Kauai Veterans Memorial Hospital

All Charges

Charge

Type

Setting

Price

ANTEGRADE FEMORAL NAIL, RT, 11MM X 46CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12973802
Hospital Revenue Code	278
Min. Negotiated Rate	$2,305.00
Max. Negotiated Rate	$4,471.70
Rate for Payer: AlohaCare Medicaid	$2,305.00
Rate for Payer: AlohaCare Medicare	$2,305.00
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Devoted Health Medicare	$2,535.50
Rate for Payer: Hawaii Medical Service Association Medicare	$2,305.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Humana Medicare	$2,305.00
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: Kaiser Permanente Medicaid	$2,351.10
Rate for Payer: Kaiser Permanente Medicare	$2,305.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: Ohana Health Plan Medicaid	$2,305.00
Rate for Payer: Ohana Health Plan Medicare	$2,305.00
Rate for Payer: UnitedHealthcare Medicare	$2,305.00
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 30CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12973803
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.60
Max. Negotiated Rate	$4,471.70
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 30CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12973803
Hospital Revenue Code	278
Min. Negotiated Rate	$2,305.00
Max. Negotiated Rate	$4,471.70
Rate for Payer: AlohaCare Medicaid	$2,305.00
Rate for Payer: AlohaCare Medicare	$2,305.00
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Devoted Health Medicare	$2,535.50
Rate for Payer: Hawaii Medical Service Association Medicare	$2,305.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Humana Medicare	$2,305.00
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: Kaiser Permanente Medicaid	$2,351.10
Rate for Payer: Kaiser Permanente Medicare	$2,305.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: Ohana Health Plan Medicaid	$2,305.00
Rate for Payer: Ohana Health Plan Medicare	$2,305.00
Rate for Payer: UnitedHealthcare Medicare	$2,305.00
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 32CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12973804
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.60
Max. Negotiated Rate	$4,471.70
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 32CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12973804
Hospital Revenue Code	278
Min. Negotiated Rate	$2,305.00
Max. Negotiated Rate	$4,471.70
Rate for Payer: AlohaCare Medicaid	$2,305.00
Rate for Payer: AlohaCare Medicare	$2,305.00
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Devoted Health Medicare	$2,535.50
Rate for Payer: Hawaii Medical Service Association Medicare	$2,305.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Humana Medicare	$2,305.00
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: Kaiser Permanente Medicaid	$2,351.10
Rate for Payer: Kaiser Permanente Medicare	$2,305.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: Ohana Health Plan Medicaid	$2,305.00
Rate for Payer: Ohana Health Plan Medicare	$2,305.00
Rate for Payer: UnitedHealthcare Medicare	$2,305.00
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 34CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12973798
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.60
Max. Negotiated Rate	$4,471.70
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 34CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12973798
Hospital Revenue Code	278
Min. Negotiated Rate	$2,305.00
Max. Negotiated Rate	$4,471.70
Rate for Payer: AlohaCare Medicaid	$2,305.00
Rate for Payer: AlohaCare Medicare	$2,305.00
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Devoted Health Medicare	$2,535.50
Rate for Payer: Hawaii Medical Service Association Medicare	$2,305.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Humana Medicare	$2,305.00
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: Kaiser Permanente Medicaid	$2,351.10
Rate for Payer: Kaiser Permanente Medicare	$2,305.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: Ohana Health Plan Medicaid	$2,305.00
Rate for Payer: Ohana Health Plan Medicare	$2,305.00
Rate for Payer: UnitedHealthcare Medicare	$2,305.00
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 36CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12973799
Hospital Revenue Code	278
Min. Negotiated Rate	$2,305.00
Max. Negotiated Rate	$4,471.70
Rate for Payer: AlohaCare Medicaid	$2,305.00
Rate for Payer: AlohaCare Medicare	$2,305.00
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Devoted Health Medicare	$2,535.50
Rate for Payer: Hawaii Medical Service Association Medicare	$2,305.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Humana Medicare	$2,305.00
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: Kaiser Permanente Medicaid	$2,351.10
Rate for Payer: Kaiser Permanente Medicare	$2,305.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: Ohana Health Plan Medicaid	$2,305.00
Rate for Payer: Ohana Health Plan Medicare	$2,305.00
Rate for Payer: UnitedHealthcare Medicare	$2,305.00
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 36CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12973799
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.60
Max. Negotiated Rate	$4,471.70
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 38CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971751
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.60
Max. Negotiated Rate	$4,471.70
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 38CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971751
Hospital Revenue Code	278
Min. Negotiated Rate	$2,305.00
Max. Negotiated Rate	$4,471.70
Rate for Payer: AlohaCare Medicaid	$2,305.00
Rate for Payer: AlohaCare Medicare	$2,305.00
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Devoted Health Medicare	$2,535.50
Rate for Payer: Hawaii Medical Service Association Medicare	$2,305.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Humana Medicare	$2,305.00
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: Kaiser Permanente Medicaid	$2,351.10
Rate for Payer: Kaiser Permanente Medicare	$2,305.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: Ohana Health Plan Medicaid	$2,305.00
Rate for Payer: Ohana Health Plan Medicare	$2,305.00
Rate for Payer: UnitedHealthcare Medicare	$2,305.00
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 40CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971750
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.60
Max. Negotiated Rate	$4,471.70
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 40CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971750
Hospital Revenue Code	278
Min. Negotiated Rate	$2,305.00
Max. Negotiated Rate	$4,471.70
Rate for Payer: AlohaCare Medicaid	$2,305.00
Rate for Payer: AlohaCare Medicare	$2,305.00
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Devoted Health Medicare	$2,535.50
Rate for Payer: Hawaii Medical Service Association Medicare	$2,305.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Humana Medicare	$2,305.00
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: Kaiser Permanente Medicaid	$2,351.10
Rate for Payer: Kaiser Permanente Medicare	$2,305.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: Ohana Health Plan Medicaid	$2,305.00
Rate for Payer: Ohana Health Plan Medicare	$2,305.00
Rate for Payer: UnitedHealthcare Medicare	$2,305.00
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 42CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971790
Hospital Revenue Code	278
Min. Negotiated Rate	$2,305.00
Max. Negotiated Rate	$4,471.70
Rate for Payer: AlohaCare Medicaid	$2,305.00
Rate for Payer: AlohaCare Medicare	$2,305.00
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Devoted Health Medicare	$2,535.50
Rate for Payer: Hawaii Medical Service Association Medicare	$2,305.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Humana Medicare	$2,305.00
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: Kaiser Permanente Medicaid	$2,351.10
Rate for Payer: Kaiser Permanente Medicare	$2,305.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: Ohana Health Plan Medicaid	$2,305.00
Rate for Payer: Ohana Health Plan Medicare	$2,305.00
Rate for Payer: UnitedHealthcare Medicare	$2,305.00
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 42CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971790
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.60
Max. Negotiated Rate	$4,471.70
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 44CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971791
Hospital Revenue Code	278
Min. Negotiated Rate	$2,305.00
Max. Negotiated Rate	$4,471.70
Rate for Payer: AlohaCare Medicaid	$2,305.00
Rate for Payer: AlohaCare Medicare	$2,305.00
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Devoted Health Medicare	$2,535.50
Rate for Payer: Hawaii Medical Service Association Medicare	$2,305.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Humana Medicare	$2,305.00
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: Kaiser Permanente Medicaid	$2,351.10
Rate for Payer: Kaiser Permanente Medicare	$2,305.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: Ohana Health Plan Medicaid	$2,305.00
Rate for Payer: Ohana Health Plan Medicare	$2,305.00
Rate for Payer: UnitedHealthcare Medicare	$2,305.00
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 44CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971791
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.60
Max. Negotiated Rate	$4,471.70
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 46CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971788
Hospital Revenue Code	278
Min. Negotiated Rate	$2,305.00
Max. Negotiated Rate	$4,471.70
Rate for Payer: AlohaCare Medicaid	$2,305.00
Rate for Payer: AlohaCare Medicare	$2,305.00
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Devoted Health Medicare	$2,535.50
Rate for Payer: Hawaii Medical Service Association Medicare	$2,305.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Humana Medicare	$2,305.00
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: Kaiser Permanente Medicaid	$2,351.10
Rate for Payer: Kaiser Permanente Medicare	$2,305.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: Ohana Health Plan Medicaid	$2,305.00
Rate for Payer: Ohana Health Plan Medicare	$2,305.00
Rate for Payer: UnitedHealthcare Medicare	$2,305.00
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 12MM X 46CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971788
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.60
Max. Negotiated Rate	$4,471.70
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 13MM X 30CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971789
Hospital Revenue Code	278
Min. Negotiated Rate	$2,305.00
Max. Negotiated Rate	$4,471.70
Rate for Payer: AlohaCare Medicaid	$2,305.00
Rate for Payer: AlohaCare Medicare	$2,305.00
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Devoted Health Medicare	$2,535.50
Rate for Payer: Hawaii Medical Service Association Medicare	$2,305.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Humana Medicare	$2,305.00
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: Kaiser Permanente Medicaid	$2,351.10
Rate for Payer: Kaiser Permanente Medicare	$2,305.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: Ohana Health Plan Medicaid	$2,305.00
Rate for Payer: Ohana Health Plan Medicare	$2,305.00
Rate for Payer: UnitedHealthcare Medicare	$2,305.00
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 13MM X 30CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971789
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.60
Max. Negotiated Rate	$4,471.70
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 13MM X 32CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971792
Hospital Revenue Code	278
Min. Negotiated Rate	$2,305.00
Max. Negotiated Rate	$4,471.70
Rate for Payer: AlohaCare Medicaid	$2,305.00
Rate for Payer: AlohaCare Medicare	$2,305.00
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Devoted Health Medicare	$2,535.50
Rate for Payer: Hawaii Medical Service Association Medicare	$2,305.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Humana Medicare	$2,305.00
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: Kaiser Permanente Medicaid	$2,351.10
Rate for Payer: Kaiser Permanente Medicare	$2,305.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: Ohana Health Plan Medicaid	$2,305.00
Rate for Payer: Ohana Health Plan Medicare	$2,305.00
Rate for Payer: UnitedHealthcare Medicare	$2,305.00
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 13MM X 32CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971792
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.60
Max. Negotiated Rate	$4,471.70
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 13MM X 34CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971793
Hospital Revenue Code	278
Min. Negotiated Rate	$2,305.00
Max. Negotiated Rate	$4,471.70
Rate for Payer: AlohaCare Medicaid	$2,305.00
Rate for Payer: AlohaCare Medicare	$2,305.00
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Devoted Health Medicare	$2,535.50
Rate for Payer: Hawaii Medical Service Association Medicare	$2,305.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Humana Medicare	$2,305.00
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: Kaiser Permanente Medicaid	$2,351.10
Rate for Payer: Kaiser Permanente Medicare	$2,305.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: Ohana Health Plan Medicaid	$2,305.00
Rate for Payer: Ohana Health Plan Medicare	$2,305.00
Rate for Payer: UnitedHealthcare Medicare	$2,305.00
Rate for Payer: University Health Alliance Commercial	$2,581.60

ANTEGRADE FEMORAL NAIL, RT, 13MM X 34CM

Facility

$4,610.00

Service Code	HCPCS C1713
Hospital Charge Code	12971793
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.60
Max. Negotiated Rate	$4,471.70
Rate for Payer: Cash Price	$2,996.50
Rate for Payer: Hawaii Western Management Group Commercial	$3,227.00
Rate for Payer: Health Management Network Commercial	$3,918.50
Rate for Payer: Kaiser Permanente Commercial	$4,149.00
Rate for Payer: MDX Hawaii PPO	$4,471.70
Rate for Payer: University Health Alliance Commercial	$2,581.60

Know your out-of-pocket cost for care.

All Charges