Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Screw LoPro TM SS 3.5 x 16mm Lock AR-8835L-16 [3627482]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3627482
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 16mm Lock AR-8835L-16 [3627482]

Facility

$1,155.16

Service Code	HCPCS C1713
Hospital Charge Code	3627482
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 18mm Cort AR-8835-18 [3644997]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3644997
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 18mm Cort AR-8835-18 [3644997]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3644997
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 20mm Cort AR-8835-20 [3644397]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3644397
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 20mm Cort AR-8835-20 [3644397]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3644397
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 22mm Cort AR-8835-22 [3642831]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3642831
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 22mm Cort AR-8835-22 [3642831]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3642831
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 24mm Cort AR-8835-24 [3644228]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3644228
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 24mm Cort AR-8835-24 [3644228]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3644228
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 26mm Cort AR-8835-26 [3642832]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3642832
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 26mm Cort AR-8835-26 [3642832]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3642832
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 28mm Cort AR-8835-28 [3643228]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3643228
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 28mm Cort AR-8835-28 [3643228]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3643228
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 32mm Cort AR-8835-32 [3642833]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3642833
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 32mm Cort AR-8835-32 [3642833]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3642833
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 32mm Lock AR-8835L-32 [3642838]

Facility

$1,010.58

Service Code	HCPCS C1713
Hospital Charge Code	3642838
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 TM SS 3.5 x 32mm Lock AR-8835L-32 [3642838]

Facility

$1,010.58

Service Code	HCPCS C1713
Hospital Charge Code	3642838
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 TM SS 3.5 x 50mm Cort AR-8835-50 [3644440]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3644440
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 50mm Cort AR-8835-50 [3644440]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3644440
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 55mm Cort AR-8835-55 [3644441]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3644441
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 55mm Cort AR-8835-55 [3644441]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3644441
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 3.5x80mm Cort AR-8835-80 [3645425]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3645425
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 3.5x80mm Cort AR-8835-80 [3645425]

Facility

$425.38

Service Code	HCPCS C1713
Hospital Charge Code	3645425
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 Lo-Pro TM SS Cortex 2.7 x 14mm AR-8827-14 [3644669]

Facility

$520.25

Service Code	HCPCS C1713
Hospital Charge Code	3644669
Hospital Revenue Code	278
Min. Negotiated Rate	$291.34
Max. Negotiated Rate	$504.64
Rate for Payer: Cash Price	$338.16
Rate for Payer: Hawaii Western Management Group Commercial	$364.18
Rate for Payer: Health Management Network Commercial	$442.21
Rate for Payer: MDX Hawaii PPO	$504.64
Rate for Payer: University Health Alliance Commercial	$291.34

Know your out-of-pocket cost for care.

All Charges