Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Screw LoPro SS Lock 2.7 x 12mm AR-8827L-12 [3643130]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3643130
Hospital Revenue Code	278
Min. Negotiated Rate	$646.89
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

Screw LoPro SS Lock 2.7 x 14mm AR-8827L-14 [3643131]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3643131
Hospital Revenue Code	278
Min. Negotiated Rate	$589.13
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: Kaiser Permanente Commercial	$727.75
Rate for Payer: Kaiser Permanente Medicaid	$589.13
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

Screw LoPro SS Lock 2.7 x 14mm AR-8827L-14 [3643131]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3643131
Hospital Revenue Code	278
Min. Negotiated Rate	$646.89
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

Screw LoPro SS Lock 2.7 x 18mm AR8827L18 [3640781]

Facility

$1,010.58

Service Code	HCPCS C1713
Hospital Charge Code	3640781
Hospital Revenue Code	278
Min. Negotiated Rate	$515.40
Max. Negotiated Rate	$980.26
Rate for Payer: Cash Price	$656.88
Rate for Payer: Hawaii Western Management Group Commercial	$707.41
Rate for Payer: Health Management Network Commercial	$858.99
Rate for Payer: Kaiser Permanente Commercial	$636.67
Rate for Payer: Kaiser Permanente Medicaid	$515.40
Rate for Payer: MDX Hawaii PPO	$980.26
Rate for Payer: University Health Alliance Commercial	$565.92

Screw LoPro SS Lock 2.7 x 18mm AR8827L18 [3640781]

Facility

$1,010.58

Service Code	HCPCS C1713
Hospital Charge Code	3640781
Hospital Revenue Code	278
Min. Negotiated Rate	$565.92
Max. Negotiated Rate	$980.26
Rate for Payer: Cash Price	$656.88
Rate for Payer: Hawaii Western Management Group Commercial	$707.41
Rate for Payer: Health Management Network Commercial	$858.99
Rate for Payer: MDX Hawaii PPO	$980.26
Rate for Payer: University Health Alliance Commercial	$565.92

Screw Lopro Ti 3.5mm x 18mm AR-8935-18 [3644986]

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	3644986
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

Screw Lopro Ti 3.5mm x 18mm AR-8935-18 [3644986]

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	3644986
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 Ti 3.5mm x 22mm AR-8935-22 [3644987]

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	3644987
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 Ti 3.5mm x 22mm AR-8935-22 [3644987]

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	3644987
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

Screw Lo-Pro Ti 3.5mm x 24mm AR-8935-24 [3642680]

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	3642680
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

Screw Lo-Pro Ti 3.5mm x 24mm AR-8935-24 [3642680]

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	3642680
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 TM SS 3.5 x 10mm Cort AR-8835-10 [3627481]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3627481
Hospital Revenue Code	278
Min. Negotiated Rate	$216.94
Max. Negotiated Rate	$412.62
Rate for Payer: Cash Price	$276.50
Rate for Payer: Hawaii Western Management Group Commercial	$297.77
Rate for Payer: Health Management Network Commercial	$361.57
Rate for Payer: Kaiser Permanente Commercial	$267.99
Rate for Payer: Kaiser Permanente Medicaid	$216.94
Rate for Payer: MDX Hawaii PPO	$412.62
Rate for Payer: University Health Alliance Commercial	$238.21

Screw LoPro TM SS 3.5 x 10mm Cort AR-8835-10 [3627481]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3627481
Hospital Revenue Code	278
Min. Negotiated Rate	$238.21
Max. Negotiated Rate	$412.62
Rate for Payer: Cash Price	$276.50
Rate for Payer: Hawaii Western Management Group Commercial	$297.77
Rate for Payer: Health Management Network Commercial	$361.57
Rate for Payer: MDX Hawaii PPO	$412.62
Rate for Payer: University Health Alliance Commercial	$238.21

Screw LoPro TM SS 3.5 x 10mm Lock AR-8835L-10 [3641601]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3641601
Hospital Revenue Code	278
Min. Negotiated Rate	$589.13
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: Kaiser Permanente Commercial	$727.75
Rate for Payer: Kaiser Permanente Medicaid	$589.13
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

Screw LoPro TM SS 3.5 x 10mm Lock AR-8835L-10 [3641601]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3641601
Hospital Revenue Code	278
Min. Negotiated Rate	$646.89
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

Screw LoPro TM SS 3.5 x 12mm Cort AR-8835-12 [3641453]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3641453
Hospital Revenue Code	278
Min. Negotiated Rate	$238.21
Max. Negotiated Rate	$412.62
Rate for Payer: Cash Price	$276.50
Rate for Payer: Hawaii Western Management Group Commercial	$297.77
Rate for Payer: Health Management Network Commercial	$361.57
Rate for Payer: MDX Hawaii PPO	$412.62
Rate for Payer: University Health Alliance Commercial	$238.21

Screw LoPro TM SS 3.5 x 12mm Cort AR-8835-12 [3641453]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3641453
Hospital Revenue Code	278
Min. Negotiated Rate	$216.94
Max. Negotiated Rate	$412.62
Rate for Payer: Cash Price	$276.50
Rate for Payer: Hawaii Western Management Group Commercial	$297.77
Rate for Payer: Health Management Network Commercial	$361.57
Rate for Payer: Kaiser Permanente Commercial	$267.99
Rate for Payer: Kaiser Permanente Medicaid	$216.94
Rate for Payer: MDX Hawaii PPO	$412.62
Rate for Payer: University Health Alliance Commercial	$238.21

Screw LoPro TM SS 3.5 x 12mm Lock AR-8835L-12 [3641455]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3641455
Hospital Revenue Code	278
Min. Negotiated Rate	$589.13
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: Kaiser Permanente Commercial	$727.75
Rate for Payer: Kaiser Permanente Medicaid	$589.13
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

Screw LoPro TM SS 3.5 x 12mm Lock AR-8835L-12 [3641455]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3641455
Hospital Revenue Code	278
Min. Negotiated Rate	$646.89
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

Screw LoPro TM SS 3.5 x 14mm Cort AR-8835-14 [3627481A]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3627481A
Hospital Revenue Code	278
Min. Negotiated Rate	$238.21
Max. Negotiated Rate	$412.62
Rate for Payer: Cash Price	$276.50
Rate for Payer: Hawaii Western Management Group Commercial	$297.77
Rate for Payer: Health Management Network Commercial	$361.57
Rate for Payer: MDX Hawaii PPO	$412.62
Rate for Payer: University Health Alliance Commercial	$238.21

Screw LoPro TM SS 3.5 x 14mm Cort AR-8835-14 [3627481A]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3627481A
Hospital Revenue Code	278
Min. Negotiated Rate	$216.94
Max. Negotiated Rate	$412.62
Rate for Payer: Cash Price	$276.50
Rate for Payer: Hawaii Western Management Group Commercial	$297.77
Rate for Payer: Health Management Network Commercial	$361.57
Rate for Payer: Kaiser Permanente Commercial	$267.99
Rate for Payer: Kaiser Permanente Medicaid	$216.94
Rate for Payer: MDX Hawaii PPO	$412.62
Rate for Payer: University Health Alliance Commercial	$238.21

Screw LoPro TM SS 3.5 x 14mm Lock AR-8835L-14 [3642834]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3642834
Hospital Revenue Code	278
Min. Negotiated Rate	$646.89
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

Screw LoPro TM SS 3.5 x 14mm Lock AR-8835L-14 [3642834]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3642834
Hospital Revenue Code	278
Min. Negotiated Rate	$589.13
Max. Negotiated Rate	$1,120.51
Rate for Payer: Cash Price	$750.85
Rate for Payer: Hawaii Western Management Group Commercial	$808.61
Rate for Payer: Health Management Network Commercial	$981.89
Rate for Payer: Kaiser Permanente Commercial	$727.75
Rate for Payer: Kaiser Permanente Medicaid	$589.13
Rate for Payer: MDX Hawaii PPO	$1,120.51
Rate for Payer: University Health Alliance Commercial	$646.89

Screw LoPro TM SS 3.5 x 16mm Cort AR-8835-16 [3643227]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3643227
Hospital Revenue Code	278
Min. Negotiated Rate	$216.94
Max. Negotiated Rate	$412.62
Rate for Payer: Cash Price	$276.50
Rate for Payer: Hawaii Western Management Group Commercial	$297.77
Rate for Payer: Health Management Network Commercial	$361.57
Rate for Payer: Kaiser Permanente Commercial	$267.99
Rate for Payer: Kaiser Permanente Medicaid	$216.94
Rate for Payer: MDX Hawaii PPO	$412.62
Rate for Payer: University Health Alliance Commercial	$238.21

Screw LoPro TM SS 3.5 x 16mm Cort AR-8835-16 [3643227]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3643227
Hospital Revenue Code	278
Min. Negotiated Rate	$238.21
Max. Negotiated Rate	$412.62
Rate for Payer: Cash Price	$276.50
Rate for Payer: Hawaii Western Management Group Commercial	$297.77
Rate for Payer: Health Management Network Commercial	$361.57
Rate for Payer: MDX Hawaii PPO	$412.62
Rate for Payer: University Health Alliance Commercial	$238.21

Know your out-of-pocket cost for care.

All Charges