Honoka'a Hospital and Skilled Nursing Facility

All Charges

Charge

Type

Setting

Price

TROCAR 5-12MM VISIPORT PLUS

Facility

$241.00

Hospital Revenue Code	272
Min. Negotiated Rate	$204.85
Max. Negotiated Rate	$233.77
Rate for Payer: Cash Price	$144.60
Rate for Payer: Health Management Network Commercial	$204.85
Rate for Payer: Kaiser Permanente Commercial	$216.90
Rate for Payer: MDX Hawaii PPO	$233.77

TROCAR 5MM STEP

Facility

$204.00

Hospital Revenue Code	272
Min. Negotiated Rate	$173.40
Max. Negotiated Rate	$197.88
Rate for Payer: Cash Price	$122.40
Rate for Payer: Health Management Network Commercial	$173.40
Rate for Payer: Kaiser Permanente Commercial	$183.60
Rate for Payer: MDX Hawaii PPO	$197.88

TROCAR 5MM STEP

Facility

$204.00

Hospital Revenue Code	272
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$197.88
Rate for Payer: AlohaCare Medicaid	$102.00
Rate for Payer: AlohaCare Medicare	$155.04
Rate for Payer: Cash Price	$122.40
Rate for Payer: Devoted Health Medicare	$171.36
Rate for Payer: Hawaii Medical Service Association Medicare	$155.04
Rate for Payer: Hawaii Western Management Group Commercial	$193.80
Rate for Payer: Health Management Network Commercial	$173.40
Rate for Payer: Humana Medicare	$155.04
Rate for Payer: Kaiser Permanente Commercial	$183.60
Rate for Payer: Kaiser Permanente Medicaid	$104.04
Rate for Payer: Kaiser Permanente Medicare	$155.04
Rate for Payer: MDX Hawaii PPO	$197.88
Rate for Payer: Ohana Health Plan Medicaid	$155.04
Rate for Payer: Ohana Health Plan Medicare	$155.04
Rate for Payer: UnitedHealthcare Medicare	$155.04
Rate for Payer: University Health Alliance Commercial	$148.70

TROCAR BALLOON 12X100MM CFF73

Facility

$525.00

Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$509.25
Rate for Payer: AlohaCare Medicaid	$262.50
Rate for Payer: AlohaCare Medicare	$399.00
Rate for Payer: Cash Price	$315.00
Rate for Payer: Devoted Health Medicare	$441.00
Rate for Payer: Hawaii Medical Service Association Medicare	$399.00
Rate for Payer: Hawaii Western Management Group Commercial	$498.75
Rate for Payer: Health Management Network Commercial	$446.25
Rate for Payer: Humana Medicare	$399.00
Rate for Payer: Kaiser Permanente Commercial	$472.50
Rate for Payer: Kaiser Permanente Medicaid	$267.75
Rate for Payer: Kaiser Permanente Medicare	$399.00
Rate for Payer: MDX Hawaii PPO	$509.25
Rate for Payer: Ohana Health Plan Medicaid	$399.00
Rate for Payer: Ohana Health Plan Medicare	$399.00
Rate for Payer: UnitedHealthcare Medicare	$399.00
Rate for Payer: University Health Alliance Commercial	$382.67

TROCAR BALLOON 12X100MM CFF73

Facility

$525.00

Hospital Revenue Code	272
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$509.25
Rate for Payer: Cash Price	$315.00
Rate for Payer: Health Management Network Commercial	$446.25
Rate for Payer: Kaiser Permanente Commercial	$472.50
Rate for Payer: MDX Hawaii PPO	$509.25

TROCAR BALLOON 12X150MM CFF71

Facility

$375.00

Hospital Revenue Code	272
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$363.75
Rate for Payer: Cash Price	$225.00
Rate for Payer: Health Management Network Commercial	$318.75
Rate for Payer: Kaiser Permanente Commercial	$337.50
Rate for Payer: MDX Hawaii PPO	$363.75

TROCAR BALLOON 12X150MM CFF71

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

TROCAR BALLOON OVAL

Facility

$3,258.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,629.00
Max. Negotiated Rate	$3,160.26
Rate for Payer: AlohaCare Medicaid	$1,629.00
Rate for Payer: AlohaCare Medicare	$2,476.08
Rate for Payer: Cash Price	$1,954.80
Rate for Payer: Devoted Health Medicare	$2,736.72
Rate for Payer: Hawaii Medical Service Association Medicare	$2,476.08
Rate for Payer: Hawaii Western Management Group Commercial	$3,095.10
Rate for Payer: Health Management Network Commercial	$2,769.30
Rate for Payer: Humana Medicare	$2,476.08
Rate for Payer: Kaiser Permanente Commercial	$2,932.20
Rate for Payer: Kaiser Permanente Medicaid	$1,661.58
Rate for Payer: Kaiser Permanente Medicare	$2,476.08
Rate for Payer: MDX Hawaii PPO	$3,160.26
Rate for Payer: Ohana Health Plan Medicaid	$2,476.08
Rate for Payer: Ohana Health Plan Medicare	$2,476.08
Rate for Payer: UnitedHealthcare Medicare	$2,476.08
Rate for Payer: University Health Alliance Commercial	$2,374.76

TROCAR BALLOON OVAL

Facility

$3,258.00

Hospital Revenue Code	272
Min. Negotiated Rate	$2,769.30
Max. Negotiated Rate	$3,160.26
Rate for Payer: Cash Price	$1,954.80
Rate for Payer: Health Management Network Commercial	$2,769.30
Rate for Payer: Kaiser Permanente Commercial	$2,932.20
Rate for Payer: MDX Hawaii PPO	$3,160.26

TROCAR BALLOON ROUND

Facility

$2,457.00

Hospital Revenue Code	272
Min. Negotiated Rate	$2,088.45
Max. Negotiated Rate	$2,383.29
Rate for Payer: Cash Price	$1,474.20
Rate for Payer: Health Management Network Commercial	$2,088.45
Rate for Payer: Kaiser Permanente Commercial	$2,211.30
Rate for Payer: MDX Hawaii PPO	$2,383.29

TROCAR BALLOON ROUND

Facility

$2,457.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,228.50
Max. Negotiated Rate	$2,383.29
Rate for Payer: AlohaCare Medicaid	$1,228.50
Rate for Payer: AlohaCare Medicare	$1,867.32
Rate for Payer: Cash Price	$1,474.20
Rate for Payer: Devoted Health Medicare	$2,063.88
Rate for Payer: Hawaii Medical Service Association Medicare	$1,867.32
Rate for Payer: Hawaii Western Management Group Commercial	$2,334.15
Rate for Payer: Health Management Network Commercial	$2,088.45
Rate for Payer: Humana Medicare	$1,867.32
Rate for Payer: Kaiser Permanente Commercial	$2,211.30
Rate for Payer: Kaiser Permanente Medicaid	$1,253.07
Rate for Payer: Kaiser Permanente Medicare	$1,867.32
Rate for Payer: MDX Hawaii PPO	$2,383.29
Rate for Payer: Ohana Health Plan Medicaid	$1,867.32
Rate for Payer: Ohana Health Plan Medicare	$1,867.32
Rate for Payer: UnitedHealthcare Medicare	$1,867.32
Rate for Payer: University Health Alliance Commercial	$1,790.91

TROCAR CLOSURE ENDOCLOSE

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

TROCAR CLOSURE ENDOCLOSE

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

TROCAR EXPAND SLV

Facility

$204.00

Hospital Revenue Code	272
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$197.88
Rate for Payer: AlohaCare Medicaid	$102.00
Rate for Payer: AlohaCare Medicare	$155.04
Rate for Payer: Cash Price	$122.40
Rate for Payer: Devoted Health Medicare	$171.36
Rate for Payer: Hawaii Medical Service Association Medicare	$155.04
Rate for Payer: Hawaii Western Management Group Commercial	$193.80
Rate for Payer: Health Management Network Commercial	$173.40
Rate for Payer: Humana Medicare	$155.04
Rate for Payer: Kaiser Permanente Commercial	$183.60
Rate for Payer: Kaiser Permanente Medicaid	$104.04
Rate for Payer: Kaiser Permanente Medicare	$155.04
Rate for Payer: MDX Hawaii PPO	$197.88
Rate for Payer: Ohana Health Plan Medicaid	$155.04
Rate for Payer: Ohana Health Plan Medicare	$155.04
Rate for Payer: UnitedHealthcare Medicare	$155.04
Rate for Payer: University Health Alliance Commercial	$148.70

TROCAR EXPAND SLV

Facility

$204.00

Hospital Revenue Code	272
Min. Negotiated Rate	$173.40
Max. Negotiated Rate	$197.88
Rate for Payer: Cash Price	$122.40
Rate for Payer: Health Management Network Commercial	$173.40
Rate for Payer: Kaiser Permanente Commercial	$183.60
Rate for Payer: MDX Hawaii PPO	$197.88

TROCAR LAPAROSCOPIC 5MM CFF03

Facility

$360.00

Hospital Revenue Code	272
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$349.20
Rate for Payer: AlohaCare Medicaid	$180.00
Rate for Payer: AlohaCare Medicare	$273.60
Rate for Payer: Cash Price	$216.00
Rate for Payer: Devoted Health Medicare	$302.40
Rate for Payer: Hawaii Medical Service Association Medicare	$273.60
Rate for Payer: Hawaii Western Management Group Commercial	$342.00
Rate for Payer: Health Management Network Commercial	$306.00
Rate for Payer: Humana Medicare	$273.60
Rate for Payer: Kaiser Permanente Commercial	$324.00
Rate for Payer: Kaiser Permanente Medicaid	$183.60
Rate for Payer: Kaiser Permanente Medicare	$273.60
Rate for Payer: MDX Hawaii PPO	$349.20
Rate for Payer: Ohana Health Plan Medicaid	$273.60
Rate for Payer: Ohana Health Plan Medicare	$273.60
Rate for Payer: UnitedHealthcare Medicare	$273.60
Rate for Payer: University Health Alliance Commercial	$262.40

TROCAR LAPAROSCOPIC 5MM CFF03

Facility

$360.00

Hospital Revenue Code	272
Min. Negotiated Rate	$306.00
Max. Negotiated Rate	$349.20
Rate for Payer: Cash Price	$216.00
Rate for Payer: Health Management Network Commercial	$306.00
Rate for Payer: Kaiser Permanente Commercial	$324.00
Rate for Payer: MDX Hawaii PPO	$349.20

TROCAR REP 5MM

Facility

$193.00

Hospital Revenue Code	272
Min. Negotiated Rate	$96.50
Max. Negotiated Rate	$187.21
Rate for Payer: AlohaCare Medicaid	$96.50
Rate for Payer: AlohaCare Medicare	$146.68
Rate for Payer: Cash Price	$115.80
Rate for Payer: Devoted Health Medicare	$162.12
Rate for Payer: Hawaii Medical Service Association Medicare	$146.68
Rate for Payer: Hawaii Western Management Group Commercial	$183.35
Rate for Payer: Health Management Network Commercial	$164.05
Rate for Payer: Humana Medicare	$146.68
Rate for Payer: Kaiser Permanente Commercial	$173.70
Rate for Payer: Kaiser Permanente Medicaid	$98.43
Rate for Payer: Kaiser Permanente Medicare	$146.68
Rate for Payer: MDX Hawaii PPO	$187.21
Rate for Payer: Ohana Health Plan Medicaid	$146.68
Rate for Payer: Ohana Health Plan Medicare	$146.68
Rate for Payer: UnitedHealthcare Medicare	$146.68
Rate for Payer: University Health Alliance Commercial	$140.68

TROCAR REP 5MM

Facility

$193.00

Hospital Revenue Code	272
Min. Negotiated Rate	$164.05
Max. Negotiated Rate	$187.21
Rate for Payer: Cash Price	$115.80
Rate for Payer: Health Management Network Commercial	$164.05
Rate for Payer: Kaiser Permanente Commercial	$173.70
Rate for Payer: MDX Hawaii PPO	$187.21

TROCAR SHIELDED BLADED 11X100

Facility

$375.00

Hospital Revenue Code	272
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$363.75
Rate for Payer: Cash Price	$225.00
Rate for Payer: Health Management Network Commercial	$318.75
Rate for Payer: Kaiser Permanente Commercial	$337.50
Rate for Payer: MDX Hawaii PPO	$363.75

TROCAR SHIELDED BLADED 11X100

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

TROCAR STEP 12MM

Facility

$214.00

Hospital Revenue Code	272
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

TROCAR STEP 12MM

Facility

$214.00

Hospital Revenue Code	272
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

TROCAR STEP 5MM SHORT

Facility

$214.00

Hospital Revenue Code	272
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

TROCAR STEP 5MM SHORT

Facility

$214.00

Hospital Revenue Code	272
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

Know your out-of-pocket cost for care.

All Charges