Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

PR REVSC EVASC FPVT ST PLMT UNI SF LES 1ST VSL

Professional

Both

$20,898.00

Service Code	HCPCS 37267
Min. Negotiated Rate	$377.49
Max. Negotiated Rate	$17,763.30
Rate for Payer: AlohaCare Medicare	$377.49
Rate for Payer: Cash Price	$12,538.80
Rate for Payer: Cash Price	$12,538.80
Rate for Payer: Devoted Health Medicare	$415.24
Rate for Payer: Hawaii Medical Service Association Medicare	$377.49
Rate for Payer: Health Management Network Commercial	$17,763.30
Rate for Payer: Kaiser Permanente Commercial	$452.99
Rate for Payer: Kaiser Permanente Medicaid	$452.99
Rate for Payer: Kaiser Permanente Medicare	$452.99
Rate for Payer: Ohana Health Plan Medicare	$377.49
Rate for Payer: UnitedHealthcare Medicare	$377.49

PR REVSC EVASC IMVT ANGIOP UNI SF LES 1ST VSL

Professional

Both

$6,213.00

Service Code	HCPCS 37296
Min. Negotiated Rate	$471.80
Max. Negotiated Rate	$5,281.05
Rate for Payer: AlohaCare Medicare	$471.80
Rate for Payer: Cash Price	$3,727.80
Rate for Payer: Cash Price	$3,727.80
Rate for Payer: Devoted Health Medicare	$518.98
Rate for Payer: Hawaii Medical Service Association Medicare	$471.80
Rate for Payer: Health Management Network Commercial	$5,281.05
Rate for Payer: Kaiser Permanente Commercial	$566.16
Rate for Payer: Kaiser Permanente Medicaid	$566.16
Rate for Payer: Kaiser Permanente Medicare	$566.16
Rate for Payer: Ohana Health Plan Medicare	$471.80
Rate for Payer: UnitedHealthcare Medicare	$471.80

PR REVSC EVASC IVT ANGIOP UNI CPLX LES 1ST VSL

Professional

Both

$6,955.00

Service Code	HCPCS 37256
Min. Negotiated Rate	$463.43
Max. Negotiated Rate	$5,911.75
Rate for Payer: AlohaCare Medicare	$463.43
Rate for Payer: Cash Price	$4,173.00
Rate for Payer: Cash Price	$4,173.00
Rate for Payer: Devoted Health Medicare	$509.77
Rate for Payer: Hawaii Medical Service Association Medicare	$463.43
Rate for Payer: Health Management Network Commercial	$5,911.75
Rate for Payer: Kaiser Permanente Commercial	$556.12
Rate for Payer: Kaiser Permanente Medicaid	$556.12
Rate for Payer: Kaiser Permanente Medicare	$556.12
Rate for Payer: Ohana Health Plan Medicare	$463.43
Rate for Payer: UnitedHealthcare Medicare	$463.43

PR REVSC EVASC IVT ANGIOP UNI CPLX LES EA ADDL VSL

Professional

Both

$1,092.00

Service Code	HCPCS 37257
Min. Negotiated Rate	$165.19
Max. Negotiated Rate	$928.20
Rate for Payer: AlohaCare Medicare	$165.19
Rate for Payer: Cash Price	$655.20
Rate for Payer: Cash Price	$655.20
Rate for Payer: Devoted Health Medicare	$181.71
Rate for Payer: Hawaii Medical Service Association Medicare	$165.19
Rate for Payer: Health Management Network Commercial	$928.20
Rate for Payer: Kaiser Permanente Commercial	$198.23
Rate for Payer: Kaiser Permanente Medicaid	$198.23
Rate for Payer: Kaiser Permanente Medicare	$198.23
Rate for Payer: Ohana Health Plan Medicare	$165.19
Rate for Payer: UnitedHealthcare Medicare	$165.19

PR REVSC EVASC IVT ANGIOP UNI SF LES 1ST VSL

Professional

Both

$4,012.00

Service Code	HCPCS 37254
Min. Negotiated Rate	$316.39
Max. Negotiated Rate	$3,410.20
Rate for Payer: AlohaCare Medicare	$316.39
Rate for Payer: Cash Price	$2,407.20
Rate for Payer: Cash Price	$2,407.20
Rate for Payer: Devoted Health Medicare	$348.03
Rate for Payer: Hawaii Medical Service Association Medicare	$316.39
Rate for Payer: Health Management Network Commercial	$3,410.20
Rate for Payer: Kaiser Permanente Commercial	$379.67
Rate for Payer: Kaiser Permanente Medicaid	$379.67
Rate for Payer: Kaiser Permanente Medicare	$379.67
Rate for Payer: Ohana Health Plan Medicare	$316.39
Rate for Payer: UnitedHealthcare Medicare	$316.39

PR REVSC EVASC IVT ANGIOP UNI SF LES EA ADDL VSL

Professional

Both

$4,671.00

Service Code	HCPCS 37255
Min. Negotiated Rate	$127.61
Max. Negotiated Rate	$3,970.35
Rate for Payer: AlohaCare Medicare	$127.61
Rate for Payer: Cash Price	$2,802.60
Rate for Payer: Cash Price	$2,802.60
Rate for Payer: Devoted Health Medicare	$140.37
Rate for Payer: Hawaii Medical Service Association Medicare	$127.61
Rate for Payer: Health Management Network Commercial	$3,970.35
Rate for Payer: Kaiser Permanente Commercial	$153.13
Rate for Payer: Kaiser Permanente Medicaid	$153.13
Rate for Payer: Kaiser Permanente Medicare	$153.13
Rate for Payer: Ohana Health Plan Medicare	$127.61
Rate for Payer: UnitedHealthcare Medicare	$127.61

PR REVSC EVASC IVT ST PLMT UNI CPLX LES 1ST VSL

Professional

Both

$10,691.00

Service Code	HCPCS 37260
Min. Negotiated Rate	$544.92
Max. Negotiated Rate	$9,087.35
Rate for Payer: AlohaCare Medicare	$544.92
Rate for Payer: Cash Price	$6,414.60
Rate for Payer: Cash Price	$6,414.60
Rate for Payer: Devoted Health Medicare	$599.41
Rate for Payer: Hawaii Medical Service Association Medicare	$544.92
Rate for Payer: Health Management Network Commercial	$9,087.35
Rate for Payer: Kaiser Permanente Commercial	$653.90
Rate for Payer: Kaiser Permanente Medicaid	$653.90
Rate for Payer: Kaiser Permanente Medicare	$653.90
Rate for Payer: Ohana Health Plan Medicare	$544.92
Rate for Payer: UnitedHealthcare Medicare	$544.92

PR REVSC EVASC IVT ST PLMT UNI CPLX LES EA ADDL VSL

Professional

Both

$13,433.00

Service Code	HCPCS 37261
Min. Negotiated Rate	$180.30
Max. Negotiated Rate	$11,418.05
Rate for Payer: AlohaCare Medicare	$180.30
Rate for Payer: Cash Price	$8,059.80
Rate for Payer: Cash Price	$8,059.80
Rate for Payer: Devoted Health Medicare	$198.33
Rate for Payer: Hawaii Medical Service Association Medicare	$180.30
Rate for Payer: Health Management Network Commercial	$11,418.05
Rate for Payer: Kaiser Permanente Commercial	$216.36
Rate for Payer: Kaiser Permanente Medicaid	$216.36
Rate for Payer: Kaiser Permanente Medicare	$216.36
Rate for Payer: Ohana Health Plan Medicare	$180.30
Rate for Payer: UnitedHealthcare Medicare	$180.30

PR REVSC EVASC IVT ST PLMT UNI SF LES 1ST VSL

Professional

Both

$6,955.00

Service Code	HCPCS 37258
Min. Negotiated Rate	$377.11
Max. Negotiated Rate	$5,911.75
Rate for Payer: AlohaCare Medicare	$377.11
Rate for Payer: Cash Price	$4,173.00
Rate for Payer: Cash Price	$4,173.00
Rate for Payer: Devoted Health Medicare	$414.82
Rate for Payer: Hawaii Medical Service Association Medicare	$377.11
Rate for Payer: Health Management Network Commercial	$5,911.75
Rate for Payer: Kaiser Permanente Commercial	$452.53
Rate for Payer: Kaiser Permanente Medicaid	$452.53
Rate for Payer: Kaiser Permanente Medicare	$452.53
Rate for Payer: Ohana Health Plan Medicare	$377.11
Rate for Payer: UnitedHealthcare Medicare	$377.11

PR REVSC EVASC IVT ST PLMT UNI SF LES EA ADDL VSL

Professional

Both

$2,337.00

Service Code	HCPCS 37259
Min. Negotiated Rate	$169.65
Max. Negotiated Rate	$1,986.45
Rate for Payer: AlohaCare Medicare	$169.65
Rate for Payer: Cash Price	$1,402.20
Rate for Payer: Cash Price	$1,402.20
Rate for Payer: Devoted Health Medicare	$186.62
Rate for Payer: Hawaii Medical Service Association Medicare	$169.65
Rate for Payer: Health Management Network Commercial	$1,986.45
Rate for Payer: Kaiser Permanente Commercial	$203.58
Rate for Payer: Kaiser Permanente Medicaid	$203.58
Rate for Payer: Kaiser Permanente Medicare	$203.58
Rate for Payer: Ohana Health Plan Medicare	$169.65
Rate for Payer: UnitedHealthcare Medicare	$169.65

PR REVSC EVASC TPVT ANGIOP UNI CPLX LES 1ST VSL

Professional

Both

$11,950.00

Service Code	HCPCS 37282
Min. Negotiated Rate	$528.01
Max. Negotiated Rate	$10,157.50
Rate for Payer: AlohaCare Medicare	$528.01
Rate for Payer: Cash Price	$7,170.00
Rate for Payer: Cash Price	$7,170.00
Rate for Payer: Devoted Health Medicare	$580.81
Rate for Payer: Hawaii Medical Service Association Medicare	$528.01
Rate for Payer: Health Management Network Commercial	$10,157.50
Rate for Payer: Kaiser Permanente Commercial	$633.61
Rate for Payer: Kaiser Permanente Medicaid	$633.61
Rate for Payer: Kaiser Permanente Medicare	$633.61
Rate for Payer: Ohana Health Plan Medicare	$528.01
Rate for Payer: UnitedHealthcare Medicare	$528.01

PR REVSC EVASC TPVT ANGIOP UNI CPLX LES EA ADDL VSL

Professional

Both

$1,653.00

Service Code	HCPCS 37283
Min. Negotiated Rate	$180.79
Max. Negotiated Rate	$1,405.05
Rate for Payer: AlohaCare Medicare	$180.79
Rate for Payer: Cash Price	$991.80
Rate for Payer: Cash Price	$991.80
Rate for Payer: Devoted Health Medicare	$198.87
Rate for Payer: Hawaii Medical Service Association Medicare	$180.79
Rate for Payer: Health Management Network Commercial	$1,405.05
Rate for Payer: Kaiser Permanente Commercial	$216.95
Rate for Payer: Kaiser Permanente Medicaid	$216.95
Rate for Payer: Kaiser Permanente Medicare	$216.95
Rate for Payer: Ohana Health Plan Medicare	$180.79
Rate for Payer: UnitedHealthcare Medicare	$180.79

PR REVSC EVASC TPVT ANGIOP UNI SF LES 1ST VSL

Professional

Both

$5,217.00

Service Code	HCPCS 37280
Min. Negotiated Rate	$420.99
Max. Negotiated Rate	$4,434.45
Rate for Payer: AlohaCare Medicare	$420.99
Rate for Payer: Cash Price	$3,130.20
Rate for Payer: Cash Price	$3,130.20
Rate for Payer: Devoted Health Medicare	$463.09
Rate for Payer: Hawaii Medical Service Association Medicare	$420.99
Rate for Payer: Health Management Network Commercial	$4,434.45
Rate for Payer: Kaiser Permanente Commercial	$505.19
Rate for Payer: Kaiser Permanente Medicaid	$505.19
Rate for Payer: Kaiser Permanente Medicare	$505.19
Rate for Payer: Ohana Health Plan Medicare	$420.99
Rate for Payer: UnitedHealthcare Medicare	$420.99

PR REVSC EVASC TPVT ANGIOP UNI SF LES EA ADDL VSL

Professional

Both

$1,421.00

Service Code	HCPCS 37281
Min. Negotiated Rate	$127.02
Max. Negotiated Rate	$1,207.85
Rate for Payer: AlohaCare Medicare	$127.02
Rate for Payer: Cash Price	$852.60
Rate for Payer: Cash Price	$852.60
Rate for Payer: Devoted Health Medicare	$139.72
Rate for Payer: Hawaii Medical Service Association Medicare	$127.02
Rate for Payer: Health Management Network Commercial	$1,207.85
Rate for Payer: Kaiser Permanente Commercial	$152.42
Rate for Payer: Kaiser Permanente Medicaid	$152.42
Rate for Payer: Kaiser Permanente Medicare	$152.42
Rate for Payer: Ohana Health Plan Medicare	$127.02
Rate for Payer: UnitedHealthcare Medicare	$127.02

PR REVSC EVASC TPVT ATHRC UNI CPLX LES 1ST VSL

Professional

Both

$20,948.00

Service Code	HCPCS 37290
Min. Negotiated Rate	$727.43
Max. Negotiated Rate	$17,805.80
Rate for Payer: AlohaCare Medicare	$727.43
Rate for Payer: Cash Price	$12,568.80
Rate for Payer: Cash Price	$12,568.80
Rate for Payer: Devoted Health Medicare	$800.17
Rate for Payer: Hawaii Medical Service Association Medicare	$727.43
Rate for Payer: Health Management Network Commercial	$17,805.80
Rate for Payer: Kaiser Permanente Commercial	$872.92
Rate for Payer: Kaiser Permanente Medicaid	$872.92
Rate for Payer: Kaiser Permanente Medicare	$872.92
Rate for Payer: Ohana Health Plan Medicare	$727.43
Rate for Payer: UnitedHealthcare Medicare	$727.43

PR REVSC EVASC TPVT ATHRC UNI CPLX LES EA ADDL VSL

Professional

Both

$2,045.00

Service Code	HCPCS 37291
Min. Negotiated Rate	$278.15
Max. Negotiated Rate	$1,738.25
Rate for Payer: AlohaCare Medicare	$278.15
Rate for Payer: Cash Price	$1,227.00
Rate for Payer: Cash Price	$1,227.00
Rate for Payer: Devoted Health Medicare	$305.96
Rate for Payer: Hawaii Medical Service Association Medicare	$278.15
Rate for Payer: Health Management Network Commercial	$1,738.25
Rate for Payer: Kaiser Permanente Commercial	$333.78
Rate for Payer: Kaiser Permanente Medicaid	$333.78
Rate for Payer: Kaiser Permanente Medicare	$333.78
Rate for Payer: Ohana Health Plan Medicare	$278.15
Rate for Payer: UnitedHealthcare Medicare	$278.15

PR REVSC EVASC TPVT ATHRC UNI SF LES 1ST VSL

Professional

Both

$15,323.00

Service Code	HCPCS 37288
Min. Negotiated Rate	$578.37
Max. Negotiated Rate	$13,024.55
Rate for Payer: AlohaCare Medicare	$578.37
Rate for Payer: Cash Price	$9,193.80
Rate for Payer: Cash Price	$9,193.80
Rate for Payer: Devoted Health Medicare	$636.21
Rate for Payer: Hawaii Medical Service Association Medicare	$578.37
Rate for Payer: Health Management Network Commercial	$13,024.55
Rate for Payer: Kaiser Permanente Commercial	$694.04
Rate for Payer: Kaiser Permanente Medicaid	$694.04
Rate for Payer: Kaiser Permanente Medicare	$694.04
Rate for Payer: Ohana Health Plan Medicare	$578.37
Rate for Payer: UnitedHealthcare Medicare	$578.37

PR REVSC EVASC TPVT ATHRC UNI SF LES EA ADDL VSL

Professional

Both

$1,764.00

Service Code	HCPCS 37289
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$1,499.40
Rate for Payer: AlohaCare Medicare	$203.63
Rate for Payer: Cash Price	$1,058.40
Rate for Payer: Cash Price	$1,058.40
Rate for Payer: Devoted Health Medicare	$223.99
Rate for Payer: Hawaii Medical Service Association Medicare	$203.63
Rate for Payer: Health Management Network Commercial	$1,499.40
Rate for Payer: Kaiser Permanente Commercial	$244.36
Rate for Payer: Kaiser Permanente Medicaid	$244.36
Rate for Payer: Kaiser Permanente Medicare	$244.36
Rate for Payer: Ohana Health Plan Medicare	$203.63
Rate for Payer: UnitedHealthcare Medicare	$203.63

PR REVSC EVASC TPVT ST ATHRC UNI SF LES EA ADDL VSL

Professional

Both

$6,892.00

Service Code	HCPCS 37293
Min. Negotiated Rate	$284.79
Max. Negotiated Rate	$5,858.20
Rate for Payer: AlohaCare Medicare	$284.79
Rate for Payer: Cash Price	$4,135.20
Rate for Payer: Cash Price	$4,135.20
Rate for Payer: Devoted Health Medicare	$313.27
Rate for Payer: Hawaii Medical Service Association Medicare	$284.79
Rate for Payer: Health Management Network Commercial	$5,858.20
Rate for Payer: Kaiser Permanente Commercial	$341.75
Rate for Payer: Kaiser Permanente Medicaid	$341.75
Rate for Payer: Kaiser Permanente Medicare	$341.75
Rate for Payer: Ohana Health Plan Medicare	$284.79
Rate for Payer: UnitedHealthcare Medicare	$284.79

PR REVSC EVASC TPVT ST PLMT UNI CPLX LES 1ST VSL

Professional

Both

$20,436.00

Service Code	HCPCS 37286
Min. Negotiated Rate	$584.90
Max. Negotiated Rate	$17,370.60
Rate for Payer: AlohaCare Medicare	$584.90
Rate for Payer: Cash Price	$12,261.60
Rate for Payer: Cash Price	$12,261.60
Rate for Payer: Devoted Health Medicare	$643.39
Rate for Payer: Hawaii Medical Service Association Medicare	$584.90
Rate for Payer: Health Management Network Commercial	$17,370.60
Rate for Payer: Kaiser Permanente Commercial	$701.88
Rate for Payer: Kaiser Permanente Medicaid	$701.88
Rate for Payer: Kaiser Permanente Medicare	$701.88
Rate for Payer: Ohana Health Plan Medicare	$584.90
Rate for Payer: UnitedHealthcare Medicare	$584.90

PR REVSC EVASC TPVT ST PLMT UNI CPLX LES EA ADD VSL

Professional

Both

$9,761.00

Service Code	HCPCS 37287
Min. Negotiated Rate	$216.77
Max. Negotiated Rate	$8,296.85
Rate for Payer: AlohaCare Medicare	$216.77
Rate for Payer: Cash Price	$5,856.60
Rate for Payer: Cash Price	$5,856.60
Rate for Payer: Devoted Health Medicare	$238.45
Rate for Payer: Hawaii Medical Service Association Medicare	$216.77
Rate for Payer: Health Management Network Commercial	$8,296.85
Rate for Payer: Kaiser Permanente Commercial	$260.12
Rate for Payer: Kaiser Permanente Medicaid	$260.12
Rate for Payer: Kaiser Permanente Medicare	$260.12
Rate for Payer: Ohana Health Plan Medicare	$216.77
Rate for Payer: UnitedHealthcare Medicare	$216.77

PR REVSC EVASC TPVT ST PLMT UNI SF LES 1ST VSL

Professional

Both

$11,049.00

Service Code	HCPCS 37284
Min. Negotiated Rate	$436.21
Max. Negotiated Rate	$9,391.65
Rate for Payer: AlohaCare Medicare	$436.21
Rate for Payer: Cash Price	$6,629.40
Rate for Payer: Cash Price	$6,629.40
Rate for Payer: Devoted Health Medicare	$479.83
Rate for Payer: Hawaii Medical Service Association Medicare	$436.21
Rate for Payer: Health Management Network Commercial	$9,391.65
Rate for Payer: Kaiser Permanente Commercial	$523.45
Rate for Payer: Kaiser Permanente Medicaid	$523.45
Rate for Payer: Kaiser Permanente Medicare	$523.45
Rate for Payer: Ohana Health Plan Medicare	$436.21
Rate for Payer: UnitedHealthcare Medicare	$436.21

PR REVSC EVASC TPVT ST PLMT UNI SF LES EA ADDL VSL

Professional

Both

$5,502.00

Service Code	HCPCS 37285
Min. Negotiated Rate	$144.29
Max. Negotiated Rate	$4,676.70
Rate for Payer: AlohaCare Medicare	$144.29
Rate for Payer: Cash Price	$3,301.20
Rate for Payer: Cash Price	$3,301.20
Rate for Payer: Devoted Health Medicare	$158.72
Rate for Payer: Hawaii Medical Service Association Medicare	$144.29
Rate for Payer: Health Management Network Commercial	$4,676.70
Rate for Payer: Kaiser Permanente Commercial	$173.15
Rate for Payer: Kaiser Permanente Medicaid	$173.15
Rate for Payer: Kaiser Permanente Medicare	$173.15
Rate for Payer: Ohana Health Plan Medicare	$144.29
Rate for Payer: UnitedHealthcare Medicare	$144.29

PR REVSC EVSC TPVT ST ATHRC UNI CPLX LES EA ADD VSL

Professional

Both

$11,829.00

Service Code	HCPCS 37295
Min. Negotiated Rate	$358.60
Max. Negotiated Rate	$10,054.65
Rate for Payer: AlohaCare Medicare	$358.60
Rate for Payer: Cash Price	$7,097.40
Rate for Payer: Cash Price	$7,097.40
Rate for Payer: Devoted Health Medicare	$394.46
Rate for Payer: Hawaii Medical Service Association Medicare	$358.60
Rate for Payer: Health Management Network Commercial	$10,054.65
Rate for Payer: Kaiser Permanente Commercial	$430.32
Rate for Payer: Kaiser Permanente Medicaid	$430.32
Rate for Payer: Kaiser Permanente Medicare	$430.32
Rate for Payer: Ohana Health Plan Medicare	$358.60
Rate for Payer: UnitedHealthcare Medicare	$358.60

PR RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR

Professional

Both

$2,589.00

Service Code	HCPCS 30420
Min. Negotiated Rate	$976.30
Max. Negotiated Rate	$2,200.65
Rate for Payer: AlohaCare Medicaid	$1,542.48
Rate for Payer: AlohaCare Medicare	$1,370.10
Rate for Payer: Cash Price	$1,553.40
Rate for Payer: Cash Price	$1,553.40
Rate for Payer: Devoted Health Medicare	$1,507.11
Rate for Payer: Hawaii Medical Service Association Medicare	$1,370.10
Rate for Payer: Hawaii Western Management Group Commercial	$976.30
Rate for Payer: Health Management Network Commercial	$2,200.65
Rate for Payer: Kaiser Permanente Commercial	$1,644.12
Rate for Payer: Kaiser Permanente Medicaid	$1,644.12
Rate for Payer: Kaiser Permanente Medicare	$1,644.12
Rate for Payer: Ohana Health Plan Medicaid	$1,542.48
Rate for Payer: Ohana Health Plan Medicare	$1,370.10
Rate for Payer: UnitedHealthcare Medicaid	$1,542.48
Rate for Payer: UnitedHealthcare Medicare	$1,370.10

Know your out-of-pocket cost for care.

All Charges