Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Affixus Screw HFN A/R 75mm 8145-01-075 [3641315]

Facility

$2,624.38

Service Code	HCPCS C1713
Hospital Charge Code	3641315
Hospital Revenue Code	278
Min. Negotiated Rate	$1,338.43
Max. Negotiated Rate	$2,545.65
Rate for Payer: Cash Price	$1,705.85
Rate for Payer: Hawaii Western Management Group Commercial	$1,837.07
Rate for Payer: Health Management Network Commercial	$2,230.72
Rate for Payer: Kaiser Permanente Commercial	$1,653.36
Rate for Payer: Kaiser Permanente Medicaid	$1,338.43
Rate for Payer: MDX Hawaii PPO	$2,545.65
Rate for Payer: University Health Alliance Commercial	$1,469.65

Affixus Screw HFN A/R 75mm 8145-01-075 [3641315]

Facility

$2,624.38

Service Code	HCPCS C1713
Hospital Charge Code	3641315
Hospital Revenue Code	278
Min. Negotiated Rate	$1,469.65
Max. Negotiated Rate	$2,545.65
Rate for Payer: Cash Price	$1,705.85
Rate for Payer: Hawaii Western Management Group Commercial	$1,837.07
Rate for Payer: Health Management Network Commercial	$2,230.72
Rate for Payer: MDX Hawaii PPO	$2,545.65
Rate for Payer: University Health Alliance Commercial	$1,469.65

Affixus Screw HFN A/R 80mm 8145-01-080 [3640923]

Facility

$1,856.25

Service Code	HCPCS C1713
Hospital Charge Code	3640923
Hospital Revenue Code	278
Min. Negotiated Rate	$1,039.50
Max. Negotiated Rate	$1,800.56
Rate for Payer: Cash Price	$1,206.56
Rate for Payer: Hawaii Western Management Group Commercial	$1,299.38
Rate for Payer: Health Management Network Commercial	$1,577.81
Rate for Payer: MDX Hawaii PPO	$1,800.56
Rate for Payer: University Health Alliance Commercial	$1,039.50

Affixus Screw HFN A/R 80mm 8145-01-080 [3640923]

Facility

$1,856.25

Service Code	HCPCS C1713
Hospital Charge Code	3640923
Hospital Revenue Code	278
Min. Negotiated Rate	$946.69
Max. Negotiated Rate	$1,800.56
Rate for Payer: Cash Price	$1,206.56
Rate for Payer: Hawaii Western Management Group Commercial	$1,299.38
Rate for Payer: Health Management Network Commercial	$1,577.81
Rate for Payer: Kaiser Permanente Commercial	$1,169.44
Rate for Payer: Kaiser Permanente Medicaid	$946.69
Rate for Payer: MDX Hawaii PPO	$1,800.56
Rate for Payer: University Health Alliance Commercial	$1,039.50

Affixus Screw HFN A/R 85mm 8145-01-085 [3640922]

Facility

$3,473.00

Service Code	HCPCS C1713
Hospital Charge Code	3640922
Hospital Revenue Code	278
Min. Negotiated Rate	$1,944.88
Max. Negotiated Rate	$3,368.81
Rate for Payer: Cash Price	$2,257.45
Rate for Payer: Hawaii Western Management Group Commercial	$2,431.10
Rate for Payer: Health Management Network Commercial	$2,952.05
Rate for Payer: MDX Hawaii PPO	$3,368.81
Rate for Payer: University Health Alliance Commercial	$1,944.88

Affixus Screw HFN A/R 85mm 8145-01-085 [3640922]

Facility

$3,473.00

Service Code	HCPCS C1713
Hospital Charge Code	3640922
Hospital Revenue Code	278
Min. Negotiated Rate	$1,771.23
Max. Negotiated Rate	$3,368.81
Rate for Payer: Cash Price	$2,257.45
Rate for Payer: Hawaii Western Management Group Commercial	$2,431.10
Rate for Payer: Health Management Network Commercial	$2,952.05
Rate for Payer: Kaiser Permanente Commercial	$2,187.99
Rate for Payer: Kaiser Permanente Medicaid	$1,771.23
Rate for Payer: MDX Hawaii PPO	$3,368.81
Rate for Payer: University Health Alliance Commercial	$1,944.88

Affixus Screw HFN A/R 90mm 8145-01-090 [3640913]

Facility

$2,249.23

Service Code	HCPCS C1713
Hospital Charge Code	3640913
Hospital Revenue Code	278
Min. Negotiated Rate	$1,147.11
Max. Negotiated Rate	$2,181.75
Rate for Payer: Cash Price	$1,462.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,574.46
Rate for Payer: Health Management Network Commercial	$1,911.85
Rate for Payer: Kaiser Permanente Commercial	$1,417.01
Rate for Payer: Kaiser Permanente Medicaid	$1,147.11
Rate for Payer: MDX Hawaii PPO	$2,181.75
Rate for Payer: University Health Alliance Commercial	$1,259.57

Affixus Screw HFN A/R 90mm 8145-01-090 [3640913]

Facility

$2,249.23

Service Code	HCPCS C1713
Hospital Charge Code	3640913
Hospital Revenue Code	278
Min. Negotiated Rate	$1,259.57
Max. Negotiated Rate	$2,181.75
Rate for Payer: Cash Price	$1,462.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,574.46
Rate for Payer: Health Management Network Commercial	$1,911.85
Rate for Payer: MDX Hawaii PPO	$2,181.75
Rate for Payer: University Health Alliance Commercial	$1,259.57

Affixus Screw HFN A/R 95mm 8145-01-095 [3643196]

Facility

$3,473.00

Service Code	HCPCS C1713
Hospital Charge Code	3643196
Hospital Revenue Code	278
Min. Negotiated Rate	$1,944.88
Max. Negotiated Rate	$3,368.81
Rate for Payer: Cash Price	$2,257.45
Rate for Payer: Hawaii Western Management Group Commercial	$2,431.10
Rate for Payer: Health Management Network Commercial	$2,952.05
Rate for Payer: MDX Hawaii PPO	$3,368.81
Rate for Payer: University Health Alliance Commercial	$1,944.88

Affixus Screw HFN A/R 95mm 8145-01-095 [3643196]

Facility

$3,473.00

Service Code	HCPCS C1713
Hospital Charge Code	3643196
Hospital Revenue Code	278
Min. Negotiated Rate	$1,771.23
Max. Negotiated Rate	$3,368.81
Rate for Payer: Cash Price	$2,257.45
Rate for Payer: Hawaii Western Management Group Commercial	$2,431.10
Rate for Payer: Health Management Network Commercial	$2,952.05
Rate for Payer: Kaiser Permanente Commercial	$2,187.99
Rate for Payer: Kaiser Permanente Medicaid	$1,771.23
Rate for Payer: MDX Hawaii PPO	$3,368.81
Rate for Payer: University Health Alliance Commercial	$1,944.88

Affixus Screw Lag HFN 10.5mm x 100mm 8145-10-100 [3640902]

Facility

$6,998.00

Service Code	HCPCS C1713
Hospital Charge Code	3640902
Hospital Revenue Code	278
Min. Negotiated Rate	$3,918.88
Max. Negotiated Rate	$6,788.06
Rate for Payer: Cash Price	$4,548.70
Rate for Payer: Hawaii Western Management Group Commercial	$4,898.60
Rate for Payer: Health Management Network Commercial	$5,948.30
Rate for Payer: MDX Hawaii PPO	$6,788.06
Rate for Payer: University Health Alliance Commercial	$3,918.88

Affixus Screw Lag HFN 10.5mm x 100mm 8145-10-100 [3640902]

Facility

$6,998.00

Service Code	HCPCS C1713
Hospital Charge Code	3640902
Hospital Revenue Code	278
Min. Negotiated Rate	$3,568.98
Max. Negotiated Rate	$6,788.06
Rate for Payer: Cash Price	$4,548.70
Rate for Payer: Hawaii Western Management Group Commercial	$4,898.60
Rate for Payer: Health Management Network Commercial	$5,948.30
Rate for Payer: Kaiser Permanente Commercial	$4,408.74
Rate for Payer: Kaiser Permanente Medicaid	$3,568.98
Rate for Payer: MDX Hawaii PPO	$6,788.06
Rate for Payer: University Health Alliance Commercial	$3,918.88

Affixus Screw Lag HFN 10.5mm x 105mm 8145-10-105 [3640870]

Facility

$4,894.10

Service Code	HCPCS C1713
Hospital Charge Code	3640870
Hospital Revenue Code	278
Min. Negotiated Rate	$2,740.70
Max. Negotiated Rate	$4,747.28
Rate for Payer: Cash Price	$3,181.17
Rate for Payer: Hawaii Western Management Group Commercial	$3,425.87
Rate for Payer: Health Management Network Commercial	$4,159.98
Rate for Payer: MDX Hawaii PPO	$4,747.28
Rate for Payer: University Health Alliance Commercial	$2,740.70

Affixus Screw Lag HFN 10.5mm x 105mm 8145-10-105 [3640870]

Facility

$4,894.10

Service Code	HCPCS C1713
Hospital Charge Code	3640870
Hospital Revenue Code	278
Min. Negotiated Rate	$2,495.99
Max. Negotiated Rate	$4,747.28
Rate for Payer: Cash Price	$3,181.17
Rate for Payer: Hawaii Western Management Group Commercial	$3,425.87
Rate for Payer: Health Management Network Commercial	$4,159.98
Rate for Payer: Kaiser Permanente Commercial	$3,083.28
Rate for Payer: Kaiser Permanente Medicaid	$2,495.99
Rate for Payer: MDX Hawaii PPO	$4,747.28
Rate for Payer: University Health Alliance Commercial	$2,740.70

Affixus Screw Lag HFN 10.5mm x 110mm 8145-10-110 [3642700]

Facility

$6,998.00

Service Code	HCPCS C1713
Hospital Charge Code	3642700
Hospital Revenue Code	278
Min. Negotiated Rate	$3,568.98
Max. Negotiated Rate	$6,788.06
Rate for Payer: Cash Price	$4,548.70
Rate for Payer: Hawaii Western Management Group Commercial	$4,898.60
Rate for Payer: Health Management Network Commercial	$5,948.30
Rate for Payer: Kaiser Permanente Commercial	$4,408.74
Rate for Payer: Kaiser Permanente Medicaid	$3,568.98
Rate for Payer: MDX Hawaii PPO	$6,788.06
Rate for Payer: University Health Alliance Commercial	$3,918.88

Affixus Screw Lag HFN 10.5mm x 110mm 8145-10-110 [3642700]

Facility

$6,998.00

Service Code	HCPCS C1713
Hospital Charge Code	3642700
Hospital Revenue Code	278
Min. Negotiated Rate	$3,918.88
Max. Negotiated Rate	$6,788.06
Rate for Payer: Cash Price	$4,548.70
Rate for Payer: Hawaii Western Management Group Commercial	$4,898.60
Rate for Payer: Health Management Network Commercial	$5,948.30
Rate for Payer: MDX Hawaii PPO	$6,788.06
Rate for Payer: University Health Alliance Commercial	$3,918.88

Affixus Screw Lag HFN 10.5mm x 115mm 8145-10-115 [3641606]

Facility

$5,493.00

Service Code	HCPCS C1713
Hospital Charge Code	3641606
Hospital Revenue Code	278
Min. Negotiated Rate	$3,076.08
Max. Negotiated Rate	$5,328.21
Rate for Payer: Cash Price	$3,570.45
Rate for Payer: Hawaii Western Management Group Commercial	$3,845.10
Rate for Payer: Health Management Network Commercial	$4,669.05
Rate for Payer: MDX Hawaii PPO	$5,328.21
Rate for Payer: University Health Alliance Commercial	$3,076.08

Affixus Screw Lag HFN 10.5mm x 115mm 8145-10-115 [3641606]

Facility

$5,493.00

Service Code	HCPCS C1713
Hospital Charge Code	3641606
Hospital Revenue Code	278
Min. Negotiated Rate	$2,801.43
Max. Negotiated Rate	$5,328.21
Rate for Payer: Cash Price	$3,570.45
Rate for Payer: Hawaii Western Management Group Commercial	$3,845.10
Rate for Payer: Health Management Network Commercial	$4,669.05
Rate for Payer: Kaiser Permanente Commercial	$3,460.59
Rate for Payer: Kaiser Permanente Medicaid	$2,801.43
Rate for Payer: MDX Hawaii PPO	$5,328.21
Rate for Payer: University Health Alliance Commercial	$3,076.08

Affixus Screw Lag HFN 10.5mm x 85mm 8145-10-085 [3627533A]

Facility

$5,493.00

Service Code	HCPCS C1713
Hospital Charge Code	3627533A
Hospital Revenue Code	278
Min. Negotiated Rate	$2,801.43
Max. Negotiated Rate	$5,328.21
Rate for Payer: Cash Price	$3,570.45
Rate for Payer: Hawaii Western Management Group Commercial	$3,845.10
Rate for Payer: Health Management Network Commercial	$4,669.05
Rate for Payer: Kaiser Permanente Commercial	$3,460.59
Rate for Payer: Kaiser Permanente Medicaid	$2,801.43
Rate for Payer: MDX Hawaii PPO	$5,328.21
Rate for Payer: University Health Alliance Commercial	$3,076.08

Affixus Screw Lag HFN 10.5mm x 85mm 8145-10-085 [3627533A]

Facility

$5,493.00

Service Code	HCPCS C1713
Hospital Charge Code	3627533A
Hospital Revenue Code	278
Min. Negotiated Rate	$3,076.08
Max. Negotiated Rate	$5,328.21
Rate for Payer: Cash Price	$3,570.45
Rate for Payer: Hawaii Western Management Group Commercial	$3,845.10
Rate for Payer: Health Management Network Commercial	$4,669.05
Rate for Payer: MDX Hawaii PPO	$5,328.21
Rate for Payer: University Health Alliance Commercial	$3,076.08

Affixus Screw Lag HFN 10.5mm x 90mm 8145-10-090 [3627533]

Facility

$5,493.00

Service Code	HCPCS C1713
Hospital Charge Code	3627533
Hospital Revenue Code	278
Min. Negotiated Rate	$2,801.43
Max. Negotiated Rate	$5,328.21
Rate for Payer: Cash Price	$3,570.45
Rate for Payer: Hawaii Western Management Group Commercial	$3,845.10
Rate for Payer: Health Management Network Commercial	$4,669.05
Rate for Payer: Kaiser Permanente Commercial	$3,460.59
Rate for Payer: Kaiser Permanente Medicaid	$2,801.43
Rate for Payer: MDX Hawaii PPO	$5,328.21
Rate for Payer: University Health Alliance Commercial	$3,076.08

Affixus Screw Lag HFN 10.5mm x 90mm 8145-10-090 [3627533]

Facility

$5,493.00

Service Code	HCPCS C1713
Hospital Charge Code	3627533
Hospital Revenue Code	278
Min. Negotiated Rate	$3,076.08
Max. Negotiated Rate	$5,328.21
Rate for Payer: Cash Price	$3,570.45
Rate for Payer: Hawaii Western Management Group Commercial	$3,845.10
Rate for Payer: Health Management Network Commercial	$4,669.05
Rate for Payer: MDX Hawaii PPO	$5,328.21
Rate for Payer: University Health Alliance Commercial	$3,076.08

Affixus Screw Lag HFN 10.5mm x 95mm 8145-10-095 [3627533B]

Facility

$5,493.00

Service Code	HCPCS C1713
Hospital Charge Code	3627533B
Hospital Revenue Code	278
Min. Negotiated Rate	$2,801.43
Max. Negotiated Rate	$5,328.21
Rate for Payer: Cash Price	$3,570.45
Rate for Payer: Hawaii Western Management Group Commercial	$3,845.10
Rate for Payer: Health Management Network Commercial	$4,669.05
Rate for Payer: Kaiser Permanente Commercial	$3,460.59
Rate for Payer: Kaiser Permanente Medicaid	$2,801.43
Rate for Payer: MDX Hawaii PPO	$5,328.21
Rate for Payer: University Health Alliance Commercial	$3,076.08

Affixus Screw Lag HFN 10.5mm x 95mm 8145-10-095 [3627533B]

Facility

$5,493.00

Service Code	HCPCS C1713
Hospital Charge Code	3627533B
Hospital Revenue Code	278
Min. Negotiated Rate	$3,076.08
Max. Negotiated Rate	$5,328.21
Rate for Payer: Cash Price	$3,570.45
Rate for Payer: Hawaii Western Management Group Commercial	$3,845.10
Rate for Payer: Health Management Network Commercial	$4,669.05
Rate for Payer: MDX Hawaii PPO	$5,328.21
Rate for Payer: University Health Alliance Commercial	$3,076.08

AFP-L3 FRACTION ISOFORM & TOTAL AFP W/RATIO

Professional

Both

$128.00

Service Code	HCPCS 82107
Min. Negotiated Rate	$62.99
Max. Negotiated Rate	$108.80
Rate for Payer: AlohaCare Medicaid	$62.99
Rate for Payer: AlohaCare Medicare	$64.41
Rate for Payer: Cash Price	$83.20
Rate for Payer: Cash Price	$83.20
Rate for Payer: Devoted Health Medicare	$70.85
Rate for Payer: Hawaii Medical Service Association Medicare	$64.41
Rate for Payer: Health Management Network Commercial	$108.80
Rate for Payer: Kaiser Permanente Commercial	$77.29
Rate for Payer: Kaiser Permanente Medicaid	$77.29
Rate for Payer: Kaiser Permanente Medicare	$77.29
Rate for Payer: Ohana Health Plan Medicaid	$62.99
Rate for Payer: Ohana Health Plan Medicare	$64.41
Rate for Payer: UnitedHealthcare Medicaid	$62.99
Rate for Payer: UnitedHealthcare Medicare	$64.41

Know your out-of-pocket cost for care.

All Charges