|
Drill Bit Cann 5.0mm AR-8770-02 [3644920]
|
Facility
|
IP
|
$1,686.50
|
|
| Hospital Charge Code |
3644920
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,433.53 |
| Max. Negotiated Rate |
$1,635.90 |
| Rate for Payer: Cash Price |
$1,096.23
|
| Rate for Payer: Health Management Network Commercial |
$1,433.53
|
| Rate for Payer: MDX Hawaii PPO |
$1,635.90
|
|
|
Drill Bit Cann Countersink 2.7mm DRLL-CSK-27 [3644422]
|
Facility
|
OP
|
$973.09
|
|
| Hospital Charge Code |
3644422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$496.28 |
| Max. Negotiated Rate |
$943.90 |
| Rate for Payer: Cash Price |
$632.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$924.44
|
| Rate for Payer: Health Management Network Commercial |
$827.13
|
| Rate for Payer: Kaiser Permanente Commercial |
$613.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$496.28
|
| Rate for Payer: MDX Hawaii PPO |
$943.90
|
| Rate for Payer: University Health Alliance Commercial |
$709.29
|
|
|
Drill Bit Cann Countersink 2.7mm DRLL-CSK-27 [3644422]
|
Facility
|
IP
|
$973.09
|
|
| Hospital Charge Code |
3644422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$827.13 |
| Max. Negotiated Rate |
$943.90 |
| Rate for Payer: Cash Price |
$632.51
|
| Rate for Payer: Health Management Network Commercial |
$827.13
|
| Rate for Payer: MDX Hawaii PPO |
$943.90
|
|
|
Drill Bit Cann Countersink 3.5mm DRLL-CSK-35 [3644457]
|
Facility
|
OP
|
$973.09
|
|
| Hospital Charge Code |
3644457
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$496.28 |
| Max. Negotiated Rate |
$943.90 |
| Rate for Payer: Cash Price |
$632.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$924.44
|
| Rate for Payer: Health Management Network Commercial |
$827.13
|
| Rate for Payer: Kaiser Permanente Commercial |
$613.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$496.28
|
| Rate for Payer: MDX Hawaii PPO |
$943.90
|
| Rate for Payer: University Health Alliance Commercial |
$709.29
|
|
|
Drill Bit Cann Countersink 3.5mm DRLL-CSK-35 [3644457]
|
Facility
|
IP
|
$973.09
|
|
| Hospital Charge Code |
3644457
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$827.13 |
| Max. Negotiated Rate |
$943.90 |
| Rate for Payer: Cash Price |
$632.51
|
| Rate for Payer: Health Management Network Commercial |
$827.13
|
| Rate for Payer: MDX Hawaii PPO |
$943.90
|
|
|
Drill Bit Cann Profile 3.4mm 231201130 [3642223]
|
Facility
|
OP
|
$1,427.25
|
|
| Hospital Charge Code |
3642223
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$727.90 |
| Max. Negotiated Rate |
$1,384.43 |
| Rate for Payer: Cash Price |
$927.71
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,355.89
|
| Rate for Payer: Health Management Network Commercial |
$1,213.16
|
| Rate for Payer: Kaiser Permanente Commercial |
$899.17
|
| Rate for Payer: Kaiser Permanente Medicaid |
$727.90
|
| Rate for Payer: MDX Hawaii PPO |
$1,384.43
|
| Rate for Payer: University Health Alliance Commercial |
$1,040.32
|
|
|
Drill Bit Cann Profile 3.4mm 231201130 [3642223]
|
Facility
|
IP
|
$1,427.25
|
|
| Hospital Charge Code |
3642223
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,213.16 |
| Max. Negotiated Rate |
$1,384.43 |
| Rate for Payer: Cash Price |
$927.71
|
| Rate for Payer: Health Management Network Commercial |
$1,213.16
|
| Rate for Payer: MDX Hawaii PPO |
$1,384.43
|
|
|
Drill Bit Cann QC 2.7mm x 160mm 310.67 [3603886]
|
Facility
|
OP
|
$2,896.96
|
|
| Hospital Charge Code |
3603886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,477.45 |
| Max. Negotiated Rate |
$2,810.05 |
| Rate for Payer: Cash Price |
$1,883.02
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,752.11
|
| Rate for Payer: Health Management Network Commercial |
$2,462.42
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,825.08
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,477.45
|
| Rate for Payer: MDX Hawaii PPO |
$2,810.05
|
| Rate for Payer: University Health Alliance Commercial |
$2,111.59
|
|
|
Drill Bit Cann QC 2.7mm x 160mm 310.67 [3603886]
|
Facility
|
IP
|
$2,896.96
|
|
| Hospital Charge Code |
3603886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,462.42 |
| Max. Negotiated Rate |
$2,810.05 |
| Rate for Payer: Cash Price |
$1,883.02
|
| Rate for Payer: Health Management Network Commercial |
$2,462.42
|
| Rate for Payer: MDX Hawaii PPO |
$2,810.05
|
|
|
Drill Bit Cann QC 3.2mm x 170mm 310.65 [3600830]
|
Facility
|
IP
|
$2,850.38
|
|
| Hospital Charge Code |
3600830
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,422.82 |
| Max. Negotiated Rate |
$2,764.87 |
| Rate for Payer: Cash Price |
$1,852.75
|
| Rate for Payer: Health Management Network Commercial |
$2,422.82
|
| Rate for Payer: MDX Hawaii PPO |
$2,764.87
|
|
|
Drill Bit Cann QC 3.2mm x 170mm 310.65 [3600830]
|
Facility
|
OP
|
$2,850.38
|
|
| Hospital Charge Code |
3600830
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,453.69 |
| Max. Negotiated Rate |
$2,764.87 |
| Rate for Payer: Cash Price |
$1,852.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,707.86
|
| Rate for Payer: Health Management Network Commercial |
$2,422.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,795.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,453.69
|
| Rate for Payer: MDX Hawaii PPO |
$2,764.87
|
| Rate for Payer: University Health Alliance Commercial |
$2,077.64
|
|
|
Drill Bit Cann QC 4.5mm x 170mm 310.66 [3600844]
|
Facility
|
IP
|
$2,850.38
|
|
| Hospital Charge Code |
3600844
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,422.82 |
| Max. Negotiated Rate |
$2,764.87 |
| Rate for Payer: Cash Price |
$1,852.75
|
| Rate for Payer: Health Management Network Commercial |
$2,422.82
|
| Rate for Payer: MDX Hawaii PPO |
$2,764.87
|
|
|
Drill Bit Cann QC 4.5mm x 170mm 310.66 [3600844]
|
Facility
|
OP
|
$2,850.38
|
|
| Hospital Charge Code |
3600844
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,453.69 |
| Max. Negotiated Rate |
$2,764.87 |
| Rate for Payer: Cash Price |
$1,852.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,707.86
|
| Rate for Payer: Health Management Network Commercial |
$2,422.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,795.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,453.69
|
| Rate for Payer: MDX Hawaii PPO |
$2,764.87
|
| Rate for Payer: University Health Alliance Commercial |
$2,077.64
|
|
|
Drill Bit Cann Qc 4.5mm x 233mm 310.69 [3600949]
|
Facility
|
OP
|
$2,850.38
|
|
| Hospital Charge Code |
3600949
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,453.69 |
| Max. Negotiated Rate |
$2,764.87 |
| Rate for Payer: Cash Price |
$1,852.75
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,707.86
|
| Rate for Payer: Health Management Network Commercial |
$2,422.82
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,795.74
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,453.69
|
| Rate for Payer: MDX Hawaii PPO |
$2,764.87
|
| Rate for Payer: University Health Alliance Commercial |
$2,077.64
|
|
|
Drill Bit Cann Qc 4.5mm x 233mm 310.69 [3600949]
|
Facility
|
IP
|
$2,850.38
|
|
| Hospital Charge Code |
3600949
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,422.82 |
| Max. Negotiated Rate |
$2,764.87 |
| Rate for Payer: Cash Price |
$1,852.75
|
| Rate for Payer: Health Management Network Commercial |
$2,422.82
|
| Rate for Payer: MDX Hawaii PPO |
$2,764.87
|
|
|
Drill Bit Cann QC 7.3mm x 300mm 310.495 [3600849]
|
Facility
|
OP
|
$2,903.17
|
|
| Hospital Charge Code |
3600849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,480.62 |
| Max. Negotiated Rate |
$2,816.07 |
| Rate for Payer: Cash Price |
$1,887.06
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$2,758.01
|
| Rate for Payer: Health Management Network Commercial |
$2,467.69
|
| Rate for Payer: Kaiser Permanente Commercial |
$1,829.00
|
| Rate for Payer: Kaiser Permanente Medicaid |
$1,480.62
|
| Rate for Payer: MDX Hawaii PPO |
$2,816.07
|
| Rate for Payer: University Health Alliance Commercial |
$2,116.12
|
|
|
Drill Bit Cann QC 7.3mm x 300mm 310.495 [3600849]
|
Facility
|
IP
|
$2,903.17
|
|
| Hospital Charge Code |
3600849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,467.69 |
| Max. Negotiated Rate |
$2,816.07 |
| Rate for Payer: Cash Price |
$1,887.06
|
| Rate for Payer: Health Management Network Commercial |
$2,467.69
|
| Rate for Payer: MDX Hawaii PPO |
$2,816.07
|
|
|
Drill Bit Cannulated 2.9mm AR-8741-25 [3644512]
|
Facility
|
OP
|
$1,223.44
|
|
| Hospital Charge Code |
3644512
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$623.95 |
| Max. Negotiated Rate |
$1,186.74 |
| Rate for Payer: Cash Price |
$795.24
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$1,162.27
|
| Rate for Payer: Health Management Network Commercial |
$1,039.92
|
| Rate for Payer: Kaiser Permanente Commercial |
$770.77
|
| Rate for Payer: Kaiser Permanente Medicaid |
$623.95
|
| Rate for Payer: MDX Hawaii PPO |
$1,186.74
|
| Rate for Payer: University Health Alliance Commercial |
$891.77
|
|
|
Drill Bit Cannulated 2.9mm AR-8741-25 [3644512]
|
Facility
|
IP
|
$1,223.44
|
|
| Hospital Charge Code |
3644512
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,039.92 |
| Max. Negotiated Rate |
$1,186.74 |
| Rate for Payer: Cash Price |
$795.24
|
| Rate for Payer: Health Management Network Commercial |
$1,039.92
|
| Rate for Payer: MDX Hawaii PPO |
$1,186.74
|
|
|
Drill Bit Cannulated Flex12mm Long 03.043.016 [3643791]
|
Facility
|
IP
|
$6,869.48
|
|
| Hospital Charge Code |
3643791
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,839.06 |
| Max. Negotiated Rate |
$6,663.40 |
| Rate for Payer: Cash Price |
$4,465.16
|
| Rate for Payer: Health Management Network Commercial |
$5,839.06
|
| Rate for Payer: MDX Hawaii PPO |
$6,663.40
|
|
|
Drill Bit Cannulated Flex12mm Long 03.043.016 [3643791]
|
Facility
|
OP
|
$6,869.48
|
|
| Hospital Charge Code |
3643791
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,503.43 |
| Max. Negotiated Rate |
$6,663.40 |
| Rate for Payer: Cash Price |
$4,465.16
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$6,526.01
|
| Rate for Payer: Health Management Network Commercial |
$5,839.06
|
| Rate for Payer: Kaiser Permanente Commercial |
$4,327.77
|
| Rate for Payer: Kaiser Permanente Medicaid |
$3,503.43
|
| Rate for Payer: MDX Hawaii PPO |
$6,663.40
|
| Rate for Payer: University Health Alliance Commercial |
$5,007.16
|
|
|
Drill Bit Cannulated QC 1.9mm DRLL-CDC-19 [3644421]
|
Facility
|
OP
|
$973.09
|
|
| Hospital Charge Code |
3644421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$496.28 |
| Max. Negotiated Rate |
$943.90 |
| Rate for Payer: Cash Price |
$632.51
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$924.44
|
| Rate for Payer: Health Management Network Commercial |
$827.13
|
| Rate for Payer: Kaiser Permanente Commercial |
$613.05
|
| Rate for Payer: Kaiser Permanente Medicaid |
$496.28
|
| Rate for Payer: MDX Hawaii PPO |
$943.90
|
| Rate for Payer: University Health Alliance Commercial |
$709.29
|
|
|
Drill Bit Cannulated QC 1.9mm DRLL-CDC-19 [3644421]
|
Facility
|
IP
|
$973.09
|
|
| Hospital Charge Code |
3644421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$827.13 |
| Max. Negotiated Rate |
$943.90 |
| Rate for Payer: Cash Price |
$632.51
|
| Rate for Payer: Health Management Network Commercial |
$827.13
|
| Rate for Payer: MDX Hawaii PPO |
$943.90
|
|
|
Drill Bit Cannulated QC 2.7mm DRLL-CDC-27 [3642786]
|
Facility
|
OP
|
$930.25
|
|
| Hospital Charge Code |
3642786
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$474.43 |
| Max. Negotiated Rate |
$902.34 |
| Rate for Payer: Cash Price |
$604.66
|
| Rate for Payer: Hawaii Western Management Group Commercial |
$883.74
|
| Rate for Payer: Health Management Network Commercial |
$790.71
|
| Rate for Payer: Kaiser Permanente Commercial |
$586.06
|
| Rate for Payer: Kaiser Permanente Medicaid |
$474.43
|
| Rate for Payer: MDX Hawaii PPO |
$902.34
|
| Rate for Payer: University Health Alliance Commercial |
$678.06
|
|
|
Drill Bit Cannulated QC 2.7mm DRLL-CDC-27 [3642786]
|
Facility
|
IP
|
$930.25
|
|
| Hospital Charge Code |
3642786
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$790.71 |
| Max. Negotiated Rate |
$902.34 |
| Rate for Payer: Cash Price |
$604.66
|
| Rate for Payer: Health Management Network Commercial |
$790.71
|
| Rate for Payer: MDX Hawaii PPO |
$902.34
|
|