Kau Hospital

All Charges

Charge

Type

Setting

Price

K-WIRE .035X6" DBL 316-0117

Facility

$147.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$124.95
Max. Negotiated Rate	$142.59
Rate for Payer: Cash Price	$88.20
Rate for Payer: Health Management Network Commercial	$124.95
Rate for Payer: Kaiser Permanente Commercial	$132.30
Rate for Payer: MDX Hawaii PPO	$142.59

K-WIRE .045" DIAMOND 186-27-12

Facility

$87.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$48.72
Max. Negotiated Rate	$84.39
Rate for Payer: Cash Price	$52.20
Rate for Payer: Hawaii Western Management Group Commercial	$60.90
Rate for Payer: Health Management Network Commercial	$73.95
Rate for Payer: Kaiser Permanente Commercial	$78.30
Rate for Payer: MDX Hawaii PPO	$84.39
Rate for Payer: University Health Alliance Commercial	$48.72

K-WIRE .045" DIAMOND 186-27-12

Facility

$87.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$26.97
Max. Negotiated Rate	$84.39
Rate for Payer: AlohaCare Medicaid	$43.50
Rate for Payer: AlohaCare Medicare	$26.97
Rate for Payer: Cash Price	$52.20
Rate for Payer: Devoted Health Medicare	$29.58
Rate for Payer: Hawaii Medical Service Association Medicare	$26.97
Rate for Payer: Hawaii Western Management Group Commercial	$60.90
Rate for Payer: Health Management Network Commercial	$73.95
Rate for Payer: Humana Medicare	$26.97
Rate for Payer: Kaiser Permanente Commercial	$78.30
Rate for Payer: Kaiser Permanente Medicaid	$44.37
Rate for Payer: Kaiser Permanente Medicare	$26.97
Rate for Payer: MDX Hawaii PPO	$84.39
Rate for Payer: Ohana Health Plan Medicaid	$26.97
Rate for Payer: Ohana Health Plan Medicare	$26.97
Rate for Payer: UnitedHealthcare Medicare	$26.97
Rate for Payer: University Health Alliance Commercial	$48.72

K-WIRE .045X6" 316-0006

Facility

$147.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$124.95
Max. Negotiated Rate	$142.59
Rate for Payer: Cash Price	$88.20
Rate for Payer: Health Management Network Commercial	$124.95
Rate for Payer: Kaiser Permanente Commercial	$132.30
Rate for Payer: MDX Hawaii PPO	$142.59

K-WIRE .045X6" 316-0006

Facility

$147.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$45.57
Max. Negotiated Rate	$142.59
Rate for Payer: AlohaCare Medicaid	$73.50
Rate for Payer: AlohaCare Medicare	$45.57
Rate for Payer: Cash Price	$88.20
Rate for Payer: Devoted Health Medicare	$49.98
Rate for Payer: Hawaii Medical Service Association Medicare	$45.57
Rate for Payer: Hawaii Western Management Group Commercial	$139.65
Rate for Payer: Health Management Network Commercial	$124.95
Rate for Payer: Humana Medicare	$45.57
Rate for Payer: Kaiser Permanente Commercial	$132.30
Rate for Payer: Kaiser Permanente Medicaid	$74.97
Rate for Payer: Kaiser Permanente Medicare	$45.57
Rate for Payer: MDX Hawaii PPO	$142.59
Rate for Payer: Ohana Health Plan Medicaid	$45.57
Rate for Payer: Ohana Health Plan Medicare	$45.57
Rate for Payer: UnitedHealthcare Medicare	$45.57
Rate for Payer: University Health Alliance Commercial	$107.15

K-WIRE .062X6" DBL 316-0118

Facility

$147.00

Service Code	HCPCS C1747
Hospital Revenue Code	272
Min. Negotiated Rate	$45.57
Max. Negotiated Rate	$142.59
Rate for Payer: AlohaCare Medicaid	$73.50
Rate for Payer: AlohaCare Medicare	$45.57
Rate for Payer: Cash Price	$88.20
Rate for Payer: Devoted Health Medicare	$49.98
Rate for Payer: Hawaii Medical Service Association Medicare	$45.57
Rate for Payer: Hawaii Western Management Group Commercial	$139.65
Rate for Payer: Health Management Network Commercial	$124.95
Rate for Payer: Humana Medicare	$45.57
Rate for Payer: Kaiser Permanente Commercial	$132.30
Rate for Payer: Kaiser Permanente Medicaid	$74.97
Rate for Payer: Kaiser Permanente Medicare	$45.57
Rate for Payer: MDX Hawaii PPO	$142.59
Rate for Payer: Ohana Health Plan Medicaid	$45.57
Rate for Payer: Ohana Health Plan Medicare	$45.57
Rate for Payer: UnitedHealthcare Medicare	$45.57
Rate for Payer: University Health Alliance Commercial	$107.15

K-WIRE .062X6" DBL 316-0118

Facility

$147.00

Service Code	HCPCS C1747
Hospital Revenue Code	272
Min. Negotiated Rate	$124.95
Max. Negotiated Rate	$142.59
Rate for Payer: Cash Price	$88.20
Rate for Payer: Health Management Network Commercial	$124.95
Rate for Payer: Kaiser Permanente Commercial	$132.30
Rate for Payer: MDX Hawaii PPO	$142.59

KWIRE .062X7.25" 321-0122

Facility

$126.00

Service Code	HCPCS C1713
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

KWIRE .062X7.25" 321-0122

Facility

$126.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$39.06
Max. Negotiated Rate	$122.22
Rate for Payer: AlohaCare Medicaid	$63.00
Rate for Payer: AlohaCare Medicare	$39.06
Rate for Payer: Cash Price	$75.60
Rate for Payer: Devoted Health Medicare	$42.84
Rate for Payer: Hawaii Medical Service Association Medicare	$39.06
Rate for Payer: Hawaii Western Management Group Commercial	$119.70
Rate for Payer: Health Management Network Commercial	$107.10
Rate for Payer: Humana Medicare	$39.06
Rate for Payer: Kaiser Permanente Commercial	$113.40
Rate for Payer: Kaiser Permanente Medicaid	$64.26
Rate for Payer: Kaiser Permanente Medicare	$39.06
Rate for Payer: MDX Hawaii PPO	$122.22
Rate for Payer: Ohana Health Plan Medicaid	$39.06
Rate for Payer: Ohana Health Plan Medicare	$39.06
Rate for Payer: UnitedHealthcare Medicare	$39.06
Rate for Payer: University Health Alliance Commercial	$91.84

K-WIRE 0.7X80MM WIRE-0.7/080

Facility

$140.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$135.80
Rate for Payer: Cash Price	$84.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: MDX Hawaii PPO	$135.80

K-WIRE 0.7X80MM WIRE-0.7/080

Facility

$140.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$135.80
Rate for Payer: AlohaCare Medicaid	$70.00
Rate for Payer: AlohaCare Medicare	$43.40
Rate for Payer: Cash Price	$84.00
Rate for Payer: Devoted Health Medicare	$47.60
Rate for Payer: Hawaii Medical Service Association Medicare	$43.40
Rate for Payer: Hawaii Western Management Group Commercial	$133.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Humana Medicare	$43.40
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: Kaiser Permanente Medicaid	$71.40
Rate for Payer: Kaiser Permanente Medicare	$43.40
Rate for Payer: MDX Hawaii PPO	$135.80
Rate for Payer: Ohana Health Plan Medicaid	$43.40
Rate for Payer: Ohana Health Plan Medicare	$43.40
Rate for Payer: UnitedHealthcare Medicare	$43.40
Rate for Payer: University Health Alliance Commercial	$102.05

K-WIRE 0.8, 80MM WIRE-0.8/080

Facility

$140.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$135.80
Rate for Payer: Cash Price	$84.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: MDX Hawaii PPO	$135.80

K-WIRE 0.8, 80MM WIRE-0.8/080

Facility

$140.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$135.80
Rate for Payer: AlohaCare Medicaid	$70.00
Rate for Payer: AlohaCare Medicare	$43.40
Rate for Payer: Cash Price	$84.00
Rate for Payer: Devoted Health Medicare	$47.60
Rate for Payer: Hawaii Medical Service Association Medicare	$43.40
Rate for Payer: Hawaii Western Management Group Commercial	$133.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Humana Medicare	$43.40
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: Kaiser Permanente Medicaid	$71.40
Rate for Payer: Kaiser Permanente Medicare	$43.40
Rate for Payer: MDX Hawaii PPO	$135.80
Rate for Payer: Ohana Health Plan Medicaid	$43.40
Rate for Payer: Ohana Health Plan Medicare	$43.40
Rate for Payer: UnitedHealthcare Medicare	$43.40
Rate for Payer: University Health Alliance Commercial	$102.05

K-WIRE 0.8X120MM WIRE-0.8/120

Facility

$140.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$135.80
Rate for Payer: AlohaCare Medicaid	$70.00
Rate for Payer: AlohaCare Medicare	$43.40
Rate for Payer: Cash Price	$84.00
Rate for Payer: Devoted Health Medicare	$47.60
Rate for Payer: Hawaii Medical Service Association Medicare	$43.40
Rate for Payer: Hawaii Western Management Group Commercial	$133.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Humana Medicare	$43.40
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: Kaiser Permanente Medicaid	$71.40
Rate for Payer: Kaiser Permanente Medicare	$43.40
Rate for Payer: MDX Hawaii PPO	$135.80
Rate for Payer: Ohana Health Plan Medicaid	$43.40
Rate for Payer: Ohana Health Plan Medicare	$43.40
Rate for Payer: UnitedHealthcare Medicare	$43.40
Rate for Payer: University Health Alliance Commercial	$102.05

K-WIRE 0.8X120MM WIRE-0.8/120

Facility

$140.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$135.80
Rate for Payer: Cash Price	$84.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: MDX Hawaii PPO	$135.80

K-WIRE 0.9MM WIRE-0.9

Facility

$90.00

Service Code	HCPCS C1713
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

K-WIRE 0.9MM WIRE-0.9

Facility

$90.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$27.90
Max. Negotiated Rate	$87.30
Rate for Payer: AlohaCare Medicaid	$45.00
Rate for Payer: AlohaCare Medicare	$27.90
Rate for Payer: Cash Price	$54.00
Rate for Payer: Devoted Health Medicare	$30.60
Rate for Payer: Hawaii Medical Service Association Medicare	$27.90
Rate for Payer: Hawaii Western Management Group Commercial	$85.50
Rate for Payer: Health Management Network Commercial	$76.50
Rate for Payer: Humana Medicare	$27.90
Rate for Payer: Kaiser Permanente Commercial	$81.00
Rate for Payer: Kaiser Permanente Medicaid	$45.90
Rate for Payer: Kaiser Permanente Medicare	$27.90
Rate for Payer: MDX Hawaii PPO	$87.30
Rate for Payer: Ohana Health Plan Medicaid	$27.90
Rate for Payer: Ohana Health Plan Medicare	$27.90
Rate for Payer: UnitedHealthcare Medicare	$27.90
Rate for Payer: University Health Alliance Commercial	$65.60

K-WIRE 0.9MM WIRE-0.9/100

Facility

$140.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$135.80
Rate for Payer: Cash Price	$84.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: MDX Hawaii PPO	$135.80

K-WIRE 0.9MM WIRE-0.9/100

Facility

$140.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$135.80
Rate for Payer: AlohaCare Medicaid	$70.00
Rate for Payer: AlohaCare Medicare	$43.40
Rate for Payer: Cash Price	$84.00
Rate for Payer: Devoted Health Medicare	$47.60
Rate for Payer: Hawaii Medical Service Association Medicare	$43.40
Rate for Payer: Hawaii Western Management Group Commercial	$133.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Humana Medicare	$43.40
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: Kaiser Permanente Medicaid	$71.40
Rate for Payer: Kaiser Permanente Medicare	$43.40
Rate for Payer: MDX Hawaii PPO	$135.80
Rate for Payer: Ohana Health Plan Medicaid	$43.40
Rate for Payer: Ohana Health Plan Medicare	$43.40
Rate for Payer: UnitedHealthcare Medicare	$43.40
Rate for Payer: University Health Alliance Commercial	$102.05

K-WIRE 0.9X120

Facility

$140.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$135.80
Rate for Payer: AlohaCare Medicaid	$70.00
Rate for Payer: AlohaCare Medicare	$43.40
Rate for Payer: Cash Price	$84.00
Rate for Payer: Devoted Health Medicare	$47.60
Rate for Payer: Hawaii Medical Service Association Medicare	$43.40
Rate for Payer: Hawaii Western Management Group Commercial	$98.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Humana Medicare	$43.40
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: Kaiser Permanente Medicaid	$71.40
Rate for Payer: Kaiser Permanente Medicare	$43.40
Rate for Payer: MDX Hawaii PPO	$135.80
Rate for Payer: Ohana Health Plan Medicaid	$43.40
Rate for Payer: Ohana Health Plan Medicare	$43.40
Rate for Payer: UnitedHealthcare Medicare	$43.40
Rate for Payer: University Health Alliance Commercial	$78.40

K-WIRE 0.9X120

Facility

$140.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$78.40
Max. Negotiated Rate	$135.80
Rate for Payer: Cash Price	$84.00
Rate for Payer: Hawaii Western Management Group Commercial	$98.00
Rate for Payer: Health Management Network Commercial	$119.00
Rate for Payer: Kaiser Permanente Commercial	$126.00
Rate for Payer: MDX Hawaii PPO	$135.80
Rate for Payer: University Health Alliance Commercial	$78.40

KWIRE 1.0/150MM TRO PT 292.10

Facility

$73.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$62.05
Max. Negotiated Rate	$70.81
Rate for Payer: Cash Price	$43.80
Rate for Payer: Health Management Network Commercial	$62.05
Rate for Payer: Kaiser Permanente Commercial	$65.70
Rate for Payer: MDX Hawaii PPO	$70.81

KWIRE 1.0/150MM TRO PT 292.10

Facility

$73.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$22.63
Max. Negotiated Rate	$70.81
Rate for Payer: AlohaCare Medicaid	$36.50
Rate for Payer: AlohaCare Medicare	$22.63
Rate for Payer: Cash Price	$43.80
Rate for Payer: Devoted Health Medicare	$24.82
Rate for Payer: Hawaii Medical Service Association Medicare	$22.63
Rate for Payer: Hawaii Western Management Group Commercial	$69.35
Rate for Payer: Health Management Network Commercial	$62.05
Rate for Payer: Humana Medicare	$22.63
Rate for Payer: Kaiser Permanente Commercial	$65.70
Rate for Payer: Kaiser Permanente Medicaid	$37.23
Rate for Payer: Kaiser Permanente Medicare	$22.63
Rate for Payer: MDX Hawaii PPO	$70.81
Rate for Payer: Ohana Health Plan Medicaid	$22.63
Rate for Payer: Ohana Health Plan Medicare	$22.63
Rate for Payer: UnitedHealthcare Medicare	$22.63
Rate for Payer: University Health Alliance Commercial	$53.21

KWIRE 1.0X150 4901-10-1-15

Facility

$91.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$28.21
Max. Negotiated Rate	$88.27
Rate for Payer: AlohaCare Medicaid	$45.50
Rate for Payer: AlohaCare Medicare	$28.21
Rate for Payer: Cash Price	$54.60
Rate for Payer: Devoted Health Medicare	$30.94
Rate for Payer: Hawaii Medical Service Association Medicare	$28.21
Rate for Payer: Hawaii Western Management Group Commercial	$86.45
Rate for Payer: Health Management Network Commercial	$77.35
Rate for Payer: Humana Medicare	$28.21
Rate for Payer: Kaiser Permanente Commercial	$81.90
Rate for Payer: Kaiser Permanente Medicaid	$46.41
Rate for Payer: Kaiser Permanente Medicare	$28.21
Rate for Payer: MDX Hawaii PPO	$88.27
Rate for Payer: Ohana Health Plan Medicaid	$28.21
Rate for Payer: Ohana Health Plan Medicare	$28.21
Rate for Payer: UnitedHealthcare Medicare	$28.21
Rate for Payer: University Health Alliance Commercial	$66.33

KWIRE 1.0X150 4901-10-1-15

Facility

$91.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$77.35
Max. Negotiated Rate	$88.27
Rate for Payer: Cash Price	$54.60
Rate for Payer: Health Management Network Commercial	$77.35
Rate for Payer: Kaiser Permanente Commercial	$81.90
Rate for Payer: MDX Hawaii PPO	$88.27

Know your out-of-pocket cost for care.

All Charges