Kau Hospital

All Charges

Charge

Type

Setting

Price

KWIRE 702459

Facility

$447.00

Service Code	HCPCS C1769
Hospital Revenue Code	272
Min. Negotiated Rate	$138.57
Max. Negotiated Rate	$433.59
Rate for Payer: AlohaCare Medicaid	$223.50
Rate for Payer: AlohaCare Medicare	$138.57
Rate for Payer: Cash Price	$268.20
Rate for Payer: Devoted Health Medicare	$151.98
Rate for Payer: Hawaii Medical Service Association Medicare	$138.57
Rate for Payer: Hawaii Western Management Group Commercial	$424.65
Rate for Payer: Health Management Network Commercial	$379.95
Rate for Payer: Humana Medicare	$138.57
Rate for Payer: Kaiser Permanente Commercial	$402.30
Rate for Payer: Kaiser Permanente Medicaid	$227.97
Rate for Payer: Kaiser Permanente Medicare	$138.57
Rate for Payer: MDX Hawaii PPO	$433.59
Rate for Payer: Ohana Health Plan Medicaid	$138.57
Rate for Payer: Ohana Health Plan Medicare	$138.57
Rate for Payer: UnitedHealthcare Medicare	$138.57
Rate for Payer: University Health Alliance Commercial	$325.82

K-WIRE DBL END 9" 47-186-46

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 DBL END 9" 47-186-46

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 DB TR 045X6 1642-06-045

Facility

$133.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$41.23
Max. Negotiated Rate	$129.01
Rate for Payer: AlohaCare Medicaid	$66.50
Rate for Payer: AlohaCare Medicare	$41.23
Rate for Payer: Cash Price	$79.80
Rate for Payer: Devoted Health Medicare	$45.22
Rate for Payer: Hawaii Medical Service Association Medicare	$41.23
Rate for Payer: Hawaii Western Management Group Commercial	$93.10
Rate for Payer: Health Management Network Commercial	$113.05
Rate for Payer: Humana Medicare	$41.23
Rate for Payer: Kaiser Permanente Commercial	$119.70
Rate for Payer: Kaiser Permanente Medicaid	$67.83
Rate for Payer: Kaiser Permanente Medicare	$41.23
Rate for Payer: MDX Hawaii PPO	$129.01
Rate for Payer: Ohana Health Plan Medicaid	$41.23
Rate for Payer: Ohana Health Plan Medicare	$41.23
Rate for Payer: UnitedHealthcare Medicare	$41.23
Rate for Payer: University Health Alliance Commercial	$74.48

K-WIRE DB TR 045X6 1642-06-045

Facility

$133.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$74.48
Max. Negotiated Rate	$129.01
Rate for Payer: Cash Price	$79.80
Rate for Payer: Hawaii Western Management Group Commercial	$93.10
Rate for Payer: Health Management Network Commercial	$113.05
Rate for Payer: Kaiser Permanente Commercial	$119.70
Rate for Payer: MDX Hawaii PPO	$129.01
Rate for Payer: University Health Alliance Commercial	$74.48

K-WIRE DB TR 062X6 1642-06-062

Facility

$133.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$74.48
Max. Negotiated Rate	$129.01
Rate for Payer: Cash Price	$79.80
Rate for Payer: Hawaii Western Management Group Commercial	$93.10
Rate for Payer: Health Management Network Commercial	$113.05
Rate for Payer: Kaiser Permanente Commercial	$119.70
Rate for Payer: MDX Hawaii PPO	$129.01
Rate for Payer: University Health Alliance Commercial	$74.48

K-WIRE DB TR 062X6 1642-06-062

Facility

$133.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$41.23
Max. Negotiated Rate	$129.01
Rate for Payer: AlohaCare Medicaid	$66.50
Rate for Payer: AlohaCare Medicare	$41.23
Rate for Payer: Cash Price	$79.80
Rate for Payer: Devoted Health Medicare	$45.22
Rate for Payer: Hawaii Medical Service Association Medicare	$41.23
Rate for Payer: Hawaii Western Management Group Commercial	$93.10
Rate for Payer: Health Management Network Commercial	$113.05
Rate for Payer: Humana Medicare	$41.23
Rate for Payer: Kaiser Permanente Commercial	$119.70
Rate for Payer: Kaiser Permanente Medicaid	$67.83
Rate for Payer: Kaiser Permanente Medicare	$41.23
Rate for Payer: MDX Hawaii PPO	$129.01
Rate for Payer: Ohana Health Plan Medicaid	$41.23
Rate for Payer: Ohana Health Plan Medicare	$41.23
Rate for Payer: UnitedHealthcare Medicare	$41.23
Rate for Payer: University Health Alliance Commercial	$74.48

K-WIRE DOUBLE ENDED 47-186-62

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 DOUBLE ENDED 47-186-62

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 DRILL TIP 2.0X315 703561

Facility

$390.00

Hospital Revenue Code	272
Min. Negotiated Rate	$120.90
Max. Negotiated Rate	$378.30
Rate for Payer: AlohaCare Medicaid	$195.00
Rate for Payer: AlohaCare Medicare	$120.90
Rate for Payer: Cash Price	$234.00
Rate for Payer: Devoted Health Medicare	$132.60
Rate for Payer: Hawaii Medical Service Association Medicare	$120.90
Rate for Payer: Hawaii Western Management Group Commercial	$370.50
Rate for Payer: Health Management Network Commercial	$331.50
Rate for Payer: Humana Medicare	$120.90
Rate for Payer: Kaiser Permanente Commercial	$351.00
Rate for Payer: Kaiser Permanente Medicaid	$198.90
Rate for Payer: Kaiser Permanente Medicare	$120.90
Rate for Payer: MDX Hawaii PPO	$378.30
Rate for Payer: Ohana Health Plan Medicaid	$120.90
Rate for Payer: Ohana Health Plan Medicare	$120.90
Rate for Payer: UnitedHealthcare Medicare	$120.90
Rate for Payer: University Health Alliance Commercial	$284.27

KWIRE DRILL TIP 2.0X315 703561

Facility

$390.00

Hospital Revenue Code	272
Min. Negotiated Rate	$331.50
Max. Negotiated Rate	$378.30
Rate for Payer: Cash Price	$234.00
Rate for Payer: Health Management Network Commercial	$331.50
Rate for Payer: Kaiser Permanente Commercial	$351.00
Rate for Payer: MDX Hawaii PPO	$378.30

K-WIRE GUIDE .101X2.5 323-1300

Facility

$260.00

Hospital Revenue Code	272
Min. Negotiated Rate	$221.00
Max. Negotiated Rate	$252.20
Rate for Payer: Cash Price	$156.00
Rate for Payer: Health Management Network Commercial	$221.00
Rate for Payer: Kaiser Permanente Commercial	$234.00
Rate for Payer: MDX Hawaii PPO	$252.20

K-WIRE GUIDE .101X2.5 323-1300

Facility

$260.00

Hospital Revenue Code	272
Min. Negotiated Rate	$80.60
Max. Negotiated Rate	$252.20
Rate for Payer: AlohaCare Medicaid	$130.00
Rate for Payer: AlohaCare Medicare	$80.60
Rate for Payer: Cash Price	$156.00
Rate for Payer: Devoted Health Medicare	$88.40
Rate for Payer: Hawaii Medical Service Association Medicare	$80.60
Rate for Payer: Hawaii Western Management Group Commercial	$247.00
Rate for Payer: Health Management Network Commercial	$221.00
Rate for Payer: Humana Medicare	$80.60
Rate for Payer: Kaiser Permanente Commercial	$234.00
Rate for Payer: Kaiser Permanente Medicaid	$132.60
Rate for Payer: Kaiser Permanente Medicare	$80.60
Rate for Payer: MDX Hawaii PPO	$252.20
Rate for Payer: Ohana Health Plan Medicaid	$80.60
Rate for Payer: Ohana Health Plan Medicare	$80.60
Rate for Payer: UnitedHealthcare Medicare	$80.60
Rate for Payer: University Health Alliance Commercial	$189.51

K-WIRE KIRSC 2.5X285MM #292.26

Facility

$93.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$28.83
Max. Negotiated Rate	$90.21
Rate for Payer: AlohaCare Medicaid	$46.50
Rate for Payer: AlohaCare Medicare	$28.83
Rate for Payer: Cash Price	$55.80
Rate for Payer: Devoted Health Medicare	$31.62
Rate for Payer: Hawaii Medical Service Association Medicare	$28.83
Rate for Payer: Hawaii Western Management Group Commercial	$65.10
Rate for Payer: Health Management Network Commercial	$79.05
Rate for Payer: Humana Medicare	$28.83
Rate for Payer: Kaiser Permanente Commercial	$83.70
Rate for Payer: Kaiser Permanente Medicaid	$47.43
Rate for Payer: Kaiser Permanente Medicare	$28.83
Rate for Payer: MDX Hawaii PPO	$90.21
Rate for Payer: Ohana Health Plan Medicaid	$28.83
Rate for Payer: Ohana Health Plan Medicare	$28.83
Rate for Payer: UnitedHealthcare Medicare	$28.83
Rate for Payer: University Health Alliance Commercial	$52.08

K-WIRE KIRSC 2.5X285MM #292.26

Facility

$93.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$52.08
Max. Negotiated Rate	$90.21
Rate for Payer: Cash Price	$55.80
Rate for Payer: Hawaii Western Management Group Commercial	$65.10
Rate for Payer: Health Management Network Commercial	$79.05
Rate for Payer: Kaiser Permanente Commercial	$83.70
Rate for Payer: MDX Hawaii PPO	$90.21
Rate for Payer: University Health Alliance Commercial	$52.08

K-WIRE OLI OLIVE-1.6/100

Facility

$428.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$132.68
Max. Negotiated Rate	$415.16
Rate for Payer: AlohaCare Medicaid	$214.00
Rate for Payer: AlohaCare Medicare	$132.68
Rate for Payer: Cash Price	$256.80
Rate for Payer: Devoted Health Medicare	$145.52
Rate for Payer: Hawaii Medical Service Association Medicare	$132.68
Rate for Payer: Hawaii Western Management Group Commercial	$406.60
Rate for Payer: Health Management Network Commercial	$363.80
Rate for Payer: Humana Medicare	$132.68
Rate for Payer: Kaiser Permanente Commercial	$385.20
Rate for Payer: Kaiser Permanente Medicaid	$218.28
Rate for Payer: Kaiser Permanente Medicare	$132.68
Rate for Payer: MDX Hawaii PPO	$415.16
Rate for Payer: Ohana Health Plan Medicaid	$132.68
Rate for Payer: Ohana Health Plan Medicare	$132.68
Rate for Payer: UnitedHealthcare Medicare	$132.68
Rate for Payer: University Health Alliance Commercial	$311.97

K-WIRE OLI OLIVE-1.6/100

Facility

$428.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$363.80
Max. Negotiated Rate	$415.16
Rate for Payer: Cash Price	$256.80
Rate for Payer: Health Management Network Commercial	$363.80
Rate for Payer: Kaiser Permanente Commercial	$385.20
Rate for Payer: MDX Hawaii PPO	$415.16

KWIRE OLIVE 705150

Facility

$402.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$341.70
Max. Negotiated Rate	$389.94
Rate for Payer: Cash Price	$241.20
Rate for Payer: Health Management Network Commercial	$341.70
Rate for Payer: Kaiser Permanente Commercial	$361.80
Rate for Payer: MDX Hawaii PPO	$389.94

KWIRE OLIVE 705150

Facility

$402.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$124.62
Max. Negotiated Rate	$389.94
Rate for Payer: AlohaCare Medicaid	$201.00
Rate for Payer: AlohaCare Medicare	$124.62
Rate for Payer: Cash Price	$241.20
Rate for Payer: Devoted Health Medicare	$136.68
Rate for Payer: Hawaii Medical Service Association Medicare	$124.62
Rate for Payer: Hawaii Western Management Group Commercial	$381.90
Rate for Payer: Health Management Network Commercial	$341.70
Rate for Payer: Humana Medicare	$124.62
Rate for Payer: Kaiser Permanente Commercial	$361.80
Rate for Payer: Kaiser Permanente Medicaid	$205.02
Rate for Payer: Kaiser Permanente Medicare	$124.62
Rate for Payer: MDX Hawaii PPO	$389.94
Rate for Payer: Ohana Health Plan Medicaid	$124.62
Rate for Payer: Ohana Health Plan Medicare	$124.62
Rate for Payer: UnitedHealthcare Medicare	$124.62
Rate for Payer: University Health Alliance Commercial	$293.02

K-WIRE OLIVE TIP 1.6MMX100MM

Facility

$769.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$238.39
Max. Negotiated Rate	$745.93
Rate for Payer: AlohaCare Medicaid	$384.50
Rate for Payer: AlohaCare Medicare	$238.39
Rate for Payer: Cash Price	$461.40
Rate for Payer: Devoted Health Medicare	$261.46
Rate for Payer: Hawaii Medical Service Association Medicare	$238.39
Rate for Payer: Hawaii Western Management Group Commercial	$538.30
Rate for Payer: Health Management Network Commercial	$653.65
Rate for Payer: Humana Medicare	$238.39
Rate for Payer: Kaiser Permanente Commercial	$692.10
Rate for Payer: Kaiser Permanente Medicaid	$392.19
Rate for Payer: Kaiser Permanente Medicare	$238.39
Rate for Payer: MDX Hawaii PPO	$745.93
Rate for Payer: Ohana Health Plan Medicaid	$238.39
Rate for Payer: Ohana Health Plan Medicare	$238.39
Rate for Payer: UnitedHealthcare Medicare	$238.39
Rate for Payer: University Health Alliance Commercial	$430.64

K-WIRE OLIVE TIP 1.6MMX100MM

Facility

$769.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$430.64
Max. Negotiated Rate	$745.93
Rate for Payer: Cash Price	$461.40
Rate for Payer: Hawaii Western Management Group Commercial	$538.30
Rate for Payer: Health Management Network Commercial	$653.65
Rate for Payer: Kaiser Permanente Commercial	$692.10
Rate for Payer: MDX Hawaii PPO	$745.93
Rate for Payer: University Health Alliance Commercial	$430.64

K-WIRE S3 2.0X152MM KW20SS

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 S3 2.0X152MM KW20SS

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 TI 2.0X150MM 492.20

Facility

$131.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$111.35
Max. Negotiated Rate	$127.07
Rate for Payer: Cash Price	$78.60
Rate for Payer: Health Management Network Commercial	$111.35
Rate for Payer: Kaiser Permanente Commercial	$117.90
Rate for Payer: MDX Hawaii PPO	$127.07

K-WIRE TI 2.0X150MM 492.20

Facility

$131.00

Service Code	HCPCS C1713
Hospital Revenue Code	272
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$127.07
Rate for Payer: AlohaCare Medicaid	$65.50
Rate for Payer: AlohaCare Medicare	$40.61
Rate for Payer: Cash Price	$78.60
Rate for Payer: Devoted Health Medicare	$44.54
Rate for Payer: Hawaii Medical Service Association Medicare	$40.61
Rate for Payer: Hawaii Western Management Group Commercial	$124.45
Rate for Payer: Health Management Network Commercial	$111.35
Rate for Payer: Humana Medicare	$40.61
Rate for Payer: Kaiser Permanente Commercial	$117.90
Rate for Payer: Kaiser Permanente Medicaid	$66.81
Rate for Payer: Kaiser Permanente Medicare	$40.61
Rate for Payer: MDX Hawaii PPO	$127.07
Rate for Payer: Ohana Health Plan Medicaid	$40.61
Rate for Payer: Ohana Health Plan Medicare	$40.61
Rate for Payer: UnitedHealthcare Medicare	$40.61
Rate for Payer: University Health Alliance Commercial	$95.49

Know your out-of-pocket cost for care.

All Charges