Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Drill Bit 3.3mm NCB-L 245mm 02.00024.344 [3644826]

Facility

$1,005.22

Hospital Charge Code	3644826
Hospital Revenue Code	272
Min. Negotiated Rate	$854.44
Max. Negotiated Rate	$975.06
Rate for Payer: Cash Price	$653.39
Rate for Payer: Health Management Network Commercial	$854.44
Rate for Payer: MDX Hawaii PPO	$975.06

Drill Bit 3.5mm AR-4160-35 [3644226]

Facility

$833.86

Hospital Charge Code	3644226
Hospital Revenue Code	272
Min. Negotiated Rate	$708.78
Max. Negotiated Rate	$808.84
Rate for Payer: Cash Price	$542.01
Rate for Payer: Health Management Network Commercial	$708.78
Rate for Payer: MDX Hawaii PPO	$808.84

Drill Bit 3.5mm AR-4160-35 [3644226]

Facility

$833.86

Hospital Charge Code	3644226
Hospital Revenue Code	272
Min. Negotiated Rate	$425.27
Max. Negotiated Rate	$808.84
Rate for Payer: Cash Price	$542.01
Rate for Payer: Hawaii Western Management Group Commercial	$792.17
Rate for Payer: Health Management Network Commercial	$708.78
Rate for Payer: Kaiser Permanente Commercial	$525.33
Rate for Payer: Kaiser Permanente Medicaid	$425.27
Rate for Payer: MDX Hawaii PPO	$808.84
Rate for Payer: University Health Alliance Commercial	$607.80

Drill Bit 3.5mm So-112-35-703 [3643624]

Facility

$962.50

Hospital Charge Code	3643624
Hospital Revenue Code	272
Min. Negotiated Rate	$490.88
Max. Negotiated Rate	$933.62
Rate for Payer: Cash Price	$625.62
Rate for Payer: Hawaii Western Management Group Commercial	$914.38
Rate for Payer: Health Management Network Commercial	$818.12
Rate for Payer: Kaiser Permanente Commercial	$606.38
Rate for Payer: Kaiser Permanente Medicaid	$490.88
Rate for Payer: MDX Hawaii PPO	$933.62
Rate for Payer: University Health Alliance Commercial	$701.57

Drill Bit 3.5mm So-112-35-703 [3643624]

Facility

$962.50

Hospital Charge Code	3643624
Hospital Revenue Code	272
Min. Negotiated Rate	$818.12
Max. Negotiated Rate	$933.62
Rate for Payer: Cash Price	$625.62
Rate for Payer: Health Management Network Commercial	$818.12
Rate for Payer: MDX Hawaii PPO	$933.62

Drill Bit 3.5 mm x 195mm 310.37 [3607803]

Facility

$652.39

Hospital Charge Code	3607803
Hospital Revenue Code	272
Min. Negotiated Rate	$332.72
Max. Negotiated Rate	$632.82
Rate for Payer: Cash Price	$424.05
Rate for Payer: Hawaii Western Management Group Commercial	$619.77
Rate for Payer: Health Management Network Commercial	$554.53
Rate for Payer: Kaiser Permanente Commercial	$411.01
Rate for Payer: Kaiser Permanente Medicaid	$332.72
Rate for Payer: MDX Hawaii PPO	$632.82
Rate for Payer: University Health Alliance Commercial	$475.53

Drill Bit 3.5 mm x 195mm 310.37 [3607803]

Facility

$652.39

Hospital Charge Code	3607803
Hospital Revenue Code	272
Min. Negotiated Rate	$554.53
Max. Negotiated Rate	$632.82
Rate for Payer: Cash Price	$424.05
Rate for Payer: Health Management Network Commercial	$554.53
Rate for Payer: MDX Hawaii PPO	$632.82

Drill Bit 3.5mmX50mm DRLLSSC35050 [3642987]

Facility

$1,117.88

Hospital Charge Code	3642987
Hospital Revenue Code	272
Min. Negotiated Rate	$950.20
Max. Negotiated Rate	$1,084.34
Rate for Payer: Cash Price	$726.62
Rate for Payer: Health Management Network Commercial	$950.20
Rate for Payer: MDX Hawaii PPO	$1,084.34

Drill Bit 3.5mmX50mm DRLLSSC35050 [3642987]

Facility

$1,117.88

Hospital Charge Code	3642987
Hospital Revenue Code	272
Min. Negotiated Rate	$570.12
Max. Negotiated Rate	$1,084.34
Rate for Payer: Cash Price	$726.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,061.99
Rate for Payer: Health Management Network Commercial	$950.20
Rate for Payer: Kaiser Permanente Commercial	$704.26
Rate for Payer: Kaiser Permanente Medicaid	$570.12
Rate for Payer: MDX Hawaii PPO	$1,084.34
Rate for Payer: University Health Alliance Commercial	$814.82

Drill Bit 3.5mm x 70mm DRLL-SSC-35070 [3644275]

Facility

$1,160.52

Hospital Charge Code	3644275
Hospital Revenue Code	272
Min. Negotiated Rate	$986.44
Max. Negotiated Rate	$1,125.70
Rate for Payer: Cash Price	$754.34
Rate for Payer: Health Management Network Commercial	$986.44
Rate for Payer: MDX Hawaii PPO	$1,125.70

Drill Bit 3.5mm x 70mm DRLL-SSC-35070 [3644275]

Facility

$1,160.52

Hospital Charge Code	3644275
Hospital Revenue Code	272
Min. Negotiated Rate	$591.87
Max. Negotiated Rate	$1,125.70
Rate for Payer: Cash Price	$754.34
Rate for Payer: Hawaii Western Management Group Commercial	$1,102.49
Rate for Payer: Health Management Network Commercial	$986.44
Rate for Payer: Kaiser Permanente Commercial	$731.13
Rate for Payer: Kaiser Permanente Medicaid	$591.87
Rate for Payer: MDX Hawaii PPO	$1,125.70
Rate for Payer: University Health Alliance Commercial	$845.90

Drill Bit 3.7mm AR-8973-37 [3644786]

Facility

$1,289.04

Hospital Charge Code	3644786
Hospital Revenue Code	272
Min. Negotiated Rate	$657.41
Max. Negotiated Rate	$1,250.37
Rate for Payer: Cash Price	$837.88
Rate for Payer: Hawaii Western Management Group Commercial	$1,224.59
Rate for Payer: Health Management Network Commercial	$1,095.68
Rate for Payer: Kaiser Permanente Commercial	$812.10
Rate for Payer: Kaiser Permanente Medicaid	$657.41
Rate for Payer: MDX Hawaii PPO	$1,250.37
Rate for Payer: University Health Alliance Commercial	$939.58

Drill Bit 3.7mm AR-8973-37 [3644786]

Facility

$1,289.04

Hospital Charge Code	3644786
Hospital Revenue Code	272
Min. Negotiated Rate	$1,095.68
Max. Negotiated Rate	$1,250.37
Rate for Payer: Cash Price	$837.88
Rate for Payer: Health Management Network Commercial	$1,095.68
Rate for Payer: MDX Hawaii PPO	$1,250.37

Drill Bit 3.8mm Three Fluted QC Calib 03.019.016 [3640528]

Facility

$1,787.16

Hospital Charge Code	3640528
Hospital Revenue Code	272
Min. Negotiated Rate	$911.45
Max. Negotiated Rate	$1,733.55
Rate for Payer: Cash Price	$1,161.65
Rate for Payer: Hawaii Western Management Group Commercial	$1,697.80
Rate for Payer: Health Management Network Commercial	$1,519.09
Rate for Payer: Kaiser Permanente Commercial	$1,125.91
Rate for Payer: Kaiser Permanente Medicaid	$911.45
Rate for Payer: MDX Hawaii PPO	$1,733.55
Rate for Payer: University Health Alliance Commercial	$1,302.66

Drill Bit 3.8mm Three Fluted QC Calib 03.019.016 [3640528]

Facility

$1,787.16

Hospital Charge Code	3640528
Hospital Revenue Code	272
Min. Negotiated Rate	$1,519.09
Max. Negotiated Rate	$1,733.55
Rate for Payer: Cash Price	$1,161.65
Rate for Payer: Health Management Network Commercial	$1,519.09
Rate for Payer: MDX Hawaii PPO	$1,733.55

Drill Bit 4.0mm Calib Grad Depth Mark 804-03-049 [3644086]

Facility

$716.05

Hospital Charge Code	3644086
Hospital Revenue Code	272
Min. Negotiated Rate	$365.19
Max. Negotiated Rate	$694.57
Rate for Payer: Cash Price	$465.43
Rate for Payer: Hawaii Western Management Group Commercial	$680.25
Rate for Payer: Health Management Network Commercial	$608.64
Rate for Payer: Kaiser Permanente Commercial	$451.11
Rate for Payer: Kaiser Permanente Medicaid	$365.19
Rate for Payer: MDX Hawaii PPO	$694.57
Rate for Payer: University Health Alliance Commercial	$521.93

Drill Bit 4.0mm Calib Grad Depth Mark 804-03-049 [3644086]

Facility

$716.05

Hospital Charge Code	3644086
Hospital Revenue Code	272
Min. Negotiated Rate	$608.64
Max. Negotiated Rate	$694.57
Rate for Payer: Cash Price	$465.43
Rate for Payer: Health Management Network Commercial	$608.64
Rate for Payer: MDX Hawaii PPO	$694.57

Drill Bit 4.2mm Three Fluted QC Calib 03.010.061 [3640063]

Facility

$1,871.36

Hospital Charge Code	3640063
Hospital Revenue Code	272
Min. Negotiated Rate	$954.39
Max. Negotiated Rate	$1,815.22
Rate for Payer: Cash Price	$1,216.38
Rate for Payer: Hawaii Western Management Group Commercial	$1,777.79
Rate for Payer: Health Management Network Commercial	$1,590.66
Rate for Payer: Kaiser Permanente Commercial	$1,178.96
Rate for Payer: Kaiser Permanente Medicaid	$954.39
Rate for Payer: MDX Hawaii PPO	$1,815.22
Rate for Payer: University Health Alliance Commercial	$1,364.03

Drill Bit 4.2mm Three Fluted QC Calib 03.010.061 [3640063]

Facility

$1,871.36

Hospital Charge Code	3640063
Hospital Revenue Code	272
Min. Negotiated Rate	$1,590.66
Max. Negotiated Rate	$1,815.22
Rate for Payer: Cash Price	$1,216.38
Rate for Payer: Health Management Network Commercial	$1,590.66
Rate for Payer: MDX Hawaii PPO	$1,815.22

Drill Bit 4.2mm Three Fluted QC Ndle Pt 03.010.104 [3640091A]

Facility

$1,384.30

Hospital Charge Code	3640091A
Hospital Revenue Code	272
Min. Negotiated Rate	$705.99
Max. Negotiated Rate	$1,342.77
Rate for Payer: Cash Price	$899.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,315.09
Rate for Payer: Health Management Network Commercial	$1,176.65
Rate for Payer: Kaiser Permanente Commercial	$872.11
Rate for Payer: Kaiser Permanente Medicaid	$705.99
Rate for Payer: MDX Hawaii PPO	$1,342.77
Rate for Payer: University Health Alliance Commercial	$1,009.02

Drill Bit 4.2mm Three Fluted QC Ndle Pt 03.010.104 [3640091A]

Facility

$1,384.30

Hospital Charge Code	3640091A
Hospital Revenue Code	272
Min. Negotiated Rate	$1,176.65
Max. Negotiated Rate	$1,342.77
Rate for Payer: Cash Price	$899.80
Rate for Payer: Health Management Network Commercial	$1,176.65
Rate for Payer: MDX Hawaii PPO	$1,342.77

Drill Bit 4.3mm Long Distal Graduated 2112-01-405 [3627648]

Facility

$2,081.13

Hospital Charge Code	3627648
Hospital Revenue Code	272
Min. Negotiated Rate	$1,768.96
Max. Negotiated Rate	$2,018.70
Rate for Payer: Cash Price	$1,352.73
Rate for Payer: Health Management Network Commercial	$1,768.96
Rate for Payer: MDX Hawaii PPO	$2,018.70

Drill Bit 4.3mm Long Distal Graduated 2112-01-405 [3627648]

Facility

$2,081.13

Hospital Charge Code	3627648
Hospital Revenue Code	272
Min. Negotiated Rate	$1,061.38
Max. Negotiated Rate	$2,018.70
Rate for Payer: Cash Price	$1,352.73
Rate for Payer: Hawaii Western Management Group Commercial	$1,977.07
Rate for Payer: Health Management Network Commercial	$1,768.96
Rate for Payer: Kaiser Permanente Commercial	$1,311.11
Rate for Payer: Kaiser Permanente Medicaid	$1,061.38
Rate for Payer: MDX Hawaii PPO	$2,018.70
Rate for Payer: University Health Alliance Commercial	$1,516.94

Drill Bit 4.3mm NCB 195mm 02.00024.002 [3642528]

Facility

$1,005.22

Hospital Charge Code	3642528
Hospital Revenue Code	272
Min. Negotiated Rate	$854.44
Max. Negotiated Rate	$975.06
Rate for Payer: Cash Price	$653.39
Rate for Payer: Health Management Network Commercial	$854.44
Rate for Payer: MDX Hawaii PPO	$975.06

Drill Bit 4.3mm NCB 195mm 02.00024.002 [3642528]

Facility

$1,005.22

Hospital Charge Code	3642528
Hospital Revenue Code	272
Min. Negotiated Rate	$512.66
Max. Negotiated Rate	$975.06
Rate for Payer: Cash Price	$653.39
Rate for Payer: Hawaii Western Management Group Commercial	$954.96
Rate for Payer: Health Management Network Commercial	$854.44
Rate for Payer: Kaiser Permanente Commercial	$633.29
Rate for Payer: Kaiser Permanente Medicaid	$512.66
Rate for Payer: MDX Hawaii PPO	$975.06
Rate for Payer: University Health Alliance Commercial	$732.70

Know your out-of-pocket cost for care.

All Charges