Kauai Veterans Memorial Hospital

All Charges

Charge

Type

Setting

Price

CANNULATED CANC SCREW, FT, 7.0X110MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974121
Hospital Revenue Code	278
Min. Negotiated Rate	$259.50
Max. Negotiated Rate	$503.43
Rate for Payer: AlohaCare Medicaid	$259.50
Rate for Payer: AlohaCare Medicare	$259.50
Rate for Payer: Cash Price	$337.35
Rate for Payer: Devoted Health Medicare	$285.45
Rate for Payer: Hawaii Medical Service Association Medicare	$259.50
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Humana Medicare	$259.50
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: Kaiser Permanente Medicaid	$264.69
Rate for Payer: Kaiser Permanente Medicare	$259.50
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: Ohana Health Plan Medicaid	$259.50
Rate for Payer: Ohana Health Plan Medicare	$259.50
Rate for Payer: UnitedHealthcare Medicare	$259.50
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X110MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974121
Hospital Revenue Code	278
Min. Negotiated Rate	$290.64
Max. Negotiated Rate	$503.43
Rate for Payer: Cash Price	$337.35
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X115MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974106
Hospital Revenue Code	278
Min. Negotiated Rate	$259.50
Max. Negotiated Rate	$503.43
Rate for Payer: AlohaCare Medicaid	$259.50
Rate for Payer: AlohaCare Medicare	$259.50
Rate for Payer: Cash Price	$337.35
Rate for Payer: Devoted Health Medicare	$285.45
Rate for Payer: Hawaii Medical Service Association Medicare	$259.50
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Humana Medicare	$259.50
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: Kaiser Permanente Medicaid	$264.69
Rate for Payer: Kaiser Permanente Medicare	$259.50
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: Ohana Health Plan Medicaid	$259.50
Rate for Payer: Ohana Health Plan Medicare	$259.50
Rate for Payer: UnitedHealthcare Medicare	$259.50
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X115MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974106
Hospital Revenue Code	278
Min. Negotiated Rate	$290.64
Max. Negotiated Rate	$503.43
Rate for Payer: Cash Price	$337.35
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X120MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974111
Hospital Revenue Code	278
Min. Negotiated Rate	$290.64
Max. Negotiated Rate	$503.43
Rate for Payer: Cash Price	$337.35
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X120MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974111
Hospital Revenue Code	278
Min. Negotiated Rate	$259.50
Max. Negotiated Rate	$503.43
Rate for Payer: AlohaCare Medicaid	$259.50
Rate for Payer: AlohaCare Medicare	$259.50
Rate for Payer: Cash Price	$337.35
Rate for Payer: Devoted Health Medicare	$285.45
Rate for Payer: Hawaii Medical Service Association Medicare	$259.50
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Humana Medicare	$259.50
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: Kaiser Permanente Medicaid	$264.69
Rate for Payer: Kaiser Permanente Medicare	$259.50
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: Ohana Health Plan Medicaid	$259.50
Rate for Payer: Ohana Health Plan Medicare	$259.50
Rate for Payer: UnitedHealthcare Medicare	$259.50
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X125MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974112
Hospital Revenue Code	278
Min. Negotiated Rate	$290.64
Max. Negotiated Rate	$503.43
Rate for Payer: Cash Price	$337.35
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X125MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974112
Hospital Revenue Code	278
Min. Negotiated Rate	$259.50
Max. Negotiated Rate	$503.43
Rate for Payer: AlohaCare Medicaid	$259.50
Rate for Payer: AlohaCare Medicare	$259.50
Rate for Payer: Cash Price	$337.35
Rate for Payer: Devoted Health Medicare	$285.45
Rate for Payer: Hawaii Medical Service Association Medicare	$259.50
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Humana Medicare	$259.50
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: Kaiser Permanente Medicaid	$264.69
Rate for Payer: Kaiser Permanente Medicare	$259.50
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: Ohana Health Plan Medicaid	$259.50
Rate for Payer: Ohana Health Plan Medicare	$259.50
Rate for Payer: UnitedHealthcare Medicare	$259.50
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X130MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974113
Hospital Revenue Code	278
Min. Negotiated Rate	$259.50
Max. Negotiated Rate	$503.43
Rate for Payer: AlohaCare Medicaid	$259.50
Rate for Payer: AlohaCare Medicare	$259.50
Rate for Payer: Cash Price	$337.35
Rate for Payer: Devoted Health Medicare	$285.45
Rate for Payer: Hawaii Medical Service Association Medicare	$259.50
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Humana Medicare	$259.50
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: Kaiser Permanente Medicaid	$264.69
Rate for Payer: Kaiser Permanente Medicare	$259.50
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: Ohana Health Plan Medicaid	$259.50
Rate for Payer: Ohana Health Plan Medicare	$259.50
Rate for Payer: UnitedHealthcare Medicare	$259.50
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X130MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974113
Hospital Revenue Code	278
Min. Negotiated Rate	$290.64
Max. Negotiated Rate	$503.43
Rate for Payer: Cash Price	$337.35
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X30MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974114
Hospital Revenue Code	278
Min. Negotiated Rate	$290.64
Max. Negotiated Rate	$503.43
Rate for Payer: Cash Price	$337.35
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X30MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974114
Hospital Revenue Code	278
Min. Negotiated Rate	$259.50
Max. Negotiated Rate	$503.43
Rate for Payer: Kaiser Permanente Medicare	$259.50
Rate for Payer: AlohaCare Medicaid	$259.50
Rate for Payer: AlohaCare Medicare	$259.50
Rate for Payer: Cash Price	$337.35
Rate for Payer: Devoted Health Medicare	$285.45
Rate for Payer: Hawaii Medical Service Association Medicare	$259.50
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Humana Medicare	$259.50
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: Kaiser Permanente Medicaid	$264.69
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: Ohana Health Plan Medicaid	$259.50
Rate for Payer: Ohana Health Plan Medicare	$259.50
Rate for Payer: UnitedHealthcare Medicare	$259.50
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X35MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974122
Hospital Revenue Code	278
Min. Negotiated Rate	$290.64
Max. Negotiated Rate	$503.43
Rate for Payer: Cash Price	$337.35
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X35MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974122
Hospital Revenue Code	278
Min. Negotiated Rate	$259.50
Max. Negotiated Rate	$503.43
Rate for Payer: AlohaCare Medicaid	$259.50
Rate for Payer: AlohaCare Medicare	$259.50
Rate for Payer: Cash Price	$337.35
Rate for Payer: Devoted Health Medicare	$285.45
Rate for Payer: Hawaii Medical Service Association Medicare	$259.50
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Humana Medicare	$259.50
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: Kaiser Permanente Medicaid	$264.69
Rate for Payer: Kaiser Permanente Medicare	$259.50
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: Ohana Health Plan Medicaid	$259.50
Rate for Payer: Ohana Health Plan Medicare	$259.50
Rate for Payer: UnitedHealthcare Medicare	$259.50
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X40MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974115
Hospital Revenue Code	278
Min. Negotiated Rate	$259.50
Max. Negotiated Rate	$503.43
Rate for Payer: AlohaCare Medicaid	$259.50
Rate for Payer: AlohaCare Medicare	$259.50
Rate for Payer: Cash Price	$337.35
Rate for Payer: Devoted Health Medicare	$285.45
Rate for Payer: Hawaii Medical Service Association Medicare	$259.50
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Humana Medicare	$259.50
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: Kaiser Permanente Medicaid	$264.69
Rate for Payer: Kaiser Permanente Medicare	$259.50
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: Ohana Health Plan Medicaid	$259.50
Rate for Payer: Ohana Health Plan Medicare	$259.50
Rate for Payer: UnitedHealthcare Medicare	$259.50
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X40MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974115
Hospital Revenue Code	278
Min. Negotiated Rate	$290.64
Max. Negotiated Rate	$503.43
Rate for Payer: Cash Price	$337.35
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X45MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974126
Hospital Revenue Code	278
Min. Negotiated Rate	$290.64
Max. Negotiated Rate	$503.43
Rate for Payer: Cash Price	$337.35
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X45MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974126
Hospital Revenue Code	278
Min. Negotiated Rate	$259.50
Max. Negotiated Rate	$503.43
Rate for Payer: AlohaCare Medicaid	$259.50
Rate for Payer: AlohaCare Medicare	$259.50
Rate for Payer: Cash Price	$337.35
Rate for Payer: Devoted Health Medicare	$285.45
Rate for Payer: Hawaii Medical Service Association Medicare	$259.50
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Humana Medicare	$259.50
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: Kaiser Permanente Medicaid	$264.69
Rate for Payer: Kaiser Permanente Medicare	$259.50
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: Ohana Health Plan Medicaid	$259.50
Rate for Payer: Ohana Health Plan Medicare	$259.50
Rate for Payer: UnitedHealthcare Medicare	$259.50
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X50MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974116
Hospital Revenue Code	278
Min. Negotiated Rate	$259.50
Max. Negotiated Rate	$503.43
Rate for Payer: AlohaCare Medicaid	$259.50
Rate for Payer: AlohaCare Medicare	$259.50
Rate for Payer: Cash Price	$337.35
Rate for Payer: Devoted Health Medicare	$285.45
Rate for Payer: Hawaii Medical Service Association Medicare	$259.50
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Humana Medicare	$259.50
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: Kaiser Permanente Medicaid	$264.69
Rate for Payer: Kaiser Permanente Medicare	$259.50
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: Ohana Health Plan Medicaid	$259.50
Rate for Payer: Ohana Health Plan Medicare	$259.50
Rate for Payer: UnitedHealthcare Medicare	$259.50
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X50MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974116
Hospital Revenue Code	278
Min. Negotiated Rate	$290.64
Max. Negotiated Rate	$503.43
Rate for Payer: Cash Price	$337.35
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X55MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974127
Hospital Revenue Code	278
Min. Negotiated Rate	$290.64
Max. Negotiated Rate	$503.43
Rate for Payer: Cash Price	$337.35
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X55MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974127
Hospital Revenue Code	278
Min. Negotiated Rate	$259.50
Max. Negotiated Rate	$503.43
Rate for Payer: AlohaCare Medicaid	$259.50
Rate for Payer: AlohaCare Medicare	$259.50
Rate for Payer: Cash Price	$337.35
Rate for Payer: Devoted Health Medicare	$285.45
Rate for Payer: Hawaii Medical Service Association Medicare	$259.50
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Humana Medicare	$259.50
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: Kaiser Permanente Medicaid	$264.69
Rate for Payer: Kaiser Permanente Medicare	$259.50
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: Ohana Health Plan Medicaid	$259.50
Rate for Payer: Ohana Health Plan Medicare	$259.50
Rate for Payer: UnitedHealthcare Medicare	$259.50
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X60MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974123
Hospital Revenue Code	278
Min. Negotiated Rate	$259.50
Max. Negotiated Rate	$503.43
Rate for Payer: AlohaCare Medicaid	$259.50
Rate for Payer: AlohaCare Medicare	$259.50
Rate for Payer: Cash Price	$337.35
Rate for Payer: Devoted Health Medicare	$285.45
Rate for Payer: Hawaii Medical Service Association Medicare	$259.50
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Humana Medicare	$259.50
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: Kaiser Permanente Medicaid	$264.69
Rate for Payer: Kaiser Permanente Medicare	$259.50
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: Ohana Health Plan Medicaid	$259.50
Rate for Payer: Ohana Health Plan Medicare	$259.50
Rate for Payer: UnitedHealthcare Medicare	$259.50
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X60MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974123
Hospital Revenue Code	278
Min. Negotiated Rate	$290.64
Max. Negotiated Rate	$503.43
Rate for Payer: Cash Price	$337.35
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: University Health Alliance Commercial	$290.64

CANNULATED CANC SCREW, FT, 7.0X65MM

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	12974124
Hospital Revenue Code	278
Min. Negotiated Rate	$259.50
Max. Negotiated Rate	$503.43
Rate for Payer: AlohaCare Medicaid	$259.50
Rate for Payer: AlohaCare Medicare	$259.50
Rate for Payer: Cash Price	$337.35
Rate for Payer: Devoted Health Medicare	$285.45
Rate for Payer: Hawaii Medical Service Association Medicare	$259.50
Rate for Payer: Hawaii Western Management Group Commercial	$363.30
Rate for Payer: Health Management Network Commercial	$441.15
Rate for Payer: Humana Medicare	$259.50
Rate for Payer: Kaiser Permanente Commercial	$467.10
Rate for Payer: Kaiser Permanente Medicaid	$264.69
Rate for Payer: Kaiser Permanente Medicare	$259.50
Rate for Payer: MDX Hawaii PPO	$503.43
Rate for Payer: Ohana Health Plan Medicaid	$259.50
Rate for Payer: Ohana Health Plan Medicare	$259.50
Rate for Payer: UnitedHealthcare Medicare	$259.50
Rate for Payer: University Health Alliance Commercial	$290.64

Know your out-of-pocket cost for care.

All Charges