Kau Hospital

All Charges

Charge

Type

Setting

Price

K-WIRE 2.0X150MM 4901-20-15

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 2.0X150MM 4901-20-15

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 2.0X150MM P99-192-2015

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 2.0X150MM P99-192-2015

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

K-WIRE 2.0X285MM 292.21

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 2.0X285MM 292.21

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 2.3X230MM P99-192-2323

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 2.3X230MM P99-192-2323

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 2X150MM 11.146

Facility

$135.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$130.95
Rate for Payer: Cash Price	$81.00
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: Kaiser Permanente Commercial	$121.50
Rate for Payer: MDX Hawaii PPO	$130.95

K-WIRE 2X150MM 11.146

Facility

$135.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$41.85
Max. Negotiated Rate	$130.95
Rate for Payer: AlohaCare Medicaid	$67.50
Rate for Payer: AlohaCare Medicare	$41.85
Rate for Payer: Cash Price	$81.00
Rate for Payer: Devoted Health Medicare	$45.90
Rate for Payer: Hawaii Medical Service Association Medicare	$41.85
Rate for Payer: Hawaii Western Management Group Commercial	$128.25
Rate for Payer: Health Management Network Commercial	$114.75
Rate for Payer: Humana Medicare	$41.85
Rate for Payer: Kaiser Permanente Commercial	$121.50
Rate for Payer: Kaiser Permanente Medicaid	$68.85
Rate for Payer: Kaiser Permanente Medicare	$41.85
Rate for Payer: MDX Hawaii PPO	$130.95
Rate for Payer: Ohana Health Plan Medicaid	$41.85
Rate for Payer: Ohana Health Plan Medicare	$41.85
Rate for Payer: UnitedHealthcare Medicare	$41.85
Rate for Payer: University Health Alliance Commercial	$98.40

K-WIRE 2X150MM 6052-02-150

Facility

$360.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$201.60
Max. Negotiated Rate	$349.20
Rate for Payer: Cash Price	$216.00
Rate for Payer: Hawaii Western Management Group Commercial	$252.00
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
Rate for Payer: University Health Alliance Commercial	$201.60

K-WIRE 2X150MM 6052-02-150

Facility

$360.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$349.20
Rate for Payer: AlohaCare Medicaid	$180.00
Rate for Payer: AlohaCare Medicare	$111.60
Rate for Payer: Cash Price	$216.00
Rate for Payer: Devoted Health Medicare	$122.40
Rate for Payer: Hawaii Medical Service Association Medicare	$111.60
Rate for Payer: Hawaii Western Management Group Commercial	$252.00
Rate for Payer: Health Management Network Commercial	$306.00
Rate for Payer: Humana Medicare	$111.60
Rate for Payer: Kaiser Permanente Commercial	$324.00
Rate for Payer: Kaiser Permanente Medicaid	$183.60
Rate for Payer: Kaiser Permanente Medicare	$111.60
Rate for Payer: MDX Hawaii PPO	$349.20
Rate for Payer: Ohana Health Plan Medicaid	$111.60
Rate for Payer: Ohana Health Plan Medicare	$111.60
Rate for Payer: UnitedHealthcare Medicare	$111.60
Rate for Payer: University Health Alliance Commercial	$201.60

K-WIRE 3.2X450MM 1210-6450S

Facility

$516.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$438.60
Max. Negotiated Rate	$500.52
Rate for Payer: Cash Price	$309.60
Rate for Payer: Health Management Network Commercial	$438.60
Rate for Payer: Kaiser Permanente Commercial	$464.40
Rate for Payer: MDX Hawaii PPO	$500.52

K-WIRE 3.2X450MM 1210-6450S

Facility

$516.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$159.96
Max. Negotiated Rate	$500.52
Rate for Payer: AlohaCare Medicaid	$258.00
Rate for Payer: AlohaCare Medicare	$159.96
Rate for Payer: Cash Price	$309.60
Rate for Payer: Devoted Health Medicare	$175.44
Rate for Payer: Hawaii Medical Service Association Medicare	$159.96
Rate for Payer: Hawaii Western Management Group Commercial	$490.20
Rate for Payer: Health Management Network Commercial	$438.60
Rate for Payer: Humana Medicare	$159.96
Rate for Payer: Kaiser Permanente Commercial	$464.40
Rate for Payer: Kaiser Permanente Medicaid	$263.16
Rate for Payer: Kaiser Permanente Medicare	$159.96
Rate for Payer: MDX Hawaii PPO	$500.52
Rate for Payer: Ohana Health Plan Medicaid	$159.96
Rate for Payer: Ohana Health Plan Medicare	$159.96
Rate for Payer: UnitedHealthcare Medicare	$159.96
Rate for Payer: University Health Alliance Commercial	$376.11

K-WIRE .35X6 DBL TRO 164206035

Facility

$875.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$271.25
Max. Negotiated Rate	$848.75
Rate for Payer: AlohaCare Medicaid	$437.50
Rate for Payer: AlohaCare Medicare	$271.25
Rate for Payer: Cash Price	$525.00
Rate for Payer: Devoted Health Medicare	$297.50
Rate for Payer: Hawaii Medical Service Association Medicare	$271.25
Rate for Payer: Hawaii Western Management Group Commercial	$831.25
Rate for Payer: Health Management Network Commercial	$743.75
Rate for Payer: Humana Medicare	$271.25
Rate for Payer: Kaiser Permanente Commercial	$787.50
Rate for Payer: Kaiser Permanente Medicaid	$446.25
Rate for Payer: Kaiser Permanente Medicare	$271.25
Rate for Payer: MDX Hawaii PPO	$848.75
Rate for Payer: Ohana Health Plan Medicaid	$271.25
Rate for Payer: Ohana Health Plan Medicare	$271.25
Rate for Payer: UnitedHealthcare Medicare	$271.25
Rate for Payer: University Health Alliance Commercial	$637.79

K-WIRE .35X6 DBL TRO 164206035

Facility

$875.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$743.75
Max. Negotiated Rate	$848.75
Rate for Payer: Cash Price	$525.00
Rate for Payer: Health Management Network Commercial	$743.75
Rate for Payer: Kaiser Permanente Commercial	$787.50
Rate for Payer: MDX Hawaii PPO	$848.75

KWIRE 390142

Facility

$92.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$28.52
Max. Negotiated Rate	$89.24
Rate for Payer: AlohaCare Medicaid	$46.00
Rate for Payer: AlohaCare Medicare	$28.52
Rate for Payer: Cash Price	$55.20
Rate for Payer: Devoted Health Medicare	$31.28
Rate for Payer: Hawaii Medical Service Association Medicare	$28.52
Rate for Payer: Hawaii Western Management Group Commercial	$87.40
Rate for Payer: Health Management Network Commercial	$78.20
Rate for Payer: Humana Medicare	$28.52
Rate for Payer: Kaiser Permanente Commercial	$82.80
Rate for Payer: Kaiser Permanente Medicaid	$46.92
Rate for Payer: Kaiser Permanente Medicare	$28.52
Rate for Payer: MDX Hawaii PPO	$89.24
Rate for Payer: Ohana Health Plan Medicaid	$28.52
Rate for Payer: Ohana Health Plan Medicare	$28.52
Rate for Payer: UnitedHealthcare Medicare	$28.52
Rate for Payer: University Health Alliance Commercial	$67.06

KWIRE 390142

Facility

$92.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$78.20
Max. Negotiated Rate	$89.24
Rate for Payer: Cash Price	$55.20
Rate for Payer: Health Management Network Commercial	$78.20
Rate for Payer: Kaiser Permanente Commercial	$82.80
Rate for Payer: MDX Hawaii PPO	$89.24

K-WIRE 3X285MM 1806-0050S

Facility

$489.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$415.65
Max. Negotiated Rate	$474.33
Rate for Payer: Cash Price	$293.40
Rate for Payer: Health Management Network Commercial	$415.65
Rate for Payer: Kaiser Permanente Commercial	$440.10
Rate for Payer: MDX Hawaii PPO	$474.33

K-WIRE 3X285MM 1806-0050S

Facility

$489.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$151.59
Max. Negotiated Rate	$474.33
Rate for Payer: AlohaCare Medicaid	$244.50
Rate for Payer: AlohaCare Medicare	$151.59
Rate for Payer: Cash Price	$293.40
Rate for Payer: Devoted Health Medicare	$166.26
Rate for Payer: Hawaii Medical Service Association Medicare	$151.59
Rate for Payer: Hawaii Western Management Group Commercial	$464.55
Rate for Payer: Health Management Network Commercial	$415.65
Rate for Payer: Humana Medicare	$151.59
Rate for Payer: Kaiser Permanente Commercial	$440.10
Rate for Payer: Kaiser Permanente Medicaid	$249.39
Rate for Payer: Kaiser Permanente Medicare	$151.59
Rate for Payer: MDX Hawaii PPO	$474.33
Rate for Payer: Ohana Health Plan Medicaid	$151.59
Rate for Payer: Ohana Health Plan Medicare	$151.59
Rate for Payer: UnitedHealthcare Medicare	$151.59
Rate for Payer: University Health Alliance Commercial	$356.43

K-WIRE 3X285MM 2351-3028S

Facility

$754.00

Hospital Revenue Code	272
Min. Negotiated Rate	$640.90
Max. Negotiated Rate	$731.38
Rate for Payer: Cash Price	$452.40
Rate for Payer: Health Management Network Commercial	$640.90
Rate for Payer: Kaiser Permanente Commercial	$678.60
Rate for Payer: MDX Hawaii PPO	$731.38

K-WIRE 3X285MM 2351-3028S

Facility

$754.00

Hospital Revenue Code	272
Min. Negotiated Rate	$233.74
Max. Negotiated Rate	$731.38
Rate for Payer: AlohaCare Medicaid	$377.00
Rate for Payer: AlohaCare Medicare	$233.74
Rate for Payer: Cash Price	$452.40
Rate for Payer: Devoted Health Medicare	$256.36
Rate for Payer: Hawaii Medical Service Association Medicare	$233.74
Rate for Payer: Hawaii Western Management Group Commercial	$716.30
Rate for Payer: Health Management Network Commercial	$640.90
Rate for Payer: Humana Medicare	$233.74
Rate for Payer: Kaiser Permanente Commercial	$678.60
Rate for Payer: Kaiser Permanente Medicaid	$384.54
Rate for Payer: Kaiser Permanente Medicare	$233.74
Rate for Payer: MDX Hawaii PPO	$731.38
Rate for Payer: Ohana Health Plan Medicaid	$233.74
Rate for Payer: Ohana Health Plan Medicare	$233.74
Rate for Payer: UnitedHealthcare Medicare	$233.74
Rate for Payer: University Health Alliance Commercial	$549.59

K-WIRE 4.2X185MM 2351-3340S

Facility

$1,343.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,141.55
Max. Negotiated Rate	$1,302.71
Rate for Payer: Cash Price	$805.80
Rate for Payer: Health Management Network Commercial	$1,141.55
Rate for Payer: Kaiser Permanente Commercial	$1,208.70
Rate for Payer: MDX Hawaii PPO	$1,302.71

K-WIRE 4.2X185MM 2351-3340S

Facility

$1,343.00

Hospital Revenue Code	272
Min. Negotiated Rate	$416.33
Max. Negotiated Rate	$1,302.71
Rate for Payer: AlohaCare Medicaid	$671.50
Rate for Payer: AlohaCare Medicare	$416.33
Rate for Payer: Cash Price	$805.80
Rate for Payer: Devoted Health Medicare	$456.62
Rate for Payer: Hawaii Medical Service Association Medicare	$416.33
Rate for Payer: Hawaii Western Management Group Commercial	$1,275.85
Rate for Payer: Health Management Network Commercial	$1,141.55
Rate for Payer: Humana Medicare	$416.33
Rate for Payer: Kaiser Permanente Commercial	$1,208.70
Rate for Payer: Kaiser Permanente Medicaid	$684.93
Rate for Payer: Kaiser Permanente Medicare	$416.33
Rate for Payer: MDX Hawaii PPO	$1,302.71
Rate for Payer: Ohana Health Plan Medicaid	$416.33
Rate for Payer: Ohana Health Plan Medicare	$416.33
Rate for Payer: UnitedHealthcare Medicare	$416.33
Rate for Payer: University Health Alliance Commercial	$978.91

KWIRE 702459

Facility

$447.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$379.95
Max. Negotiated Rate	$433.59
Rate for Payer: Cash Price	$268.20
Rate for Payer: Health Management Network Commercial	$379.95
Rate for Payer: Kaiser Permanente Commercial	$402.30
Rate for Payer: MDX Hawaii PPO	$433.59

Know your out-of-pocket cost for care.

All Charges