Kau Hospital

All Charges

Charge

Type

Setting

Price

KWIRE 1.6 390164

Facility

$66.00

Service Code	HCPCS C1713
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 1.6 FULL THREAD 45-80100

Facility

$299.00

Hospital Revenue Code	272
Min. Negotiated Rate	$254.15
Max. Negotiated Rate	$290.03
Rate for Payer: Cash Price	$179.40
Rate for Payer: Health Management Network Commercial	$254.15
Rate for Payer: Kaiser Permanente Commercial	$269.10
Rate for Payer: MDX Hawaii PPO	$290.03

KWIRE 1.6 FULL THREAD 45-80100

Facility

$299.00

Hospital Revenue Code	272
Min. Negotiated Rate	$92.69
Max. Negotiated Rate	$290.03
Rate for Payer: AlohaCare Medicaid	$149.50
Rate for Payer: AlohaCare Medicare	$92.69
Rate for Payer: Cash Price	$179.40
Rate for Payer: Devoted Health Medicare	$101.66
Rate for Payer: Hawaii Medical Service Association Medicare	$92.69
Rate for Payer: Hawaii Western Management Group Commercial	$284.05
Rate for Payer: Health Management Network Commercial	$254.15
Rate for Payer: Humana Medicare	$92.69
Rate for Payer: Kaiser Permanente Commercial	$269.10
Rate for Payer: Kaiser Permanente Medicaid	$152.49
Rate for Payer: Kaiser Permanente Medicare	$92.69
Rate for Payer: MDX Hawaii PPO	$290.03
Rate for Payer: Ohana Health Plan Medicaid	$92.69
Rate for Payer: Ohana Health Plan Medicare	$92.69
Rate for Payer: UnitedHealthcare Medicare	$92.69
Rate for Payer: University Health Alliance Commercial	$217.94

K-WIRE 1.6MM KW062SS

Facility

$288.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$244.80
Max. Negotiated Rate	$279.36
Rate for Payer: Cash Price	$172.80
Rate for Payer: Health Management Network Commercial	$244.80
Rate for Payer: Kaiser Permanente Commercial	$259.20
Rate for Payer: MDX Hawaii PPO	$279.36

K-WIRE 1.6MM KW062SS

Facility

$288.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$89.28
Max. Negotiated Rate	$279.36
Rate for Payer: AlohaCare Medicaid	$144.00
Rate for Payer: AlohaCare Medicare	$89.28
Rate for Payer: Cash Price	$172.80
Rate for Payer: Devoted Health Medicare	$97.92
Rate for Payer: Hawaii Medical Service Association Medicare	$89.28
Rate for Payer: Hawaii Western Management Group Commercial	$273.60
Rate for Payer: Health Management Network Commercial	$244.80
Rate for Payer: Humana Medicare	$89.28
Rate for Payer: Kaiser Permanente Commercial	$259.20
Rate for Payer: Kaiser Permanente Medicaid	$146.88
Rate for Payer: Kaiser Permanente Medicare	$89.28
Rate for Payer: MDX Hawaii PPO	$279.36
Rate for Payer: Ohana Health Plan Medicaid	$89.28
Rate for Payer: Ohana Health Plan Medicare	$89.28
Rate for Payer: UnitedHealthcare Medicare	$89.28
Rate for Payer: University Health Alliance Commercial	$209.92

K-WIRE 1.6X100MM WIRE-1.6/100

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 1.6X100MM WIRE-1.6/100

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 1.6X150MM 292.71

Facility

$120.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$116.40
Rate for Payer: AlohaCare Medicaid	$60.00
Rate for Payer: AlohaCare Medicare	$37.20
Rate for Payer: Cash Price	$72.00
Rate for Payer: Devoted Health Medicare	$40.80
Rate for Payer: Hawaii Medical Service Association Medicare	$37.20
Rate for Payer: Hawaii Western Management Group Commercial	$114.00
Rate for Payer: Health Management Network Commercial	$102.00
Rate for Payer: Humana Medicare	$37.20
Rate for Payer: Kaiser Permanente Commercial	$108.00
Rate for Payer: Kaiser Permanente Medicaid	$61.20
Rate for Payer: Kaiser Permanente Medicare	$37.20
Rate for Payer: MDX Hawaii PPO	$116.40
Rate for Payer: Ohana Health Plan Medicaid	$37.20
Rate for Payer: Ohana Health Plan Medicare	$37.20
Rate for Payer: UnitedHealthcare Medicare	$37.20
Rate for Payer: University Health Alliance Commercial	$87.47

K-WIRE 1.6X150MM 292.71

Facility

$120.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$116.40
Rate for Payer: Cash Price	$72.00
Rate for Payer: Health Management Network Commercial	$102.00
Rate for Payer: Kaiser Permanente Commercial	$108.00
Rate for Payer: MDX Hawaii PPO	$116.40

K-WIRE 1.6X150MM 4901-16-15

Facility

$94.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$29.14
Max. Negotiated Rate	$91.18
Rate for Payer: AlohaCare Medicaid	$47.00
Rate for Payer: AlohaCare Medicare	$29.14
Rate for Payer: Cash Price	$56.40
Rate for Payer: Devoted Health Medicare	$31.96
Rate for Payer: Hawaii Medical Service Association Medicare	$29.14
Rate for Payer: Hawaii Western Management Group Commercial	$65.80
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: Humana Medicare	$29.14
Rate for Payer: Kaiser Permanente Commercial	$84.60
Rate for Payer: Kaiser Permanente Medicaid	$47.94
Rate for Payer: Kaiser Permanente Medicare	$29.14
Rate for Payer: MDX Hawaii PPO	$91.18
Rate for Payer: Ohana Health Plan Medicaid	$29.14
Rate for Payer: Ohana Health Plan Medicare	$29.14
Rate for Payer: UnitedHealthcare Medicare	$29.14
Rate for Payer: University Health Alliance Commercial	$52.64

K-WIRE 1.6X150MM 4901-16-15

Facility

$94.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$52.64
Max. Negotiated Rate	$91.18
Rate for Payer: Cash Price	$56.40
Rate for Payer: Hawaii Western Management Group Commercial	$65.80
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: Kaiser Permanente Commercial	$84.60
Rate for Payer: MDX Hawaii PPO	$91.18
Rate for Payer: University Health Alliance Commercial	$52.64

K-WIRE 1.6X285MM 292.18

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 1.6X285MM 292.18

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 1806-1417S

Facility

$512.00

Hospital Revenue Code	272
Min. Negotiated Rate	$435.20
Max. Negotiated Rate	$496.64
Rate for Payer: Cash Price	$307.20
Rate for Payer: Health Management Network Commercial	$435.20
Rate for Payer: Kaiser Permanente Commercial	$460.80
Rate for Payer: MDX Hawaii PPO	$496.64

K-WIRE 1806-1417S

Facility

$512.00

Hospital Revenue Code	272
Min. Negotiated Rate	$158.72
Max. Negotiated Rate	$496.64
Rate for Payer: AlohaCare Medicaid	$256.00
Rate for Payer: AlohaCare Medicare	$158.72
Rate for Payer: Cash Price	$307.20
Rate for Payer: Devoted Health Medicare	$174.08
Rate for Payer: Hawaii Medical Service Association Medicare	$158.72
Rate for Payer: Hawaii Western Management Group Commercial	$486.40
Rate for Payer: Health Management Network Commercial	$435.20
Rate for Payer: Humana Medicare	$158.72
Rate for Payer: Kaiser Permanente Commercial	$460.80
Rate for Payer: Kaiser Permanente Medicaid	$261.12
Rate for Payer: Kaiser Permanente Medicare	$158.72
Rate for Payer: MDX Hawaii PPO	$496.64
Rate for Payer: Ohana Health Plan Medicaid	$158.72
Rate for Payer: Ohana Health Plan Medicare	$158.72
Rate for Payer: UnitedHealthcare Medicare	$158.72
Rate for Payer: University Health Alliance Commercial	$373.20

K-WIRE 1.8X310MM 0152-0218S

Facility

$689.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$585.65
Max. Negotiated Rate	$668.33
Rate for Payer: Cash Price	$413.40
Rate for Payer: Health Management Network Commercial	$585.65
Rate for Payer: Kaiser Permanente Commercial	$620.10
Rate for Payer: MDX Hawaii PPO	$668.33

K-WIRE 1.8X310MM 0152-0218S

Facility

$689.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$213.59
Max. Negotiated Rate	$668.33
Rate for Payer: AlohaCare Medicaid	$344.50
Rate for Payer: AlohaCare Medicare	$213.59
Rate for Payer: Cash Price	$413.40
Rate for Payer: Devoted Health Medicare	$234.26
Rate for Payer: Hawaii Medical Service Association Medicare	$213.59
Rate for Payer: Hawaii Western Management Group Commercial	$654.55
Rate for Payer: Health Management Network Commercial	$585.65
Rate for Payer: Humana Medicare	$213.59
Rate for Payer: Kaiser Permanente Commercial	$620.10
Rate for Payer: Kaiser Permanente Medicaid	$351.39
Rate for Payer: Kaiser Permanente Medicare	$213.59
Rate for Payer: MDX Hawaii PPO	$668.33
Rate for Payer: Ohana Health Plan Medicaid	$213.59
Rate for Payer: Ohana Health Plan Medicare	$213.59
Rate for Payer: UnitedHealthcare Medicare	$213.59
Rate for Payer: University Health Alliance Commercial	$502.21

K-WIRE 2.0 230MM WIRE-2.0/230

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 2.0 230MM WIRE-2.0/230

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 2.0 703583

Facility

$446.00

Hospital Revenue Code	272
Min. Negotiated Rate	$379.10
Max. Negotiated Rate	$432.62
Rate for Payer: Cash Price	$267.60
Rate for Payer: Health Management Network Commercial	$379.10
Rate for Payer: Kaiser Permanente Commercial	$401.40
Rate for Payer: MDX Hawaii PPO	$432.62

KWIRE 2.0 703583

Facility

$446.00

Hospital Revenue Code	272
Min. Negotiated Rate	$138.26
Max. Negotiated Rate	$432.62
Rate for Payer: AlohaCare Medicaid	$223.00
Rate for Payer: AlohaCare Medicare	$138.26
Rate for Payer: Cash Price	$267.60
Rate for Payer: Devoted Health Medicare	$151.64
Rate for Payer: Hawaii Medical Service Association Medicare	$138.26
Rate for Payer: Hawaii Western Management Group Commercial	$423.70
Rate for Payer: Health Management Network Commercial	$379.10
Rate for Payer: Humana Medicare	$138.26
Rate for Payer: Kaiser Permanente Commercial	$401.40
Rate for Payer: Kaiser Permanente Medicaid	$227.46
Rate for Payer: Kaiser Permanente Medicare	$138.26
Rate for Payer: MDX Hawaii PPO	$432.62
Rate for Payer: Ohana Health Plan Medicaid	$138.26
Rate for Payer: Ohana Health Plan Medicare	$138.26
Rate for Payer: UnitedHealthcare Medicare	$138.26
Rate for Payer: University Health Alliance Commercial	$325.09

K-WIRE 2.0 DRILL TIP 705002

Facility

$240.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$74.40
Max. Negotiated Rate	$232.80
Rate for Payer: AlohaCare Medicaid	$120.00
Rate for Payer: AlohaCare Medicare	$74.40
Rate for Payer: Cash Price	$144.00
Rate for Payer: Devoted Health Medicare	$81.60
Rate for Payer: Hawaii Medical Service Association Medicare	$74.40
Rate for Payer: Hawaii Western Management Group Commercial	$228.00
Rate for Payer: Health Management Network Commercial	$204.00
Rate for Payer: Humana Medicare	$74.40
Rate for Payer: Kaiser Permanente Commercial	$216.00
Rate for Payer: Kaiser Permanente Medicaid	$122.40
Rate for Payer: Kaiser Permanente Medicare	$74.40
Rate for Payer: MDX Hawaii PPO	$232.80
Rate for Payer: Ohana Health Plan Medicaid	$74.40
Rate for Payer: Ohana Health Plan Medicare	$74.40
Rate for Payer: UnitedHealthcare Medicare	$74.40
Rate for Payer: University Health Alliance Commercial	$174.94

K-WIRE 2.0 DRILL TIP 705002

Facility

$240.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$232.80
Rate for Payer: Cash Price	$144.00
Rate for Payer: Health Management Network Commercial	$204.00
Rate for Payer: Kaiser Permanente Commercial	$216.00
Rate for Payer: MDX Hawaii PPO	$232.80

K-WIRE 2.0X150MM 292.20

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

K-WIRE 2.0X150MM 292.20

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

Know your out-of-pocket cost for care.

All Charges