Kau Hospital

All Charges

Charge

Type

Setting

Price

NAIL TIBIAL 9/345 #04.004.349S

Facility

$3,635.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,035.60
Max. Negotiated Rate	$3,525.95
Rate for Payer: Cash Price	$2,181.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,544.50
Rate for Payer: Health Management Network Commercial	$3,089.75
Rate for Payer: Kaiser Permanente Commercial	$3,271.50
Rate for Payer: MDX Hawaii PPO	$3,525.95
Rate for Payer: University Health Alliance Commercial	$2,035.60

NAIL TIBIAL 9/345 #04.004.349S

Facility

$3,635.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,126.85
Max. Negotiated Rate	$3,525.95
Rate for Payer: AlohaCare Medicaid	$1,817.50
Rate for Payer: AlohaCare Medicare	$1,126.85
Rate for Payer: Cash Price	$2,181.00
Rate for Payer: Devoted Health Medicare	$1,235.90
Rate for Payer: Hawaii Medical Service Association Medicare	$1,126.85
Rate for Payer: Hawaii Western Management Group Commercial	$2,544.50
Rate for Payer: Health Management Network Commercial	$3,089.75
Rate for Payer: Humana Medicare	$1,126.85
Rate for Payer: Kaiser Permanente Commercial	$3,271.50
Rate for Payer: Kaiser Permanente Medicaid	$1,853.85
Rate for Payer: Kaiser Permanente Medicare	$1,126.85
Rate for Payer: MDX Hawaii PPO	$3,525.95
Rate for Payer: Ohana Health Plan Medicaid	$1,126.85
Rate for Payer: Ohana Health Plan Medicare	$1,126.85
Rate for Payer: UnitedHealthcare Medicare	$1,126.85
Rate for Payer: University Health Alliance Commercial	$2,035.60

NAIL TIBIAL 9/360 #04.004.352S

Facility

$3,512.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,966.72
Max. Negotiated Rate	$3,406.64
Rate for Payer: Cash Price	$2,107.20
Rate for Payer: Hawaii Western Management Group Commercial	$2,458.40
Rate for Payer: Health Management Network Commercial	$2,985.20
Rate for Payer: Kaiser Permanente Commercial	$3,160.80
Rate for Payer: MDX Hawaii PPO	$3,406.64
Rate for Payer: University Health Alliance Commercial	$1,966.72

NAIL TIBIAL 9/360 #04.004.352S

Facility

$3,512.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,088.72
Max. Negotiated Rate	$3,406.64
Rate for Payer: AlohaCare Medicaid	$1,756.00
Rate for Payer: AlohaCare Medicare	$1,088.72
Rate for Payer: Cash Price	$2,107.20
Rate for Payer: Devoted Health Medicare	$1,194.08
Rate for Payer: Hawaii Medical Service Association Medicare	$1,088.72
Rate for Payer: Hawaii Western Management Group Commercial	$2,458.40
Rate for Payer: Health Management Network Commercial	$2,985.20
Rate for Payer: Humana Medicare	$1,088.72
Rate for Payer: Kaiser Permanente Commercial	$3,160.80
Rate for Payer: Kaiser Permanente Medicaid	$1,791.12
Rate for Payer: Kaiser Permanente Medicare	$1,088.72
Rate for Payer: MDX Hawaii PPO	$3,406.64
Rate for Payer: Ohana Health Plan Medicaid	$1,088.72
Rate for Payer: Ohana Health Plan Medicare	$1,088.72
Rate for Payer: UnitedHealthcare Medicare	$1,088.72
Rate for Payer: University Health Alliance Commercial	$1,966.72

NAIL TIBIAL 9/375 #04.004.355S

Facility

$3,512.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,088.72
Max. Negotiated Rate	$3,406.64
Rate for Payer: AlohaCare Medicaid	$1,756.00
Rate for Payer: AlohaCare Medicare	$1,088.72
Rate for Payer: Cash Price	$2,107.20
Rate for Payer: Devoted Health Medicare	$1,194.08
Rate for Payer: Hawaii Medical Service Association Medicare	$1,088.72
Rate for Payer: Hawaii Western Management Group Commercial	$2,458.40
Rate for Payer: Health Management Network Commercial	$2,985.20
Rate for Payer: Humana Medicare	$1,088.72
Rate for Payer: Kaiser Permanente Commercial	$3,160.80
Rate for Payer: Kaiser Permanente Medicaid	$1,791.12
Rate for Payer: Kaiser Permanente Medicare	$1,088.72
Rate for Payer: MDX Hawaii PPO	$3,406.64
Rate for Payer: Ohana Health Plan Medicaid	$1,088.72
Rate for Payer: Ohana Health Plan Medicare	$1,088.72
Rate for Payer: UnitedHealthcare Medicare	$1,088.72
Rate for Payer: University Health Alliance Commercial	$1,966.72

NAIL TIBIAL 9/375 #04.004.355S

Facility

$3,512.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,966.72
Max. Negotiated Rate	$3,406.64
Rate for Payer: Cash Price	$2,107.20
Rate for Payer: Hawaii Western Management Group Commercial	$2,458.40
Rate for Payer: Health Management Network Commercial	$2,985.20
Rate for Payer: Kaiser Permanente Commercial	$3,160.80
Rate for Payer: MDX Hawaii PPO	$3,406.64
Rate for Payer: University Health Alliance Commercial	$1,966.72

NAIL TIBIAL 9/390 #04.004.358S

Facility

$3,512.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,088.72
Max. Negotiated Rate	$3,406.64
Rate for Payer: AlohaCare Medicaid	$1,756.00
Rate for Payer: AlohaCare Medicare	$1,088.72
Rate for Payer: Cash Price	$2,107.20
Rate for Payer: Devoted Health Medicare	$1,194.08
Rate for Payer: Hawaii Medical Service Association Medicare	$1,088.72
Rate for Payer: Hawaii Western Management Group Commercial	$2,458.40
Rate for Payer: Health Management Network Commercial	$2,985.20
Rate for Payer: Humana Medicare	$1,088.72
Rate for Payer: Kaiser Permanente Commercial	$3,160.80
Rate for Payer: Kaiser Permanente Medicaid	$1,791.12
Rate for Payer: Kaiser Permanente Medicare	$1,088.72
Rate for Payer: MDX Hawaii PPO	$3,406.64
Rate for Payer: Ohana Health Plan Medicaid	$1,088.72
Rate for Payer: Ohana Health Plan Medicare	$1,088.72
Rate for Payer: UnitedHealthcare Medicare	$1,088.72
Rate for Payer: University Health Alliance Commercial	$1,966.72

NAIL TIBIAL 9/390 #04.004.358S

Facility

$3,512.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,966.72
Max. Negotiated Rate	$3,406.64
Rate for Payer: Cash Price	$2,107.20
Rate for Payer: Hawaii Western Management Group Commercial	$2,458.40
Rate for Payer: Health Management Network Commercial	$2,985.20
Rate for Payer: Kaiser Permanente Commercial	$3,160.80
Rate for Payer: MDX Hawaii PPO	$3,406.64
Rate for Payer: University Health Alliance Commercial	$1,966.72

NAIL TIBIAL 9X300 2341-0930S

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,870.00
Max. Negotiated Rate	$4,971.25
Rate for Payer: Cash Price	$3,075.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,587.50
Rate for Payer: Health Management Network Commercial	$4,356.25
Rate for Payer: Kaiser Permanente Commercial	$4,612.50
Rate for Payer: MDX Hawaii PPO	$4,971.25
Rate for Payer: University Health Alliance Commercial	$2,870.00

NAIL TIBIAL 9X300 2341-0930S

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,588.75
Max. Negotiated Rate	$4,971.25
Rate for Payer: AlohaCare Medicaid	$2,562.50
Rate for Payer: AlohaCare Medicare	$1,588.75
Rate for Payer: Cash Price	$3,075.00
Rate for Payer: Devoted Health Medicare	$1,742.50
Rate for Payer: Hawaii Medical Service Association Medicare	$1,588.75
Rate for Payer: Hawaii Western Management Group Commercial	$3,587.50
Rate for Payer: Health Management Network Commercial	$4,356.25
Rate for Payer: Humana Medicare	$1,588.75
Rate for Payer: Kaiser Permanente Commercial	$4,612.50
Rate for Payer: Kaiser Permanente Medicaid	$2,613.75
Rate for Payer: Kaiser Permanente Medicare	$1,588.75
Rate for Payer: MDX Hawaii PPO	$4,971.25
Rate for Payer: Ohana Health Plan Medicaid	$1,588.75
Rate for Payer: Ohana Health Plan Medicare	$1,588.75
Rate for Payer: UnitedHealthcare Medicare	$1,588.75
Rate for Payer: University Health Alliance Commercial	$2,870.00

NAIL TIBIAL 9X330 2341-0933S

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,870.00
Max. Negotiated Rate	$4,971.25
Rate for Payer: Cash Price	$3,075.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,587.50
Rate for Payer: Health Management Network Commercial	$4,356.25
Rate for Payer: Kaiser Permanente Commercial	$4,612.50
Rate for Payer: MDX Hawaii PPO	$4,971.25
Rate for Payer: University Health Alliance Commercial	$2,870.00

NAIL TIBIAL 9X330 2341-0933S

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,588.75
Max. Negotiated Rate	$4,971.25
Rate for Payer: AlohaCare Medicaid	$2,562.50
Rate for Payer: AlohaCare Medicare	$1,588.75
Rate for Payer: Cash Price	$3,075.00
Rate for Payer: Devoted Health Medicare	$1,742.50
Rate for Payer: Hawaii Medical Service Association Medicare	$1,588.75
Rate for Payer: Hawaii Western Management Group Commercial	$3,587.50
Rate for Payer: Health Management Network Commercial	$4,356.25
Rate for Payer: Humana Medicare	$1,588.75
Rate for Payer: Kaiser Permanente Commercial	$4,612.50
Rate for Payer: Kaiser Permanente Medicaid	$2,613.75
Rate for Payer: Kaiser Permanente Medicare	$1,588.75
Rate for Payer: MDX Hawaii PPO	$4,971.25
Rate for Payer: Ohana Health Plan Medicaid	$1,588.75
Rate for Payer: Ohana Health Plan Medicare	$1,588.75
Rate for Payer: UnitedHealthcare Medicare	$1,588.75
Rate for Payer: University Health Alliance Commercial	$2,870.00

NAIL TIBIAL 9X345MM 2341-0934S

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,588.75
Max. Negotiated Rate	$4,971.25
Rate for Payer: AlohaCare Medicaid	$2,562.50
Rate for Payer: AlohaCare Medicare	$1,588.75
Rate for Payer: Cash Price	$3,075.00
Rate for Payer: Devoted Health Medicare	$1,742.50
Rate for Payer: Hawaii Medical Service Association Medicare	$1,588.75
Rate for Payer: Hawaii Western Management Group Commercial	$3,587.50
Rate for Payer: Health Management Network Commercial	$4,356.25
Rate for Payer: Humana Medicare	$1,588.75
Rate for Payer: Kaiser Permanente Commercial	$4,612.50
Rate for Payer: Kaiser Permanente Medicaid	$2,613.75
Rate for Payer: Kaiser Permanente Medicare	$1,588.75
Rate for Payer: MDX Hawaii PPO	$4,971.25
Rate for Payer: Ohana Health Plan Medicaid	$1,588.75
Rate for Payer: Ohana Health Plan Medicare	$1,588.75
Rate for Payer: UnitedHealthcare Medicare	$1,588.75
Rate for Payer: University Health Alliance Commercial	$2,870.00

NAIL TIBIAL 9X345MM 2341-0934S

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,870.00
Max. Negotiated Rate	$4,971.25
Rate for Payer: Cash Price	$3,075.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,587.50
Rate for Payer: Health Management Network Commercial	$4,356.25
Rate for Payer: Kaiser Permanente Commercial	$4,612.50
Rate for Payer: MDX Hawaii PPO	$4,971.25
Rate for Payer: University Health Alliance Commercial	$2,870.00

NAIL TIBIAL 9X375MM 2341-0937S

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,870.00
Max. Negotiated Rate	$4,971.25
Rate for Payer: Cash Price	$3,075.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,587.50
Rate for Payer: Health Management Network Commercial	$4,356.25
Rate for Payer: Kaiser Permanente Commercial	$4,612.50
Rate for Payer: MDX Hawaii PPO	$4,971.25
Rate for Payer: University Health Alliance Commercial	$2,870.00

NAIL TIBIAL 9X375MM 2341-0937S

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,588.75
Max. Negotiated Rate	$4,971.25
Rate for Payer: AlohaCare Medicaid	$2,562.50
Rate for Payer: AlohaCare Medicare	$1,588.75
Rate for Payer: Cash Price	$3,075.00
Rate for Payer: Devoted Health Medicare	$1,742.50
Rate for Payer: Hawaii Medical Service Association Medicare	$1,588.75
Rate for Payer: Hawaii Western Management Group Commercial	$3,587.50
Rate for Payer: Health Management Network Commercial	$4,356.25
Rate for Payer: Humana Medicare	$1,588.75
Rate for Payer: Kaiser Permanente Commercial	$4,612.50
Rate for Payer: Kaiser Permanente Medicaid	$2,613.75
Rate for Payer: Kaiser Permanente Medicare	$1,588.75
Rate for Payer: MDX Hawaii PPO	$4,971.25
Rate for Payer: Ohana Health Plan Medicaid	$1,588.75
Rate for Payer: Ohana Health Plan Medicare	$1,588.75
Rate for Payer: UnitedHealthcare Medicare	$1,588.75
Rate for Payer: University Health Alliance Commercial	$2,870.00

NAIL TI CAN 10X375 04.004.455S

Facility

$3,635.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,035.60
Max. Negotiated Rate	$3,525.95
Rate for Payer: Cash Price	$2,181.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,544.50
Rate for Payer: Health Management Network Commercial	$3,089.75
Rate for Payer: Kaiser Permanente Commercial	$3,271.50
Rate for Payer: MDX Hawaii PPO	$3,525.95
Rate for Payer: University Health Alliance Commercial	$2,035.60

NAIL TI CAN 10X375 04.004.455S

Facility

$3,635.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,126.85
Max. Negotiated Rate	$3,525.95
Rate for Payer: AlohaCare Medicaid	$1,817.50
Rate for Payer: AlohaCare Medicare	$1,126.85
Rate for Payer: Cash Price	$2,181.00
Rate for Payer: Devoted Health Medicare	$1,235.90
Rate for Payer: Hawaii Medical Service Association Medicare	$1,126.85
Rate for Payer: Hawaii Western Management Group Commercial	$2,544.50
Rate for Payer: Health Management Network Commercial	$3,089.75
Rate for Payer: Humana Medicare	$1,126.85
Rate for Payer: Kaiser Permanente Commercial	$3,271.50
Rate for Payer: Kaiser Permanente Medicaid	$1,853.85
Rate for Payer: Kaiser Permanente Medicare	$1,126.85
Rate for Payer: MDX Hawaii PPO	$3,525.95
Rate for Payer: Ohana Health Plan Medicaid	$1,126.85
Rate for Payer: Ohana Health Plan Medicare	$1,126.85
Rate for Payer: UnitedHealthcare Medicare	$1,126.85
Rate for Payer: University Health Alliance Commercial	$2,035.60

NAIL TI CANN FIXTION 10MM

Facility

$5,208.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,916.48
Max. Negotiated Rate	$5,051.76
Rate for Payer: Cash Price	$3,124.80
Rate for Payer: Hawaii Western Management Group Commercial	$3,645.60
Rate for Payer: Health Management Network Commercial	$4,426.80
Rate for Payer: Kaiser Permanente Commercial	$4,687.20
Rate for Payer: MDX Hawaii PPO	$5,051.76
Rate for Payer: University Health Alliance Commercial	$2,916.48

NAIL TI CANN FIXTION 10MM

Facility

$5,208.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,614.48
Max. Negotiated Rate	$5,051.76
Rate for Payer: AlohaCare Medicaid	$2,604.00
Rate for Payer: AlohaCare Medicare	$1,614.48
Rate for Payer: Cash Price	$3,124.80
Rate for Payer: Devoted Health Medicare	$1,770.72
Rate for Payer: Hawaii Medical Service Association Medicare	$1,614.48
Rate for Payer: Hawaii Western Management Group Commercial	$3,645.60
Rate for Payer: Health Management Network Commercial	$4,426.80
Rate for Payer: Humana Medicare	$1,614.48
Rate for Payer: Kaiser Permanente Commercial	$4,687.20
Rate for Payer: Kaiser Permanente Medicaid	$2,656.08
Rate for Payer: Kaiser Permanente Medicare	$1,614.48
Rate for Payer: MDX Hawaii PPO	$5,051.76
Rate for Payer: Ohana Health Plan Medicaid	$1,614.48
Rate for Payer: Ohana Health Plan Medicare	$1,614.48
Rate for Payer: UnitedHealthcare Medicare	$1,614.48
Rate for Payer: University Health Alliance Commercial	$2,916.48

NAIL TI CANN HUMERAL 7X150MM

Facility

$5,806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,799.86
Max. Negotiated Rate	$5,631.82
Rate for Payer: AlohaCare Medicaid	$2,903.00
Rate for Payer: AlohaCare Medicare	$1,799.86
Rate for Payer: Cash Price	$3,483.60
Rate for Payer: Devoted Health Medicare	$1,974.04
Rate for Payer: Hawaii Medical Service Association Medicare	$1,799.86
Rate for Payer: Hawaii Western Management Group Commercial	$4,064.20
Rate for Payer: Health Management Network Commercial	$4,935.10
Rate for Payer: Humana Medicare	$1,799.86
Rate for Payer: Kaiser Permanente Commercial	$5,225.40
Rate for Payer: Kaiser Permanente Medicaid	$2,961.06
Rate for Payer: Kaiser Permanente Medicare	$1,799.86
Rate for Payer: MDX Hawaii PPO	$5,631.82
Rate for Payer: Ohana Health Plan Medicaid	$1,799.86
Rate for Payer: Ohana Health Plan Medicare	$1,799.86
Rate for Payer: UnitedHealthcare Medicare	$1,799.86
Rate for Payer: University Health Alliance Commercial	$3,251.36

NAIL TI CANN HUMERAL 7X150MM

Facility

$5,806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,251.36
Max. Negotiated Rate	$5,631.82
Rate for Payer: Cash Price	$3,483.60
Rate for Payer: Hawaii Western Management Group Commercial	$4,064.20
Rate for Payer: Health Management Network Commercial	$4,935.10
Rate for Payer: Kaiser Permanente Commercial	$5,225.40
Rate for Payer: MDX Hawaii PPO	$5,631.82
Rate for Payer: University Health Alliance Commercial	$3,251.36

NAIL TI CANN HUMERAL 7X200MM

Facility

$4,128.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,311.68
Max. Negotiated Rate	$4,004.16
Rate for Payer: Cash Price	$2,476.80
Rate for Payer: Hawaii Western Management Group Commercial	$2,889.60
Rate for Payer: Health Management Network Commercial	$3,508.80
Rate for Payer: Kaiser Permanente Commercial	$3,715.20
Rate for Payer: MDX Hawaii PPO	$4,004.16
Rate for Payer: University Health Alliance Commercial	$2,311.68

NAIL TI CANN HUMERAL 7X200MM

Facility

$4,128.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,279.68
Max. Negotiated Rate	$4,004.16
Rate for Payer: AlohaCare Medicaid	$2,064.00
Rate for Payer: AlohaCare Medicare	$1,279.68
Rate for Payer: Cash Price	$2,476.80
Rate for Payer: Devoted Health Medicare	$1,403.52
Rate for Payer: Hawaii Medical Service Association Medicare	$1,279.68
Rate for Payer: Hawaii Western Management Group Commercial	$2,889.60
Rate for Payer: Health Management Network Commercial	$3,508.80
Rate for Payer: Humana Medicare	$1,279.68
Rate for Payer: Kaiser Permanente Commercial	$3,715.20
Rate for Payer: Kaiser Permanente Medicaid	$2,105.28
Rate for Payer: Kaiser Permanente Medicare	$1,279.68
Rate for Payer: MDX Hawaii PPO	$4,004.16
Rate for Payer: Ohana Health Plan Medicaid	$1,279.68
Rate for Payer: Ohana Health Plan Medicare	$1,279.68
Rate for Payer: UnitedHealthcare Medicare	$1,279.68
Rate for Payer: University Health Alliance Commercial	$2,311.68

NAIL TI CANN HUMERAL 7X210MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,854.42
Max. Negotiated Rate	$5,802.54
Rate for Payer: AlohaCare Medicaid	$2,991.00
Rate for Payer: AlohaCare Medicare	$1,854.42
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Devoted Health Medicare	$2,033.88
Rate for Payer: Hawaii Medical Service Association Medicare	$1,854.42
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Humana Medicare	$1,854.42
Rate for Payer: Kaiser Permanente Commercial	$5,383.80
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: Kaiser Permanente Medicare	$1,854.42
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: Ohana Health Plan Medicaid	$1,854.42
Rate for Payer: Ohana Health Plan Medicare	$1,854.42
Rate for Payer: UnitedHealthcare Medicare	$1,854.42
Rate for Payer: University Health Alliance Commercial	$3,349.92

Know your out-of-pocket cost for care.

All Charges