Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Screw Comp Freefix Ti 3.5mmx40mm Ffc-35400-Ts [3643662]

Facility

$866.25

Service Code	HCPCS C1713
Hospital Charge Code	3643662
Hospital Revenue Code	278
Min. Negotiated Rate	$485.10
Max. Negotiated Rate	$840.26
Rate for Payer: Cash Price	$563.06
Rate for Payer: Hawaii Western Management Group Commercial	$606.38
Rate for Payer: Health Management Network Commercial	$736.31
Rate for Payer: MDX Hawaii PPO	$840.26
Rate for Payer: University Health Alliance Commercial	$485.10

Screw Comp Full Thrd Cann Xl 7.0x35mm AR-8770-35H [3645487]

Facility

$5,559.50

Service Code	HCPCS C1713
Hospital Charge Code	3645487
Hospital Revenue Code	278
Min. Negotiated Rate	$3,113.32
Max. Negotiated Rate	$5,392.72
Rate for Payer: Cash Price	$3,613.68
Rate for Payer: Hawaii Western Management Group Commercial	$3,891.65
Rate for Payer: Health Management Network Commercial	$4,725.57
Rate for Payer: MDX Hawaii PPO	$5,392.72
Rate for Payer: University Health Alliance Commercial	$3,113.32

Screw Comp Full Thrd Cann Xl 7.0x35mm AR-8770-35H [3645487]

Facility

$5,559.50

Service Code	HCPCS C1713
Hospital Charge Code	3645487
Hospital Revenue Code	278
Min. Negotiated Rate	$2,835.34
Max. Negotiated Rate	$5,392.72
Rate for Payer: Cash Price	$3,613.68
Rate for Payer: Hawaii Western Management Group Commercial	$3,891.65
Rate for Payer: Health Management Network Commercial	$4,725.57
Rate for Payer: Kaiser Permanente Commercial	$3,502.49
Rate for Payer: Kaiser Permanente Medicaid	$2,835.34
Rate for Payer: MDX Hawaii PPO	$5,392.72
Rate for Payer: University Health Alliance Commercial	$3,113.32

Screw Comp Full Thrd Cann Xl 7.0x40mm AR-8770-40H [3645488]

Facility

$5,559.50

Service Code	HCPCS C1713
Hospital Charge Code	3645488
Hospital Revenue Code	278
Min. Negotiated Rate	$3,113.32
Max. Negotiated Rate	$5,392.72
Rate for Payer: Cash Price	$3,613.68
Rate for Payer: Hawaii Western Management Group Commercial	$3,891.65
Rate for Payer: Health Management Network Commercial	$4,725.57
Rate for Payer: MDX Hawaii PPO	$5,392.72
Rate for Payer: University Health Alliance Commercial	$3,113.32

Screw Comp Full Thrd Cann Xl 7.0x40mm AR-8770-40H [3645488]

Facility

$5,559.50

Service Code	HCPCS C1713
Hospital Charge Code	3645488
Hospital Revenue Code	278
Min. Negotiated Rate	$2,835.34
Max. Negotiated Rate	$5,392.72
Rate for Payer: Cash Price	$3,613.68
Rate for Payer: Hawaii Western Management Group Commercial	$3,891.65
Rate for Payer: Health Management Network Commercial	$4,725.57
Rate for Payer: Kaiser Permanente Commercial	$3,502.49
Rate for Payer: Kaiser Permanente Medicaid	$2,835.34
Rate for Payer: MDX Hawaii PPO	$5,392.72
Rate for Payer: University Health Alliance Commercial	$3,113.32

Screw Comp Full Thrd Cann XL 7.0 x 45mm AR-8770-45H [3644921]

Facility

$5,559.50

Service Code	HCPCS C1713
Hospital Charge Code	3644921
Hospital Revenue Code	278
Min. Negotiated Rate	$2,835.34
Max. Negotiated Rate	$5,392.72
Rate for Payer: Cash Price	$3,613.68
Rate for Payer: Hawaii Western Management Group Commercial	$3,891.65
Rate for Payer: Health Management Network Commercial	$4,725.57
Rate for Payer: Kaiser Permanente Commercial	$3,502.49
Rate for Payer: Kaiser Permanente Medicaid	$2,835.34
Rate for Payer: MDX Hawaii PPO	$5,392.72
Rate for Payer: University Health Alliance Commercial	$3,113.32

Screw Comp Full Thrd Cann XL 7.0 x 45mm AR-8770-45H [3644921]

Facility

$5,559.50

Service Code	HCPCS C1713
Hospital Charge Code	3644921
Hospital Revenue Code	278
Min. Negotiated Rate	$3,113.32
Max. Negotiated Rate	$5,392.72
Rate for Payer: Cash Price	$3,613.68
Rate for Payer: Hawaii Western Management Group Commercial	$3,891.65
Rate for Payer: Health Management Network Commercial	$4,725.57
Rate for Payer: MDX Hawaii PPO	$5,392.72
Rate for Payer: University Health Alliance Commercial	$3,113.32

Screw Comp Kreulock SS 2.7mm x 12mm AR-8827CL-12 [3644807]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644807
Hospital Revenue Code	278
Min. Negotiated Rate	$1,382.87
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: Kaiser Permanente Commercial	$1,708.24
Rate for Payer: Kaiser Permanente Medicaid	$1,382.87
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7mm x 12mm AR-8827CL-12 [3644807]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644807
Hospital Revenue Code	278
Min. Negotiated Rate	$1,518.44
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 10mm AR-8827CL-10 [3644396]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644396
Hospital Revenue Code	278
Min. Negotiated Rate	$1,518.44
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 10mm AR-8827CL-10 [3644396]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644396
Hospital Revenue Code	278
Min. Negotiated Rate	$1,382.87
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: Kaiser Permanente Commercial	$1,708.24
Rate for Payer: Kaiser Permanente Medicaid	$1,382.87
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 14mm AR-8827CL-14 [3643220]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3643220
Hospital Revenue Code	278
Min. Negotiated Rate	$1,382.87
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: Kaiser Permanente Commercial	$1,708.24
Rate for Payer: Kaiser Permanente Medicaid	$1,382.87
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 14mm AR-8827CL-14 [3643220]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3643220
Hospital Revenue Code	278
Min. Negotiated Rate	$1,518.44
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 16mm AR-8827CL-16 [3643221]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3643221
Hospital Revenue Code	278
Min. Negotiated Rate	$1,382.87
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: Kaiser Permanente Commercial	$1,708.24
Rate for Payer: Kaiser Permanente Medicaid	$1,382.87
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 16mm AR-8827CL-16 [3643221]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3643221
Hospital Revenue Code	278
Min. Negotiated Rate	$1,518.44
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 18mm AR-8827CL-18 [3643222]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3643222
Hospital Revenue Code	278
Min. Negotiated Rate	$1,382.87
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: Kaiser Permanente Commercial	$1,708.24
Rate for Payer: Kaiser Permanente Medicaid	$1,382.87
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 18mm AR-8827CL-18 [3643222]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3643222
Hospital Revenue Code	278
Min. Negotiated Rate	$1,518.44
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 20mm AR-8827CL-20 [3644671]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644671
Hospital Revenue Code	278
Min. Negotiated Rate	$1,518.44
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 20mm AR-8827CL-20 [3644671]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644671
Hospital Revenue Code	278
Min. Negotiated Rate	$1,382.87
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: Kaiser Permanente Commercial	$1,708.24
Rate for Payer: Kaiser Permanente Medicaid	$1,382.87
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 22mm AR-8827CL-22 [3644414]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644414
Hospital Revenue Code	278
Min. Negotiated Rate	$1,382.87
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: Kaiser Permanente Commercial	$1,708.24
Rate for Payer: Kaiser Permanente Medicaid	$1,382.87
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 22mm AR-8827CL-22 [3644414]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644414
Hospital Revenue Code	278
Min. Negotiated Rate	$1,518.44
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock Ss 2.7x28mm AR-8827CL-28 [3645424]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3645424
Hospital Revenue Code	278
Min. Negotiated Rate	$1,382.87
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: Kaiser Permanente Commercial	$1,708.24
Rate for Payer: Kaiser Permanente Medicaid	$1,382.87
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock Ss 2.7x28mm AR-8827CL-28 [3645424]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3645424
Hospital Revenue Code	278
Min. Negotiated Rate	$1,518.44
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 34mm AR-8827CL-34 [3644672]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644672
Hospital Revenue Code	278
Min. Negotiated Rate	$1,518.44
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Screw Comp Kreulock SS 2.7 x 34mm AR-8827CL-34 [3644672]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644672
Hospital Revenue Code	278
Min. Negotiated Rate	$1,382.87
Max. Negotiated Rate	$2,630.16
Rate for Payer: Cash Price	$1,762.48
Rate for Payer: Hawaii Western Management Group Commercial	$1,898.05
Rate for Payer: Health Management Network Commercial	$2,304.78
Rate for Payer: Kaiser Permanente Commercial	$1,708.24
Rate for Payer: Kaiser Permanente Medicaid	$1,382.87
Rate for Payer: MDX Hawaii PPO	$2,630.16
Rate for Payer: University Health Alliance Commercial	$1,518.44

Know your out-of-pocket cost for care.

All Charges