Kona Community Hospital

All Charges

Charge

Type

Setting

Price

R3con Locking Plate Screw 3.5 x 22mm P50-353-3522 [3644934]

Facility

$1,543.00

Service Code	HCPCS C1713
Hospital Charge Code	3644934
Hospital Revenue Code	278
Min. Negotiated Rate	$864.08
Max. Negotiated Rate	$1,496.71
Rate for Payer: Cash Price	$1,002.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,080.10
Rate for Payer: Health Management Network Commercial	$1,311.55
Rate for Payer: MDX Hawaii PPO	$1,496.71
Rate for Payer: University Health Alliance Commercial	$864.08

R3con Locking Plate Screw 3.5 x 24mm P50-353-3524 [3644329]

Facility

$1,543.00

Service Code	HCPCS C1713
Hospital Charge Code	3644329
Hospital Revenue Code	278
Min. Negotiated Rate	$864.08
Max. Negotiated Rate	$1,496.71
Rate for Payer: Cash Price	$1,002.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,080.10
Rate for Payer: Health Management Network Commercial	$1,311.55
Rate for Payer: MDX Hawaii PPO	$1,496.71
Rate for Payer: University Health Alliance Commercial	$864.08

R3con Locking Plate Screw 3.5 x 24mm P50-353-3524 [3644329]

Facility

$1,543.00

Service Code	HCPCS C1713
Hospital Charge Code	3644329
Hospital Revenue Code	278
Min. Negotiated Rate	$786.93
Max. Negotiated Rate	$1,496.71
Rate for Payer: Cash Price	$1,002.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,080.10
Rate for Payer: Health Management Network Commercial	$1,311.55
Rate for Payer: Kaiser Permanente Commercial	$972.09
Rate for Payer: Kaiser Permanente Medicaid	$786.93
Rate for Payer: MDX Hawaii PPO	$1,496.71
Rate for Payer: University Health Alliance Commercial	$864.08

R3con Locking Plate Screw 3.5 x 26mm P50-353-3526 [3644533]

Facility

$1,543.00

Service Code	HCPCS C1713
Hospital Charge Code	3644533
Hospital Revenue Code	278
Min. Negotiated Rate	$786.93
Max. Negotiated Rate	$1,496.71
Rate for Payer: Cash Price	$1,002.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,080.10
Rate for Payer: Health Management Network Commercial	$1,311.55
Rate for Payer: Kaiser Permanente Commercial	$972.09
Rate for Payer: Kaiser Permanente Medicaid	$786.93
Rate for Payer: MDX Hawaii PPO	$1,496.71
Rate for Payer: University Health Alliance Commercial	$864.08

R3con Locking Plate Screw 3.5 x 26mm P50-353-3526 [3644533]

Facility

$1,543.00

Service Code	HCPCS C1713
Hospital Charge Code	3644533
Hospital Revenue Code	278
Min. Negotiated Rate	$864.08
Max. Negotiated Rate	$1,496.71
Rate for Payer: Cash Price	$1,002.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,080.10
Rate for Payer: Health Management Network Commercial	$1,311.55
Rate for Payer: MDX Hawaii PPO	$1,496.71
Rate for Payer: University Health Alliance Commercial	$864.08

R3con Locking Plate Screw 3.5 x 28mm P50-353-3528 [3644330]

Facility

$1,543.00

Service Code	HCPCS C1713
Hospital Charge Code	3644330
Hospital Revenue Code	278
Min. Negotiated Rate	$786.93
Max. Negotiated Rate	$1,496.71
Rate for Payer: Cash Price	$1,002.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,080.10
Rate for Payer: Health Management Network Commercial	$1,311.55
Rate for Payer: Kaiser Permanente Commercial	$972.09
Rate for Payer: Kaiser Permanente Medicaid	$786.93
Rate for Payer: MDX Hawaii PPO	$1,496.71
Rate for Payer: University Health Alliance Commercial	$864.08

R3con Locking Plate Screw 3.5 x 28mm P50-353-3528 [3644330]

Facility

$1,543.00

Service Code	HCPCS C1713
Hospital Charge Code	3644330
Hospital Revenue Code	278
Min. Negotiated Rate	$864.08
Max. Negotiated Rate	$1,496.71
Rate for Payer: Cash Price	$1,002.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,080.10
Rate for Payer: Health Management Network Commercial	$1,311.55
Rate for Payer: MDX Hawaii PPO	$1,496.71
Rate for Payer: University Health Alliance Commercial	$864.08

R3con Locking Plate Screw 3.5 x 30mm P50-353-3530 [3644779]

Facility

$1,543.00

Service Code	HCPCS C1713
Hospital Charge Code	3644779
Hospital Revenue Code	278
Min. Negotiated Rate	$786.93
Max. Negotiated Rate	$1,496.71
Rate for Payer: Cash Price	$1,002.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,080.10
Rate for Payer: Health Management Network Commercial	$1,311.55
Rate for Payer: Kaiser Permanente Commercial	$972.09
Rate for Payer: Kaiser Permanente Medicaid	$786.93
Rate for Payer: MDX Hawaii PPO	$1,496.71
Rate for Payer: University Health Alliance Commercial	$864.08

R3con Locking Plate Screw 3.5 x 30mm P50-353-3530 [3644779]

Facility

$1,543.00

Service Code	HCPCS C1713
Hospital Charge Code	3644779
Hospital Revenue Code	278
Min. Negotiated Rate	$864.08
Max. Negotiated Rate	$1,496.71
Rate for Payer: Cash Price	$1,002.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,080.10
Rate for Payer: Health Management Network Commercial	$1,311.55
Rate for Payer: MDX Hawaii PPO	$1,496.71
Rate for Payer: University Health Alliance Commercial	$864.08

R3con Locking Plate Screw 3.5 x 34mm P50-353-3534 [3644780]

Facility

$1,543.00

Service Code	HCPCS C1713
Hospital Charge Code	3644780
Hospital Revenue Code	278
Min. Negotiated Rate	$864.08
Max. Negotiated Rate	$1,496.71
Rate for Payer: Cash Price	$1,002.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,080.10
Rate for Payer: Health Management Network Commercial	$1,311.55
Rate for Payer: MDX Hawaii PPO	$1,496.71
Rate for Payer: University Health Alliance Commercial	$864.08

R3con Locking Plate Screw 3.5 x 34mm P50-353-3534 [3644780]

Facility

$1,543.00

Service Code	HCPCS C1713
Hospital Charge Code	3644780
Hospital Revenue Code	278
Min. Negotiated Rate	$786.93
Max. Negotiated Rate	$1,496.71
Rate for Payer: Cash Price	$1,002.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,080.10
Rate for Payer: Health Management Network Commercial	$1,311.55
Rate for Payer: Kaiser Permanente Commercial	$972.09
Rate for Payer: Kaiser Permanente Medicaid	$786.93
Rate for Payer: MDX Hawaii PPO	$1,496.71
Rate for Payer: University Health Alliance Commercial	$864.08

R3con Locking Plate Screw 4.2mm x 28mm P50-353-4228 [3644906]

Facility

$1,543.00

Service Code	HCPCS C1713
Hospital Charge Code	3644906
Hospital Revenue Code	278
Min. Negotiated Rate	$864.08
Max. Negotiated Rate	$1,496.71
Rate for Payer: Cash Price	$1,002.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,080.10
Rate for Payer: Health Management Network Commercial	$1,311.55
Rate for Payer: MDX Hawaii PPO	$1,496.71
Rate for Payer: University Health Alliance Commercial	$864.08

R3con Locking Plate Screw 4.2mm x 28mm P50-353-4228 [3644906]

Facility

$1,543.00

Service Code	HCPCS C1713
Hospital Charge Code	3644906
Hospital Revenue Code	278
Min. Negotiated Rate	$786.93
Max. Negotiated Rate	$1,496.71
Rate for Payer: Cash Price	$1,002.95
Rate for Payer: Hawaii Western Management Group Commercial	$1,080.10
Rate for Payer: Health Management Network Commercial	$1,311.55
Rate for Payer: Kaiser Permanente Commercial	$972.09
Rate for Payer: Kaiser Permanente Medicaid	$786.93
Rate for Payer: MDX Hawaii PPO	$1,496.71
Rate for Payer: University Health Alliance Commercial	$864.08

R3con Non-Locking Plate Screw 2.7 x 17mm P50-453-2717 [3644534]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3644534
Hospital Revenue Code	278
Min. Negotiated Rate	$589.13
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: Kaiser Permanente Commercial	$727.75
Rate for Payer: Kaiser Permanente Medicaid	$589.13
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

R3con Non-Locking Plate Screw 2.7 x 17mm P50-453-2717 [3644534]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3644534
Hospital Revenue Code	278
Min. Negotiated Rate	$646.89
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

R3con Non-Locking Plate Screw 2.7 x 18mm P50-453-2718 [3644535]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3644535
Hospital Revenue Code	278
Min. Negotiated Rate	$589.13
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: Kaiser Permanente Commercial	$727.75
Rate for Payer: Kaiser Permanente Medicaid	$589.13
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

R3con Non-Locking Plate Screw 2.7 x 18mm P50-453-2718 [3644535]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3644535
Hospital Revenue Code	278
Min. Negotiated Rate	$646.89
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

R3con Non-Locking Plate Screw 2.7 x 19mm P50-453-2719 [3644536]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3644536
Hospital Revenue Code	278
Min. Negotiated Rate	$589.13
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: Kaiser Permanente Commercial	$727.75
Rate for Payer: Kaiser Permanente Medicaid	$589.13
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

R3con Non-Locking Plate Screw 2.7 x 19mm P50-453-2719 [3644536]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3644536
Hospital Revenue Code	278
Min. Negotiated Rate	$646.89
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

R3con Non Locking Plate Screw 3.5mm x 24mm P50-453-3524 [3644907]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3644907
Hospital Revenue Code	278
Min. Negotiated Rate	$646.89
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

R3con Non Locking Plate Screw 3.5mm x 24mm P50-453-3524 [3644907]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3644907
Hospital Revenue Code	278
Min. Negotiated Rate	$589.13
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: Kaiser Permanente Commercial	$727.75
Rate for Payer: Kaiser Permanente Medicaid	$589.13
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

R3con Non Locking Plate Screw 3.5 x 12mm P50-453-3512 [3644935]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3644935
Hospital Revenue Code	278
Min. Negotiated Rate	$589.13
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: Kaiser Permanente Commercial	$727.75
Rate for Payer: Kaiser Permanente Medicaid	$589.13
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

R3con Non Locking Plate Screw 3.5 x 12mm P50-453-3512 [3644935]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3644935
Hospital Revenue Code	278
Min. Negotiated Rate	$646.89
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

R3con Non-Locking Plate Screw 3.5 x 14mm P50-453-3514 [3644331]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3644331
Hospital Revenue Code	278
Min. Negotiated Rate	$646.89
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

R3con Non-Locking Plate Screw 3.5 x 14mm P50-453-3514 [3644331]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3644331
Hospital Revenue Code	278
Min. Negotiated Rate	$589.13
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: Kaiser Permanente Commercial	$727.75
Rate for Payer: Kaiser Permanente Medicaid	$589.13
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

Know your out-of-pocket cost for care.

All Charges