Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Screw Lopro 2.0 x 13mm Cort AR-18720-13 [3644789]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644789
Hospital Revenue Code	278
Min. Negotiated Rate	$567.28
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: Kaiser Permanente Commercial	$700.76
Rate for Payer: Kaiser Permanente Medicaid	$567.28
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.0 x 14mm Cort AR-18720-14 [3644473]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644473
Hospital Revenue Code	278
Min. Negotiated Rate	$567.28
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: Kaiser Permanente Commercial	$700.76
Rate for Payer: Kaiser Permanente Medicaid	$567.28
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.0 x 14mm Cort AR-18720-14 [3644473]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644473
Hospital Revenue Code	278
Min. Negotiated Rate	$622.90
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.0 x 16mm Cort AR-18720-16 [3644474]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644474
Hospital Revenue Code	278
Min. Negotiated Rate	$567.28
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: Kaiser Permanente Commercial	$700.76
Rate for Payer: Kaiser Permanente Medicaid	$567.28
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.0 x 16mm Cort AR-18720-16 [3644474]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644474
Hospital Revenue Code	278
Min. Negotiated Rate	$622.90
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.0 x 18mm Cort AR-18720-18 [3644475]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644475
Hospital Revenue Code	278
Min. Negotiated Rate	$622.90
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.0 x 18mm Cort AR-18720-18 [3644475]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644475
Hospital Revenue Code	278
Min. Negotiated Rate	$567.28
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: Kaiser Permanente Commercial	$700.76
Rate for Payer: Kaiser Permanente Medicaid	$567.28
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.0 x 8mm Cort AR-18720-08 [3644470]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644470
Hospital Revenue Code	278
Min. Negotiated Rate	$567.28
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: Kaiser Permanente Commercial	$700.76
Rate for Payer: Kaiser Permanente Medicaid	$567.28
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.0 x 8mm Cort AR-18720-08 [3644470]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644470
Hospital Revenue Code	278
Min. Negotiated Rate	$622.90
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.0 x 9mm Cort AR-18720-09 [3644471]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644471
Hospital Revenue Code	278
Min. Negotiated Rate	$567.28
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: Kaiser Permanente Commercial	$700.76
Rate for Payer: Kaiser Permanente Medicaid	$567.28
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.0 x 9mm Cort AR-18720-09 [3644471]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644471
Hospital Revenue Code	278
Min. Negotiated Rate	$622.90
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.4 x 14mm Cort AR-18724-14 [3644583]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644583
Hospital Revenue Code	278
Min. Negotiated Rate	$567.28
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: Kaiser Permanente Commercial	$700.76
Rate for Payer: Kaiser Permanente Medicaid	$567.28
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.4 x 14mm Cort AR-18724-14 [3644583]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644583
Hospital Revenue Code	278
Min. Negotiated Rate	$622.90
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.4 x 15mm Cort AR-18724-15 [3644584]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644584
Hospital Revenue Code	278
Min. Negotiated Rate	$622.90
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.4 x 15mm Cort AR-18724-15 [3644584]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644584
Hospital Revenue Code	278
Min. Negotiated Rate	$567.28
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: Kaiser Permanente Commercial	$700.76
Rate for Payer: Kaiser Permanente Medicaid	$567.28
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.4 x 16mm Cort AR-18724-16 [3644585]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644585
Hospital Revenue Code	278
Min. Negotiated Rate	$567.28
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: Kaiser Permanente Commercial	$700.76
Rate for Payer: Kaiser Permanente Medicaid	$567.28
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.4 x 16mm Cort AR-18724-16 [3644585]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644585
Hospital Revenue Code	278
Min. Negotiated Rate	$622.90
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.4 x 20mm Cortex AR-8916CX24-20 [3644602]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644602
Hospital Revenue Code	278
Min. Negotiated Rate	$567.28
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: Kaiser Permanente Commercial	$700.76
Rate for Payer: Kaiser Permanente Medicaid	$567.28
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.4 x 20mm Cortex AR-8916CX24-20 [3644602]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644602
Hospital Revenue Code	278
Min. Negotiated Rate	$622.90
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.4 x 22mm Cort AR-18724-22 [3644586]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644586
Hospital Revenue Code	278
Min. Negotiated Rate	$622.90
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.4 x 22mm Cort AR-18724-22 [3644586]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644586
Hospital Revenue Code	278
Min. Negotiated Rate	$567.28
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: Kaiser Permanente Commercial	$700.76
Rate for Payer: Kaiser Permanente Medicaid	$567.28
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.4 x 24mm Cortex AR-8916CX24-24 [3644603]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644603
Hospital Revenue Code	278
Min. Negotiated Rate	$567.28
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: Kaiser Permanente Commercial	$700.76
Rate for Payer: Kaiser Permanente Medicaid	$567.28
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 2.4 x 24mm Cortex AR-8916CX24-24 [3644603]

Facility

$1,112.32

Service Code	HCPCS C1713
Hospital Charge Code	3644603
Hospital Revenue Code	278
Min. Negotiated Rate	$622.90
Max. Negotiated Rate	$1,078.95
Rate for Payer: Cash Price	$723.01
Rate for Payer: Hawaii Western Management Group Commercial	$778.62
Rate for Payer: Health Management Network Commercial	$945.47
Rate for Payer: MDX Hawaii PPO	$1,078.95
Rate for Payer: University Health Alliance Commercial	$622.90

Screw Lopro 3.5 x 16mm DRP Cort AR-8735-16 [3644597]

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	3644597
Hospital Revenue Code	278
Min. Negotiated Rate	$371.00
Max. Negotiated Rate	$642.62
Rate for Payer: Cash Price	$430.62
Rate for Payer: Hawaii Western Management Group Commercial	$463.75
Rate for Payer: Health Management Network Commercial	$563.12
Rate for Payer: MDX Hawaii PPO	$642.62
Rate for Payer: University Health Alliance Commercial	$371.00

Screw Lopro 3.5 x 16mm DRP Cort AR-8735-16 [3644597]

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	3644597
Hospital Revenue Code	278
Min. Negotiated Rate	$337.88
Max. Negotiated Rate	$642.62
Rate for Payer: Cash Price	$430.62
Rate for Payer: Hawaii Western Management Group Commercial	$463.75
Rate for Payer: Health Management Network Commercial	$563.12
Rate for Payer: Kaiser Permanente Commercial	$417.38
Rate for Payer: Kaiser Permanente Medicaid	$337.88
Rate for Payer: MDX Hawaii PPO	$642.62
Rate for Payer: University Health Alliance Commercial	$371.00

Know your out-of-pocket cost for care.

All Charges