Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Knot Pusher/Suture Cutter w/Portal Skid AR-5845 [3643064]

Facility

$2,070.88

Hospital Charge Code	3643064
Hospital Revenue Code	272
Min. Negotiated Rate	$1,056.15
Max. Negotiated Rate	$2,008.75
Rate for Payer: Cash Price	$1,346.07
Rate for Payer: Hawaii Western Management Group Commercial	$1,967.34
Rate for Payer: Health Management Network Commercial	$1,760.25
Rate for Payer: Kaiser Permanente Commercial	$1,304.65
Rate for Payer: Kaiser Permanente Medicaid	$1,056.15
Rate for Payer: MDX Hawaii PPO	$2,008.75
Rate for Payer: University Health Alliance Commercial	$1,509.46

Komet Guidewire Anat Sterile 2.4 x 228mm 804-09-098 [3643851]

Facility

$1,522.50

Service Code	HCPCS C1769
Hospital Charge Code	3643851
Hospital Revenue Code	272
Min. Negotiated Rate	$776.48
Max. Negotiated Rate	$1,476.83
Rate for Payer: Cash Price	$989.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,446.38
Rate for Payer: Health Management Network Commercial	$1,294.12
Rate for Payer: Kaiser Permanente Commercial	$959.17
Rate for Payer: Kaiser Permanente Medicaid	$776.48
Rate for Payer: MDX Hawaii PPO	$1,476.83
Rate for Payer: University Health Alliance Commercial	$1,109.75

Komet Guidewire Anat Sterile 2.4 x 228mm 804-09-098 [3643851]

Facility

$1,522.50

Service Code	HCPCS C1769
Hospital Charge Code	3643851
Hospital Revenue Code	272
Min. Negotiated Rate	$1,294.12
Max. Negotiated Rate	$1,476.83
Rate for Payer: Cash Price	$989.62
Rate for Payer: Health Management Network Commercial	$1,294.12
Rate for Payer: MDX Hawaii PPO	$1,476.83

Komet Pin Trocar Round Shank 804-08-004 [3642509]

Facility

$1,768.50

Hospital Charge Code	3642509
Hospital Revenue Code	272
Min. Negotiated Rate	$901.93
Max. Negotiated Rate	$1,715.44
Rate for Payer: Cash Price	$1,149.53
Rate for Payer: Hawaii Western Management Group Commercial	$1,680.08
Rate for Payer: Health Management Network Commercial	$1,503.22
Rate for Payer: Kaiser Permanente Commercial	$1,114.15
Rate for Payer: Kaiser Permanente Medicaid	$901.93
Rate for Payer: MDX Hawaii PPO	$1,715.44
Rate for Payer: University Health Alliance Commercial	$1,289.06

Komet Pin Trocar Round Shank 804-08-004 [3642509]

Facility

$1,768.50

Hospital Charge Code	3642509
Hospital Revenue Code	272
Min. Negotiated Rate	$1,503.22
Max. Negotiated Rate	$1,715.44
Rate for Payer: Cash Price	$1,149.53
Rate for Payer: Health Management Network Commercial	$1,503.22
Rate for Payer: MDX Hawaii PPO	$1,715.44

K-Wire 1.6mm THD Trocar Tip NS 829016006 [3642119]

Facility

$311.60

Service Code	HCPCS C1713
Hospital Charge Code	3642119
Hospital Revenue Code	278
Min. Negotiated Rate	$158.92
Max. Negotiated Rate	$302.25
Rate for Payer: Cash Price	$202.54
Rate for Payer: Hawaii Western Management Group Commercial	$218.12
Rate for Payer: Health Management Network Commercial	$264.86
Rate for Payer: Kaiser Permanente Commercial	$196.31
Rate for Payer: Kaiser Permanente Medicaid	$158.92
Rate for Payer: MDX Hawaii PPO	$302.25
Rate for Payer: University Health Alliance Commercial	$174.50

K-Wire 1.6mm THD Trocar Tip NS 829016006 [3642119]

Facility

$311.60

Service Code	HCPCS C1713
Hospital Charge Code	3642119
Hospital Revenue Code	278
Min. Negotiated Rate	$174.50
Max. Negotiated Rate	$302.25
Rate for Payer: Cash Price	$202.54
Rate for Payer: Hawaii Western Management Group Commercial	$218.12
Rate for Payer: Health Management Network Commercial	$264.86
Rate for Payer: MDX Hawaii PPO	$302.25
Rate for Payer: University Health Alliance Commercial	$174.50

K-Wire 2.0mm 141796 [3644308]

Facility

$873.49

Hospital Charge Code	3644308
Hospital Revenue Code	272
Min. Negotiated Rate	$742.47
Max. Negotiated Rate	$847.29
Rate for Payer: Cash Price	$567.77
Rate for Payer: Health Management Network Commercial	$742.47
Rate for Payer: MDX Hawaii PPO	$847.29

K-Wire 2.0mm 141796 [3644308]

Facility

$873.49

Hospital Charge Code	3644308
Hospital Revenue Code	272
Min. Negotiated Rate	$445.48
Max. Negotiated Rate	$847.29
Rate for Payer: Cash Price	$567.77
Rate for Payer: Hawaii Western Management Group Commercial	$829.82
Rate for Payer: Health Management Network Commercial	$742.47
Rate for Payer: Kaiser Permanente Commercial	$550.30
Rate for Payer: Kaiser Permanente Medicaid	$445.48
Rate for Payer: MDX Hawaii PPO	$847.29
Rate for Payer: University Health Alliance Commercial	$636.69

K Wire 2.0mm x 4IN ST 7000-20K4 [3644923]

Facility

$1,687.53

Hospital Charge Code	3644923
Hospital Revenue Code	272
Min. Negotiated Rate	$1,434.40
Max. Negotiated Rate	$1,636.90
Rate for Payer: Cash Price	$1,096.89
Rate for Payer: Health Management Network Commercial	$1,434.40
Rate for Payer: MDX Hawaii PPO	$1,636.90

K Wire 2.0mm x 4IN ST 7000-20K4 [3644923]

Facility

$1,687.53

Hospital Charge Code	3644923
Hospital Revenue Code	272
Min. Negotiated Rate	$860.64
Max. Negotiated Rate	$1,636.90
Rate for Payer: Cash Price	$1,096.89
Rate for Payer: Hawaii Western Management Group Commercial	$1,603.15
Rate for Payer: Health Management Network Commercial	$1,434.40
Rate for Payer: Kaiser Permanente Commercial	$1,063.14
Rate for Payer: Kaiser Permanente Medicaid	$860.64
Rate for Payer: MDX Hawaii PPO	$1,636.90
Rate for Payer: University Health Alliance Commercial	$1,230.04

K Wire 2.0mm x 6in ST 7000-20K6 [3644925]

Facility

$1,687.53

Hospital Charge Code	3644925
Hospital Revenue Code	272
Min. Negotiated Rate	$860.64
Max. Negotiated Rate	$1,636.90
Rate for Payer: Cash Price	$1,096.89
Rate for Payer: Hawaii Western Management Group Commercial	$1,603.15
Rate for Payer: Health Management Network Commercial	$1,434.40
Rate for Payer: Kaiser Permanente Commercial	$1,063.14
Rate for Payer: Kaiser Permanente Medicaid	$860.64
Rate for Payer: MDX Hawaii PPO	$1,636.90
Rate for Payer: University Health Alliance Commercial	$1,230.04

K Wire 2.0mm x 6in ST 7000-20K6 [3644925]

Facility

$1,687.53

Hospital Charge Code	3644925
Hospital Revenue Code	272
Min. Negotiated Rate	$1,434.40
Max. Negotiated Rate	$1,636.90
Rate for Payer: Cash Price	$1,096.89
Rate for Payer: Health Management Network Commercial	$1,434.40
Rate for Payer: MDX Hawaii PPO	$1,636.90

K-Wire Double End Trocar Tip Smooth 0.9 x 150mm P99-292-0915 [3644502]

Facility

$265.80

Hospital Charge Code	3644502
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

K-Wire Double End Trocar Tip Smooth 0.9 x 150mm P99-292-0915 [3644502]

Facility

$265.80

Hospital Charge Code	3644502
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

K-Wire Double End Trocar Tip Smooth 1.6 x 150mm P99-292-1615 [3644481]

Facility

$265.80

Hospital Charge Code	3644481
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

K-Wire Double End Trocar Tip Smooth 1.6 x 150mm P99-292-1615 [3644481]

Facility

$265.80

Hospital Charge Code	3644481
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

K-Wire Single Ended Trocar Tip Smooth 1.2 x 150mm P99-192-1215 [3644341]

Facility

$265.80

Hospital Charge Code	3644341
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

K-Wire Single Ended Trocar Tip Smooth 1.2 x 150mm P99-192-1215 [3644341]

Facility

$265.80

Hospital Charge Code	3644341
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

K-Wire Single Ended Trocar Tip Smooth 2.0 x 150mm P99-192-2015 [3644342]

Facility

$265.80

Hospital Charge Code	3644342
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

K-Wire Single Ended Trocar Tip Smooth 2.0 x 150mm P99-192-2015 [3644342]

Facility

$265.80

Hospital Charge Code	3644342
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

K-Wire Single End Trocar Tip Smooth 0.9 x 150mm P99-192-0915 [3644507]

Facility

$265.80

Hospital Charge Code	3644507
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

K-Wire Single End Trocar Tip Smooth 0.9 x 150mm P99-192-0915 [3644507]

Facility

$265.80

Hospital Charge Code	3644507
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

K Wire Single End Trocar Tip Smooth 1.1 x 150mm P99-192-1115 [3644916]

Facility

$265.80

Hospital Charge Code	3644916
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

K Wire Single End Trocar Tip Smooth 1.1 x 150mm P99-192-1115 [3644916]

Facility

$265.80

Hospital Charge Code	3644916
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

Know your out-of-pocket cost for care.

All Charges