Kona Community Hospital

All Charges

Charge

Type

Setting

Price

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	$265.33
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: Kaiser Permanente Commercial	$327.76
Rate for Payer: Kaiser Permanente Medicaid	$265.33
Rate for Payer: MDX Hawaii PPO	$504.64
Rate for Payer: University Health Alliance Commercial	$291.34

Screw Lo-Pro Tm Ss Cortex 2.7 x 16mm AR-8827-16 [3644345]

Facility

$520.25

Service Code	HCPCS C1713
Hospital Charge Code	3644345
Hospital Revenue Code	278
Min. Negotiated Rate	$265.33
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: Kaiser Permanente Commercial	$327.76
Rate for Payer: Kaiser Permanente Medicaid	$265.33
Rate for Payer: MDX Hawaii PPO	$504.64
Rate for Payer: University Health Alliance Commercial	$291.34

Screw Lo-Pro Tm Ss Cortex 2.7 x 16mm AR-8827-16 [3644345]

Facility

$520.25

Service Code	HCPCS C1713
Hospital Charge Code	3644345
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

Screw Lo-Pro Tm Ss Cortex 2.7 x 18mm AR-8827-18 [3644346]

Facility

$520.25

Service Code	HCPCS C1713
Hospital Charge Code	3644346
Hospital Revenue Code	278
Min. Negotiated Rate	$265.33
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: Kaiser Permanente Commercial	$327.76
Rate for Payer: Kaiser Permanente Medicaid	$265.33
Rate for Payer: MDX Hawaii PPO	$504.64
Rate for Payer: University Health Alliance Commercial	$291.34

Screw Lo-Pro Tm Ss Cortex 2.7 x 18mm AR-8827-18 [3644346]

Facility

$520.25

Service Code	HCPCS C1713
Hospital Charge Code	3644346
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

Screw Lo-pro TM SS Cortex 2.7 x 20mm AR-8827-20 [3644785]

Facility

$520.25

Service Code	HCPCS C1713
Hospital Charge Code	3644785
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

Screw Lo-pro TM SS Cortex 2.7 x 20mm AR-8827-20 [3644785]

Facility

$520.25

Service Code	HCPCS C1713
Hospital Charge Code	3644785
Hospital Revenue Code	278
Min. Negotiated Rate	$265.33
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: Kaiser Permanente Commercial	$327.76
Rate for Payer: Kaiser Permanente Medicaid	$265.33
Rate for Payer: MDX Hawaii PPO	$504.64
Rate for Payer: University Health Alliance Commercial	$291.34

Screw Lo-Pro TM SS Cortex 2.7 x 32mm AR-8827-32 [3644670]

Facility

$520.25

Service Code	HCPCS C1713
Hospital Charge Code	3644670
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

Screw Lo-Pro TM SS Cortex 2.7 x 32mm AR-8827-32 [3644670]

Facility

$520.25

Service Code	HCPCS C1713
Hospital Charge Code	3644670
Hospital Revenue Code	278
Min. Negotiated Rate	$265.33
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: Kaiser Permanente Commercial	$327.76
Rate for Payer: Kaiser Permanente Medicaid	$265.33
Rate for Payer: MDX Hawaii PPO	$504.64
Rate for Payer: University Health Alliance Commercial	$291.34

Screw Lo-Pro TM SS Cortex 2.7 x 40mm AR-8827-40 [3644761]

Facility

$520.25

Service Code	HCPCS C1713
Hospital Charge Code	3644761
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

Screw Lo-Pro TM SS Cortex 2.7 x 40mm AR-8827-40 [3644761]

Facility

$520.25

Service Code	HCPCS C1713
Hospital Charge Code	3644761
Hospital Revenue Code	278
Min. Negotiated Rate	$265.33
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: Kaiser Permanente Commercial	$327.76
Rate for Payer: Kaiser Permanente Medicaid	$265.33
Rate for Payer: MDX Hawaii PPO	$504.64
Rate for Payer: University Health Alliance Commercial	$291.34

Screw Lo-Pro TM SS Cortex 2.7 x 42mm AR-8827-42 [3644762]

Facility

$520.25

Service Code	HCPCS C1713
Hospital Charge Code	3644762
Hospital Revenue Code	278
Min. Negotiated Rate	$265.33
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: Kaiser Permanente Commercial	$327.76
Rate for Payer: Kaiser Permanente Medicaid	$265.33
Rate for Payer: MDX Hawaii PPO	$504.64
Rate for Payer: University Health Alliance Commercial	$291.34

Screw Lo-Pro TM SS Cortex 2.7 x 42mm AR-8827-42 [3644762]

Facility

$520.25

Service Code	HCPCS C1713
Hospital Charge Code	3644762
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

Screw LP Cortical 3.5 X 20mm 131218020 [3640871D]

Facility

$697.84

Service Code	HCPCS C1713
Hospital Charge Code	3640871D
Hospital Revenue Code	278
Min. Negotiated Rate	$355.90
Max. Negotiated Rate	$676.90
Rate for Payer: Cash Price	$453.60
Rate for Payer: Hawaii Western Management Group Commercial	$488.49
Rate for Payer: Health Management Network Commercial	$593.16
Rate for Payer: Kaiser Permanente Commercial	$439.64
Rate for Payer: Kaiser Permanente Medicaid	$355.90
Rate for Payer: MDX Hawaii PPO	$676.90
Rate for Payer: University Health Alliance Commercial	$390.79

Screw LP Cortical 3.5 X 20mm 131218020 [3640871D]

Facility

$697.84

Service Code	HCPCS C1713
Hospital Charge Code	3640871D
Hospital Revenue Code	278
Min. Negotiated Rate	$390.79
Max. Negotiated Rate	$676.90
Rate for Payer: Cash Price	$453.60
Rate for Payer: Hawaii Western Management Group Commercial	$488.49
Rate for Payer: Health Management Network Commercial	$593.16
Rate for Payer: MDX Hawaii PPO	$676.90
Rate for Payer: University Health Alliance Commercial	$390.79

Screw LP Cortical 3.5 X 22mm 131218022 [3641312]

Facility

$697.84

Service Code	HCPCS C1713
Hospital Charge Code	3641312
Hospital Revenue Code	278
Min. Negotiated Rate	$355.90
Max. Negotiated Rate	$676.90
Rate for Payer: Cash Price	$453.60
Rate for Payer: Hawaii Western Management Group Commercial	$488.49
Rate for Payer: Health Management Network Commercial	$593.16
Rate for Payer: Kaiser Permanente Commercial	$439.64
Rate for Payer: Kaiser Permanente Medicaid	$355.90
Rate for Payer: MDX Hawaii PPO	$676.90
Rate for Payer: University Health Alliance Commercial	$390.79

Screw LP Cortical 3.5 X 22mm 131218022 [3641312]

Facility

$697.84

Service Code	HCPCS C1713
Hospital Charge Code	3641312
Hospital Revenue Code	278
Min. Negotiated Rate	$390.79
Max. Negotiated Rate	$676.90
Rate for Payer: Cash Price	$453.60
Rate for Payer: Hawaii Western Management Group Commercial	$488.49
Rate for Payer: Health Management Network Commercial	$593.16
Rate for Payer: MDX Hawaii PPO	$676.90
Rate for Payer: University Health Alliance Commercial	$390.79

Screw LP Cortical 3.5 X 24mm 131218024 [3640871]

Facility

$697.84

Service Code	HCPCS C1713
Hospital Charge Code	3640871
Hospital Revenue Code	278
Min. Negotiated Rate	$390.79
Max. Negotiated Rate	$676.90
Rate for Payer: Cash Price	$453.60
Rate for Payer: Hawaii Western Management Group Commercial	$488.49
Rate for Payer: Health Management Network Commercial	$593.16
Rate for Payer: MDX Hawaii PPO	$676.90
Rate for Payer: University Health Alliance Commercial	$390.79

Screw LP Cortical 3.5 X 24mm 131218024 [3640871]

Facility

$697.84

Service Code	HCPCS C1713
Hospital Charge Code	3640871
Hospital Revenue Code	278
Min. Negotiated Rate	$355.90
Max. Negotiated Rate	$676.90
Rate for Payer: Cash Price	$453.60
Rate for Payer: Hawaii Western Management Group Commercial	$488.49
Rate for Payer: Health Management Network Commercial	$593.16
Rate for Payer: Kaiser Permanente Commercial	$439.64
Rate for Payer: Kaiser Permanente Medicaid	$355.90
Rate for Payer: MDX Hawaii PPO	$676.90
Rate for Payer: University Health Alliance Commercial	$390.79

Screw LP Cortical 3.5 x 26mm 131218026 [3644234]

Facility

$697.84

Service Code	HCPCS C1713
Hospital Charge Code	3644234
Hospital Revenue Code	278
Min. Negotiated Rate	$355.90
Max. Negotiated Rate	$676.90
Rate for Payer: Cash Price	$453.60
Rate for Payer: Hawaii Western Management Group Commercial	$488.49
Rate for Payer: Health Management Network Commercial	$593.16
Rate for Payer: Kaiser Permanente Commercial	$439.64
Rate for Payer: Kaiser Permanente Medicaid	$355.90
Rate for Payer: MDX Hawaii PPO	$676.90
Rate for Payer: University Health Alliance Commercial	$390.79

Screw LP Cortical 3.5 x 26mm 131218026 [3644234]

Facility

$697.84

Service Code	HCPCS C1713
Hospital Charge Code	3644234
Hospital Revenue Code	278
Min. Negotiated Rate	$390.79
Max. Negotiated Rate	$676.90
Rate for Payer: Cash Price	$453.60
Rate for Payer: Hawaii Western Management Group Commercial	$488.49
Rate for Payer: Health Management Network Commercial	$593.16
Rate for Payer: MDX Hawaii PPO	$676.90
Rate for Payer: University Health Alliance Commercial	$390.79

Screw LP Cortical 3.5 X 85mm 131218085 [3642047]

Facility

$466.38

Service Code	HCPCS C1713
Hospital Charge Code	3642047
Hospital Revenue Code	278
Min. Negotiated Rate	$237.85
Max. Negotiated Rate	$452.39
Rate for Payer: Cash Price	$303.15
Rate for Payer: Hawaii Western Management Group Commercial	$326.47
Rate for Payer: Health Management Network Commercial	$396.42
Rate for Payer: Kaiser Permanente Commercial	$293.82
Rate for Payer: Kaiser Permanente Medicaid	$237.85
Rate for Payer: MDX Hawaii PPO	$452.39
Rate for Payer: University Health Alliance Commercial	$261.17

Screw LP Cortical 3.5 X 85mm 131218085 [3642047]

Facility

$466.38

Service Code	HCPCS C1713
Hospital Charge Code	3642047
Hospital Revenue Code	278
Min. Negotiated Rate	$261.17
Max. Negotiated Rate	$452.39
Rate for Payer: Cash Price	$303.15
Rate for Payer: Hawaii Western Management Group Commercial	$326.47
Rate for Payer: Health Management Network Commercial	$396.42
Rate for Payer: MDX Hawaii PPO	$452.39
Rate for Payer: University Health Alliance Commercial	$261.17

Screw Lp Non Locking 2.7mmx10mm 131227210 [3644106]

Facility

$697.84

Service Code	HCPCS C1713
Hospital Charge Code	3644106
Hospital Revenue Code	278
Min. Negotiated Rate	$355.90
Max. Negotiated Rate	$676.90
Rate for Payer: Cash Price	$453.60
Rate for Payer: Hawaii Western Management Group Commercial	$488.49
Rate for Payer: Health Management Network Commercial	$593.16
Rate for Payer: Kaiser Permanente Commercial	$439.64
Rate for Payer: Kaiser Permanente Medicaid	$355.90
Rate for Payer: MDX Hawaii PPO	$676.90
Rate for Payer: University Health Alliance Commercial	$390.79

Screw Lp Non Locking 2.7mmx10mm 131227210 [3644106]

Facility

$697.84

Service Code	HCPCS C1713
Hospital Charge Code	3644106
Hospital Revenue Code	278
Min. Negotiated Rate	$390.79
Max. Negotiated Rate	$676.90
Rate for Payer: Cash Price	$453.60
Rate for Payer: Hawaii Western Management Group Commercial	$488.49
Rate for Payer: Health Management Network Commercial	$593.16
Rate for Payer: MDX Hawaii PPO	$676.90
Rate for Payer: University Health Alliance Commercial	$390.79

Know your out-of-pocket cost for care.

All Charges