Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

REAMER CANNULATED 2.7MM 117066

Facility

$3,240.00

Hospital Revenue Code	272
Min. Negotiated Rate	$2,754.00
Max. Negotiated Rate	$3,142.80
Rate for Payer: Cash Price	$1,944.00
Rate for Payer: Health Management Network Commercial	$2,754.00
Rate for Payer: Kaiser Permanente Commercial	$2,916.00
Rate for Payer: MDX Hawaii PPO	$3,142.80

REAMER FUSION CUP 18 RMRUFC-18

Facility

$1,211.00

Hospital Revenue Code	272
Min. Negotiated Rate	$605.50
Max. Negotiated Rate	$1,174.67
Rate for Payer: AlohaCare Medicaid	$605.50
Rate for Payer: AlohaCare Medicare	$920.36
Rate for Payer: Cash Price	$726.60
Rate for Payer: Devoted Health Medicare	$1,017.24
Rate for Payer: Hawaii Medical Service Association Medicare	$920.36
Rate for Payer: Hawaii Western Management Group Commercial	$1,150.45
Rate for Payer: Health Management Network Commercial	$1,029.35
Rate for Payer: Humana Medicare	$920.36
Rate for Payer: Kaiser Permanente Commercial	$1,089.90
Rate for Payer: Kaiser Permanente Medicaid	$617.61
Rate for Payer: Kaiser Permanente Medicare	$920.36
Rate for Payer: MDX Hawaii PPO	$1,174.67
Rate for Payer: Ohana Health Plan Medicaid	$920.36
Rate for Payer: Ohana Health Plan Medicare	$920.36
Rate for Payer: UnitedHealthcare Medicare	$920.36
Rate for Payer: University Health Alliance Commercial	$882.70

REAMER FUSION CUP 18 RMRUFC-18

Facility

$1,211.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,029.35
Max. Negotiated Rate	$1,174.67
Rate for Payer: Cash Price	$726.60
Rate for Payer: Health Management Network Commercial	$1,029.35
Rate for Payer: Kaiser Permanente Commercial	$1,089.90
Rate for Payer: MDX Hawaii PPO	$1,174.67

REAMER HEAD 12MM 352.250S

Facility

$1,536.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,305.60
Max. Negotiated Rate	$1,489.92
Rate for Payer: Cash Price	$921.60
Rate for Payer: Health Management Network Commercial	$1,305.60
Rate for Payer: Kaiser Permanente Commercial	$1,382.40
Rate for Payer: MDX Hawaii PPO	$1,489.92

REAMER HEAD 12MM 352.250S

Facility

$1,536.00

Hospital Revenue Code	272
Min. Negotiated Rate	$768.00
Max. Negotiated Rate	$1,489.92
Rate for Payer: AlohaCare Medicaid	$768.00
Rate for Payer: AlohaCare Medicare	$1,167.36
Rate for Payer: Cash Price	$921.60
Rate for Payer: Devoted Health Medicare	$1,290.24
Rate for Payer: Hawaii Medical Service Association Medicare	$1,167.36
Rate for Payer: Hawaii Western Management Group Commercial	$1,459.20
Rate for Payer: Health Management Network Commercial	$1,305.60
Rate for Payer: Humana Medicare	$1,167.36
Rate for Payer: Kaiser Permanente Commercial	$1,382.40
Rate for Payer: Kaiser Permanente Medicaid	$783.36
Rate for Payer: Kaiser Permanente Medicare	$1,167.36
Rate for Payer: MDX Hawaii PPO	$1,489.92
Rate for Payer: Ohana Health Plan Medicaid	$1,167.36
Rate for Payer: Ohana Health Plan Medicare	$1,167.36
Rate for Payer: UnitedHealthcare Medicare	$1,167.36
Rate for Payer: University Health Alliance Commercial	$1,119.59

REAMER HEAD 14MM 352.254S

Facility

$1,536.00

Hospital Revenue Code	272
Min. Negotiated Rate	$768.00
Max. Negotiated Rate	$1,489.92
Rate for Payer: AlohaCare Medicaid	$768.00
Rate for Payer: AlohaCare Medicare	$1,167.36
Rate for Payer: Cash Price	$921.60
Rate for Payer: Devoted Health Medicare	$1,290.24
Rate for Payer: Hawaii Medical Service Association Medicare	$1,167.36
Rate for Payer: Hawaii Western Management Group Commercial	$1,459.20
Rate for Payer: Health Management Network Commercial	$1,305.60
Rate for Payer: Humana Medicare	$1,167.36
Rate for Payer: Kaiser Permanente Commercial	$1,382.40
Rate for Payer: Kaiser Permanente Medicaid	$783.36
Rate for Payer: Kaiser Permanente Medicare	$1,167.36
Rate for Payer: MDX Hawaii PPO	$1,489.92
Rate for Payer: Ohana Health Plan Medicaid	$1,167.36
Rate for Payer: Ohana Health Plan Medicare	$1,167.36
Rate for Payer: UnitedHealthcare Medicare	$1,167.36
Rate for Payer: University Health Alliance Commercial	$1,119.59

REAMER HEAD 14MM 352.254S

Facility

$1,536.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,305.60
Max. Negotiated Rate	$1,489.92
Rate for Payer: Cash Price	$921.60
Rate for Payer: Health Management Network Commercial	$1,305.60
Rate for Payer: Kaiser Permanente Commercial	$1,382.40
Rate for Payer: MDX Hawaii PPO	$1,489.92

REAMER LOW PROFILE AR-1408LP

Facility

$768.00

Hospital Revenue Code	272
Min. Negotiated Rate	$652.80
Max. Negotiated Rate	$744.96
Rate for Payer: Cash Price	$460.80
Rate for Payer: Health Management Network Commercial	$652.80
Rate for Payer: Kaiser Permanente Commercial	$691.20
Rate for Payer: MDX Hawaii PPO	$744.96

REAMER LOW PROFILE AR-1408LP

Facility

$768.00

Hospital Revenue Code	272
Min. Negotiated Rate	$384.00
Max. Negotiated Rate	$744.96
Rate for Payer: AlohaCare Medicaid	$384.00
Rate for Payer: AlohaCare Medicare	$583.68
Rate for Payer: Cash Price	$460.80
Rate for Payer: Devoted Health Medicare	$645.12
Rate for Payer: Hawaii Medical Service Association Medicare	$583.68
Rate for Payer: Hawaii Western Management Group Commercial	$729.60
Rate for Payer: Health Management Network Commercial	$652.80
Rate for Payer: Humana Medicare	$583.68
Rate for Payer: Kaiser Permanente Commercial	$691.20
Rate for Payer: Kaiser Permanente Medicaid	$391.68
Rate for Payer: Kaiser Permanente Medicare	$583.68
Rate for Payer: MDX Hawaii PPO	$744.96
Rate for Payer: Ohana Health Plan Medicaid	$583.68
Rate for Payer: Ohana Health Plan Medicare	$583.68
Rate for Payer: UnitedHealthcare Medicare	$583.68
Rate for Payer: University Health Alliance Commercial	$559.80

REAMING ROD 2.5X850MM 359.083S

Facility

$843.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$421.50
Max. Negotiated Rate	$817.71
Rate for Payer: Kaiser Permanente Commercial	$758.70
Rate for Payer: AlohaCare Medicaid	$421.50
Rate for Payer: AlohaCare Medicare	$640.68
Rate for Payer: Cash Price	$505.80
Rate for Payer: Devoted Health Medicare	$708.12
Rate for Payer: Hawaii Medical Service Association Medicare	$640.68
Rate for Payer: Hawaii Western Management Group Commercial	$800.85
Rate for Payer: Health Management Network Commercial	$716.55
Rate for Payer: Humana Medicare	$640.68
Rate for Payer: Kaiser Permanente Medicaid	$429.93
Rate for Payer: Kaiser Permanente Medicare	$640.68
Rate for Payer: MDX Hawaii PPO	$817.71
Rate for Payer: Ohana Health Plan Medicaid	$640.68
Rate for Payer: Ohana Health Plan Medicare	$640.68
Rate for Payer: UnitedHealthcare Medicare	$640.68
Rate for Payer: University Health Alliance Commercial	$614.46

REAMING ROD 2.5X850MM 359.083S

Facility

$843.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$716.55
Max. Negotiated Rate	$817.71
Rate for Payer: Cash Price	$505.80
Rate for Payer: Health Management Network Commercial	$716.55
Rate for Payer: Kaiser Permanente Commercial	$758.70
Rate for Payer: MDX Hawaii PPO	$817.71

REAMING ROD 2.5X950MM 351.706S

Facility

$518.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$440.30
Max. Negotiated Rate	$502.46
Rate for Payer: Cash Price	$310.80
Rate for Payer: Health Management Network Commercial	$440.30
Rate for Payer: Kaiser Permanente Commercial	$466.20
Rate for Payer: MDX Hawaii PPO	$502.46

REAMING ROD 2.5X950MM 351.706S

Facility

$518.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$259.00
Max. Negotiated Rate	$502.46
Rate for Payer: AlohaCare Medicaid	$259.00
Rate for Payer: AlohaCare Medicare	$393.68
Rate for Payer: Cash Price	$310.80
Rate for Payer: Devoted Health Medicare	$435.12
Rate for Payer: Hawaii Medical Service Association Medicare	$393.68
Rate for Payer: Hawaii Western Management Group Commercial	$492.10
Rate for Payer: Health Management Network Commercial	$440.30
Rate for Payer: Humana Medicare	$393.68
Rate for Payer: Kaiser Permanente Commercial	$466.20
Rate for Payer: Kaiser Permanente Medicaid	$264.18
Rate for Payer: Kaiser Permanente Medicare	$393.68
Rate for Payer: MDX Hawaii PPO	$502.46
Rate for Payer: Ohana Health Plan Medicaid	$393.68
Rate for Payer: Ohana Health Plan Medicare	$393.68
Rate for Payer: UnitedHealthcare Medicare	$393.68
Rate for Payer: University Health Alliance Commercial	$377.57

REAMING ROD 3.0X950MM 351.71S

Facility

$784.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$392.00
Max. Negotiated Rate	$760.48
Rate for Payer: AlohaCare Medicaid	$392.00
Rate for Payer: AlohaCare Medicare	$595.84
Rate for Payer: Cash Price	$470.40
Rate for Payer: Devoted Health Medicare	$658.56
Rate for Payer: Hawaii Medical Service Association Medicare	$595.84
Rate for Payer: Hawaii Western Management Group Commercial	$744.80
Rate for Payer: Health Management Network Commercial	$666.40
Rate for Payer: Humana Medicare	$595.84
Rate for Payer: Kaiser Permanente Commercial	$705.60
Rate for Payer: Kaiser Permanente Medicaid	$399.84
Rate for Payer: Kaiser Permanente Medicare	$595.84
Rate for Payer: MDX Hawaii PPO	$760.48
Rate for Payer: Ohana Health Plan Medicaid	$595.84
Rate for Payer: Ohana Health Plan Medicare	$595.84
Rate for Payer: UnitedHealthcare Medicare	$595.84
Rate for Payer: University Health Alliance Commercial	$571.46

REAMING ROD 3.0X950MM 351.71S

Facility

$784.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$666.40
Max. Negotiated Rate	$760.48
Rate for Payer: Cash Price	$470.40
Rate for Payer: Health Management Network Commercial	$666.40
Rate for Payer: Kaiser Permanente Commercial	$705.60
Rate for Payer: MDX Hawaii PPO	$760.48

REAMING ROD 3.0X950MM 351.76S

Facility

$1,023.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$869.55
Max. Negotiated Rate	$992.31
Rate for Payer: Cash Price	$613.80
Rate for Payer: Health Management Network Commercial	$869.55
Rate for Payer: Kaiser Permanente Commercial	$920.70
Rate for Payer: MDX Hawaii PPO	$992.31

REAMING ROD 3.0X950MM 351.76S

Facility

$1,023.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$511.50
Max. Negotiated Rate	$992.31
Rate for Payer: AlohaCare Medicaid	$511.50
Rate for Payer: AlohaCare Medicare	$777.48
Rate for Payer: Cash Price	$613.80
Rate for Payer: Devoted Health Medicare	$859.32
Rate for Payer: Hawaii Medical Service Association Medicare	$777.48
Rate for Payer: Hawaii Western Management Group Commercial	$971.85
Rate for Payer: Health Management Network Commercial	$869.55
Rate for Payer: Humana Medicare	$777.48
Rate for Payer: Kaiser Permanente Commercial	$920.70
Rate for Payer: Kaiser Permanente Medicaid	$521.73
Rate for Payer: Kaiser Permanente Medicare	$777.48
Rate for Payer: MDX Hawaii PPO	$992.31
Rate for Payer: Ohana Health Plan Medicaid	$777.48
Rate for Payer: Ohana Health Plan Medicare	$777.48
Rate for Payer: UnitedHealthcare Medicare	$777.48
Rate for Payer: University Health Alliance Commercial	$745.66

RECHARGER 97755

Facility

$3,400.00

Service Code	HCPCS C1820
Hospital Revenue Code	278
Min. Negotiated Rate	$1,904.00
Max. Negotiated Rate	$3,298.00
Rate for Payer: Cash Price	$2,040.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,380.00
Rate for Payer: Health Management Network Commercial	$2,890.00
Rate for Payer: Kaiser Permanente Commercial	$3,060.00
Rate for Payer: MDX Hawaii PPO	$3,298.00
Rate for Payer: University Health Alliance Commercial	$1,904.00

RECHARGER 97755

Facility

$3,400.00

Service Code	HCPCS C1820
Hospital Revenue Code	278
Min. Negotiated Rate	$1,700.00
Max. Negotiated Rate	$3,298.00
Rate for Payer: AlohaCare Medicaid	$1,700.00
Rate for Payer: AlohaCare Medicare	$2,584.00
Rate for Payer: Cash Price	$2,040.00
Rate for Payer: Devoted Health Medicare	$2,856.00
Rate for Payer: Hawaii Medical Service Association Medicare	$2,584.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,380.00
Rate for Payer: Health Management Network Commercial	$2,890.00
Rate for Payer: Humana Medicare	$2,584.00
Rate for Payer: Kaiser Permanente Commercial	$3,060.00
Rate for Payer: Kaiser Permanente Medicaid	$1,734.00
Rate for Payer: Kaiser Permanente Medicare	$2,584.00
Rate for Payer: MDX Hawaii PPO	$3,298.00
Rate for Payer: Ohana Health Plan Medicaid	$2,584.00
Rate for Payer: Ohana Health Plan Medicare	$2,584.00
Rate for Payer: UnitedHealthcare Medicare	$2,584.00
Rate for Payer: University Health Alliance Commercial	$1,904.00

RECIP BLADE, HEAVY 277-96-327

Facility

$215.00

Hospital Revenue Code	272
Min. Negotiated Rate	$182.75
Max. Negotiated Rate	$208.55
Rate for Payer: Cash Price	$129.00
Rate for Payer: Health Management Network Commercial	$182.75
Rate for Payer: Kaiser Permanente Commercial	$193.50
Rate for Payer: MDX Hawaii PPO	$208.55

RECIP BLADE, HEAVY 277-96-327

Facility

$215.00

Hospital Revenue Code	272
Min. Negotiated Rate	$107.50
Max. Negotiated Rate	$208.55
Rate for Payer: AlohaCare Medicaid	$107.50
Rate for Payer: AlohaCare Medicare	$163.40
Rate for Payer: Cash Price	$129.00
Rate for Payer: Devoted Health Medicare	$180.60
Rate for Payer: Hawaii Medical Service Association Medicare	$163.40
Rate for Payer: Hawaii Western Management Group Commercial	$204.25
Rate for Payer: Health Management Network Commercial	$182.75
Rate for Payer: Humana Medicare	$163.40
Rate for Payer: Kaiser Permanente Commercial	$193.50
Rate for Payer: Kaiser Permanente Medicaid	$109.65
Rate for Payer: Kaiser Permanente Medicare	$163.40
Rate for Payer: MDX Hawaii PPO	$208.55
Rate for Payer: Ohana Health Plan Medicaid	$163.40
Rate for Payer: Ohana Health Plan Medicare	$163.40
Rate for Payer: UnitedHealthcare Medicare	$163.40
Rate for Payer: University Health Alliance Commercial	$156.71

RECTAL RESECTION WITH CC

Facility

$71,224.51

Service Code	MSDRG 333
Min. Negotiated Rate	$71,224.51
Max. Negotiated Rate	$71,224.51
Rate for Payer: Hawaii Medical Service Association Commercial	$71,224.51

RECTAL RESECTION WITH MCC

Facility

$71,224.51

Service Code	MSDRG 332
Min. Negotiated Rate	$71,224.51
Max. Negotiated Rate	$71,224.51
Rate for Payer: Hawaii Medical Service Association Commercial	$71,224.51

RECTAL RESECTION WITHOUT CC/MCC

Facility

$34,083.48

Service Code	MSDRG 334
Min. Negotiated Rate	$34,083.48
Max. Negotiated Rate	$34,083.48
Rate for Payer: Hawaii Medical Service Association Commercial	$34,083.48

RED BLOOD CELL DISORDERS WITH MCC

Facility

$31,049.62

Service Code	MSDRG 811
Min. Negotiated Rate	$31,049.62
Max. Negotiated Rate	$31,049.62
Rate for Payer: Hawaii Medical Service Association Commercial	$31,049.62

Know your out-of-pocket cost for care.

All Charges