Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Nail Frn Ti Cann 10mm 380mm Rt 04.033.068s [3643574]

Facility

$12,194.10

Service Code	HCPCS C1713
Hospital Charge Code	3643574
Hospital Revenue Code	278
Min. Negotiated Rate	$6,218.99
Max. Negotiated Rate	$11,828.28
Rate for Payer: Cash Price	$7,926.17
Rate for Payer: Hawaii Western Management Group Commercial	$8,535.87
Rate for Payer: Health Management Network Commercial	$10,364.99
Rate for Payer: Kaiser Permanente Commercial	$7,682.28
Rate for Payer: Kaiser Permanente Medicaid	$6,218.99
Rate for Payer: MDX Hawaii PPO	$11,828.28
Rate for Payer: University Health Alliance Commercial	$6,828.70

Nail Frn Ti Cann 10mm 420mm Lt [3643569]

Facility

$10,257.20

Service Code	HCPCS C1713
Hospital Charge Code	3643569
Hospital Revenue Code	278
Min. Negotiated Rate	$5,231.17
Max. Negotiated Rate	$9,949.48
Rate for Payer: Cash Price	$6,667.18
Rate for Payer: Hawaii Western Management Group Commercial	$7,180.04
Rate for Payer: Health Management Network Commercial	$8,718.62
Rate for Payer: Kaiser Permanente Commercial	$6,462.04
Rate for Payer: Kaiser Permanente Medicaid	$5,231.17
Rate for Payer: MDX Hawaii PPO	$9,949.48
Rate for Payer: University Health Alliance Commercial	$5,744.03

Nail Frn Ti Cann 10mm 420mm Lt [3643569]

Facility

$10,257.20

Service Code	HCPCS C1713
Hospital Charge Code	3643569
Hospital Revenue Code	278
Min. Negotiated Rate	$5,744.03
Max. Negotiated Rate	$9,949.48
Rate for Payer: Cash Price	$6,667.18
Rate for Payer: Hawaii Western Management Group Commercial	$7,180.04
Rate for Payer: Health Management Network Commercial	$8,718.62
Rate for Payer: MDX Hawaii PPO	$9,949.48
Rate for Payer: University Health Alliance Commercial	$5,744.03

Nail Frn Ti Cann 12mm 400mm Rt [3643555]

Facility

$6,253.00

Service Code	HCPCS C1713
Hospital Charge Code	3643555
Hospital Revenue Code	278
Min. Negotiated Rate	$3,189.03
Max. Negotiated Rate	$6,065.41
Rate for Payer: Cash Price	$4,064.45
Rate for Payer: Hawaii Western Management Group Commercial	$4,377.10
Rate for Payer: Health Management Network Commercial	$5,315.05
Rate for Payer: Kaiser Permanente Commercial	$3,939.39
Rate for Payer: Kaiser Permanente Medicaid	$3,189.03
Rate for Payer: MDX Hawaii PPO	$6,065.41
Rate for Payer: University Health Alliance Commercial	$3,501.68

Nail Frn Ti Cann 12mm 400mm Rt [3643555]

Facility

$6,253.00

Service Code	HCPCS C1713
Hospital Charge Code	3643555
Hospital Revenue Code	278
Min. Negotiated Rate	$3,501.68
Max. Negotiated Rate	$6,065.41
Rate for Payer: Cash Price	$4,064.45
Rate for Payer: Hawaii Western Management Group Commercial	$4,377.10
Rate for Payer: Health Management Network Commercial	$5,315.05
Rate for Payer: MDX Hawaii PPO	$6,065.41
Rate for Payer: University Health Alliance Commercial	$3,501.68

Nail Frn Ti Cann 9mm 360mm Rt 04.033.966s [3643560]

Facility

$12,194.10

Service Code	HCPCS C1713
Hospital Charge Code	3643560
Hospital Revenue Code	278
Min. Negotiated Rate	$6,218.99
Max. Negotiated Rate	$11,828.28
Rate for Payer: Cash Price	$7,926.17
Rate for Payer: Hawaii Western Management Group Commercial	$8,535.87
Rate for Payer: Health Management Network Commercial	$10,364.99
Rate for Payer: Kaiser Permanente Commercial	$7,682.28
Rate for Payer: Kaiser Permanente Medicaid	$6,218.99
Rate for Payer: MDX Hawaii PPO	$11,828.28
Rate for Payer: University Health Alliance Commercial	$6,828.70

Nail Frn Ti Cann 9mm 360mm Rt 04.033.966s [3643560]

Facility

$12,194.10

Service Code	HCPCS C1713
Hospital Charge Code	3643560
Hospital Revenue Code	278
Min. Negotiated Rate	$6,828.70
Max. Negotiated Rate	$11,828.28
Rate for Payer: Cash Price	$7,926.17
Rate for Payer: Hawaii Western Management Group Commercial	$8,535.87
Rate for Payer: Health Management Network Commercial	$10,364.99
Rate for Payer: MDX Hawaii PPO	$11,828.28
Rate for Payer: University Health Alliance Commercial	$6,828.70

Nail Hand Threaded 3.0mm x 50mm Ti RHS-30050 [3645377]

Facility

$5,143.00

Service Code	HCPCS C1713
Hospital Charge Code	3645377
Hospital Revenue Code	278
Min. Negotiated Rate	$2,622.93
Max. Negotiated Rate	$4,988.71
Rate for Payer: Cash Price	$3,342.95
Rate for Payer: Hawaii Western Management Group Commercial	$3,600.10
Rate for Payer: Health Management Network Commercial	$4,371.55
Rate for Payer: Kaiser Permanente Commercial	$3,240.09
Rate for Payer: Kaiser Permanente Medicaid	$2,622.93
Rate for Payer: MDX Hawaii PPO	$4,988.71
Rate for Payer: University Health Alliance Commercial	$2,880.08

Nail Hand Threaded 3.0mm x 50mm Ti RHS-30050 [3645377]

Facility

$5,143.00

Service Code	HCPCS C1713
Hospital Charge Code	3645377
Hospital Revenue Code	278
Min. Negotiated Rate	$2,880.08
Max. Negotiated Rate	$4,988.71
Rate for Payer: Cash Price	$3,342.95
Rate for Payer: Hawaii Western Management Group Commercial	$3,600.10
Rate for Payer: Health Management Network Commercial	$4,371.55
Rate for Payer: MDX Hawaii PPO	$4,988.71
Rate for Payer: University Health Alliance Commercial	$2,880.08

Nail HFN 130 deg 11mm X 180mm 8145-11-180 [3640740]

Facility

$11,513.00

Service Code	HCPCS C1713
Hospital Charge Code	3640740
Hospital Revenue Code	278
Min. Negotiated Rate	$5,871.63
Max. Negotiated Rate	$11,167.61
Rate for Payer: Cash Price	$7,483.45
Rate for Payer: Hawaii Western Management Group Commercial	$8,059.10
Rate for Payer: Health Management Network Commercial	$9,786.05
Rate for Payer: Kaiser Permanente Commercial	$7,253.19
Rate for Payer: Kaiser Permanente Medicaid	$5,871.63
Rate for Payer: MDX Hawaii PPO	$11,167.61
Rate for Payer: University Health Alliance Commercial	$6,447.28

Nail HFN 130 deg 11mm X 180mm 8145-11-180 [3640740]

Facility

$11,513.00

Service Code	HCPCS C1713
Hospital Charge Code	3640740
Hospital Revenue Code	278
Min. Negotiated Rate	$6,447.28
Max. Negotiated Rate	$11,167.61
Rate for Payer: Cash Price	$7,483.45
Rate for Payer: Hawaii Western Management Group Commercial	$8,059.10
Rate for Payer: Health Management Network Commercial	$9,786.05
Rate for Payer: MDX Hawaii PPO	$11,167.61
Rate for Payer: University Health Alliance Commercial	$6,447.28

Nail HFN 130 deg 11mm x 360mm LT 814611360 [3641463]

Facility

$10,125.00

Service Code	HCPCS C1713
Hospital Charge Code	3641463
Hospital Revenue Code	278
Min. Negotiated Rate	$5,163.75
Max. Negotiated Rate	$9,821.25
Rate for Payer: Cash Price	$6,581.25
Rate for Payer: Hawaii Western Management Group Commercial	$7,087.50
Rate for Payer: Health Management Network Commercial	$8,606.25
Rate for Payer: Kaiser Permanente Commercial	$6,378.75
Rate for Payer: Kaiser Permanente Medicaid	$5,163.75
Rate for Payer: MDX Hawaii PPO	$9,821.25
Rate for Payer: University Health Alliance Commercial	$5,670.00

Nail HFN 130 deg 11mm x 360mm LT 814611360 [3641463]

Facility

$10,125.00

Service Code	HCPCS C1713
Hospital Charge Code	3641463
Hospital Revenue Code	278
Min. Negotiated Rate	$5,670.00
Max. Negotiated Rate	$9,821.25
Rate for Payer: Cash Price	$6,581.25
Rate for Payer: Hawaii Western Management Group Commercial	$7,087.50
Rate for Payer: Health Management Network Commercial	$8,606.25
Rate for Payer: MDX Hawaii PPO	$9,821.25
Rate for Payer: University Health Alliance Commercial	$5,670.00

Nail HFN 130 deg 11mm x 380mm LT 814611380 [3642996]

Facility

$10,125.00

Service Code	HCPCS C1713
Hospital Charge Code	3642996
Hospital Revenue Code	278
Min. Negotiated Rate	$5,670.00
Max. Negotiated Rate	$9,821.25
Rate for Payer: Cash Price	$6,581.25
Rate for Payer: Hawaii Western Management Group Commercial	$7,087.50
Rate for Payer: Health Management Network Commercial	$8,606.25
Rate for Payer: MDX Hawaii PPO	$9,821.25
Rate for Payer: University Health Alliance Commercial	$5,670.00

Nail HFN 130 deg 11mm x 380mm LT 814611380 [3642996]

Facility

$10,125.00

Service Code	HCPCS C1713
Hospital Charge Code	3642996
Hospital Revenue Code	278
Min. Negotiated Rate	$5,163.75
Max. Negotiated Rate	$9,821.25
Rate for Payer: Cash Price	$6,581.25
Rate for Payer: Hawaii Western Management Group Commercial	$7,087.50
Rate for Payer: Health Management Network Commercial	$8,606.25
Rate for Payer: Kaiser Permanente Commercial	$6,378.75
Rate for Payer: Kaiser Permanente Medicaid	$5,163.75
Rate for Payer: MDX Hawaii PPO	$9,821.25
Rate for Payer: University Health Alliance Commercial	$5,670.00

Nail HFN 130 deg 11mm x 380mm RT 814511380 [3641120]

Facility

$10,125.00

Service Code	HCPCS C1713
Hospital Charge Code	3641120
Hospital Revenue Code	278
Min. Negotiated Rate	$5,163.75
Max. Negotiated Rate	$9,821.25
Rate for Payer: Cash Price	$6,581.25
Rate for Payer: Hawaii Western Management Group Commercial	$7,087.50
Rate for Payer: Health Management Network Commercial	$8,606.25
Rate for Payer: Kaiser Permanente Commercial	$6,378.75
Rate for Payer: Kaiser Permanente Medicaid	$5,163.75
Rate for Payer: MDX Hawaii PPO	$9,821.25
Rate for Payer: University Health Alliance Commercial	$5,670.00

Nail HFN 130 deg 11mm x 380mm RT 814511380 [3641120]

Facility

$10,125.00

Service Code	HCPCS C1713
Hospital Charge Code	3641120
Hospital Revenue Code	278
Min. Negotiated Rate	$5,670.00
Max. Negotiated Rate	$9,821.25
Rate for Payer: Cash Price	$6,581.25
Rate for Payer: Hawaii Western Management Group Commercial	$7,087.50
Rate for Payer: Health Management Network Commercial	$8,606.25
Rate for Payer: MDX Hawaii PPO	$9,821.25
Rate for Payer: University Health Alliance Commercial	$5,670.00

Nail HFN 130 deg 11mm x 400mm RT 814511400 [3642055]

Facility

$15,678.00

Service Code	HCPCS C1713
Hospital Charge Code	3642055
Hospital Revenue Code	278
Min. Negotiated Rate	$7,995.78
Max. Negotiated Rate	$15,207.66
Rate for Payer: Cash Price	$10,190.70
Rate for Payer: Hawaii Western Management Group Commercial	$10,974.60
Rate for Payer: Health Management Network Commercial	$13,326.30
Rate for Payer: Kaiser Permanente Commercial	$9,877.14
Rate for Payer: Kaiser Permanente Medicaid	$7,995.78
Rate for Payer: MDX Hawaii PPO	$15,207.66
Rate for Payer: University Health Alliance Commercial	$8,779.68

Nail HFN 130 deg 11mm x 400mm RT 814511400 [3642055]

Facility

$15,678.00

Service Code	HCPCS C1713
Hospital Charge Code	3642055
Hospital Revenue Code	278
Min. Negotiated Rate	$8,779.68
Max. Negotiated Rate	$15,207.66
Rate for Payer: Cash Price	$10,190.70
Rate for Payer: Hawaii Western Management Group Commercial	$10,974.60
Rate for Payer: Health Management Network Commercial	$13,326.30
Rate for Payer: MDX Hawaii PPO	$15,207.66
Rate for Payer: University Health Alliance Commercial	$8,779.68

Nail HFN 130 deg 11mm x 440mm RT 8145-11-440 [3643236]

Facility

$10,125.00

Service Code	HCPCS C1713
Hospital Charge Code	3643236
Hospital Revenue Code	278
Min. Negotiated Rate	$5,163.75
Max. Negotiated Rate	$9,821.25
Rate for Payer: Cash Price	$6,581.25
Rate for Payer: Hawaii Western Management Group Commercial	$7,087.50
Rate for Payer: Health Management Network Commercial	$8,606.25
Rate for Payer: Kaiser Permanente Commercial	$6,378.75
Rate for Payer: Kaiser Permanente Medicaid	$5,163.75
Rate for Payer: MDX Hawaii PPO	$9,821.25
Rate for Payer: University Health Alliance Commercial	$5,670.00

Nail HFN 130 deg 11mm x 440mm RT 8145-11-440 [3643236]

Facility

$10,125.00

Service Code	HCPCS C1713
Hospital Charge Code	3643236
Hospital Revenue Code	278
Min. Negotiated Rate	$5,670.00
Max. Negotiated Rate	$9,821.25
Rate for Payer: Cash Price	$6,581.25
Rate for Payer: Hawaii Western Management Group Commercial	$7,087.50
Rate for Payer: Health Management Network Commercial	$8,606.25
Rate for Payer: MDX Hawaii PPO	$9,821.25
Rate for Payer: University Health Alliance Commercial	$5,670.00

Nail HFN 130 deg 13mm x 180mm 814513180 [3640921]

Facility

$11,513.00

Service Code	HCPCS C1713
Hospital Charge Code	3640921
Hospital Revenue Code	278
Min. Negotiated Rate	$5,871.63
Max. Negotiated Rate	$11,167.61
Rate for Payer: Cash Price	$7,483.45
Rate for Payer: Hawaii Western Management Group Commercial	$8,059.10
Rate for Payer: Health Management Network Commercial	$9,786.05
Rate for Payer: Kaiser Permanente Commercial	$7,253.19
Rate for Payer: Kaiser Permanente Medicaid	$5,871.63
Rate for Payer: MDX Hawaii PPO	$11,167.61
Rate for Payer: University Health Alliance Commercial	$6,447.28

Nail HFN 130 deg 13mm x 180mm 814513180 [3640921]

Facility

$11,513.00

Service Code	HCPCS C1713
Hospital Charge Code	3640921
Hospital Revenue Code	278
Min. Negotiated Rate	$6,447.28
Max. Negotiated Rate	$11,167.61
Rate for Payer: Cash Price	$7,483.45
Rate for Payer: Hawaii Western Management Group Commercial	$8,059.10
Rate for Payer: Health Management Network Commercial	$9,786.05
Rate for Payer: MDX Hawaii PPO	$11,167.61
Rate for Payer: University Health Alliance Commercial	$6,447.28

Nail HFN 130 deg 13mm x 360mm 814513360 [3641031]

Facility

$15,678.00

Service Code	HCPCS C1713
Hospital Charge Code	3641031
Hospital Revenue Code	278
Min. Negotiated Rate	$7,995.78
Max. Negotiated Rate	$15,207.66
Rate for Payer: Cash Price	$10,190.70
Rate for Payer: Hawaii Western Management Group Commercial	$10,974.60
Rate for Payer: Health Management Network Commercial	$13,326.30
Rate for Payer: Kaiser Permanente Commercial	$9,877.14
Rate for Payer: Kaiser Permanente Medicaid	$7,995.78
Rate for Payer: MDX Hawaii PPO	$15,207.66
Rate for Payer: University Health Alliance Commercial	$8,779.68

Nail HFN 130 deg 13mm x 360mm 814513360 [3641031]

Facility

$15,678.00

Service Code	HCPCS C1713
Hospital Charge Code	3641031
Hospital Revenue Code	278
Min. Negotiated Rate	$8,779.68
Max. Negotiated Rate	$15,207.66
Rate for Payer: Cash Price	$10,190.70
Rate for Payer: Hawaii Western Management Group Commercial	$10,974.60
Rate for Payer: Health Management Network Commercial	$13,326.30
Rate for Payer: MDX Hawaii PPO	$15,207.66
Rate for Payer: University Health Alliance Commercial	$8,779.68

Know your out-of-pocket cost for care.

All Charges