Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Screw Cann Ti 6.5x85mm 32mm Thread 408.439 [3606394FF]

Facility

$1,377.59

Service Code	HCPCS C1713
Hospital Charge Code	3606394FF
Hospital Revenue Code	278
Min. Negotiated Rate	$702.57
Max. Negotiated Rate	$1,336.26
Rate for Payer: Cash Price	$895.43
Rate for Payer: Hawaii Western Management Group Commercial	$964.31
Rate for Payer: Health Management Network Commercial	$1,170.95
Rate for Payer: Kaiser Permanente Commercial	$867.88
Rate for Payer: Kaiser Permanente Medicaid	$702.57
Rate for Payer: MDX Hawaii PPO	$1,336.26
Rate for Payer: University Health Alliance Commercial	$771.45

Screw Cann Ti 6.5 X 90mm 16mm Thread 408.413 [3606394H]

Facility

$1,948.39

Service Code	HCPCS C1713
Hospital Charge Code	3606394H
Hospital Revenue Code	278
Min. Negotiated Rate	$993.68
Max. Negotiated Rate	$1,889.94
Rate for Payer: Cash Price	$1,266.45
Rate for Payer: Hawaii Western Management Group Commercial	$1,363.87
Rate for Payer: Health Management Network Commercial	$1,656.13
Rate for Payer: Kaiser Permanente Commercial	$1,227.49
Rate for Payer: Kaiser Permanente Medicaid	$993.68
Rate for Payer: MDX Hawaii PPO	$1,889.94
Rate for Payer: University Health Alliance Commercial	$1,091.10

Screw Cann Ti 6.5 X 90mm 16mm Thread 408.413 [3606394H]

Facility

$1,948.39

Service Code	HCPCS C1713
Hospital Charge Code	3606394H
Hospital Revenue Code	278
Min. Negotiated Rate	$1,091.10
Max. Negotiated Rate	$1,889.94
Rate for Payer: Cash Price	$1,266.45
Rate for Payer: Hawaii Western Management Group Commercial	$1,363.87
Rate for Payer: Health Management Network Commercial	$1,656.13
Rate for Payer: MDX Hawaii PPO	$1,889.94
Rate for Payer: University Health Alliance Commercial	$1,091.10

Screw Cann Ti 6.5x90mm 32mm Thread 408.440 [3606394GG]

Facility

$1,377.59

Service Code	HCPCS C1713
Hospital Charge Code	3606394GG
Hospital Revenue Code	278
Min. Negotiated Rate	$771.45
Max. Negotiated Rate	$1,336.26
Rate for Payer: Cash Price	$895.43
Rate for Payer: Hawaii Western Management Group Commercial	$964.31
Rate for Payer: Health Management Network Commercial	$1,170.95
Rate for Payer: MDX Hawaii PPO	$1,336.26
Rate for Payer: University Health Alliance Commercial	$771.45

Screw Cann Ti 6.5x90mm 32mm Thread 408.440 [3606394GG]

Facility

$1,377.59

Service Code	HCPCS C1713
Hospital Charge Code	3606394GG
Hospital Revenue Code	278
Min. Negotiated Rate	$702.57
Max. Negotiated Rate	$1,336.26
Rate for Payer: Cash Price	$895.43
Rate for Payer: Hawaii Western Management Group Commercial	$964.31
Rate for Payer: Health Management Network Commercial	$1,170.95
Rate for Payer: Kaiser Permanente Commercial	$867.88
Rate for Payer: Kaiser Permanente Medicaid	$702.57
Rate for Payer: MDX Hawaii PPO	$1,336.26
Rate for Payer: University Health Alliance Commercial	$771.45

Screw Cann Ti 6.5 X 95mm 16mm Thread 408.414 [3606394I]

Facility

$1,948.39

Service Code	HCPCS C1713
Hospital Charge Code	3606394I
Hospital Revenue Code	278
Min. Negotiated Rate	$993.68
Max. Negotiated Rate	$1,889.94
Rate for Payer: Cash Price	$1,266.45
Rate for Payer: Hawaii Western Management Group Commercial	$1,363.87
Rate for Payer: Health Management Network Commercial	$1,656.13
Rate for Payer: Kaiser Permanente Commercial	$1,227.49
Rate for Payer: Kaiser Permanente Medicaid	$993.68
Rate for Payer: MDX Hawaii PPO	$1,889.94
Rate for Payer: University Health Alliance Commercial	$1,091.10

Screw Cann Ti 6.5 X 95mm 16mm Thread 408.414 [3606394I]

Facility

$1,948.39

Service Code	HCPCS C1713
Hospital Charge Code	3606394I
Hospital Revenue Code	278
Min. Negotiated Rate	$1,091.10
Max. Negotiated Rate	$1,889.94
Rate for Payer: Cash Price	$1,266.45
Rate for Payer: Hawaii Western Management Group Commercial	$1,363.87
Rate for Payer: Health Management Network Commercial	$1,656.13
Rate for Payer: MDX Hawaii PPO	$1,889.94
Rate for Payer: University Health Alliance Commercial	$1,091.10

Screw Cann Ti 7.3 x 100mm 16mm Thread 408.900 [3606396E]

Facility

$1,936.34

Service Code	HCPCS C1713
Hospital Charge Code	3606396E
Hospital Revenue Code	278
Min. Negotiated Rate	$987.53
Max. Negotiated Rate	$1,878.25
Rate for Payer: Cash Price	$1,258.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,355.44
Rate for Payer: Health Management Network Commercial	$1,645.89
Rate for Payer: Kaiser Permanente Commercial	$1,219.89
Rate for Payer: Kaiser Permanente Medicaid	$987.53
Rate for Payer: MDX Hawaii PPO	$1,878.25
Rate for Payer: University Health Alliance Commercial	$1,084.35

Screw Cann Ti 7.3 x 100mm 16mm Thread 408.900 [3606396E]

Facility

$1,936.34

Service Code	HCPCS C1713
Hospital Charge Code	3606396E
Hospital Revenue Code	278
Min. Negotiated Rate	$1,084.35
Max. Negotiated Rate	$1,878.25
Rate for Payer: Cash Price	$1,258.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,355.44
Rate for Payer: Health Management Network Commercial	$1,645.89
Rate for Payer: MDX Hawaii PPO	$1,878.25
Rate for Payer: University Health Alliance Commercial	$1,084.35

Screw Cann Ti 7.3x100mm 32mm Thread 409.900 [3606397G]

Facility

$1,936.34

Service Code	HCPCS C1713
Hospital Charge Code	3606397G
Hospital Revenue Code	278
Min. Negotiated Rate	$987.53
Max. Negotiated Rate	$1,878.25
Rate for Payer: Cash Price	$1,258.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,355.44
Rate for Payer: Health Management Network Commercial	$1,645.89
Rate for Payer: Kaiser Permanente Commercial	$1,219.89
Rate for Payer: Kaiser Permanente Medicaid	$987.53
Rate for Payer: MDX Hawaii PPO	$1,878.25
Rate for Payer: University Health Alliance Commercial	$1,084.35

Screw Cann Ti 7.3x100mm 32mm Thread 409.900 [3606397G]

Facility

$1,936.34

Service Code	HCPCS C1713
Hospital Charge Code	3606397G
Hospital Revenue Code	278
Min. Negotiated Rate	$1,084.35
Max. Negotiated Rate	$1,878.25
Rate for Payer: Cash Price	$1,258.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,355.44
Rate for Payer: Health Management Network Commercial	$1,645.89
Rate for Payer: MDX Hawaii PPO	$1,878.25
Rate for Payer: University Health Alliance Commercial	$1,084.35

Screw Cann Ti 7.3x50mm 32mm Thread 409.850 [3606397K]

Facility

$1,894.47

Service Code	HCPCS C1713
Hospital Charge Code	3606397K
Hospital Revenue Code	278
Min. Negotiated Rate	$966.18
Max. Negotiated Rate	$1,837.64
Rate for Payer: Cash Price	$1,231.41
Rate for Payer: Hawaii Western Management Group Commercial	$1,326.13
Rate for Payer: Health Management Network Commercial	$1,610.30
Rate for Payer: Kaiser Permanente Commercial	$1,193.52
Rate for Payer: Kaiser Permanente Medicaid	$966.18
Rate for Payer: MDX Hawaii PPO	$1,837.64
Rate for Payer: University Health Alliance Commercial	$1,060.90

Screw Cann Ti 7.3x50mm 32mm Thread 409.850 [3606397K]

Facility

$1,894.47

Service Code	HCPCS C1713
Hospital Charge Code	3606397K
Hospital Revenue Code	278
Min. Negotiated Rate	$1,060.90
Max. Negotiated Rate	$1,837.64
Rate for Payer: Cash Price	$1,231.41
Rate for Payer: Hawaii Western Management Group Commercial	$1,326.13
Rate for Payer: Health Management Network Commercial	$1,610.30
Rate for Payer: MDX Hawaii PPO	$1,837.64
Rate for Payer: University Health Alliance Commercial	$1,060.90

Screw Cann Ti 7.3x60mm 32mm Thread 409.860 [3606397I]

Facility

$1,894.47

Service Code	HCPCS C1713
Hospital Charge Code	3606397I
Hospital Revenue Code	278
Min. Negotiated Rate	$966.18
Max. Negotiated Rate	$1,837.64
Rate for Payer: Cash Price	$1,231.41
Rate for Payer: Hawaii Western Management Group Commercial	$1,326.13
Rate for Payer: Health Management Network Commercial	$1,610.30
Rate for Payer: Kaiser Permanente Commercial	$1,193.52
Rate for Payer: Kaiser Permanente Medicaid	$966.18
Rate for Payer: MDX Hawaii PPO	$1,837.64
Rate for Payer: University Health Alliance Commercial	$1,060.90

Screw Cann Ti 7.3x60mm 32mm Thread 409.860 [3606397I]

Facility

$1,894.47

Service Code	HCPCS C1713
Hospital Charge Code	3606397I
Hospital Revenue Code	278
Min. Negotiated Rate	$1,060.90
Max. Negotiated Rate	$1,837.64
Rate for Payer: Cash Price	$1,231.41
Rate for Payer: Hawaii Western Management Group Commercial	$1,326.13
Rate for Payer: Health Management Network Commercial	$1,610.30
Rate for Payer: MDX Hawaii PPO	$1,837.64
Rate for Payer: University Health Alliance Commercial	$1,060.90

Screw Cann Ti 7.3 x 65mm 32mm thread 409.865 [3606397]

Facility

$1,371.89

Service Code	HCPCS C1713
Hospital Charge Code	3606397
Hospital Revenue Code	278
Min. Negotiated Rate	$699.66
Max. Negotiated Rate	$1,330.73
Rate for Payer: Cash Price	$891.73
Rate for Payer: Hawaii Western Management Group Commercial	$960.32
Rate for Payer: Health Management Network Commercial	$1,166.11
Rate for Payer: Kaiser Permanente Commercial	$864.29
Rate for Payer: Kaiser Permanente Medicaid	$699.66
Rate for Payer: MDX Hawaii PPO	$1,330.73
Rate for Payer: University Health Alliance Commercial	$768.26

Screw Cann Ti 7.3 x 65mm 32mm thread 409.865 [3606397]

Facility

$1,371.89

Service Code	HCPCS C1713
Hospital Charge Code	3606397
Hospital Revenue Code	278
Min. Negotiated Rate	$768.26
Max. Negotiated Rate	$1,330.73
Rate for Payer: Cash Price	$891.73
Rate for Payer: Hawaii Western Management Group Commercial	$960.32
Rate for Payer: Health Management Network Commercial	$1,166.11
Rate for Payer: MDX Hawaii PPO	$1,330.73
Rate for Payer: University Health Alliance Commercial	$768.26

Screw Cann Ti 7.3x70mm 32mm Thread 409.870 [3606397F]

Facility

$1,894.47

Service Code	HCPCS C1713
Hospital Charge Code	3606397F
Hospital Revenue Code	278
Min. Negotiated Rate	$966.18
Max. Negotiated Rate	$1,837.64
Rate for Payer: Cash Price	$1,231.41
Rate for Payer: Hawaii Western Management Group Commercial	$1,326.13
Rate for Payer: Health Management Network Commercial	$1,610.30
Rate for Payer: Kaiser Permanente Commercial	$1,193.52
Rate for Payer: Kaiser Permanente Medicaid	$966.18
Rate for Payer: MDX Hawaii PPO	$1,837.64
Rate for Payer: University Health Alliance Commercial	$1,060.90

Screw Cann Ti 7.3x70mm 32mm Thread 409.870 [3606397F]

Facility

$1,894.47

Service Code	HCPCS C1713
Hospital Charge Code	3606397F
Hospital Revenue Code	278
Min. Negotiated Rate	$1,060.90
Max. Negotiated Rate	$1,837.64
Rate for Payer: Cash Price	$1,231.41
Rate for Payer: Hawaii Western Management Group Commercial	$1,326.13
Rate for Payer: Health Management Network Commercial	$1,610.30
Rate for Payer: MDX Hawaii PPO	$1,837.64
Rate for Payer: University Health Alliance Commercial	$1,060.90

Screw Cann Ti 7.3 x 85mm 16mm Thread 408.885 [3606396C]

Facility

$1,936.34

Service Code	HCPCS C1713
Hospital Charge Code	3606396C
Hospital Revenue Code	278
Min. Negotiated Rate	$987.53
Max. Negotiated Rate	$1,878.25
Rate for Payer: Cash Price	$1,258.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,355.44
Rate for Payer: Health Management Network Commercial	$1,645.89
Rate for Payer: Kaiser Permanente Commercial	$1,219.89
Rate for Payer: Kaiser Permanente Medicaid	$987.53
Rate for Payer: MDX Hawaii PPO	$1,878.25
Rate for Payer: University Health Alliance Commercial	$1,084.35

Screw Cann Ti 7.3 x 85mm 16mm Thread 408.885 [3606396C]

Facility

$1,936.34

Service Code	HCPCS C1713
Hospital Charge Code	3606396C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,084.35
Max. Negotiated Rate	$1,878.25
Rate for Payer: Cash Price	$1,258.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,355.44
Rate for Payer: Health Management Network Commercial	$1,645.89
Rate for Payer: MDX Hawaii PPO	$1,878.25
Rate for Payer: University Health Alliance Commercial	$1,084.35

Screw Cann Ti 7.3 x 90mm 16mm Thread 408.890 [3606396D]

Facility

$1,936.34

Service Code	HCPCS C1713
Hospital Charge Code	3606396D
Hospital Revenue Code	278
Min. Negotiated Rate	$987.53
Max. Negotiated Rate	$1,878.25
Rate for Payer: Cash Price	$1,258.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,355.44
Rate for Payer: Health Management Network Commercial	$1,645.89
Rate for Payer: Kaiser Permanente Commercial	$1,219.89
Rate for Payer: Kaiser Permanente Medicaid	$987.53
Rate for Payer: MDX Hawaii PPO	$1,878.25
Rate for Payer: University Health Alliance Commercial	$1,084.35

Screw Cann Ti 7.3 x 90mm 16mm Thread 408.890 [3606396D]

Facility

$1,936.34

Service Code	HCPCS C1713
Hospital Charge Code	3606396D
Hospital Revenue Code	278
Min. Negotiated Rate	$1,084.35
Max. Negotiated Rate	$1,878.25
Rate for Payer: Cash Price	$1,258.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,355.44
Rate for Payer: Health Management Network Commercial	$1,645.89
Rate for Payer: MDX Hawaii PPO	$1,878.25
Rate for Payer: University Health Alliance Commercial	$1,084.35

Screw Cann Ti 7.3 x 90mm 32mm thread 409.890 [3606397D]

Facility

$1,936.34

Service Code	HCPCS C1713
Hospital Charge Code	3606397D
Hospital Revenue Code	278
Min. Negotiated Rate	$987.53
Max. Negotiated Rate	$1,878.25
Rate for Payer: Cash Price	$1,258.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,355.44
Rate for Payer: Health Management Network Commercial	$1,645.89
Rate for Payer: Kaiser Permanente Commercial	$1,219.89
Rate for Payer: Kaiser Permanente Medicaid	$987.53
Rate for Payer: MDX Hawaii PPO	$1,878.25
Rate for Payer: University Health Alliance Commercial	$1,084.35

Screw Cann Ti 7.3 x 90mm 32mm thread 409.890 [3606397D]

Facility

$1,936.34

Service Code	HCPCS C1713
Hospital Charge Code	3606397D
Hospital Revenue Code	278
Min. Negotiated Rate	$1,084.35
Max. Negotiated Rate	$1,878.25
Rate for Payer: Cash Price	$1,258.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,355.44
Rate for Payer: Health Management Network Commercial	$1,645.89
Rate for Payer: MDX Hawaii PPO	$1,878.25
Rate for Payer: University Health Alliance Commercial	$1,084.35

Know your out-of-pocket cost for care.

All Charges