Kona Community Hospital

All Charges

Charge

Type

Setting

Price

External Fixator Fx Rod 250 mm 394.84 [3601112]

Facility

$1,779.27

Hospital Charge Code	3601112
Hospital Revenue Code	272
Min. Negotiated Rate	$907.43
Max. Negotiated Rate	$1,725.89
Rate for Payer: Cash Price	$1,156.53
Rate for Payer: Hawaii Western Management Group Commercial	$1,690.31
Rate for Payer: Health Management Network Commercial	$1,512.38
Rate for Payer: Kaiser Permanente Commercial	$1,120.94
Rate for Payer: Kaiser Permanente Medicaid	$907.43
Rate for Payer: MDX Hawaii PPO	$1,725.89
Rate for Payer: University Health Alliance Commercial	$1,296.91

External Fixator Fx Rod 300 mm 394.85 [3601111]

Facility

$1,779.26

Hospital Charge Code	3601111
Hospital Revenue Code	272
Min. Negotiated Rate	$907.42
Max. Negotiated Rate	$1,725.88
Rate for Payer: Cash Price	$1,156.52
Rate for Payer: Hawaii Western Management Group Commercial	$1,690.30
Rate for Payer: Health Management Network Commercial	$1,512.37
Rate for Payer: Kaiser Permanente Commercial	$1,120.93
Rate for Payer: Kaiser Permanente Medicaid	$907.42
Rate for Payer: MDX Hawaii PPO	$1,725.88
Rate for Payer: University Health Alliance Commercial	$1,296.90

External Fixator Fx Rod 300 mm 394.85 [3601111]

Facility

$1,779.26

Hospital Charge Code	3601111
Hospital Revenue Code	272
Min. Negotiated Rate	$1,512.37
Max. Negotiated Rate	$1,725.88
Rate for Payer: Cash Price	$1,156.52
Rate for Payer: Health Management Network Commercial	$1,512.37
Rate for Payer: MDX Hawaii PPO	$1,725.88

External Fixator Fx Rod 350 mm 394.86 [3601120]

Facility

$1,779.27

Hospital Charge Code	3601120
Hospital Revenue Code	272
Min. Negotiated Rate	$1,512.38
Max. Negotiated Rate	$1,725.89
Rate for Payer: Cash Price	$1,156.53
Rate for Payer: Health Management Network Commercial	$1,512.38
Rate for Payer: MDX Hawaii PPO	$1,725.89

External Fixator Fx Rod 350 mm 394.86 [3601120]

Facility

$1,779.27

Hospital Charge Code	3601120
Hospital Revenue Code	272
Min. Negotiated Rate	$907.43
Max. Negotiated Rate	$1,725.89
Rate for Payer: Cash Price	$1,156.53
Rate for Payer: Hawaii Western Management Group Commercial	$1,690.31
Rate for Payer: Health Management Network Commercial	$1,512.38
Rate for Payer: Kaiser Permanente Commercial	$1,120.94
Rate for Payer: Kaiser Permanente Medicaid	$907.43
Rate for Payer: MDX Hawaii PPO	$1,725.89
Rate for Payer: University Health Alliance Commercial	$1,296.91

External Fixator Fx Scrw Schanz 6.0 294.68 [3601189]

Facility

$752.46

Hospital Charge Code	3601189
Hospital Revenue Code	272
Min. Negotiated Rate	$639.59
Max. Negotiated Rate	$729.89
Rate for Payer: Cash Price	$489.10
Rate for Payer: Health Management Network Commercial	$639.59
Rate for Payer: MDX Hawaii PPO	$729.89

External Fixator Fx Scrw Schanz 6.0 294.68 [3601189]

Facility

$752.46

Hospital Charge Code	3601189
Hospital Revenue Code	272
Min. Negotiated Rate	$383.75
Max. Negotiated Rate	$729.89
Rate for Payer: Cash Price	$489.10
Rate for Payer: Hawaii Western Management Group Commercial	$714.84
Rate for Payer: Health Management Network Commercial	$639.59
Rate for Payer: Kaiser Permanente Commercial	$474.05
Rate for Payer: Kaiser Permanente Medicaid	$383.75
Rate for Payer: MDX Hawaii PPO	$729.89
Rate for Payer: University Health Alliance Commercial	$548.47

External Fixator Fx TI Screw Schanz 5.0 494.788 [3640694]

Facility

$1,330.27

Hospital Charge Code	3640694
Hospital Revenue Code	272
Min. Negotiated Rate	$678.44
Max. Negotiated Rate	$1,290.36
Rate for Payer: Cash Price	$864.68
Rate for Payer: Hawaii Western Management Group Commercial	$1,263.76
Rate for Payer: Health Management Network Commercial	$1,130.73
Rate for Payer: Kaiser Permanente Commercial	$838.07
Rate for Payer: Kaiser Permanente Medicaid	$678.44
Rate for Payer: MDX Hawaii PPO	$1,290.36
Rate for Payer: University Health Alliance Commercial	$969.63

External Fixator Fx TI Screw Schanz 5.0 494.788 [3640694]

Facility

$1,330.27

Hospital Charge Code	3640694
Hospital Revenue Code	272
Min. Negotiated Rate	$1,130.73
Max. Negotiated Rate	$1,290.36
Rate for Payer: Cash Price	$864.68
Rate for Payer: Health Management Network Commercial	$1,130.73
Rate for Payer: MDX Hawaii PPO	$1,290.36

External Fixator Fx Transfix Pin 6.0mm x 225mm 294.950 [3601137]

Facility

$1,041.63

Hospital Charge Code	3601137
Hospital Revenue Code	272
Min. Negotiated Rate	$531.23
Max. Negotiated Rate	$1,010.38
Rate for Payer: Cash Price	$677.06
Rate for Payer: Hawaii Western Management Group Commercial	$989.55
Rate for Payer: Health Management Network Commercial	$885.39
Rate for Payer: Kaiser Permanente Commercial	$656.23
Rate for Payer: Kaiser Permanente Medicaid	$531.23
Rate for Payer: MDX Hawaii PPO	$1,010.38
Rate for Payer: University Health Alliance Commercial	$759.24

External Fixator Fx Transfix Pin 6.0mm x 225mm 294.950 [3601137]

Facility

$1,041.63

Hospital Charge Code	3601137
Hospital Revenue Code	272
Min. Negotiated Rate	$885.39
Max. Negotiated Rate	$1,010.38
Rate for Payer: Cash Price	$677.06
Rate for Payer: Health Management Network Commercial	$885.39
Rate for Payer: MDX Hawaii PPO	$1,010.38

External Fixator Rod 11mmX200mm 394.83 [3601119]

Facility

$1,671.64

Hospital Charge Code	3601119
Hospital Revenue Code	272
Min. Negotiated Rate	$852.54
Max. Negotiated Rate	$1,621.49
Rate for Payer: Cash Price	$1,086.57
Rate for Payer: Hawaii Western Management Group Commercial	$1,588.06
Rate for Payer: Health Management Network Commercial	$1,420.89
Rate for Payer: Kaiser Permanente Commercial	$1,053.13
Rate for Payer: Kaiser Permanente Medicaid	$852.54
Rate for Payer: MDX Hawaii PPO	$1,621.49
Rate for Payer: University Health Alliance Commercial	$1,218.46

External Fixator Rod 11mmX200mm 394.83 [3601119]

Facility

$1,671.64

Hospital Charge Code	3601119
Hospital Revenue Code	272
Min. Negotiated Rate	$1,420.89
Max. Negotiated Rate	$1,621.49
Rate for Payer: Cash Price	$1,086.57
Rate for Payer: Health Management Network Commercial	$1,420.89
Rate for Payer: MDX Hawaii PPO	$1,621.49

External Fixator Rod 11mmX400mm 394.87 [3601121]

Facility

$1,933.53

Hospital Charge Code	3601121
Hospital Revenue Code	272
Min. Negotiated Rate	$986.10
Max. Negotiated Rate	$1,875.52
Rate for Payer: Cash Price	$1,256.79
Rate for Payer: Hawaii Western Management Group Commercial	$1,836.85
Rate for Payer: Health Management Network Commercial	$1,643.50
Rate for Payer: Kaiser Permanente Commercial	$1,218.12
Rate for Payer: Kaiser Permanente Medicaid	$986.10
Rate for Payer: MDX Hawaii PPO	$1,875.52
Rate for Payer: University Health Alliance Commercial	$1,409.35

External Fixator Rod 11mmX400mm 394.87 [3601121]

Facility

$1,933.53

Hospital Charge Code	3601121
Hospital Revenue Code	272
Min. Negotiated Rate	$1,643.50
Max. Negotiated Rate	$1,875.52
Rate for Payer: Cash Price	$1,256.79
Rate for Payer: Health Management Network Commercial	$1,643.50
Rate for Payer: MDX Hawaii PPO	$1,875.52

External Fixator Rod Attchmt Lg Multi Pin Clamp 390.003 [3601157]

Facility

$2,928.50

Hospital Charge Code	3601157
Hospital Revenue Code	272
Min. Negotiated Rate	$2,489.22
Max. Negotiated Rate	$2,840.64
Rate for Payer: Cash Price	$1,903.52
Rate for Payer: Health Management Network Commercial	$2,489.22
Rate for Payer: MDX Hawaii PPO	$2,840.64

External Fixator Rod Attchmt Lg Multi Pin Clamp 390.003 [3601157]

Facility

$2,928.50

Hospital Charge Code	3601157
Hospital Revenue Code	272
Min. Negotiated Rate	$1,493.54
Max. Negotiated Rate	$2,840.64
Rate for Payer: Cash Price	$1,903.52
Rate for Payer: Hawaii Western Management Group Commercial	$2,782.07
Rate for Payer: Health Management Network Commercial	$2,489.22
Rate for Payer: Kaiser Permanente Commercial	$1,844.95
Rate for Payer: Kaiser Permanente Medicaid	$1,493.54
Rate for Payer: MDX Hawaii PPO	$2,840.64
Rate for Payer: University Health Alliance Commercial	$2,134.58

External Fixator Screw Schanz 5.0mmX200mm 294.56 [3601124]

Facility

$827.97

Hospital Charge Code	3601124
Hospital Revenue Code	272
Min. Negotiated Rate	$703.77
Max. Negotiated Rate	$803.13
Rate for Payer: Cash Price	$538.18
Rate for Payer: Health Management Network Commercial	$703.77
Rate for Payer: MDX Hawaii PPO	$803.13

External Fixator Screw Schanz 5.0mmX200mm 294.56 [3601124]

Facility

$827.97

Hospital Charge Code	3601124
Hospital Revenue Code	272
Min. Negotiated Rate	$422.26
Max. Negotiated Rate	$803.13
Rate for Payer: Cash Price	$538.18
Rate for Payer: Hawaii Western Management Group Commercial	$786.57
Rate for Payer: Health Management Network Commercial	$703.77
Rate for Payer: Kaiser Permanente Commercial	$521.62
Rate for Payer: Kaiser Permanente Medicaid	$422.26
Rate for Payer: MDX Hawaii PPO	$803.13
Rate for Payer: University Health Alliance Commercial	$603.51

External Fixator Ti Screw Schanz 5.0 150mm 494.784 [3601148]

Facility

$1,700.75

Hospital Charge Code	3601148
Hospital Revenue Code	272
Min. Negotiated Rate	$867.38
Max. Negotiated Rate	$1,649.73
Rate for Payer: Cash Price	$1,105.49
Rate for Payer: Hawaii Western Management Group Commercial	$1,615.71
Rate for Payer: Health Management Network Commercial	$1,445.64
Rate for Payer: Kaiser Permanente Commercial	$1,071.47
Rate for Payer: Kaiser Permanente Medicaid	$867.38
Rate for Payer: MDX Hawaii PPO	$1,649.73
Rate for Payer: University Health Alliance Commercial	$1,239.68

External Fixator Ti Screw Schanz 5.0 150mm 494.784 [3601148]

Facility

$1,700.75

Hospital Charge Code	3601148
Hospital Revenue Code	272
Min. Negotiated Rate	$1,445.64
Max. Negotiated Rate	$1,649.73
Rate for Payer: Cash Price	$1,105.49
Rate for Payer: Health Management Network Commercial	$1,445.64
Rate for Payer: MDX Hawaii PPO	$1,649.73

External Fixator Ti Screw Schanz 5.0 175mm 494.785 [3601147]

Facility

$1,700.75

Hospital Charge Code	3601147
Hospital Revenue Code	272
Min. Negotiated Rate	$867.38
Max. Negotiated Rate	$1,649.73
Rate for Payer: Cash Price	$1,105.49
Rate for Payer: Hawaii Western Management Group Commercial	$1,615.71
Rate for Payer: Health Management Network Commercial	$1,445.64
Rate for Payer: Kaiser Permanente Commercial	$1,071.47
Rate for Payer: Kaiser Permanente Medicaid	$867.38
Rate for Payer: MDX Hawaii PPO	$1,649.73
Rate for Payer: University Health Alliance Commercial	$1,239.68

External Fixator Ti Screw Schanz 5.0 175mm 494.785 [3601147]

Facility

$1,700.75

Hospital Charge Code	3601147
Hospital Revenue Code	272
Min. Negotiated Rate	$1,445.64
Max. Negotiated Rate	$1,649.73
Rate for Payer: Cash Price	$1,105.49
Rate for Payer: Health Management Network Commercial	$1,445.64
Rate for Payer: MDX Hawaii PPO	$1,649.73

External Fixator Ti Scrw Schanz 5.0 200mm [3601138]

Facility

$1,588.10

Hospital Charge Code	3601138
Hospital Revenue Code	272
Min. Negotiated Rate	$1,349.88
Max. Negotiated Rate	$1,540.46
Rate for Payer: Cash Price	$1,032.26
Rate for Payer: Health Management Network Commercial	$1,349.88
Rate for Payer: MDX Hawaii PPO	$1,540.46

External Fixator Ti Scrw Schanz 5.0 200mm [3601138]

Facility

$1,588.10

Hospital Charge Code	3601138
Hospital Revenue Code	272
Min. Negotiated Rate	$809.93
Max. Negotiated Rate	$1,540.46
Rate for Payer: Cash Price	$1,032.26
Rate for Payer: Hawaii Western Management Group Commercial	$1,508.69
Rate for Payer: Health Management Network Commercial	$1,349.88
Rate for Payer: Kaiser Permanente Commercial	$1,000.50
Rate for Payer: Kaiser Permanente Medicaid	$809.93
Rate for Payer: MDX Hawaii PPO	$1,540.46
Rate for Payer: University Health Alliance Commercial	$1,157.57

Know your out-of-pocket cost for care.

All Charges