Kau Hospital

All Charges

Charge

Type

Setting

Price

K-WIRE 1.0X150MM 292.50

Facility

$72.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$22.32
Max. Negotiated Rate	$69.84
Rate for Payer: AlohaCare Medicaid	$36.00
Rate for Payer: AlohaCare Medicare	$22.32
Rate for Payer: Cash Price	$43.20
Rate for Payer: Devoted Health Medicare	$24.48
Rate for Payer: Hawaii Medical Service Association Medicare	$22.32
Rate for Payer: Hawaii Western Management Group Commercial	$68.40
Rate for Payer: Health Management Network Commercial	$61.20
Rate for Payer: Humana Medicare	$22.32
Rate for Payer: Kaiser Permanente Commercial	$64.80
Rate for Payer: Kaiser Permanente Medicaid	$36.72
Rate for Payer: Kaiser Permanente Medicare	$22.32
Rate for Payer: MDX Hawaii PPO	$69.84
Rate for Payer: Ohana Health Plan Medicaid	$22.32
Rate for Payer: Ohana Health Plan Medicare	$22.32
Rate for Payer: UnitedHealthcare Medicare	$22.32
Rate for Payer: University Health Alliance Commercial	$52.48

K-WIRE 1.0X150MM 292.50

Facility

$72.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$61.20
Max. Negotiated Rate	$69.84
Rate for Payer: Cash Price	$43.20
Rate for Payer: Health Management Network Commercial	$61.20
Rate for Payer: Kaiser Permanente Commercial	$64.80
Rate for Payer: MDX Hawaii PPO	$69.84

K-WIRE 1.0X285MM 292.11

Facility

$76.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$23.56
Max. Negotiated Rate	$73.72
Rate for Payer: AlohaCare Medicaid	$38.00
Rate for Payer: AlohaCare Medicare	$23.56
Rate for Payer: Cash Price	$45.60
Rate for Payer: Devoted Health Medicare	$25.84
Rate for Payer: Hawaii Medical Service Association Medicare	$23.56
Rate for Payer: Hawaii Western Management Group Commercial	$72.20
Rate for Payer: Health Management Network Commercial	$64.60
Rate for Payer: Humana Medicare	$23.56
Rate for Payer: Kaiser Permanente Commercial	$68.40
Rate for Payer: Kaiser Permanente Medicaid	$38.76
Rate for Payer: Kaiser Permanente Medicare	$23.56
Rate for Payer: MDX Hawaii PPO	$73.72
Rate for Payer: Ohana Health Plan Medicaid	$23.56
Rate for Payer: Ohana Health Plan Medicare	$23.56
Rate for Payer: UnitedHealthcare Medicare	$23.56
Rate for Payer: University Health Alliance Commercial	$55.40

K-WIRE 1.0X285MM 292.11

Facility

$76.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$64.60
Max. Negotiated Rate	$73.72
Rate for Payer: Cash Price	$45.60
Rate for Payer: Health Management Network Commercial	$64.60
Rate for Payer: Kaiser Permanente Commercial	$68.40
Rate for Payer: MDX Hawaii PPO	$73.72

K-WIRE 1.1X100MM WIRE1.1/100

Facility

$96.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$29.76
Max. Negotiated Rate	$93.12
Rate for Payer: AlohaCare Medicaid	$48.00
Rate for Payer: AlohaCare Medicare	$29.76
Rate for Payer: Cash Price	$57.60
Rate for Payer: Devoted Health Medicare	$32.64
Rate for Payer: Hawaii Medical Service Association Medicare	$29.76
Rate for Payer: Hawaii Western Management Group Commercial	$91.20
Rate for Payer: Health Management Network Commercial	$81.60
Rate for Payer: Humana Medicare	$29.76
Rate for Payer: Kaiser Permanente Commercial	$86.40
Rate for Payer: Kaiser Permanente Medicaid	$48.96
Rate for Payer: Kaiser Permanente Medicare	$29.76
Rate for Payer: MDX Hawaii PPO	$93.12
Rate for Payer: Ohana Health Plan Medicaid	$29.76
Rate for Payer: Ohana Health Plan Medicare	$29.76
Rate for Payer: UnitedHealthcare Medicare	$29.76
Rate for Payer: University Health Alliance Commercial	$69.97

K-WIRE 1.1X100MM WIRE1.1/100

Facility

$96.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$81.60
Max. Negotiated Rate	$93.12
Rate for Payer: Cash Price	$57.60
Rate for Payer: Health Management Network Commercial	$81.60
Rate for Payer: Kaiser Permanente Commercial	$86.40
Rate for Payer: MDX Hawaii PPO	$93.12

KWIRE 1.1X100MM WIRE-1.1/100

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

KWIRE 1.1X100MM WIRE-1.1/100

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

KWIRE 1.25MMX150MM 390157

Facility

$66.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$64.02
Rate for Payer: Cash Price	$39.60
Rate for Payer: Health Management Network Commercial	$56.10
Rate for Payer: Kaiser Permanente Commercial	$59.40
Rate for Payer: MDX Hawaii PPO	$64.02

KWIRE 1.25MMX150MM 390157

Facility

$66.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$20.46
Max. Negotiated Rate	$64.02
Rate for Payer: AlohaCare Medicaid	$33.00
Rate for Payer: AlohaCare Medicare	$20.46
Rate for Payer: Cash Price	$39.60
Rate for Payer: Devoted Health Medicare	$22.44
Rate for Payer: Hawaii Medical Service Association Medicare	$20.46
Rate for Payer: Hawaii Western Management Group Commercial	$62.70
Rate for Payer: Health Management Network Commercial	$56.10
Rate for Payer: Humana Medicare	$20.46
Rate for Payer: Kaiser Permanente Commercial	$59.40
Rate for Payer: Kaiser Permanente Medicaid	$33.66
Rate for Payer: Kaiser Permanente Medicare	$20.46
Rate for Payer: MDX Hawaii PPO	$64.02
Rate for Payer: Ohana Health Plan Medicaid	$20.46
Rate for Payer: Ohana Health Plan Medicare	$20.46
Rate for Payer: UnitedHealthcare Medicare	$20.46
Rate for Payer: University Health Alliance Commercial	$48.11

K-WIRE 1.25X150MM 292.12

Facility

$69.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$21.39
Max. Negotiated Rate	$66.93
Rate for Payer: AlohaCare Medicaid	$34.50
Rate for Payer: AlohaCare Medicare	$21.39
Rate for Payer: Cash Price	$41.40
Rate for Payer: Devoted Health Medicare	$23.46
Rate for Payer: Hawaii Medical Service Association Medicare	$21.39
Rate for Payer: Hawaii Western Management Group Commercial	$65.55
Rate for Payer: Health Management Network Commercial	$58.65
Rate for Payer: Humana Medicare	$21.39
Rate for Payer: Kaiser Permanente Commercial	$62.10
Rate for Payer: Kaiser Permanente Medicaid	$35.19
Rate for Payer: Kaiser Permanente Medicare	$21.39
Rate for Payer: MDX Hawaii PPO	$66.93
Rate for Payer: Ohana Health Plan Medicaid	$21.39
Rate for Payer: Ohana Health Plan Medicare	$21.39
Rate for Payer: UnitedHealthcare Medicare	$21.39
Rate for Payer: University Health Alliance Commercial	$50.29

K-WIRE 1.25X150MM 292.12

Facility

$69.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$58.65
Max. Negotiated Rate	$66.93
Rate for Payer: Cash Price	$41.40
Rate for Payer: Health Management Network Commercial	$58.65
Rate for Payer: Kaiser Permanente Commercial	$62.10
Rate for Payer: MDX Hawaii PPO	$66.93

K-WIRE 1.25X150MM 4901-12-15

Facility

$91.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
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	$63.70
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	$50.96

K-WIRE 1.25X150MM 4901-12-15

Facility

$91.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$50.96
Max. Negotiated Rate	$88.27
Rate for Payer: Cash Price	$54.60
Rate for Payer: Hawaii Western Management Group Commercial	$63.70
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
Rate for Payer: University Health Alliance Commercial	$50.96

K-WIRE 1.25 X 285MM 292.13

Facility

$86.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$73.10
Max. Negotiated Rate	$83.42
Rate for Payer: Cash Price	$51.60
Rate for Payer: Health Management Network Commercial	$73.10
Rate for Payer: Kaiser Permanente Commercial	$77.40
Rate for Payer: MDX Hawaii PPO	$83.42

K-WIRE 1.25 X 285MM 292.13

Facility

$86.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$26.66
Max. Negotiated Rate	$83.42
Rate for Payer: AlohaCare Medicaid	$43.00
Rate for Payer: AlohaCare Medicare	$26.66
Rate for Payer: Cash Price	$51.60
Rate for Payer: Devoted Health Medicare	$29.24
Rate for Payer: Hawaii Medical Service Association Medicare	$26.66
Rate for Payer: Hawaii Western Management Group Commercial	$81.70
Rate for Payer: Health Management Network Commercial	$73.10
Rate for Payer: Humana Medicare	$26.66
Rate for Payer: Kaiser Permanente Commercial	$77.40
Rate for Payer: Kaiser Permanente Medicaid	$43.86
Rate for Payer: Kaiser Permanente Medicare	$26.66
Rate for Payer: MDX Hawaii PPO	$83.42
Rate for Payer: Ohana Health Plan Medicaid	$26.66
Rate for Payer: Ohana Health Plan Medicare	$26.66
Rate for Payer: UnitedHealthcare Medicare	$26.66
Rate for Payer: University Health Alliance Commercial	$62.69

K-WIRE 1.2X100MM P99-192-1210

Facility

$158.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$48.98
Max. Negotiated Rate	$153.26
Rate for Payer: AlohaCare Medicaid	$79.00
Rate for Payer: AlohaCare Medicare	$48.98
Rate for Payer: Cash Price	$94.80
Rate for Payer: Devoted Health Medicare	$53.72
Rate for Payer: Hawaii Medical Service Association Medicare	$48.98
Rate for Payer: Hawaii Western Management Group Commercial	$150.10
Rate for Payer: Health Management Network Commercial	$134.30
Rate for Payer: Humana Medicare	$48.98
Rate for Payer: Kaiser Permanente Commercial	$142.20
Rate for Payer: Kaiser Permanente Medicaid	$80.58
Rate for Payer: Kaiser Permanente Medicare	$48.98
Rate for Payer: MDX Hawaii PPO	$153.26
Rate for Payer: Ohana Health Plan Medicaid	$48.98
Rate for Payer: Ohana Health Plan Medicare	$48.98
Rate for Payer: UnitedHealthcare Medicare	$48.98
Rate for Payer: University Health Alliance Commercial	$115.17

K-WIRE 1.2X100MM P99-192-1210

Facility

$158.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$134.30
Max. Negotiated Rate	$153.26
Rate for Payer: Cash Price	$94.80
Rate for Payer: Health Management Network Commercial	$134.30
Rate for Payer: Kaiser Permanente Commercial	$142.20
Rate for Payer: MDX Hawaii PPO	$153.26

K-WIRE 1.5X127 KWIR-DES-15127

Facility

$175.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$148.75
Max. Negotiated Rate	$169.75
Rate for Payer: Cash Price	$105.00
Rate for Payer: Health Management Network Commercial	$148.75
Rate for Payer: Kaiser Permanente Commercial	$157.50
Rate for Payer: MDX Hawaii PPO	$169.75

K-WIRE 1.5X127 KWIR-DES-15127

Facility

$175.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$54.25
Max. Negotiated Rate	$169.75
Rate for Payer: AlohaCare Medicaid	$87.50
Rate for Payer: AlohaCare Medicare	$54.25
Rate for Payer: Cash Price	$105.00
Rate for Payer: Devoted Health Medicare	$59.50
Rate for Payer: Hawaii Medical Service Association Medicare	$54.25
Rate for Payer: Hawaii Western Management Group Commercial	$166.25
Rate for Payer: Health Management Network Commercial	$148.75
Rate for Payer: Humana Medicare	$54.25
Rate for Payer: Kaiser Permanente Commercial	$157.50
Rate for Payer: Kaiser Permanente Medicaid	$89.25
Rate for Payer: Kaiser Permanente Medicare	$54.25
Rate for Payer: MDX Hawaii PPO	$169.75
Rate for Payer: Ohana Health Plan Medicaid	$54.25
Rate for Payer: Ohana Health Plan Medicare	$54.25
Rate for Payer: UnitedHealthcare Medicare	$54.25
Rate for Payer: University Health Alliance Commercial	$127.56

K-WIRE 1.5X250MM 11.014

Facility

$225.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$69.75
Max. Negotiated Rate	$218.25
Rate for Payer: AlohaCare Medicaid	$112.50
Rate for Payer: AlohaCare Medicare	$69.75
Rate for Payer: Cash Price	$135.00
Rate for Payer: Devoted Health Medicare	$76.50
Rate for Payer: Hawaii Medical Service Association Medicare	$69.75
Rate for Payer: Hawaii Western Management Group Commercial	$213.75
Rate for Payer: Health Management Network Commercial	$191.25
Rate for Payer: Humana Medicare	$69.75
Rate for Payer: Kaiser Permanente Commercial	$202.50
Rate for Payer: Kaiser Permanente Medicaid	$114.75
Rate for Payer: Kaiser Permanente Medicare	$69.75
Rate for Payer: MDX Hawaii PPO	$218.25
Rate for Payer: Ohana Health Plan Medicaid	$69.75
Rate for Payer: Ohana Health Plan Medicare	$69.75
Rate for Payer: UnitedHealthcare Medicare	$69.75
Rate for Payer: University Health Alliance Commercial	$164.00

K-WIRE 1.5X250MM 11.014

Facility

$225.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$218.25
Rate for Payer: Cash Price	$135.00
Rate for Payer: Health Management Network Commercial	$191.25
Rate for Payer: Kaiser Permanente Commercial	$202.50
Rate for Payer: MDX Hawaii PPO	$218.25

K-WIRE 1.6 230MM WIRE-1.6/230

Facility

$150.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$145.50
Rate for Payer: Cash Price	$90.00
Rate for Payer: Health Management Network Commercial	$127.50
Rate for Payer: Kaiser Permanente Commercial	$135.00
Rate for Payer: MDX Hawaii PPO	$145.50

K-WIRE 1.6 230MM WIRE-1.6/230

Facility

$150.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$145.50
Rate for Payer: AlohaCare Medicaid	$75.00
Rate for Payer: AlohaCare Medicare	$46.50
Rate for Payer: Cash Price	$90.00
Rate for Payer: Devoted Health Medicare	$51.00
Rate for Payer: Hawaii Medical Service Association Medicare	$46.50
Rate for Payer: Hawaii Western Management Group Commercial	$142.50
Rate for Payer: Health Management Network Commercial	$127.50
Rate for Payer: Humana Medicare	$46.50
Rate for Payer: Kaiser Permanente Commercial	$135.00
Rate for Payer: Kaiser Permanente Medicaid	$76.50
Rate for Payer: Kaiser Permanente Medicare	$46.50
Rate for Payer: MDX Hawaii PPO	$145.50
Rate for Payer: Ohana Health Plan Medicaid	$46.50
Rate for Payer: Ohana Health Plan Medicare	$46.50
Rate for Payer: UnitedHealthcare Medicare	$46.50
Rate for Payer: University Health Alliance Commercial	$109.33

KWIRE 1.6 390164

Facility

$66.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$20.46
Max. Negotiated Rate	$64.02
Rate for Payer: AlohaCare Medicaid	$33.00
Rate for Payer: AlohaCare Medicare	$20.46
Rate for Payer: Cash Price	$39.60
Rate for Payer: Devoted Health Medicare	$22.44
Rate for Payer: Hawaii Medical Service Association Medicare	$20.46
Rate for Payer: Hawaii Western Management Group Commercial	$62.70
Rate for Payer: Health Management Network Commercial	$56.10
Rate for Payer: Humana Medicare	$20.46
Rate for Payer: Kaiser Permanente Commercial	$59.40
Rate for Payer: Kaiser Permanente Medicaid	$33.66
Rate for Payer: Kaiser Permanente Medicare	$20.46
Rate for Payer: MDX Hawaii PPO	$64.02
Rate for Payer: Ohana Health Plan Medicaid	$20.46
Rate for Payer: Ohana Health Plan Medicare	$20.46
Rate for Payer: UnitedHealthcare Medicare	$20.46
Rate for Payer: University Health Alliance Commercial	$48.11

Know your out-of-pocket cost for care.

All Charges