Kau Hospital

All Charges

Charge

Type

Setting

Price

NAIL 12X360MM RT 04.037.256S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,756.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$1,756.15
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$1,926.10
Rate for Payer: Hawaii Medical Service Association Medicare	$1,756.15
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$1,756.15
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$1,756.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$1,756.15
Rate for Payer: Ohana Health Plan Medicare	$1,756.15
Rate for Payer: UnitedHealthcare Medicare	$1,756.15
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X360MM RT 04.037.256S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X360MM TI 04.013.652S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,223.20
Max. Negotiated Rate	$3,850.90
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Kaiser Permanente Commercial	$3,573.00
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 12X360MM TI 04.013.652S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,230.70
Max. Negotiated Rate	$3,850.90
Rate for Payer: AlohaCare Medicaid	$1,985.00
Rate for Payer: AlohaCare Medicare	$1,230.70
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Devoted Health Medicare	$1,349.80
Rate for Payer: Hawaii Medical Service Association Medicare	$1,230.70
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Humana Medicare	$1,230.70
Rate for Payer: Kaiser Permanente Commercial	$3,573.00
Rate for Payer: Kaiser Permanente Medicaid	$2,024.70
Rate for Payer: Kaiser Permanente Medicare	$1,230.70
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: Ohana Health Plan Medicaid	$1,230.70
Rate for Payer: Ohana Health Plan Medicare	$1,230.70
Rate for Payer: UnitedHealthcare Medicare	$1,230.70
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 12X380MM LEFT 04.037.259S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,756.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$1,756.15
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$1,926.10
Rate for Payer: Hawaii Medical Service Association Medicare	$1,756.15
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$1,756.15
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$1,756.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$1,756.15
Rate for Payer: Ohana Health Plan Medicare	$1,756.15
Rate for Payer: UnitedHealthcare Medicare	$1,756.15
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X380MM LEFT 04.037.259S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X380MM RT 04.037.258S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,756.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$1,756.15
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$1,926.10
Rate for Payer: Hawaii Medical Service Association Medicare	$1,756.15
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$1,756.15
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$1,756.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$1,756.15
Rate for Payer: Ohana Health Plan Medicare	$1,756.15
Rate for Payer: UnitedHealthcare Medicare	$1,756.15
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X380MM RT 04.037.258S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X380MM TI 04.013.656S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,223.20
Max. Negotiated Rate	$3,850.90
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Kaiser Permanente Commercial	$3,573.00
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 12X380MM TI 04.013.656S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,230.70
Max. Negotiated Rate	$3,850.90
Rate for Payer: AlohaCare Medicaid	$1,985.00
Rate for Payer: AlohaCare Medicare	$1,230.70
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Devoted Health Medicare	$1,349.80
Rate for Payer: Hawaii Medical Service Association Medicare	$1,230.70
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Humana Medicare	$1,230.70
Rate for Payer: Kaiser Permanente Commercial	$3,573.00
Rate for Payer: Kaiser Permanente Medicaid	$2,024.70
Rate for Payer: Kaiser Permanente Medicare	$1,230.70
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: Ohana Health Plan Medicaid	$1,230.70
Rate for Payer: Ohana Health Plan Medicare	$1,230.70
Rate for Payer: UnitedHealthcare Medicare	$1,230.70
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 12X400MM LEFT 04.037.261S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X400MM LEFT 04.037.261S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,756.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$1,756.15
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$1,926.10
Rate for Payer: Hawaii Medical Service Association Medicare	$1,756.15
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$1,756.15
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$1,756.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$1,756.15
Rate for Payer: Ohana Health Plan Medicare	$1,756.15
Rate for Payer: UnitedHealthcare Medicare	$1,756.15
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X400MM RT 04.037.260S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X400MM RT 04.037.260S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,756.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$1,756.15
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$1,926.10
Rate for Payer: Hawaii Medical Service Association Medicare	$1,756.15
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$1,756.15
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$1,756.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$1,756.15
Rate for Payer: Ohana Health Plan Medicare	$1,756.15
Rate for Payer: UnitedHealthcare Medicare	$1,756.15
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X420MM LEFT 04.037.263S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,756.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$1,756.15
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$1,926.10
Rate for Payer: Hawaii Medical Service Association Medicare	$1,756.15
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$1,756.15
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$1,756.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$1,756.15
Rate for Payer: Ohana Health Plan Medicare	$1,756.15
Rate for Payer: UnitedHealthcare Medicare	$1,756.15
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X420MM LEFT 04.037.263S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X420MM RT 04.037.262S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,756.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: AlohaCare Medicaid	$2,832.50
Rate for Payer: AlohaCare Medicare	$1,756.15
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Devoted Health Medicare	$1,926.10
Rate for Payer: Hawaii Medical Service Association Medicare	$1,756.15
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Humana Medicare	$1,756.15
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: Kaiser Permanente Medicare	$1,756.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: Ohana Health Plan Medicaid	$1,756.15
Rate for Payer: Ohana Health Plan Medicare	$1,756.15
Rate for Payer: UnitedHealthcare Medicare	$1,756.15
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 12X420MM RT 04.037.262S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$5,098.50
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 130D LF 11X40 8530-1400S

Facility

$7,092.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,198.52
Max. Negotiated Rate	$6,879.24
Rate for Payer: AlohaCare Medicaid	$3,546.00
Rate for Payer: AlohaCare Medicare	$2,198.52
Rate for Payer: Cash Price	$4,255.20
Rate for Payer: Devoted Health Medicare	$2,411.28
Rate for Payer: Hawaii Medical Service Association Medicare	$2,198.52
Rate for Payer: Hawaii Western Management Group Commercial	$4,964.40
Rate for Payer: Health Management Network Commercial	$6,028.20
Rate for Payer: Humana Medicare	$2,198.52
Rate for Payer: Kaiser Permanente Commercial	$6,382.80
Rate for Payer: Kaiser Permanente Medicaid	$3,616.92
Rate for Payer: Kaiser Permanente Medicare	$2,198.52
Rate for Payer: MDX Hawaii PPO	$6,879.24
Rate for Payer: Ohana Health Plan Medicaid	$2,198.52
Rate for Payer: Ohana Health Plan Medicare	$2,198.52
Rate for Payer: UnitedHealthcare Medicare	$2,198.52
Rate for Payer: University Health Alliance Commercial	$3,971.52

NAIL 130D LF 11X40 8530-1400S

Facility

$7,092.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,971.52
Max. Negotiated Rate	$6,879.24
Rate for Payer: Cash Price	$4,255.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,964.40
Rate for Payer: Health Management Network Commercial	$6,028.20
Rate for Payer: Kaiser Permanente Commercial	$6,382.80
Rate for Payer: MDX Hawaii PPO	$6,879.24
Rate for Payer: University Health Alliance Commercial	$3,971.52

NAIL 13X360MM TI 04.013.752S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,230.70
Max. Negotiated Rate	$3,850.90
Rate for Payer: AlohaCare Medicaid	$1,985.00
Rate for Payer: AlohaCare Medicare	$1,230.70
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Devoted Health Medicare	$1,349.80
Rate for Payer: Hawaii Medical Service Association Medicare	$1,230.70
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Humana Medicare	$1,230.70
Rate for Payer: Kaiser Permanente Commercial	$3,573.00
Rate for Payer: Kaiser Permanente Medicaid	$2,024.70
Rate for Payer: Kaiser Permanente Medicare	$1,230.70
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: Ohana Health Plan Medicaid	$1,230.70
Rate for Payer: Ohana Health Plan Medicare	$1,230.70
Rate for Payer: UnitedHealthcare Medicare	$1,230.70
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 13X360MM TI 04.013.752S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,223.20
Max. Negotiated Rate	$3,850.90
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Kaiser Permanente Commercial	$3,573.00
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 13X380MM TI 04.013.756S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,223.20
Max. Negotiated Rate	$3,850.90
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Kaiser Permanente Commercial	$3,573.00
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 13X380MM TI 04.013.756S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,230.70
Max. Negotiated Rate	$3,850.90
Rate for Payer: AlohaCare Medicaid	$1,985.00
Rate for Payer: AlohaCare Medicare	$1,230.70
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Devoted Health Medicare	$1,349.80
Rate for Payer: Hawaii Medical Service Association Medicare	$1,230.70
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Humana Medicare	$1,230.70
Rate for Payer: Kaiser Permanente Commercial	$3,573.00
Rate for Payer: Kaiser Permanente Medicaid	$2,024.70
Rate for Payer: Kaiser Permanente Medicare	$1,230.70
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: Ohana Health Plan Medicaid	$1,230.70
Rate for Payer: Ohana Health Plan Medicare	$1,230.70
Rate for Payer: UnitedHealthcare Medicare	$1,230.70
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 1.8MM THRD IM TI 38MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,825.60
Max. Negotiated Rate	$3,162.20
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: Kaiser Permanente Commercial	$2,934.00
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: University Health Alliance Commercial	$1,825.60

Know your out-of-pocket cost for care.

All Charges