Kau Hospital

All Charges

Charge

Type

Setting

Price

PIN DRILL 1.5X100MM AR-4151DS

Facility

$1,225.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$686.00
Max. Negotiated Rate	$1,188.25
Rate for Payer: Cash Price	$735.00
Rate for Payer: Hawaii Western Management Group Commercial	$857.50
Rate for Payer: Health Management Network Commercial	$1,041.25
Rate for Payer: Kaiser Permanente Commercial	$1,102.50
Rate for Payer: MDX Hawaii PPO	$1,188.25
Rate for Payer: University Health Alliance Commercial	$686.00

PIN DRILL 1.5X100MM AR-4151DS

Facility

$1,225.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$379.75
Max. Negotiated Rate	$1,188.25
Rate for Payer: AlohaCare Medicaid	$612.50
Rate for Payer: AlohaCare Medicare	$379.75
Rate for Payer: Cash Price	$735.00
Rate for Payer: Devoted Health Medicare	$416.50
Rate for Payer: Hawaii Medical Service Association Medicare	$379.75
Rate for Payer: Hawaii Western Management Group Commercial	$857.50
Rate for Payer: Health Management Network Commercial	$1,041.25
Rate for Payer: Humana Medicare	$379.75
Rate for Payer: Kaiser Permanente Commercial	$1,102.50
Rate for Payer: Kaiser Permanente Medicaid	$624.75
Rate for Payer: Kaiser Permanente Medicare	$379.75
Rate for Payer: MDX Hawaii PPO	$1,188.25
Rate for Payer: Ohana Health Plan Medicaid	$379.75
Rate for Payer: Ohana Health Plan Medicare	$379.75
Rate for Payer: UnitedHealthcare Medicare	$379.75
Rate for Payer: University Health Alliance Commercial	$686.00

PIN GAMMA4 PRECISIN 1420-0065S

Facility

$887.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$274.97
Max. Negotiated Rate	$860.39
Rate for Payer: AlohaCare Medicaid	$443.50
Rate for Payer: AlohaCare Medicare	$274.97
Rate for Payer: Cash Price	$532.20
Rate for Payer: Devoted Health Medicare	$301.58
Rate for Payer: Hawaii Medical Service Association Medicare	$274.97
Rate for Payer: Hawaii Western Management Group Commercial	$620.90
Rate for Payer: Health Management Network Commercial	$753.95
Rate for Payer: Humana Medicare	$274.97
Rate for Payer: Kaiser Permanente Commercial	$798.30
Rate for Payer: Kaiser Permanente Medicaid	$452.37
Rate for Payer: Kaiser Permanente Medicare	$274.97
Rate for Payer: MDX Hawaii PPO	$860.39
Rate for Payer: Ohana Health Plan Medicaid	$274.97
Rate for Payer: Ohana Health Plan Medicare	$274.97
Rate for Payer: UnitedHealthcare Medicare	$274.97
Rate for Payer: University Health Alliance Commercial	$496.72

PIN GAMMA4 PRECISIN 1420-0065S

Facility

$887.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$496.72
Max. Negotiated Rate	$860.39
Rate for Payer: Cash Price	$532.20
Rate for Payer: Hawaii Western Management Group Commercial	$620.90
Rate for Payer: Health Management Network Commercial	$753.95
Rate for Payer: Kaiser Permanente Commercial	$798.30
Rate for Payer: MDX Hawaii PPO	$860.39
Rate for Payer: University Health Alliance Commercial	$496.72

PIN GLENOID 7000-35-230

Facility

$5,047.00

Service Code	HCPCS C1769
Hospital Revenue Code	278
Min. Negotiated Rate	$1,564.57
Max. Negotiated Rate	$4,895.59
Rate for Payer: AlohaCare Medicaid	$2,523.50
Rate for Payer: AlohaCare Medicare	$1,564.57
Rate for Payer: Cash Price	$3,028.20
Rate for Payer: Devoted Health Medicare	$1,715.98
Rate for Payer: Hawaii Medical Service Association Medicare	$1,564.57
Rate for Payer: Hawaii Western Management Group Commercial	$3,532.90
Rate for Payer: Health Management Network Commercial	$4,289.95
Rate for Payer: Humana Medicare	$1,564.57
Rate for Payer: Kaiser Permanente Commercial	$4,542.30
Rate for Payer: Kaiser Permanente Medicaid	$2,573.97
Rate for Payer: Kaiser Permanente Medicare	$1,564.57
Rate for Payer: MDX Hawaii PPO	$4,895.59
Rate for Payer: Ohana Health Plan Medicaid	$1,564.57
Rate for Payer: Ohana Health Plan Medicare	$1,564.57
Rate for Payer: UnitedHealthcare Medicare	$1,564.57
Rate for Payer: University Health Alliance Commercial	$2,826.32

PIN GLENOID 7000-35-230

Facility

$5,047.00

Service Code	HCPCS C1769
Hospital Revenue Code	278
Min. Negotiated Rate	$2,826.32
Max. Negotiated Rate	$4,895.59
Rate for Payer: Cash Price	$3,028.20
Rate for Payer: Hawaii Western Management Group Commercial	$3,532.90
Rate for Payer: Health Management Network Commercial	$4,289.95
Rate for Payer: Kaiser Permanente Commercial	$4,542.30
Rate for Payer: MDX Hawaii PPO	$4,895.59
Rate for Payer: University Health Alliance Commercial	$2,826.32

PIN HALF TL 4MMX180MM 54-11230

Facility

$489.00

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

PIN HALF TL 4MMX180MM 54-11230

Facility

$489.00

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

PIN HALF TL 5MMX180MM 54-11240

Facility

$490.00

Hospital Revenue Code	272
Min. Negotiated Rate	$416.50
Max. Negotiated Rate	$475.30
Rate for Payer: Cash Price	$294.00
Rate for Payer: Health Management Network Commercial	$416.50
Rate for Payer: Kaiser Permanente Commercial	$441.00
Rate for Payer: MDX Hawaii PPO	$475.30

PIN HALF TL 5MMX180MM 54-11240

Facility

$490.00

Hospital Revenue Code	272
Min. Negotiated Rate	$151.90
Max. Negotiated Rate	$475.30
Rate for Payer: AlohaCare Medicaid	$245.00
Rate for Payer: AlohaCare Medicare	$151.90
Rate for Payer: Cash Price	$294.00
Rate for Payer: Devoted Health Medicare	$166.60
Rate for Payer: Hawaii Medical Service Association Medicare	$151.90
Rate for Payer: Hawaii Western Management Group Commercial	$465.50
Rate for Payer: Health Management Network Commercial	$416.50
Rate for Payer: Humana Medicare	$151.90
Rate for Payer: Kaiser Permanente Commercial	$441.00
Rate for Payer: Kaiser Permanente Medicaid	$249.90
Rate for Payer: Kaiser Permanente Medicare	$151.90
Rate for Payer: MDX Hawaii PPO	$475.30
Rate for Payer: Ohana Health Plan Medicaid	$151.90
Rate for Payer: Ohana Health Plan Medicare	$151.90
Rate for Payer: UnitedHealthcare Medicare	$151.90
Rate for Payer: University Health Alliance Commercial	$357.16

PIN HALF TL 6MMX180MM 54-11250

Facility

$489.00

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

PIN HALF TL 6MMX180MM 54-11250

Facility

$489.00

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

PINNING SYSTEM 2544-00-111

Facility

$875.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$490.00
Max. Negotiated Rate	$848.75
Rate for Payer: Cash Price	$525.00
Rate for Payer: Hawaii Western Management Group Commercial	$612.50
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
Rate for Payer: University Health Alliance Commercial	$490.00

PINNING SYSTEM 2544-00-111

Facility

$875.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
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	$612.50
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	$490.00

PIN PRECISION 1420-0060S

Facility

$896.00

Hospital Revenue Code	272
Min. Negotiated Rate	$761.60
Max. Negotiated Rate	$869.12
Rate for Payer: Cash Price	$537.60
Rate for Payer: Health Management Network Commercial	$761.60
Rate for Payer: Kaiser Permanente Commercial	$806.40
Rate for Payer: MDX Hawaii PPO	$869.12

PIN PRECISION 1420-0060S

Facility

$896.00

Hospital Revenue Code	272
Min. Negotiated Rate	$277.76
Max. Negotiated Rate	$869.12
Rate for Payer: AlohaCare Medicaid	$448.00
Rate for Payer: AlohaCare Medicare	$277.76
Rate for Payer: Cash Price	$537.60
Rate for Payer: Devoted Health Medicare	$304.64
Rate for Payer: Hawaii Medical Service Association Medicare	$277.76
Rate for Payer: Hawaii Western Management Group Commercial	$851.20
Rate for Payer: Health Management Network Commercial	$761.60
Rate for Payer: Humana Medicare	$277.76
Rate for Payer: Kaiser Permanente Commercial	$806.40
Rate for Payer: Kaiser Permanente Medicaid	$456.96
Rate for Payer: Kaiser Permanente Medicare	$277.76
Rate for Payer: MDX Hawaii PPO	$869.12
Rate for Payer: Ohana Health Plan Medicaid	$277.76
Rate for Payer: Ohana Health Plan Medicare	$277.76
Rate for Payer: UnitedHealthcare Medicare	$277.76
Rate for Payer: University Health Alliance Commercial	$653.09

PIN SET UNIVERS II AR-9207S

Facility

$963.00

Hospital Revenue Code	272
Min. Negotiated Rate	$818.55
Max. Negotiated Rate	$934.11
Rate for Payer: Cash Price	$577.80
Rate for Payer: Health Management Network Commercial	$818.55
Rate for Payer: Kaiser Permanente Commercial	$866.70
Rate for Payer: MDX Hawaii PPO	$934.11

PIN SET UNIVERS II AR-9207S

Facility

$963.00

Hospital Revenue Code	272
Min. Negotiated Rate	$298.53
Max. Negotiated Rate	$934.11
Rate for Payer: AlohaCare Medicaid	$481.50
Rate for Payer: AlohaCare Medicare	$298.53
Rate for Payer: Cash Price	$577.80
Rate for Payer: Devoted Health Medicare	$327.42
Rate for Payer: Hawaii Medical Service Association Medicare	$298.53
Rate for Payer: Hawaii Western Management Group Commercial	$914.85
Rate for Payer: Health Management Network Commercial	$818.55
Rate for Payer: Humana Medicare	$298.53
Rate for Payer: Kaiser Permanente Commercial	$866.70
Rate for Payer: Kaiser Permanente Medicaid	$491.13
Rate for Payer: Kaiser Permanente Medicare	$298.53
Rate for Payer: MDX Hawaii PPO	$934.11
Rate for Payer: Ohana Health Plan Medicaid	$298.53
Rate for Payer: Ohana Health Plan Medicare	$298.53
Rate for Payer: UnitedHealthcare Medicare	$298.53
Rate for Payer: University Health Alliance Commercial	$701.93

PINS SHORT THREADED 11.00007

Facility

$750.00

Hospital Revenue Code	272
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$727.50
Rate for Payer: Cash Price	$450.00
Rate for Payer: Health Management Network Commercial	$637.50
Rate for Payer: Kaiser Permanente Commercial	$675.00
Rate for Payer: MDX Hawaii PPO	$727.50

PINS SHORT THREADED 11.00007

Facility

$750.00

Hospital Revenue Code	272
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$727.50
Rate for Payer: AlohaCare Medicaid	$375.00
Rate for Payer: AlohaCare Medicare	$232.50
Rate for Payer: Cash Price	$450.00
Rate for Payer: Devoted Health Medicare	$255.00
Rate for Payer: Hawaii Medical Service Association Medicare	$232.50
Rate for Payer: Hawaii Western Management Group Commercial	$712.50
Rate for Payer: Health Management Network Commercial	$637.50
Rate for Payer: Humana Medicare	$232.50
Rate for Payer: Kaiser Permanente Commercial	$675.00
Rate for Payer: Kaiser Permanente Medicaid	$382.50
Rate for Payer: Kaiser Permanente Medicare	$232.50
Rate for Payer: MDX Hawaii PPO	$727.50
Rate for Payer: Ohana Health Plan Medicaid	$232.50
Rate for Payer: Ohana Health Plan Medicare	$232.50
Rate for Payer: UnitedHealthcare Medicare	$232.50
Rate for Payer: University Health Alliance Commercial	$546.67

PIN STEIN BAY TIP 144256

Facility

$320.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$99.20
Max. Negotiated Rate	$310.40
Rate for Payer: AlohaCare Medicaid	$160.00
Rate for Payer: AlohaCare Medicare	$99.20
Rate for Payer: Cash Price	$192.00
Rate for Payer: Devoted Health Medicare	$108.80
Rate for Payer: Hawaii Medical Service Association Medicare	$99.20
Rate for Payer: Hawaii Western Management Group Commercial	$224.00
Rate for Payer: Health Management Network Commercial	$272.00
Rate for Payer: Humana Medicare	$99.20
Rate for Payer: Kaiser Permanente Commercial	$288.00
Rate for Payer: Kaiser Permanente Medicaid	$163.20
Rate for Payer: Kaiser Permanente Medicare	$99.20
Rate for Payer: MDX Hawaii PPO	$310.40
Rate for Payer: Ohana Health Plan Medicaid	$99.20
Rate for Payer: Ohana Health Plan Medicare	$99.20
Rate for Payer: UnitedHealthcare Medicare	$99.20
Rate for Payer: University Health Alliance Commercial	$179.20

PIN STEIN BAY TIP 144256

Facility

$320.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$179.20
Max. Negotiated Rate	$310.40
Rate for Payer: Cash Price	$192.00
Rate for Payer: Hawaii Western Management Group Commercial	$224.00
Rate for Payer: Health Management Network Commercial	$272.00
Rate for Payer: Kaiser Permanente Commercial	$288.00
Rate for Payer: MDX Hawaii PPO	$310.40
Rate for Payer: University Health Alliance Commercial	$179.20

PIN STEINMAN 5.0X200MM 293.74

Facility

$638.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$197.78
Max. Negotiated Rate	$618.86
Rate for Payer: AlohaCare Medicaid	$319.00
Rate for Payer: AlohaCare Medicare	$197.78
Rate for Payer: Cash Price	$382.80
Rate for Payer: Devoted Health Medicare	$216.92
Rate for Payer: Hawaii Medical Service Association Medicare	$197.78
Rate for Payer: Hawaii Western Management Group Commercial	$446.60
Rate for Payer: Health Management Network Commercial	$542.30
Rate for Payer: Humana Medicare	$197.78
Rate for Payer: Kaiser Permanente Commercial	$574.20
Rate for Payer: Kaiser Permanente Medicaid	$325.38
Rate for Payer: Kaiser Permanente Medicare	$197.78
Rate for Payer: MDX Hawaii PPO	$618.86
Rate for Payer: Ohana Health Plan Medicaid	$197.78
Rate for Payer: Ohana Health Plan Medicare	$197.78
Rate for Payer: UnitedHealthcare Medicare	$197.78
Rate for Payer: University Health Alliance Commercial	$357.28

PIN STEINMAN 5.0X200MM 293.74

Facility

$638.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$357.28
Max. Negotiated Rate	$618.86
Rate for Payer: Cash Price	$382.80
Rate for Payer: Hawaii Western Management Group Commercial	$446.60
Rate for Payer: Health Management Network Commercial	$542.30
Rate for Payer: Kaiser Permanente Commercial	$574.20
Rate for Payer: MDX Hawaii PPO	$618.86
Rate for Payer: University Health Alliance Commercial	$357.28

PIN STEINMANN 3.2MM 405800

Facility

$544.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$304.64
Max. Negotiated Rate	$527.68
Rate for Payer: Cash Price	$326.40
Rate for Payer: Hawaii Western Management Group Commercial	$380.80
Rate for Payer: Health Management Network Commercial	$462.40
Rate for Payer: Kaiser Permanente Commercial	$489.60
Rate for Payer: MDX Hawaii PPO	$527.68
Rate for Payer: University Health Alliance Commercial	$304.64

Know your out-of-pocket cost for care.

All Charges