payer: AlohaCare Medicaid	$121.50
Rate for Payer: AlohaCare Medicare	$184.68
Rate for Payer: Cash Price	$145.80
Rate for Payer: Devoted Health Medicare	$204.12
Rate for Payer: Hawaii Medical Service Association Medicare	$184.68
Rate for Payer: Hawaii Western Management Group Commercial	$230.85
Rate for Payer: Health Management Network Commercial	$206.55
Rate for Payer: Humana Medicare	$184.68
Rate for Payer: Kaiser Permanente Commercial	$218.70
Rate for Payer: Kaiser Permanente Medicaid	$123.93
Rate for Payer: Kaiser Permanente Medicare	$184.68
Rate for Payer: MDX Hawaii PPO	$235.71
Rate for Payer: Ohana Health Plan Medicaid	$184.68
Rate for Payer: Ohana Health Plan Medicare	$184.68
Rate for Payer: UnitedHealthcare Medicare	$184.68
Rate for Payer: University Health Alliance Commercial	$177.12

NEEDLE BIOPSY 18GX15

Facility

$243.00

Hospital Revenue Code	270
Min. Negotiated Rate	$206.55
Max. Negotiated Rate	$235.71
Rate for Payer: Cash Price	$145.80
Rate for Payer: Health Management Network Commercial	$206.55
Rate for Payer: Kaiser Permanente Commercial	$218.70
Rate for Payer: MDX Hawaii PPO	$235.71

NEEDLE BIOPSY 18GX20

Facility

$209.00

Hospital Revenue Code	272
Min. Negotiated Rate	$177.65
Max. Negotiated Rate	$202.73
Rate for Payer: Cash Price	$125.40
Rate for Payer: Health Management Network Commercial	$177.65
Rate for Payer: Kaiser Permanente Commercial	$188.10
Rate for Payer: MDX Hawaii PPO	$202.73

NEEDLE BIOPSY 18GX20

Facility

$209.00

Hospital Revenue Code	272
Min. Negotiated Rate	$104.50
Max. Negotiated Rate	$202.73
Rate for Payer: AlohaCare Medicaid	$104.50
Rate for Payer: AlohaCare Medicare	$158.84
Rate for Payer: Cash Price	$125.40
Rate for Payer: Devoted Health Medicare	$175.56
Rate for Payer: Hawaii Medical Service Association Medicare	$158.84
Rate for Payer: Hawaii Western Management Group Commercial	$198.55
Rate for Payer: Health Management Network Commercial	$177.65
Rate for Payer: Humana Medicare	$158.84
Rate for Payer: Kaiser Permanente Commercial	$188.10
Rate for Payer: Kaiser Permanente Medicaid	$106.59
Rate for Payer: Kaiser Permanente Medicare	$158.84
Rate for Payer: MDX Hawaii PPO	$202.73
Rate for Payer: Ohana Health Plan Medicaid	$158.84
Rate for Payer: Ohana Health Plan Medicare	$158.84
Rate for Payer: UnitedHealthcare Medicare	$158.84
Rate for Payer: University Health Alliance Commercial	$152.34

NEEDLE BONE MARROW 15G

Facility

$78.00

Hospital Revenue Code	272
Min. Negotiated Rate	$66.30
Max. Negotiated Rate	$75.66
Rate for Payer: Cash Price	$46.80
Rate for Payer: Health Management Network Commercial	$66.30
Rate for Payer: Kaiser Permanente Commercial	$70.20
Rate for Payer: MDX Hawaii PPO	$75.66

NEEDLE BONE MARROW 15G

Facility

$78.00

Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$75.66
Rate for Payer: AlohaCare Medicaid	$39.00
Rate for Payer: AlohaCare Medicare	$59.28
Rate for Payer: Cash Price	$46.80
Rate for Payer: Devoted Health Medicare	$65.52
Rate for Payer: Hawaii Medical Service Association Medicare	$59.28
Rate for Payer: Hawaii Western Management Group Commercial	$74.10
Rate for Payer: Health Management Network Commercial	$66.30
Rate for Payer: Humana Medicare	$59.28
Rate for Payer: Kaiser Permanente Commercial	$70.20
Rate for Payer: Kaiser Permanente Medicaid	$39.78
Rate for Payer: Kaiser Permanente Medicare	$59.28
Rate for Payer: MDX Hawaii PPO	$75.66
Rate for Payer: Ohana Health Plan Medicaid	$59.28
Rate for Payer: Ohana Health Plan Medicare	$59.28
Rate for Payer: UnitedHealthcare Medicare	$59.28
Rate for Payer: University Health Alliance Commercial	$56.85

NEEDLE BONE MARROW 18G

Facility

$83.00

Hospital Revenue Code	272
Min. Negotiated Rate	$41.50
Max. Negotiated Rate	$80.51
Rate for Payer: AlohaCare Medicaid	$41.50
Rate for Payer: AlohaCare Medicare	$63.08
Rate for Payer: Cash Price	$49.80
Rate for Payer: Devoted Health Medicare	$69.72
Rate for Payer: Hawaii Medical Service Association Medicare	$63.08
Rate for Payer: Hawaii Western Management Group Commercial	$78.85
Rate for Payer: Health Management Network Commercial	$70.55
Rate for Payer: Humana Medicare	$63.08
Rate for Payer: Kaiser Permanente Commercial	$74.70
Rate for Payer: Kaiser Permanente Medicaid	$42.33
Rate for Payer: Kaiser Permanente Medicare	$63.08
Rate for Payer: MDX Hawaii PPO	$80.51
Rate for Payer: Ohana Health Plan Medicaid	$63.08
Rate for Payer: Ohana Health Plan Medicare	$63.08
Rate for Payer: UnitedHealthcare Medicare	$63.08
Rate for Payer: University Health Alliance Commercial	$60.50

NEEDLE BONE MARROW 18G

Facility

$83.00

Hospital Revenue Code	272
Min. Negotiated Rate	$70.55
Max. Negotiated Rate	$80.51
Rate for Payer: Cash Price	$49.80
Rate for Payer: Health Management Network Commercial	$70.55
Rate for Payer: Kaiser Permanente Commercial	$74.70
Rate for Payer: MDX Hawaii PPO	$80.51

NEEDLE BX STNRD 20GX6

Facility

$196.00

Hospital Revenue Code	272
Min. Negotiated Rate	$166.60
Max. Negotiated Rate	$190.12
Rate for Payer: Cash Price	$117.60
Rate for Payer: Health Management Network Commercial	$166.60
Rate for Payer: Kaiser Permanente Commercial	$176.40
Rate for Payer: MDX Hawaii PPO	$190.12

NEEDLE BX STNRD 20GX6

Facility

$196.00

Hospital Revenue Code	272
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$190.12
Rate for Payer: AlohaCare Medicaid	$98.00
Rate for Payer: AlohaCare Medicare	$148.96
Rate for Payer: Cash Price	$117.60
Rate for Payer: Devoted Health Medicare	$164.64
Rate for Payer: Hawaii Medical Service Association Medicare	$148.96
Rate for Payer: Hawaii Western Management Group Commercial	$186.20
Rate for Payer: Health Management Network Commercial	$166.60
Rate for Payer: Humana Medicare	$148.96
Rate for Payer: Kaiser Permanente Commercial	$176.40
Rate for Payer: Kaiser Permanente Medicaid	$99.96
Rate for Payer: Kaiser Permanente Medicare	$148.96
Rate for Payer: MDX Hawaii PPO	$190.12
Rate for Payer: Ohana Health Plan Medicaid	$148.96
Rate for Payer: Ohana Health Plan Medicare	$148.96
Rate for Payer: UnitedHealthcare Medicare	$148.96
Rate for Payer: University Health Alliance Commercial	$142.86

Know your out-of-pocket cost for care.

All Charges