Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Drill Pin 3.7mm AR-2272 [3644560]

Facility

$1,289.04

Hospital Charge Code	3644560
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 Pin 3.7mm AR-2272 [3644560]

Facility

$1,289.04

Hospital Charge Code	3644560
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 Pin Headless Trocar 75mm 00-5901-020-00 [3641173]

Facility

$1,778.75

Service Code	HCPCS C1713
Hospital Charge Code	3641173
Hospital Revenue Code	278
Min. Negotiated Rate	$907.16
Max. Negotiated Rate	$1,725.39
Rate for Payer: Cash Price	$1,156.19
Rate for Payer: Hawaii Western Management Group Commercial	$1,245.12
Rate for Payer: Health Management Network Commercial	$1,511.94
Rate for Payer: Kaiser Permanente Commercial	$1,120.61
Rate for Payer: Kaiser Permanente Medicaid	$907.16
Rate for Payer: MDX Hawaii PPO	$1,725.39
Rate for Payer: University Health Alliance Commercial	$996.10

Drill Pin Headless Trocar 75mm 00-5901-020-00 [3641173]

Facility

$1,778.75

Service Code	HCPCS C1713
Hospital Charge Code	3641173
Hospital Revenue Code	278
Min. Negotiated Rate	$996.10
Max. Negotiated Rate	$1,725.39
Rate for Payer: Cash Price	$1,156.19
Rate for Payer: Hawaii Western Management Group Commercial	$1,245.12
Rate for Payer: Health Management Network Commercial	$1,511.94
Rate for Payer: MDX Hawaii PPO	$1,725.39
Rate for Payer: University Health Alliance Commercial	$996.10

Drill Sleeve 1.7mm F/2.4 Hole AR-8916-18 [3644600]

Facility

$357.94

Hospital Charge Code	3644600
Hospital Revenue Code	272
Min. Negotiated Rate	$182.55
Max. Negotiated Rate	$347.20
Rate for Payer: Cash Price	$232.66
Rate for Payer: Hawaii Western Management Group Commercial	$340.04
Rate for Payer: Health Management Network Commercial	$304.25
Rate for Payer: Kaiser Permanente Commercial	$225.50
Rate for Payer: Kaiser Permanente Medicaid	$182.55
Rate for Payer: MDX Hawaii PPO	$347.20
Rate for Payer: University Health Alliance Commercial	$260.90

Drill Sleeve 1.7mm F/2.4 Hole AR-8916-18 [3644600]

Facility

$357.94

Hospital Charge Code	3644600
Hospital Revenue Code	272
Min. Negotiated Rate	$304.25
Max. Negotiated Rate	$347.20
Rate for Payer: Cash Price	$232.66
Rate for Payer: Health Management Network Commercial	$304.25
Rate for Payer: MDX Hawaii PPO	$347.20

Drill Sleeve 2.7mm Measuring 110017661 [3642580]

Facility

$1,049.13

Hospital Charge Code	3642580
Hospital Revenue Code	272
Min. Negotiated Rate	$891.76
Max. Negotiated Rate	$1,017.66
Rate for Payer: Cash Price	$681.93
Rate for Payer: Health Management Network Commercial	$891.76
Rate for Payer: MDX Hawaii PPO	$1,017.66

Drill Sleeve 2.7mm Measuring 110017661 [3642580]

Facility

$1,049.13

Hospital Charge Code	3642580
Hospital Revenue Code	272
Min. Negotiated Rate	$535.06
Max. Negotiated Rate	$1,017.66
Rate for Payer: Cash Price	$681.93
Rate for Payer: Hawaii Western Management Group Commercial	$996.67
Rate for Payer: Health Management Network Commercial	$891.76
Rate for Payer: Kaiser Permanente Commercial	$660.95
Rate for Payer: Kaiser Permanente Medicaid	$535.06
Rate for Payer: MDX Hawaii PPO	$1,017.66
Rate for Payer: University Health Alliance Commercial	$764.71

Drill Solid Side Cutting 2.0mm x 40mm DRLL-SSC-20040 [3642639]

Facility

$699.99

Hospital Charge Code	3642639
Hospital Revenue Code	272
Min. Negotiated Rate	$594.99
Max. Negotiated Rate	$678.99
Rate for Payer: Cash Price	$454.99
Rate for Payer: Health Management Network Commercial	$594.99
Rate for Payer: MDX Hawaii PPO	$678.99

Drill Solid Side Cutting 2.0mm x 40mm DRLL-SSC-20040 [3642639]

Facility

$699.99

Hospital Charge Code	3642639
Hospital Revenue Code	272
Min. Negotiated Rate	$356.99
Max. Negotiated Rate	$678.99
Rate for Payer: Cash Price	$454.99
Rate for Payer: Hawaii Western Management Group Commercial	$664.99
Rate for Payer: Health Management Network Commercial	$594.99
Rate for Payer: Kaiser Permanente Commercial	$440.99
Rate for Payer: Kaiser Permanente Medicaid	$356.99
Rate for Payer: MDX Hawaii PPO	$678.99
Rate for Payer: University Health Alliance Commercial	$510.22

Drill Solid Side Cutting 2.5mm x 40mm DRLL-SSC-25040 [3642640]

Facility

$699.99

Hospital Charge Code	3642640
Hospital Revenue Code	272
Min. Negotiated Rate	$356.99
Max. Negotiated Rate	$678.99
Rate for Payer: Cash Price	$454.99
Rate for Payer: Hawaii Western Management Group Commercial	$664.99
Rate for Payer: Health Management Network Commercial	$594.99
Rate for Payer: Kaiser Permanente Commercial	$440.99
Rate for Payer: Kaiser Permanente Medicaid	$356.99
Rate for Payer: MDX Hawaii PPO	$678.99
Rate for Payer: University Health Alliance Commercial	$510.22

Drill Solid Side Cutting 2.5mm x 40mm DRLL-SSC-25040 [3642640]

Facility

$699.99

Hospital Charge Code	3642640
Hospital Revenue Code	272
Min. Negotiated Rate	$594.99
Max. Negotiated Rate	$678.99
Rate for Payer: Cash Price	$454.99
Rate for Payer: Health Management Network Commercial	$594.99
Rate for Payer: MDX Hawaii PPO	$678.99

Drill Tip Guide Pin, 2.4mm Ar-1250l [3644558]

Facility

$265.80

Hospital Charge Code	3644558
Hospital Revenue Code	272
Min. Negotiated Rate	$225.93
Max. Negotiated Rate	$257.83
Rate for Payer: Cash Price	$172.77
Rate for Payer: Health Management Network Commercial	$225.93
Rate for Payer: MDX Hawaii PPO	$257.83

Drill Tip Guide Pin, 2.4mm Ar-1250l [3644558]

Facility

$265.80

Hospital Charge Code	3644558
Hospital Revenue Code	272
Min. Negotiated Rate	$135.56
Max. Negotiated Rate	$257.83
Rate for Payer: Cash Price	$172.77
Rate for Payer: Hawaii Western Management Group Commercial	$252.51
Rate for Payer: Health Management Network Commercial	$225.93
Rate for Payer: Kaiser Permanente Commercial	$167.45
Rate for Payer: Kaiser Permanente Medicaid	$135.56
Rate for Payer: MDX Hawaii PPO	$257.83
Rate for Payer: University Health Alliance Commercial	$193.74

Drill Tip Guidewire 2.5mm x 200mm 310.243 [3600890]

Facility

$537.33

Service Code	HCPCS C1769
Hospital Charge Code	3600890
Hospital Revenue Code	272
Min. Negotiated Rate	$274.04
Max. Negotiated Rate	$521.21
Rate for Payer: Cash Price	$349.26
Rate for Payer: Hawaii Western Management Group Commercial	$510.46
Rate for Payer: Health Management Network Commercial	$456.73
Rate for Payer: Kaiser Permanente Commercial	$338.52
Rate for Payer: Kaiser Permanente Medicaid	$274.04
Rate for Payer: MDX Hawaii PPO	$521.21
Rate for Payer: University Health Alliance Commercial	$391.66

Drill Tip Guidewire 2.5mm x 200mm 310.243 [3600890]

Facility

$537.33

Service Code	HCPCS C1769
Hospital Charge Code	3600890
Hospital Revenue Code	272
Min. Negotiated Rate	$456.73
Max. Negotiated Rate	$521.21
Rate for Payer: Cash Price	$349.26
Rate for Payer: Health Management Network Commercial	$456.73
Rate for Payer: MDX Hawaii PPO	$521.21

Driver 3.5mm Power Hex Rsp 804-03-022 [3644120]

Facility

$3,855.50

Hospital Charge Code	3644120
Hospital Revenue Code	272
Min. Negotiated Rate	$3,277.18
Max. Negotiated Rate	$3,739.84
Rate for Payer: Cash Price	$2,506.08
Rate for Payer: Health Management Network Commercial	$3,277.18
Rate for Payer: MDX Hawaii PPO	$3,739.84

Driver 3.5mm Power Hex Rsp 804-03-022 [3644120]

Facility

$3,855.50

Hospital Charge Code	3644120
Hospital Revenue Code	272
Min. Negotiated Rate	$1,966.31
Max. Negotiated Rate	$3,739.84
Rate for Payer: Cash Price	$2,506.08
Rate for Payer: Hawaii Western Management Group Commercial	$3,662.72
Rate for Payer: Health Management Network Commercial	$3,277.18
Rate for Payer: Kaiser Permanente Commercial	$2,428.97
Rate for Payer: Kaiser Permanente Medicaid	$1,966.31
Rate for Payer: MDX Hawaii PPO	$3,739.84
Rate for Payer: University Health Alliance Commercial	$2,810.27

Driver AO Cann T8 DRVR-CAN-T8 [3645374]

Facility

$1,983.75

Hospital Charge Code	3645374
Hospital Revenue Code	272
Min. Negotiated Rate	$1,686.19
Max. Negotiated Rate	$1,924.24
Rate for Payer: Cash Price	$1,289.44
Rate for Payer: Health Management Network Commercial	$1,686.19
Rate for Payer: MDX Hawaii PPO	$1,924.24

Driver AO Cann T8 DRVR-CAN-T8 [3645374]

Facility

$1,983.75

Hospital Charge Code	3645374
Hospital Revenue Code	272
Min. Negotiated Rate	$1,011.71
Max. Negotiated Rate	$1,924.24
Rate for Payer: Cash Price	$1,289.44
Rate for Payer: Hawaii Western Management Group Commercial	$1,884.56
Rate for Payer: Health Management Network Commercial	$1,686.19
Rate for Payer: Kaiser Permanente Commercial	$1,249.76
Rate for Payer: Kaiser Permanente Medicaid	$1,011.71
Rate for Payer: MDX Hawaii PPO	$1,924.24
Rate for Payer: University Health Alliance Commercial	$1,445.96

Driver AO Connection Square Tip DRVR-AOS-S20 [3642642]

Facility

$673.21

Hospital Charge Code	3642642
Hospital Revenue Code	272
Min. Negotiated Rate	$343.34
Max. Negotiated Rate	$653.01
Rate for Payer: Cash Price	$437.59
Rate for Payer: Hawaii Western Management Group Commercial	$639.55
Rate for Payer: Health Management Network Commercial	$572.23
Rate for Payer: Kaiser Permanente Commercial	$424.12
Rate for Payer: Kaiser Permanente Medicaid	$343.34
Rate for Payer: MDX Hawaii PPO	$653.01
Rate for Payer: University Health Alliance Commercial	$490.70

Driver AO Connection Square Tip DRVR-AOS-S20 [3642642]

Facility

$673.21

Hospital Charge Code	3642642
Hospital Revenue Code	272
Min. Negotiated Rate	$572.23
Max. Negotiated Rate	$653.01
Rate for Payer: Cash Price	$437.59
Rate for Payer: Health Management Network Commercial	$572.23
Rate for Payer: MDX Hawaii PPO	$653.01

Driver HCS 2.5mm DRVR-HCS-0915 [3644423]

Facility

$973.09

Hospital Charge Code	3644423
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

Driver HCS 2.5mm DRVR-HCS-0915 [3644423]

Facility

$973.09

Hospital Charge Code	3644423
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

Driver Hcs 3.5mm DRVR-HCS-1420 [3644458]

Facility

$973.09

Hospital Charge Code	3644458
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

Know your out-of-pocket cost for care.

All Charges