Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Screw Comp Kreulock SS 2.7 x 44mm AR-8827CL-44 [3644964]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644964
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 44mm AR-8827CL-44 [3644964]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644964
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 3.5 x 10mm AR-8835CL-10 [3644483]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644483
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 3.5 x 10mm AR-8835CL-10 [3644483]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644483
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 3.5 x 12mm AR-8835CL-12 [3644484]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644484
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 3.5 x 12mm AR-8835CL-12 [3644484]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644484
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 3.5 x 14mm AR-8835CL-14 [3644763]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644763
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 3.5 x 14mm AR-8835CL-14 [3644763]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644763
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 3.5 x 32mm AR-8835CL-32 [3644966]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644966
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 3.5 x 32mm AR-8835CL-32 [3644966]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644966
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 3.5 x 36mm AR-8835CL-36 [3644967]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644967
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 3.5 x 36mm AR-8835CL-36 [3644967]

Facility

$2,711.50

Service Code	HCPCS C1713
Hospital Charge Code	3644967
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 Multi Thread Ti 3.0mm x 10mm MTNL-30100-TS [3642729]

Facility

$860.64

Service Code	HCPCS C1713
Hospital Charge Code	3642729
Hospital Revenue Code	278
Min. Negotiated Rate	$438.93
Max. Negotiated Rate	$834.82
Rate for Payer: Cash Price	$559.42
Rate for Payer: Hawaii Western Management Group Commercial	$602.45
Rate for Payer: Health Management Network Commercial	$731.54
Rate for Payer: Kaiser Permanente Commercial	$542.20
Rate for Payer: Kaiser Permanente Medicaid	$438.93
Rate for Payer: MDX Hawaii PPO	$834.82
Rate for Payer: University Health Alliance Commercial	$481.96

Screw Comp Multi Thread Ti 3.0mm x 10mm MTNL-30100-TS [3642729]

Facility

$860.64

Service Code	HCPCS C1713
Hospital Charge Code	3642729
Hospital Revenue Code	278
Min. Negotiated Rate	$481.96
Max. Negotiated Rate	$834.82
Rate for Payer: Cash Price	$559.42
Rate for Payer: Hawaii Western Management Group Commercial	$602.45
Rate for Payer: Health Management Network Commercial	$731.54
Rate for Payer: MDX Hawaii PPO	$834.82
Rate for Payer: University Health Alliance Commercial	$481.96

Screw Comp Multi Thread Ti 3.0mm x 12mm MTNL-30120-TS [3642730]

Facility

$860.64

Service Code	HCPCS C1713
Hospital Charge Code	3642730
Hospital Revenue Code	278
Min. Negotiated Rate	$438.93
Max. Negotiated Rate	$834.82
Rate for Payer: Cash Price	$559.42
Rate for Payer: Hawaii Western Management Group Commercial	$602.45
Rate for Payer: Health Management Network Commercial	$731.54
Rate for Payer: Kaiser Permanente Commercial	$542.20
Rate for Payer: Kaiser Permanente Medicaid	$438.93
Rate for Payer: MDX Hawaii PPO	$834.82
Rate for Payer: University Health Alliance Commercial	$481.96

Screw Comp Multi Thread Ti 3.0mm x 12mm MTNL-30120-TS [3642730]

Facility

$860.64

Service Code	HCPCS C1713
Hospital Charge Code	3642730
Hospital Revenue Code	278
Min. Negotiated Rate	$481.96
Max. Negotiated Rate	$834.82
Rate for Payer: Cash Price	$559.42
Rate for Payer: Hawaii Western Management Group Commercial	$602.45
Rate for Payer: Health Management Network Commercial	$731.54
Rate for Payer: MDX Hawaii PPO	$834.82
Rate for Payer: University Health Alliance Commercial	$481.96

Screw Comp Multi Thread Ti 3.0mm x 14mm MTNL-30140-TS [3642775]

Facility

$860.64

Service Code	HCPCS C1713
Hospital Charge Code	3642775
Hospital Revenue Code	278
Min. Negotiated Rate	$438.93
Max. Negotiated Rate	$834.82
Rate for Payer: Cash Price	$559.42
Rate for Payer: Hawaii Western Management Group Commercial	$602.45
Rate for Payer: Health Management Network Commercial	$731.54
Rate for Payer: Kaiser Permanente Commercial	$542.20
Rate for Payer: Kaiser Permanente Medicaid	$438.93
Rate for Payer: MDX Hawaii PPO	$834.82
Rate for Payer: University Health Alliance Commercial	$481.96

Screw Comp Multi Thread Ti 3.0mm x 14mm MTNL-30140-TS [3642775]

Facility

$860.64

Service Code	HCPCS C1713
Hospital Charge Code	3642775
Hospital Revenue Code	278
Min. Negotiated Rate	$481.96
Max. Negotiated Rate	$834.82
Rate for Payer: Cash Price	$559.42
Rate for Payer: Hawaii Western Management Group Commercial	$602.45
Rate for Payer: Health Management Network Commercial	$731.54
Rate for Payer: MDX Hawaii PPO	$834.82
Rate for Payer: University Health Alliance Commercial	$481.96

Screw Comp Multi Thread Ti 3.0mmX8mm MTNL30080TS [3642773]

Facility

$568.75

Service Code	HCPCS C1713
Hospital Charge Code	3642773
Hospital Revenue Code	278
Min. Negotiated Rate	$290.06
Max. Negotiated Rate	$551.69
Rate for Payer: Cash Price	$369.69
Rate for Payer: Hawaii Western Management Group Commercial	$398.12
Rate for Payer: Health Management Network Commercial	$483.44
Rate for Payer: Kaiser Permanente Commercial	$358.31
Rate for Payer: Kaiser Permanente Medicaid	$290.06
Rate for Payer: MDX Hawaii PPO	$551.69
Rate for Payer: University Health Alliance Commercial	$318.50

Screw Comp Multi Thread Ti 3.0mmX8mm MTNL30080TS [3642773]

Facility

$568.75

Service Code	HCPCS C1713
Hospital Charge Code	3642773
Hospital Revenue Code	278
Min. Negotiated Rate	$318.50
Max. Negotiated Rate	$551.69
Rate for Payer: Cash Price	$369.69
Rate for Payer: Hawaii Western Management Group Commercial	$398.12
Rate for Payer: Health Management Network Commercial	$483.44
Rate for Payer: MDX Hawaii PPO	$551.69
Rate for Payer: University Health Alliance Commercial	$318.50

Screw Comp Multi Thread Ti 3.5mmX20mm MTNL35200TS [3642737]

Facility

$726.25

Service Code	HCPCS C1713
Hospital Charge Code	3642737
Hospital Revenue Code	278
Min. Negotiated Rate	$406.70
Max. Negotiated Rate	$704.46
Rate for Payer: Cash Price	$472.06
Rate for Payer: Hawaii Western Management Group Commercial	$508.38
Rate for Payer: Health Management Network Commercial	$617.31
Rate for Payer: MDX Hawaii PPO	$704.46
Rate for Payer: University Health Alliance Commercial	$406.70

Screw Comp Multi Thread Ti 3.5mmX20mm MTNL35200TS [3642737]

Facility

$726.25

Service Code	HCPCS C1713
Hospital Charge Code	3642737
Hospital Revenue Code	278
Min. Negotiated Rate	$370.39
Max. Negotiated Rate	$704.46
Rate for Payer: Cash Price	$472.06
Rate for Payer: Hawaii Western Management Group Commercial	$508.38
Rate for Payer: Health Management Network Commercial	$617.31
Rate for Payer: Kaiser Permanente Commercial	$457.54
Rate for Payer: Kaiser Permanente Medicaid	$370.39
Rate for Payer: MDX Hawaii PPO	$704.46
Rate for Payer: University Health Alliance Commercial	$406.70

Screw Comp Multi Thread Ti 3.5mmx22mm MTNL-35220-TS [3643608]

Facility

$761.25

Service Code	HCPCS C1713
Hospital Charge Code	3643608
Hospital Revenue Code	278
Min. Negotiated Rate	$388.24
Max. Negotiated Rate	$738.41
Rate for Payer: Cash Price	$494.81
Rate for Payer: Hawaii Western Management Group Commercial	$532.88
Rate for Payer: Health Management Network Commercial	$647.06
Rate for Payer: Kaiser Permanente Commercial	$479.59
Rate for Payer: Kaiser Permanente Medicaid	$388.24
Rate for Payer: MDX Hawaii PPO	$738.41
Rate for Payer: University Health Alliance Commercial	$426.30

Screw Comp Multi Thread Ti 3.5mmx22mm MTNL-35220-TS [3643608]

Facility

$761.25

Service Code	HCPCS C1713
Hospital Charge Code	3643608
Hospital Revenue Code	278
Min. Negotiated Rate	$426.30
Max. Negotiated Rate	$738.41
Rate for Payer: Cash Price	$494.81
Rate for Payer: Hawaii Western Management Group Commercial	$532.88
Rate for Payer: Health Management Network Commercial	$647.06
Rate for Payer: MDX Hawaii PPO	$738.41
Rate for Payer: University Health Alliance Commercial	$426.30

Screw Comp Multi Thread Ti 3.5mmX24mm MTNL35240TS [3642738]

Facility

$726.25

Service Code	HCPCS C1713
Hospital Charge Code	3642738
Hospital Revenue Code	278
Min. Negotiated Rate	$370.39
Max. Negotiated Rate	$704.46
Rate for Payer: Cash Price	$472.06
Rate for Payer: Hawaii Western Management Group Commercial	$508.38
Rate for Payer: Health Management Network Commercial	$617.31
Rate for Payer: Kaiser Permanente Commercial	$457.54
Rate for Payer: Kaiser Permanente Medicaid	$370.39
Rate for Payer: MDX Hawaii PPO	$704.46
Rate for Payer: University Health Alliance Commercial	$406.70

Know your out-of-pocket cost for care.

All Charges