Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Screw Fluted Lock Ti 2.3mm x 12mm TPFL-23120-TS [3644290]

Facility

$694.63

Service Code	HCPCS C1713
Hospital Charge Code	3644290
Hospital Revenue Code	278
Min. Negotiated Rate	$354.26
Max. Negotiated Rate	$673.79
Rate for Payer: Cash Price	$451.51
Rate for Payer: Hawaii Western Management Group Commercial	$486.24
Rate for Payer: Health Management Network Commercial	$590.44
Rate for Payer: Kaiser Permanente Commercial	$437.62
Rate for Payer: Kaiser Permanente Medicaid	$354.26
Rate for Payer: MDX Hawaii PPO	$673.79
Rate for Payer: University Health Alliance Commercial	$388.99

Screw Fluted Lock Ti 2.3mm x 12mm TPFL-23120-TS [3644290]

Facility

$694.63

Service Code	HCPCS C1713
Hospital Charge Code	3644290
Hospital Revenue Code	278
Min. Negotiated Rate	$388.99
Max. Negotiated Rate	$673.79
Rate for Payer: Cash Price	$451.51
Rate for Payer: Hawaii Western Management Group Commercial	$486.24
Rate for Payer: Health Management Network Commercial	$590.44
Rate for Payer: MDX Hawaii PPO	$673.79
Rate for Payer: University Health Alliance Commercial	$388.99

Screw Fluted Lock Ti 2.3mm x 30mm TPFL-23300-TS [3644291]

Facility

$694.63

Service Code	HCPCS C1713
Hospital Charge Code	3644291
Hospital Revenue Code	278
Min. Negotiated Rate	$388.99
Max. Negotiated Rate	$673.79
Rate for Payer: Cash Price	$451.51
Rate for Payer: Hawaii Western Management Group Commercial	$486.24
Rate for Payer: Health Management Network Commercial	$590.44
Rate for Payer: MDX Hawaii PPO	$673.79
Rate for Payer: University Health Alliance Commercial	$388.99

Screw Fluted Lock Ti 2.3mm x 30mm TPFL-23300-TS [3644291]

Facility

$694.63

Service Code	HCPCS C1713
Hospital Charge Code	3644291
Hospital Revenue Code	278
Min. Negotiated Rate	$354.26
Max. Negotiated Rate	$673.79
Rate for Payer: Cash Price	$451.51
Rate for Payer: Hawaii Western Management Group Commercial	$486.24
Rate for Payer: Health Management Network Commercial	$590.44
Rate for Payer: Kaiser Permanente Commercial	$437.62
Rate for Payer: Kaiser Permanente Medicaid	$354.26
Rate for Payer: MDX Hawaii PPO	$673.79
Rate for Payer: University Health Alliance Commercial	$388.99

Screw Fluted Lock Ti 2.3mm x 32mm TPFL-23320-TS [3644292]

Facility

$694.63

Service Code	HCPCS C1713
Hospital Charge Code	3644292
Hospital Revenue Code	278
Min. Negotiated Rate	$354.26
Max. Negotiated Rate	$673.79
Rate for Payer: Cash Price	$451.51
Rate for Payer: Hawaii Western Management Group Commercial	$486.24
Rate for Payer: Health Management Network Commercial	$590.44
Rate for Payer: Kaiser Permanente Commercial	$437.62
Rate for Payer: Kaiser Permanente Medicaid	$354.26
Rate for Payer: MDX Hawaii PPO	$673.79
Rate for Payer: University Health Alliance Commercial	$388.99

Screw Fluted Lock Ti 2.3mm x 32mm TPFL-23320-TS [3644292]

Facility

$694.63

Service Code	HCPCS C1713
Hospital Charge Code	3644292
Hospital Revenue Code	278
Min. Negotiated Rate	$388.99
Max. Negotiated Rate	$673.79
Rate for Payer: Cash Price	$451.51
Rate for Payer: Hawaii Western Management Group Commercial	$486.24
Rate for Payer: Health Management Network Commercial	$590.44
Rate for Payer: MDX Hawaii PPO	$673.79
Rate for Payer: University Health Alliance Commercial	$388.99

Screw Fully Threaded 1.2mmx10mm 331-1210 [3643887]

Facility

$460.75

Service Code	HCPCS C1713
Hospital Charge Code	3643887
Hospital Revenue Code	278
Min. Negotiated Rate	$234.98
Max. Negotiated Rate	$446.93
Rate for Payer: Cash Price	$299.49
Rate for Payer: Hawaii Western Management Group Commercial	$322.52
Rate for Payer: Health Management Network Commercial	$391.64
Rate for Payer: Kaiser Permanente Commercial	$290.27
Rate for Payer: Kaiser Permanente Medicaid	$234.98
Rate for Payer: MDX Hawaii PPO	$446.93
Rate for Payer: University Health Alliance Commercial	$258.02

Screw Fully Threaded 1.2mmx10mm 331-1210 [3643887]

Facility

$460.75

Service Code	HCPCS C1713
Hospital Charge Code	3643887
Hospital Revenue Code	278
Min. Negotiated Rate	$258.02
Max. Negotiated Rate	$446.93
Rate for Payer: Cash Price	$299.49
Rate for Payer: Hawaii Western Management Group Commercial	$322.52
Rate for Payer: Health Management Network Commercial	$391.64
Rate for Payer: MDX Hawaii PPO	$446.93
Rate for Payer: University Health Alliance Commercial	$258.02

Screw Fully Threaded 1.2mmx12mm 331-1212 [3643888]

Facility

$460.75

Service Code	HCPCS C1713
Hospital Charge Code	3643888
Hospital Revenue Code	278
Min. Negotiated Rate	$234.98
Max. Negotiated Rate	$446.93
Rate for Payer: Cash Price	$299.49
Rate for Payer: Hawaii Western Management Group Commercial	$322.52
Rate for Payer: Health Management Network Commercial	$391.64
Rate for Payer: Kaiser Permanente Commercial	$290.27
Rate for Payer: Kaiser Permanente Medicaid	$234.98
Rate for Payer: MDX Hawaii PPO	$446.93
Rate for Payer: University Health Alliance Commercial	$258.02

Screw Fully Threaded 1.2mmx12mm 331-1212 [3643888]

Facility

$460.75

Service Code	HCPCS C1713
Hospital Charge Code	3643888
Hospital Revenue Code	278
Min. Negotiated Rate	$258.02
Max. Negotiated Rate	$446.93
Rate for Payer: Cash Price	$299.49
Rate for Payer: Hawaii Western Management Group Commercial	$322.52
Rate for Payer: Health Management Network Commercial	$391.64
Rate for Payer: MDX Hawaii PPO	$446.93
Rate for Payer: University Health Alliance Commercial	$258.02

Screw Fully Threaded 1.2mmx16mm 331-1216 [3643889]

Facility

$460.75

Service Code	HCPCS C1713
Hospital Charge Code	3643889
Hospital Revenue Code	278
Min. Negotiated Rate	$234.98
Max. Negotiated Rate	$446.93
Rate for Payer: Cash Price	$299.49
Rate for Payer: Hawaii Western Management Group Commercial	$322.52
Rate for Payer: Health Management Network Commercial	$391.64
Rate for Payer: Kaiser Permanente Commercial	$290.27
Rate for Payer: Kaiser Permanente Medicaid	$234.98
Rate for Payer: MDX Hawaii PPO	$446.93
Rate for Payer: University Health Alliance Commercial	$258.02

Screw Fully Threaded 1.2mmx16mm 331-1216 [3643889]

Facility

$460.75

Service Code	HCPCS C1713
Hospital Charge Code	3643889
Hospital Revenue Code	278
Min. Negotiated Rate	$258.02
Max. Negotiated Rate	$446.93
Rate for Payer: Cash Price	$299.49
Rate for Payer: Hawaii Western Management Group Commercial	$322.52
Rate for Payer: Health Management Network Commercial	$391.64
Rate for Payer: MDX Hawaii PPO	$446.93
Rate for Payer: University Health Alliance Commercial	$258.02

Screw Fully Threaded 1.6mmX10mm 331-1610 [3641770]

Facility

$602.19

Service Code	HCPCS C1713
Hospital Charge Code	3641770
Hospital Revenue Code	278
Min. Negotiated Rate	$307.12
Max. Negotiated Rate	$584.12
Rate for Payer: Cash Price	$391.42
Rate for Payer: Hawaii Western Management Group Commercial	$421.53
Rate for Payer: Health Management Network Commercial	$511.86
Rate for Payer: Kaiser Permanente Commercial	$379.38
Rate for Payer: Kaiser Permanente Medicaid	$307.12
Rate for Payer: MDX Hawaii PPO	$584.12
Rate for Payer: University Health Alliance Commercial	$337.23

Screw Fully Threaded 1.6mmX10mm 331-1610 [3641770]

Facility

$602.19

Service Code	HCPCS C1713
Hospital Charge Code	3641770
Hospital Revenue Code	278
Min. Negotiated Rate	$337.23
Max. Negotiated Rate	$584.12
Rate for Payer: Cash Price	$391.42
Rate for Payer: Hawaii Western Management Group Commercial	$421.53
Rate for Payer: Health Management Network Commercial	$511.86
Rate for Payer: MDX Hawaii PPO	$584.12
Rate for Payer: University Health Alliance Commercial	$337.23

Screw Fully Threaded 1.6mmX11mm 331-1611 [3641771]

Facility

$667.86

Service Code	HCPCS C1713
Hospital Charge Code	3641771
Hospital Revenue Code	278
Min. Negotiated Rate	$340.61
Max. Negotiated Rate	$647.82
Rate for Payer: Cash Price	$434.11
Rate for Payer: Hawaii Western Management Group Commercial	$467.50
Rate for Payer: Health Management Network Commercial	$567.68
Rate for Payer: Kaiser Permanente Commercial	$420.75
Rate for Payer: Kaiser Permanente Medicaid	$340.61
Rate for Payer: MDX Hawaii PPO	$647.82
Rate for Payer: University Health Alliance Commercial	$374.00

Screw Fully Threaded 1.6mmX11mm 331-1611 [3641771]

Facility

$667.86

Service Code	HCPCS C1713
Hospital Charge Code	3641771
Hospital Revenue Code	278
Min. Negotiated Rate	$374.00
Max. Negotiated Rate	$647.82
Rate for Payer: Cash Price	$434.11
Rate for Payer: Hawaii Western Management Group Commercial	$467.50
Rate for Payer: Health Management Network Commercial	$567.68
Rate for Payer: MDX Hawaii PPO	$647.82
Rate for Payer: University Health Alliance Commercial	$374.00

Screw Fully Threaded 1.6mmX12mm 331-1612 [3642296]

Facility

$667.86

Service Code	HCPCS C1713
Hospital Charge Code	3642296
Hospital Revenue Code	278
Min. Negotiated Rate	$340.61
Max. Negotiated Rate	$647.82
Rate for Payer: Cash Price	$434.11
Rate for Payer: Hawaii Western Management Group Commercial	$467.50
Rate for Payer: Health Management Network Commercial	$567.68
Rate for Payer: Kaiser Permanente Commercial	$420.75
Rate for Payer: Kaiser Permanente Medicaid	$340.61
Rate for Payer: MDX Hawaii PPO	$647.82
Rate for Payer: University Health Alliance Commercial	$374.00

Screw Fully Threaded 1.6mmX12mm 331-1612 [3642296]

Facility

$667.86

Service Code	HCPCS C1713
Hospital Charge Code	3642296
Hospital Revenue Code	278
Min. Negotiated Rate	$374.00
Max. Negotiated Rate	$647.82
Rate for Payer: Cash Price	$434.11
Rate for Payer: Hawaii Western Management Group Commercial	$467.50
Rate for Payer: Health Management Network Commercial	$567.68
Rate for Payer: MDX Hawaii PPO	$647.82
Rate for Payer: University Health Alliance Commercial	$374.00

Screw Fully Threaded 1.6mmX6mm 331-1606 [3642293]

Facility

$423.94

Service Code	HCPCS C1713
Hospital Charge Code	3642293
Hospital Revenue Code	278
Min. Negotiated Rate	$216.21
Max. Negotiated Rate	$411.22
Rate for Payer: Cash Price	$275.56
Rate for Payer: Hawaii Western Management Group Commercial	$296.76
Rate for Payer: Health Management Network Commercial	$360.35
Rate for Payer: Kaiser Permanente Commercial	$267.08
Rate for Payer: Kaiser Permanente Medicaid	$216.21
Rate for Payer: MDX Hawaii PPO	$411.22
Rate for Payer: University Health Alliance Commercial	$237.41

Screw Fully Threaded 1.6mmX6mm 331-1606 [3642293]

Facility

$423.94

Service Code	HCPCS C1713
Hospital Charge Code	3642293
Hospital Revenue Code	278
Min. Negotiated Rate	$237.41
Max. Negotiated Rate	$411.22
Rate for Payer: Cash Price	$275.56
Rate for Payer: Hawaii Western Management Group Commercial	$296.76
Rate for Payer: Health Management Network Commercial	$360.35
Rate for Payer: MDX Hawaii PPO	$411.22
Rate for Payer: University Health Alliance Commercial	$237.41

Screw Fully Threaded 1.6mmX8mm 331-1608 [3642295]

Facility

$423.94

Service Code	HCPCS C1713
Hospital Charge Code	3642295
Hospital Revenue Code	278
Min. Negotiated Rate	$216.21
Max. Negotiated Rate	$411.22
Rate for Payer: Cash Price	$275.56
Rate for Payer: Hawaii Western Management Group Commercial	$296.76
Rate for Payer: Health Management Network Commercial	$360.35
Rate for Payer: Kaiser Permanente Commercial	$267.08
Rate for Payer: Kaiser Permanente Medicaid	$216.21
Rate for Payer: MDX Hawaii PPO	$411.22
Rate for Payer: University Health Alliance Commercial	$237.41

Screw Fully Threaded 1.6mmX8mm 331-1608 [3642295]

Facility

$423.94

Service Code	HCPCS C1713
Hospital Charge Code	3642295
Hospital Revenue Code	278
Min. Negotiated Rate	$237.41
Max. Negotiated Rate	$411.22
Rate for Payer: Cash Price	$275.56
Rate for Payer: Hawaii Western Management Group Commercial	$296.76
Rate for Payer: Health Management Network Commercial	$360.35
Rate for Payer: MDX Hawaii PPO	$411.22
Rate for Payer: University Health Alliance Commercial	$237.41

Screw Fully Threaded 1.6mmX9mm 331-1609 [3641769]

Facility

$667.86

Service Code	HCPCS C1713
Hospital Charge Code	3641769
Hospital Revenue Code	278
Min. Negotiated Rate	$340.61
Max. Negotiated Rate	$647.82
Rate for Payer: Cash Price	$434.11
Rate for Payer: Hawaii Western Management Group Commercial	$467.50
Rate for Payer: Health Management Network Commercial	$567.68
Rate for Payer: Kaiser Permanente Commercial	$420.75
Rate for Payer: Kaiser Permanente Medicaid	$340.61
Rate for Payer: MDX Hawaii PPO	$647.82
Rate for Payer: University Health Alliance Commercial	$374.00

Screw Fully Threaded 1.6mmX9mm 331-1609 [3641769]

Facility

$667.86

Service Code	HCPCS C1713
Hospital Charge Code	3641769
Hospital Revenue Code	278
Min. Negotiated Rate	$374.00
Max. Negotiated Rate	$647.82
Rate for Payer: Cash Price	$434.11
Rate for Payer: Hawaii Western Management Group Commercial	$467.50
Rate for Payer: Health Management Network Commercial	$567.68
Rate for Payer: MDX Hawaii PPO	$647.82
Rate for Payer: University Health Alliance Commercial	$374.00

Screw Fully Threaded 2.0mmX10mm 331-2010 [3641847]

Facility

$423.94

Service Code	HCPCS C1713
Hospital Charge Code	3641847
Hospital Revenue Code	278
Min. Negotiated Rate	$237.41
Max. Negotiated Rate	$411.22
Rate for Payer: Cash Price	$275.56
Rate for Payer: Hawaii Western Management Group Commercial	$296.76
Rate for Payer: Health Management Network Commercial	$360.35
Rate for Payer: MDX Hawaii PPO	$411.22
Rate for Payer: University Health Alliance Commercial	$237.41

Know your out-of-pocket cost for care.

All Charges