Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

STAPLER 12MM CANN SEAL 470380

Facility

$126.00

Hospital Revenue Code	272
Min. Negotiated Rate	$107.10
Max. Negotiated Rate	$122.22
Rate for Payer: Cash Price	$75.60
Rate for Payer: Health Management Network Commercial	$107.10
Rate for Payer: Kaiser Permanente Commercial	$113.40
Rate for Payer: MDX Hawaii PPO	$122.22

STAPLER 12MM CANN SEAL 470380

Facility

$126.00

Hospital Revenue Code	272
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$122.22
Rate for Payer: AlohaCare Medicaid	$63.00
Rate for Payer: AlohaCare Medicare	$95.76
Rate for Payer: Cash Price	$75.60
Rate for Payer: Devoted Health Medicare	$105.84
Rate for Payer: Hawaii Medical Service Association Medicare	$95.76
Rate for Payer: Hawaii Western Management Group Commercial	$119.70
Rate for Payer: Health Management Network Commercial	$107.10
Rate for Payer: Humana Medicare	$95.76
Rate for Payer: Kaiser Permanente Commercial	$113.40
Rate for Payer: Kaiser Permanente Medicaid	$64.26
Rate for Payer: Kaiser Permanente Medicare	$95.76
Rate for Payer: MDX Hawaii PPO	$122.22
Rate for Payer: Ohana Health Plan Medicaid	$95.76
Rate for Payer: Ohana Health Plan Medicare	$95.76
Rate for Payer: UnitedHealthcare Medicare	$95.76
Rate for Payer: University Health Alliance Commercial	$91.84

STAPLER 5MM JR-ST25-2.0-6

Facility

$2,475.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$2,400.75
Rate for Payer: AlohaCare Medicaid	$1,237.50
Rate for Payer: AlohaCare Medicare	$1,881.00
Rate for Payer: Cash Price	$1,485.00
Rate for Payer: Devoted Health Medicare	$2,079.00
Rate for Payer: Hawaii Medical Service Association Medicare	$1,881.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,351.25
Rate for Payer: Health Management Network Commercial	$2,103.75
Rate for Payer: Humana Medicare	$1,881.00
Rate for Payer: Kaiser Permanente Commercial	$2,227.50
Rate for Payer: Kaiser Permanente Medicaid	$1,262.25
Rate for Payer: Kaiser Permanente Medicare	$1,881.00
Rate for Payer: MDX Hawaii PPO	$2,400.75
Rate for Payer: Ohana Health Plan Medicaid	$1,881.00
Rate for Payer: Ohana Health Plan Medicare	$1,881.00
Rate for Payer: UnitedHealthcare Medicare	$1,881.00
Rate for Payer: University Health Alliance Commercial	$1,804.03

STAPLER 5MM JR-ST25-2.0-6

Facility

$2,475.00

Hospital Revenue Code	272
Min. Negotiated Rate	$2,103.75
Max. Negotiated Rate	$2,400.75
Rate for Payer: Cash Price	$1,485.00
Rate for Payer: Health Management Network Commercial	$2,103.75
Rate for Payer: Kaiser Permanente Commercial	$2,227.50
Rate for Payer: MDX Hawaii PPO	$2,400.75

STAPLER 60MM TRI 2.0 SIG60AXT

Facility

$939.00

Hospital Revenue Code	272
Min. Negotiated Rate	$798.15
Max. Negotiated Rate	$910.83
Rate for Payer: Cash Price	$563.40
Rate for Payer: Health Management Network Commercial	$798.15
Rate for Payer: Kaiser Permanente Commercial	$845.10
Rate for Payer: MDX Hawaii PPO	$910.83

STAPLER 60MM TRI 2.0 SIG60AXT

Facility

$939.00

Hospital Revenue Code	272
Min. Negotiated Rate	$469.50
Max. Negotiated Rate	$910.83
Rate for Payer: AlohaCare Medicaid	$469.50
Rate for Payer: AlohaCare Medicare	$713.64
Rate for Payer: Cash Price	$563.40
Rate for Payer: Devoted Health Medicare	$788.76
Rate for Payer: Hawaii Medical Service Association Medicare	$713.64
Rate for Payer: Hawaii Western Management Group Commercial	$892.05
Rate for Payer: Health Management Network Commercial	$798.15
Rate for Payer: Humana Medicare	$713.64
Rate for Payer: Kaiser Permanente Commercial	$845.10
Rate for Payer: Kaiser Permanente Medicaid	$478.89
Rate for Payer: Kaiser Permanente Medicare	$713.64
Rate for Payer: MDX Hawaii PPO	$910.83
Rate for Payer: Ohana Health Plan Medicaid	$713.64
Rate for Payer: Ohana Health Plan Medicare	$713.64
Rate for Payer: UnitedHealthcare Medicare	$713.64
Rate for Payer: University Health Alliance Commercial	$684.44

STAPLER ENDO GIA 60MM ART MED

Facility

$713.00

Hospital Revenue Code	272
Min. Negotiated Rate	$606.05
Max. Negotiated Rate	$691.61
Rate for Payer: Cash Price	$427.80
Rate for Payer: Health Management Network Commercial	$606.05
Rate for Payer: Kaiser Permanente Commercial	$641.70
Rate for Payer: MDX Hawaii PPO	$691.61

STAPLER ENDO GIA 60MM ART MED

Facility

$713.00

Hospital Revenue Code	272
Min. Negotiated Rate	$356.50
Max. Negotiated Rate	$691.61
Rate for Payer: AlohaCare Medicaid	$356.50
Rate for Payer: AlohaCare Medicare	$541.88
Rate for Payer: Cash Price	$427.80
Rate for Payer: Devoted Health Medicare	$598.92
Rate for Payer: Hawaii Medical Service Association Medicare	$541.88
Rate for Payer: Hawaii Western Management Group Commercial	$677.35
Rate for Payer: Health Management Network Commercial	$606.05
Rate for Payer: Humana Medicare	$541.88
Rate for Payer: Kaiser Permanente Commercial	$641.70
Rate for Payer: Kaiser Permanente Medicaid	$363.63
Rate for Payer: Kaiser Permanente Medicare	$541.88
Rate for Payer: MDX Hawaii PPO	$691.61
Rate for Payer: Ohana Health Plan Medicaid	$541.88
Rate for Payer: Ohana Health Plan Medicare	$541.88
Rate for Payer: UnitedHealthcare Medicare	$541.88
Rate for Payer: University Health Alliance Commercial	$519.71

STAPLER LINEAR 40MM GCS40B

Facility

$2,964.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,482.00
Max. Negotiated Rate	$2,875.08
Rate for Payer: AlohaCare Medicaid	$1,482.00
Rate for Payer: AlohaCare Medicare	$2,252.64
Rate for Payer: Cash Price	$1,778.40
Rate for Payer: Devoted Health Medicare	$2,489.76
Rate for Payer: Hawaii Medical Service Association Medicare	$2,252.64
Rate for Payer: Hawaii Western Management Group Commercial	$2,815.80
Rate for Payer: Health Management Network Commercial	$2,519.40
Rate for Payer: Humana Medicare	$2,252.64
Rate for Payer: Kaiser Permanente Commercial	$2,667.60
Rate for Payer: Kaiser Permanente Medicaid	$1,511.64
Rate for Payer: Kaiser Permanente Medicare	$2,252.64
Rate for Payer: MDX Hawaii PPO	$2,875.08
Rate for Payer: Ohana Health Plan Medicaid	$2,252.64
Rate for Payer: Ohana Health Plan Medicare	$2,252.64
Rate for Payer: UnitedHealthcare Medicare	$2,252.64
Rate for Payer: University Health Alliance Commercial	$2,160.46

STAPLER LINEAR 40MM GCS40B

Facility

$2,964.00

Hospital Revenue Code	272
Min. Negotiated Rate	$2,519.40
Max. Negotiated Rate	$2,875.08
Rate for Payer: Cash Price	$1,778.40
Rate for Payer: Health Management Network Commercial	$2,519.40
Rate for Payer: Kaiser Permanente Commercial	$2,667.60
Rate for Payer: MDX Hawaii PPO	$2,875.08

STAPLER PURSTRING 65MM

Facility

$279.00

Hospital Revenue Code	272
Min. Negotiated Rate	$237.15
Max. Negotiated Rate	$270.63
Rate for Payer: Cash Price	$167.40
Rate for Payer: Health Management Network Commercial	$237.15
Rate for Payer: Kaiser Permanente Commercial	$251.10
Rate for Payer: MDX Hawaii PPO	$270.63

STAPLER PURSTRING 65MM

Facility

$279.00

Hospital Revenue Code	272
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$270.63
Rate for Payer: AlohaCare Medicaid	$139.50
Rate for Payer: AlohaCare Medicare	$212.04
Rate for Payer: Cash Price	$167.40
Rate for Payer: Devoted Health Medicare	$234.36
Rate for Payer: Hawaii Medical Service Association Medicare	$212.04
Rate for Payer: Hawaii Western Management Group Commercial	$265.05
Rate for Payer: Health Management Network Commercial	$237.15
Rate for Payer: Humana Medicare	$212.04
Rate for Payer: Kaiser Permanente Commercial	$251.10
Rate for Payer: Kaiser Permanente Medicaid	$142.29
Rate for Payer: Kaiser Permanente Medicare	$212.04
Rate for Payer: MDX Hawaii PPO	$270.63
Rate for Payer: Ohana Health Plan Medicaid	$212.04
Rate for Payer: Ohana Health Plan Medicare	$212.04
Rate for Payer: UnitedHealthcare Medicare	$212.04
Rate for Payer: University Health Alliance Commercial	$203.36

STAPLER RELOAD 400MM GCR40G

Facility

$1,617.00

Hospital Revenue Code	270
Min. Negotiated Rate	$1,374.45
Max. Negotiated Rate	$1,568.49
Rate for Payer: Cash Price	$970.20
Rate for Payer: Health Management Network Commercial	$1,374.45
Rate for Payer: Kaiser Permanente Commercial	$1,455.30
Rate for Payer: MDX Hawaii PPO	$1,568.49

STAPLER RELOAD 400MM GCR40G

Facility

$1,617.00

Hospital Revenue Code	270
Min. Negotiated Rate	$808.50
Max. Negotiated Rate	$1,568.49
Rate for Payer: AlohaCare Medicaid	$808.50
Rate for Payer: AlohaCare Medicare	$1,228.92
Rate for Payer: Cash Price	$970.20
Rate for Payer: Devoted Health Medicare	$1,358.28
Rate for Payer: Hawaii Medical Service Association Medicare	$1,228.92
Rate for Payer: Hawaii Western Management Group Commercial	$1,536.15
Rate for Payer: Health Management Network Commercial	$1,374.45
Rate for Payer: Humana Medicare	$1,228.92
Rate for Payer: Kaiser Permanente Commercial	$1,455.30
Rate for Payer: Kaiser Permanente Medicaid	$824.67
Rate for Payer: Kaiser Permanente Medicare	$1,228.92
Rate for Payer: MDX Hawaii PPO	$1,568.49
Rate for Payer: Ohana Health Plan Medicaid	$1,228.92
Rate for Payer: Ohana Health Plan Medicare	$1,228.92
Rate for Payer: UnitedHealthcare Medicare	$1,228.92
Rate for Payer: University Health Alliance Commercial	$1,178.63

STAPLER RELOADS 40MM CR40B

Facility

$1,408.00

Hospital Revenue Code	270
Min. Negotiated Rate	$704.00
Max. Negotiated Rate	$1,365.76
Rate for Payer: AlohaCare Medicaid	$704.00
Rate for Payer: AlohaCare Medicare	$1,070.08
Rate for Payer: Cash Price	$844.80
Rate for Payer: Devoted Health Medicare	$1,182.72
Rate for Payer: Hawaii Medical Service Association Medicare	$1,070.08
Rate for Payer: Hawaii Western Management Group Commercial	$1,337.60
Rate for Payer: Health Management Network Commercial	$1,196.80
Rate for Payer: Humana Medicare	$1,070.08
Rate for Payer: Kaiser Permanente Commercial	$1,267.20
Rate for Payer: Kaiser Permanente Medicaid	$718.08
Rate for Payer: Kaiser Permanente Medicare	$1,070.08
Rate for Payer: MDX Hawaii PPO	$1,365.76
Rate for Payer: Ohana Health Plan Medicaid	$1,070.08
Rate for Payer: Ohana Health Plan Medicare	$1,070.08
Rate for Payer: UnitedHealthcare Medicare	$1,070.08
Rate for Payer: University Health Alliance Commercial	$1,026.29

STAPLER RELOADS 40MM CR40B

Facility

$1,408.00

Hospital Revenue Code	270
Min. Negotiated Rate	$1,196.80
Max. Negotiated Rate	$1,365.76
Rate for Payer: Cash Price	$844.80
Rate for Payer: Health Management Network Commercial	$1,196.80
Rate for Payer: Kaiser Permanente Commercial	$1,267.20
Rate for Payer: MDX Hawaii PPO	$1,365.76

STAPLER, SINGLE LOADING UNIT

Facility

$207.00

Hospital Revenue Code	272
Min. Negotiated Rate	$103.50
Max. Negotiated Rate	$200.79
Rate for Payer: Kaiser Permanente Commercial	$186.30
Rate for Payer: AlohaCare Medicaid	$103.50
Rate for Payer: AlohaCare Medicare	$157.32
Rate for Payer: Cash Price	$124.20
Rate for Payer: Devoted Health Medicare	$173.88
Rate for Payer: Hawaii Medical Service Association Medicare	$157.32
Rate for Payer: Hawaii Western Management Group Commercial	$196.65
Rate for Payer: Health Management Network Commercial	$175.95
Rate for Payer: Humana Medicare	$157.32
Rate for Payer: Kaiser Permanente Medicaid	$105.57
Rate for Payer: Kaiser Permanente Medicare	$157.32
Rate for Payer: MDX Hawaii PPO	$200.79
Rate for Payer: Ohana Health Plan Medicaid	$157.32
Rate for Payer: Ohana Health Plan Medicare	$157.32
Rate for Payer: UnitedHealthcare Medicare	$157.32
Rate for Payer: University Health Alliance Commercial	$150.88

STAPLER, SINGLE LOADING UNIT

Facility

$207.00

Hospital Revenue Code	272
Min. Negotiated Rate	$175.95
Max. Negotiated Rate	$200.79
Rate for Payer: Cash Price	$124.20
Rate for Payer: Health Management Network Commercial	$175.95
Rate for Payer: Kaiser Permanente Commercial	$186.30
Rate for Payer: MDX Hawaii PPO	$200.79

STAPLER SUREFORM 45 480445

Facility

$1,610.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,368.50
Max. Negotiated Rate	$1,561.70
Rate for Payer: Cash Price	$966.00
Rate for Payer: Health Management Network Commercial	$1,368.50
Rate for Payer: Kaiser Permanente Commercial	$1,449.00
Rate for Payer: MDX Hawaii PPO	$1,561.70

STAPLER SUREFORM 45 480445

Facility

$1,610.00

Hospital Revenue Code	272
Min. Negotiated Rate	$805.00
Max. Negotiated Rate	$1,561.70
Rate for Payer: AlohaCare Medicaid	$805.00
Rate for Payer: AlohaCare Medicare	$1,223.60
Rate for Payer: Cash Price	$966.00
Rate for Payer: Devoted Health Medicare	$1,352.40
Rate for Payer: Hawaii Medical Service Association Medicare	$1,223.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,529.50
Rate for Payer: Health Management Network Commercial	$1,368.50
Rate for Payer: Humana Medicare	$1,223.60
Rate for Payer: Kaiser Permanente Commercial	$1,449.00
Rate for Payer: Kaiser Permanente Medicaid	$821.10
Rate for Payer: Kaiser Permanente Medicare	$1,223.60
Rate for Payer: MDX Hawaii PPO	$1,561.70
Rate for Payer: Ohana Health Plan Medicaid	$1,223.60
Rate for Payer: Ohana Health Plan Medicare	$1,223.60
Rate for Payer: UnitedHealthcare Medicare	$1,223.60
Rate for Payer: University Health Alliance Commercial	$1,173.53

STAPLER SUREFORM 60 480460

Facility

$1,670.00

Hospital Revenue Code	272
Min. Negotiated Rate	$835.00
Max. Negotiated Rate	$1,619.90
Rate for Payer: AlohaCare Medicaid	$835.00
Rate for Payer: AlohaCare Medicare	$1,269.20
Rate for Payer: Cash Price	$1,002.00
Rate for Payer: Devoted Health Medicare	$1,402.80
Rate for Payer: Hawaii Medical Service Association Medicare	$1,269.20
Rate for Payer: Hawaii Western Management Group Commercial	$1,586.50
Rate for Payer: Health Management Network Commercial	$1,419.50
Rate for Payer: Humana Medicare	$1,269.20
Rate for Payer: Kaiser Permanente Commercial	$1,503.00
Rate for Payer: Kaiser Permanente Medicaid	$851.70
Rate for Payer: Kaiser Permanente Medicare	$1,269.20
Rate for Payer: MDX Hawaii PPO	$1,619.90
Rate for Payer: Ohana Health Plan Medicaid	$1,269.20
Rate for Payer: Ohana Health Plan Medicare	$1,269.20
Rate for Payer: UnitedHealthcare Medicare	$1,269.20
Rate for Payer: University Health Alliance Commercial	$1,217.26

STAPLER SUREFORM 60 480460

Facility

$1,670.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,419.50
Max. Negotiated Rate	$1,619.90
Rate for Payer: Cash Price	$1,002.00
Rate for Payer: Health Management Network Commercial	$1,419.50
Rate for Payer: Kaiser Permanente Commercial	$1,503.00
Rate for Payer: MDX Hawaii PPO	$1,619.90

STAPLER SUREFORM 8MM 488530

Facility

$1,638.00

Hospital Revenue Code	272
Min. Negotiated Rate	$819.00
Max. Negotiated Rate	$1,588.86
Rate for Payer: AlohaCare Medicaid	$819.00
Rate for Payer: AlohaCare Medicare	$1,244.88
Rate for Payer: Cash Price	$982.80
Rate for Payer: Devoted Health Medicare	$1,375.92
Rate for Payer: Hawaii Medical Service Association Medicare	$1,244.88
Rate for Payer: Hawaii Western Management Group Commercial	$1,556.10
Rate for Payer: Health Management Network Commercial	$1,392.30
Rate for Payer: Humana Medicare	$1,244.88
Rate for Payer: Kaiser Permanente Commercial	$1,474.20
Rate for Payer: Kaiser Permanente Medicaid	$835.38
Rate for Payer: Kaiser Permanente Medicare	$1,244.88
Rate for Payer: MDX Hawaii PPO	$1,588.86
Rate for Payer: Ohana Health Plan Medicaid	$1,244.88
Rate for Payer: Ohana Health Plan Medicare	$1,244.88
Rate for Payer: UnitedHealthcare Medicare	$1,244.88
Rate for Payer: University Health Alliance Commercial	$1,193.94

STAPLER SUREFORM 8MM 488530

Facility

$1,638.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,392.30
Max. Negotiated Rate	$1,588.86
Rate for Payer: Cash Price	$982.80
Rate for Payer: Health Management Network Commercial	$1,392.30
Rate for Payer: Kaiser Permanente Commercial	$1,474.20
Rate for Payer: MDX Hawaii PPO	$1,588.86

STAPLER TA90-4.8 TA9048S

Facility

$375.00

Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$363.75
Rate for Payer: AlohaCare Medicaid	$187.50
Rate for Payer: AlohaCare Medicare	$285.00
Rate for Payer: Cash Price	$225.00
Rate for Payer: Devoted Health Medicare	$315.00
Rate for Payer: Hawaii Medical Service Association Medicare	$285.00
Rate for Payer: Hawaii Western Management Group Commercial	$356.25
Rate for Payer: Health Management Network Commercial	$318.75
Rate for Payer: Humana Medicare	$285.00
Rate for Payer: Kaiser Permanente Commercial	$337.50
Rate for Payer: Kaiser Permanente Medicaid	$191.25
Rate for Payer: Kaiser Permanente Medicare	$285.00
Rate for Payer: MDX Hawaii PPO	$363.75
Rate for Payer: Ohana Health Plan Medicaid	$285.00
Rate for Payer: Ohana Health Plan Medicare	$285.00
Rate for Payer: UnitedHealthcare Medicare	$285.00
Rate for Payer: University Health Alliance Commercial	$273.34

Know your out-of-pocket cost for care.

All Charges