Kau Hospital

All Charges

Charge

Type

Setting

Price

SCREW 2.4MM LCK 40MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$249.86
Max. Negotiated Rate	$781.82
Rate for Payer: AlohaCare Medicaid	$403.00
Rate for Payer: AlohaCare Medicare	$249.86
Rate for Payer: Cash Price	$483.60
Rate for Payer: Devoted Health Medicare	$274.04
Rate for Payer: Hawaii Medical Service Association Medicare	$249.86
Rate for Payer: Hawaii Western Management Group Commercial	$564.20
Rate for Payer: Health Management Network Commercial	$685.10
Rate for Payer: Humana Medicare	$249.86
Rate for Payer: Kaiser Permanente Commercial	$725.40
Rate for Payer: Kaiser Permanente Medicaid	$411.06
Rate for Payer: Kaiser Permanente Medicare	$249.86
Rate for Payer: MDX Hawaii PPO	$781.82
Rate for Payer: Ohana Health Plan Medicaid	$249.86
Rate for Payer: Ohana Health Plan Medicare	$249.86
Rate for Payer: UnitedHealthcare Medicare	$249.86
Rate for Payer: University Health Alliance Commercial	$451.36

SCREW 2.4MM NON-LCK 42MM

Facility

$417.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$129.27
Max. Negotiated Rate	$404.49
Rate for Payer: AlohaCare Medicaid	$208.50
Rate for Payer: AlohaCare Medicare	$129.27
Rate for Payer: Cash Price	$250.20
Rate for Payer: Devoted Health Medicare	$141.78
Rate for Payer: Hawaii Medical Service Association Medicare	$129.27
Rate for Payer: Hawaii Western Management Group Commercial	$291.90
Rate for Payer: Health Management Network Commercial	$354.45
Rate for Payer: Humana Medicare	$129.27
Rate for Payer: Kaiser Permanente Commercial	$375.30
Rate for Payer: Kaiser Permanente Medicaid	$212.67
Rate for Payer: Kaiser Permanente Medicare	$129.27
Rate for Payer: MDX Hawaii PPO	$404.49
Rate for Payer: Ohana Health Plan Medicaid	$129.27
Rate for Payer: Ohana Health Plan Medicare	$129.27
Rate for Payer: UnitedHealthcare Medicare	$129.27
Rate for Payer: University Health Alliance Commercial	$233.52

SCREW 2.4MM NON-LCK 42MM

Facility

$417.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$233.52
Max. Negotiated Rate	$404.49
Rate for Payer: Cash Price	$250.20
Rate for Payer: Hawaii Western Management Group Commercial	$291.90
Rate for Payer: Health Management Network Commercial	$354.45
Rate for Payer: Kaiser Permanente Commercial	$375.30
Rate for Payer: MDX Hawaii PPO	$404.49
Rate for Payer: University Health Alliance Commercial	$233.52

SCREW 2.4MM NON-LCK 46MM

Facility

$417.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$129.27
Max. Negotiated Rate	$404.49
Rate for Payer: AlohaCare Medicaid	$208.50
Rate for Payer: AlohaCare Medicare	$129.27
Rate for Payer: Cash Price	$250.20
Rate for Payer: Devoted Health Medicare	$141.78
Rate for Payer: Hawaii Medical Service Association Medicare	$129.27
Rate for Payer: Hawaii Western Management Group Commercial	$291.90
Rate for Payer: Health Management Network Commercial	$354.45
Rate for Payer: Humana Medicare	$129.27
Rate for Payer: Kaiser Permanente Commercial	$375.30
Rate for Payer: Kaiser Permanente Medicaid	$212.67
Rate for Payer: Kaiser Permanente Medicare	$129.27
Rate for Payer: MDX Hawaii PPO	$404.49
Rate for Payer: Ohana Health Plan Medicaid	$129.27
Rate for Payer: Ohana Health Plan Medicare	$129.27
Rate for Payer: UnitedHealthcare Medicare	$129.27
Rate for Payer: University Health Alliance Commercial	$233.52

SCREW 2.4MM NON-LCK 46MM

Facility

$417.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$233.52
Max. Negotiated Rate	$404.49
Rate for Payer: Cash Price	$250.20
Rate for Payer: Hawaii Western Management Group Commercial	$291.90
Rate for Payer: Health Management Network Commercial	$354.45
Rate for Payer: Kaiser Permanente Commercial	$375.30
Rate for Payer: MDX Hawaii PPO	$404.49
Rate for Payer: University Health Alliance Commercial	$233.52

SCREW 2.4MM NON-LCK 48MM

Facility

$417.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$129.27
Max. Negotiated Rate	$404.49
Rate for Payer: AlohaCare Medicaid	$208.50
Rate for Payer: AlohaCare Medicare	$129.27
Rate for Payer: Cash Price	$250.20
Rate for Payer: Devoted Health Medicare	$141.78
Rate for Payer: Hawaii Medical Service Association Medicare	$129.27
Rate for Payer: Hawaii Western Management Group Commercial	$291.90
Rate for Payer: Health Management Network Commercial	$354.45
Rate for Payer: Humana Medicare	$129.27
Rate for Payer: Kaiser Permanente Commercial	$375.30
Rate for Payer: Kaiser Permanente Medicaid	$212.67
Rate for Payer: Kaiser Permanente Medicare	$129.27
Rate for Payer: MDX Hawaii PPO	$404.49
Rate for Payer: Ohana Health Plan Medicaid	$129.27
Rate for Payer: Ohana Health Plan Medicare	$129.27
Rate for Payer: UnitedHealthcare Medicare	$129.27
Rate for Payer: University Health Alliance Commercial	$233.52

SCREW 2.4MM NON-LCK 48MM

Facility

$417.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$233.52
Max. Negotiated Rate	$404.49
Rate for Payer: Cash Price	$250.20
Rate for Payer: Hawaii Western Management Group Commercial	$291.90
Rate for Payer: Health Management Network Commercial	$354.45
Rate for Payer: Kaiser Permanente Commercial	$375.30
Rate for Payer: MDX Hawaii PPO	$404.49
Rate for Payer: University Health Alliance Commercial	$233.52

SCREW 2.70 LCK 50MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$249.86
Max. Negotiated Rate	$781.82
Rate for Payer: AlohaCare Medicaid	$403.00
Rate for Payer: AlohaCare Medicare	$249.86
Rate for Payer: Cash Price	$483.60
Rate for Payer: Devoted Health Medicare	$274.04
Rate for Payer: Hawaii Medical Service Association Medicare	$249.86
Rate for Payer: Hawaii Western Management Group Commercial	$564.20
Rate for Payer: Health Management Network Commercial	$685.10
Rate for Payer: Humana Medicare	$249.86
Rate for Payer: Kaiser Permanente Commercial	$725.40
Rate for Payer: Kaiser Permanente Medicaid	$411.06
Rate for Payer: Kaiser Permanente Medicare	$249.86
Rate for Payer: MDX Hawaii PPO	$781.82
Rate for Payer: Ohana Health Plan Medicaid	$249.86
Rate for Payer: Ohana Health Plan Medicare	$249.86
Rate for Payer: UnitedHealthcare Medicare	$249.86
Rate for Payer: University Health Alliance Commercial	$451.36

SCREW 2.70 LCK 50MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$451.36
Max. Negotiated Rate	$781.82
Rate for Payer: Cash Price	$483.60
Rate for Payer: Hawaii Western Management Group Commercial	$564.20
Rate for Payer: Health Management Network Commercial	$685.10
Rate for Payer: Kaiser Permanente Commercial	$725.40
Rate for Payer: MDX Hawaii PPO	$781.82
Rate for Payer: University Health Alliance Commercial	$451.36

SCREW 2.70 LCK 65MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$249.86
Max. Negotiated Rate	$781.82
Rate for Payer: AlohaCare Medicaid	$403.00
Rate for Payer: AlohaCare Medicare	$249.86
Rate for Payer: Cash Price	$483.60
Rate for Payer: Devoted Health Medicare	$274.04
Rate for Payer: Hawaii Medical Service Association Medicare	$249.86
Rate for Payer: Hawaii Western Management Group Commercial	$564.20
Rate for Payer: Health Management Network Commercial	$685.10
Rate for Payer: Humana Medicare	$249.86
Rate for Payer: Kaiser Permanente Commercial	$725.40
Rate for Payer: Kaiser Permanente Medicaid	$411.06
Rate for Payer: Kaiser Permanente Medicare	$249.86
Rate for Payer: MDX Hawaii PPO	$781.82
Rate for Payer: Ohana Health Plan Medicaid	$249.86
Rate for Payer: Ohana Health Plan Medicare	$249.86
Rate for Payer: UnitedHealthcare Medicare	$249.86
Rate for Payer: University Health Alliance Commercial	$451.36

SCREW 2.70 LCK 65MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$451.36
Max. Negotiated Rate	$781.82
Rate for Payer: Cash Price	$483.60
Rate for Payer: Hawaii Western Management Group Commercial	$564.20
Rate for Payer: Health Management Network Commercial	$685.10
Rate for Payer: Kaiser Permanente Commercial	$725.40
Rate for Payer: MDX Hawaii PPO	$781.82
Rate for Payer: University Health Alliance Commercial	$451.36

SCREW 2.7 LCK 36MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$249.86
Max. Negotiated Rate	$781.82
Rate for Payer: AlohaCare Medicaid	$403.00
Rate for Payer: AlohaCare Medicare	$249.86
Rate for Payer: Cash Price	$483.60
Rate for Payer: Devoted Health Medicare	$274.04
Rate for Payer: Hawaii Medical Service Association Medicare	$249.86
Rate for Payer: Hawaii Western Management Group Commercial	$564.20
Rate for Payer: Health Management Network Commercial	$685.10
Rate for Payer: Humana Medicare	$249.86
Rate for Payer: Kaiser Permanente Commercial	$725.40
Rate for Payer: Kaiser Permanente Medicaid	$411.06
Rate for Payer: Kaiser Permanente Medicare	$249.86
Rate for Payer: MDX Hawaii PPO	$781.82
Rate for Payer: Ohana Health Plan Medicaid	$249.86
Rate for Payer: Ohana Health Plan Medicare	$249.86
Rate for Payer: UnitedHealthcare Medicare	$249.86
Rate for Payer: University Health Alliance Commercial	$451.36

SCREW 2.7 LCK 36MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$451.36
Max. Negotiated Rate	$781.82
Rate for Payer: Cash Price	$483.60
Rate for Payer: Hawaii Western Management Group Commercial	$564.20
Rate for Payer: Health Management Network Commercial	$685.10
Rate for Payer: Kaiser Permanente Commercial	$725.40
Rate for Payer: MDX Hawaii PPO	$781.82
Rate for Payer: University Health Alliance Commercial	$451.36

SCREW 2.7 LCK 40MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$451.36
Max. Negotiated Rate	$781.82
Rate for Payer: Cash Price	$483.60
Rate for Payer: Hawaii Western Management Group Commercial	$564.20
Rate for Payer: Health Management Network Commercial	$685.10
Rate for Payer: Kaiser Permanente Commercial	$725.40
Rate for Payer: MDX Hawaii PPO	$781.82
Rate for Payer: University Health Alliance Commercial	$451.36

SCREW 2.7 LCK 40MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$249.86
Max. Negotiated Rate	$781.82
Rate for Payer: AlohaCare Medicaid	$403.00
Rate for Payer: AlohaCare Medicare	$249.86
Rate for Payer: Cash Price	$483.60
Rate for Payer: Devoted Health Medicare	$274.04
Rate for Payer: Hawaii Medical Service Association Medicare	$249.86
Rate for Payer: Hawaii Western Management Group Commercial	$564.20
Rate for Payer: Health Management Network Commercial	$685.10
Rate for Payer: Humana Medicare	$249.86
Rate for Payer: Kaiser Permanente Commercial	$725.40
Rate for Payer: Kaiser Permanente Medicaid	$411.06
Rate for Payer: Kaiser Permanente Medicare	$249.86
Rate for Payer: MDX Hawaii PPO	$781.82
Rate for Payer: Ohana Health Plan Medicaid	$249.86
Rate for Payer: Ohana Health Plan Medicare	$249.86
Rate for Payer: UnitedHealthcare Medicare	$249.86
Rate for Payer: University Health Alliance Commercial	$451.36

SCREW 2.7MM 58 44MM

Facility

$417.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$233.52
Max. Negotiated Rate	$404.49
Rate for Payer: Cash Price	$250.20
Rate for Payer: Hawaii Western Management Group Commercial	$291.90
Rate for Payer: Health Management Network Commercial	$354.45
Rate for Payer: Kaiser Permanente Commercial	$375.30
Rate for Payer: MDX Hawaii PPO	$404.49
Rate for Payer: University Health Alliance Commercial	$233.52

SCREW 2.7MM 58 44MM

Facility

$417.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$129.27
Max. Negotiated Rate	$404.49
Rate for Payer: AlohaCare Medicaid	$208.50
Rate for Payer: AlohaCare Medicare	$129.27
Rate for Payer: Cash Price	$250.20
Rate for Payer: Devoted Health Medicare	$141.78
Rate for Payer: Hawaii Medical Service Association Medicare	$129.27
Rate for Payer: Hawaii Western Management Group Commercial	$291.90
Rate for Payer: Health Management Network Commercial	$354.45
Rate for Payer: Humana Medicare	$129.27
Rate for Payer: Kaiser Permanente Commercial	$375.30
Rate for Payer: Kaiser Permanente Medicaid	$212.67
Rate for Payer: Kaiser Permanente Medicare	$129.27
Rate for Payer: MDX Hawaii PPO	$404.49
Rate for Payer: Ohana Health Plan Medicaid	$129.27
Rate for Payer: Ohana Health Plan Medicare	$129.27
Rate for Payer: UnitedHealthcare Medicare	$129.27
Rate for Payer: University Health Alliance Commercial	$233.52

SCREW 2.7MM LCKING 55MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$249.86
Max. Negotiated Rate	$781.82
Rate for Payer: AlohaCare Medicaid	$403.00
Rate for Payer: AlohaCare Medicare	$249.86
Rate for Payer: Cash Price	$483.60
Rate for Payer: Devoted Health Medicare	$274.04
Rate for Payer: Hawaii Medical Service Association Medicare	$249.86
Rate for Payer: Hawaii Western Management Group Commercial	$564.20
Rate for Payer: Health Management Network Commercial	$685.10
Rate for Payer: Humana Medicare	$249.86
Rate for Payer: Kaiser Permanente Commercial	$725.40
Rate for Payer: Kaiser Permanente Medicaid	$411.06
Rate for Payer: Kaiser Permanente Medicare	$249.86
Rate for Payer: MDX Hawaii PPO	$781.82
Rate for Payer: Ohana Health Plan Medicaid	$249.86
Rate for Payer: Ohana Health Plan Medicare	$249.86
Rate for Payer: UnitedHealthcare Medicare	$249.86
Rate for Payer: University Health Alliance Commercial	$451.36

SCREW 2.7MM LCKING 55MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$451.36
Max. Negotiated Rate	$781.82
Rate for Payer: Cash Price	$483.60
Rate for Payer: Hawaii Western Management Group Commercial	$564.20
Rate for Payer: Health Management Network Commercial	$685.10
Rate for Payer: Kaiser Permanente Commercial	$725.40
Rate for Payer: MDX Hawaii PPO	$781.82
Rate for Payer: University Health Alliance Commercial	$451.36

SCREW 2.7MM LCKING 60MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$249.86
Max. Negotiated Rate	$781.82
Rate for Payer: AlohaCare Medicaid	$403.00
Rate for Payer: AlohaCare Medicare	$249.86
Rate for Payer: Cash Price	$483.60
Rate for Payer: Devoted Health Medicare	$274.04
Rate for Payer: Hawaii Medical Service Association Medicare	$249.86
Rate for Payer: Hawaii Western Management Group Commercial	$564.20
Rate for Payer: Health Management Network Commercial	$685.10
Rate for Payer: Humana Medicare	$249.86
Rate for Payer: Kaiser Permanente Commercial	$725.40
Rate for Payer: Kaiser Permanente Medicaid	$411.06
Rate for Payer: Kaiser Permanente Medicare	$249.86
Rate for Payer: MDX Hawaii PPO	$781.82
Rate for Payer: Ohana Health Plan Medicaid	$249.86
Rate for Payer: Ohana Health Plan Medicare	$249.86
Rate for Payer: UnitedHealthcare Medicare	$249.86
Rate for Payer: University Health Alliance Commercial	$451.36

SCREW 2.7MM LCKING 60MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$451.36
Max. Negotiated Rate	$781.82
Rate for Payer: Cash Price	$483.60
Rate for Payer: Hawaii Western Management Group Commercial	$564.20
Rate for Payer: Health Management Network Commercial	$685.10
Rate for Payer: Kaiser Permanente Commercial	$725.40
Rate for Payer: MDX Hawaii PPO	$781.82
Rate for Payer: University Health Alliance Commercial	$451.36

SCREW 2.7MM NONLCK 32MM 657432

Facility

$664.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$205.84
Max. Negotiated Rate	$644.08
Rate for Payer: AlohaCare Medicaid	$332.00
Rate for Payer: AlohaCare Medicare	$205.84
Rate for Payer: Cash Price	$398.40
Rate for Payer: Devoted Health Medicare	$225.76
Rate for Payer: Hawaii Medical Service Association Medicare	$205.84
Rate for Payer: Hawaii Western Management Group Commercial	$464.80
Rate for Payer: Health Management Network Commercial	$564.40
Rate for Payer: Humana Medicare	$205.84
Rate for Payer: Kaiser Permanente Commercial	$597.60
Rate for Payer: Kaiser Permanente Medicaid	$338.64
Rate for Payer: Kaiser Permanente Medicare	$205.84
Rate for Payer: MDX Hawaii PPO	$644.08
Rate for Payer: Ohana Health Plan Medicaid	$205.84
Rate for Payer: Ohana Health Plan Medicare	$205.84
Rate for Payer: UnitedHealthcare Medicare	$205.84
Rate for Payer: University Health Alliance Commercial	$371.84

SCREW 2.7MM NONLCK 32MM 657432

Facility

$664.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$371.84
Max. Negotiated Rate	$644.08
Rate for Payer: Cash Price	$398.40
Rate for Payer: Hawaii Western Management Group Commercial	$464.80
Rate for Payer: Health Management Network Commercial	$564.40
Rate for Payer: Kaiser Permanente Commercial	$597.60
Rate for Payer: MDX Hawaii PPO	$644.08
Rate for Payer: University Health Alliance Commercial	$371.84

SCREW 2.7MM NON-LCK 40MM

Facility

$417.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$233.52
Max. Negotiated Rate	$404.49
Rate for Payer: Cash Price	$250.20
Rate for Payer: Hawaii Western Management Group Commercial	$291.90
Rate for Payer: Health Management Network Commercial	$354.45
Rate for Payer: Kaiser Permanente Commercial	$375.30
Rate for Payer: MDX Hawaii PPO	$404.49
Rate for Payer: University Health Alliance Commercial	$233.52

SCREW 2.7MM NON-LCK 40MM

Facility

$417.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$129.27
Max. Negotiated Rate	$404.49
Rate for Payer: AlohaCare Medicaid	$208.50
Rate for Payer: AlohaCare Medicare	$129.27
Rate for Payer: Cash Price	$250.20
Rate for Payer: Devoted Health Medicare	$141.78
Rate for Payer: Hawaii Medical Service Association Medicare	$129.27
Rate for Payer: Hawaii Western Management Group Commercial	$291.90
Rate for Payer: Health Management Network Commercial	$354.45
Rate for Payer: Humana Medicare	$129.27
Rate for Payer: Kaiser Permanente Commercial	$375.30
Rate for Payer: Kaiser Permanente Medicaid	$212.67
Rate for Payer: Kaiser Permanente Medicare	$129.27
Rate for Payer: MDX Hawaii PPO	$404.49
Rate for Payer: Ohana Health Plan Medicaid	$129.27
Rate for Payer: Ohana Health Plan Medicare	$129.27
Rate for Payer: UnitedHealthcare Medicare	$129.27
Rate for Payer: University Health Alliance Commercial	$233.52

Know your out-of-pocket cost for care.

All Charges