Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Screw VAL Ti 2.0 x 13mm AR-18720V-13 [3644791]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644791
Hospital Revenue Code	278
Min. Negotiated Rate	$703.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: Kaiser Permanente Commercial	$869.44
Rate for Payer: Kaiser Permanente Medicaid	$703.84
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw VAL Ti 2.0 x 13mm AR-18720V-13 [3644791]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644791
Hospital Revenue Code	278
Min. Negotiated Rate	$772.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw VAL Ti 2.0 x 15mm AR-18720V-15 [3644792]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644792
Hospital Revenue Code	278
Min. Negotiated Rate	$703.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: Kaiser Permanente Commercial	$869.44
Rate for Payer: Kaiser Permanente Medicaid	$703.84
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw VAL Ti 2.0 x 15mm AR-18720V-15 [3644792]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644792
Hospital Revenue Code	278
Min. Negotiated Rate	$772.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw VAL Ti 2.4 x 12mm AR-18724V-12 [3644588]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644588
Hospital Revenue Code	278
Min. Negotiated Rate	$703.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: Kaiser Permanente Commercial	$869.44
Rate for Payer: Kaiser Permanente Medicaid	$703.84
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw VAL Ti 2.4 x 12mm AR-18724V-12 [3644588]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644588
Hospital Revenue Code	278
Min. Negotiated Rate	$772.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw VAL Ti 2.4 x 13mm AR-18724V-13 [3644589]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644589
Hospital Revenue Code	278
Min. Negotiated Rate	$703.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: Kaiser Permanente Commercial	$869.44
Rate for Payer: Kaiser Permanente Medicaid	$703.84
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw VAL Ti 2.4 x 13mm AR-18724V-13 [3644589]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644589
Hospital Revenue Code	278
Min. Negotiated Rate	$772.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw VAL Ti 2.4 x 14mm AR-18724V-14 [3644590]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644590
Hospital Revenue Code	278
Min. Negotiated Rate	$703.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: Kaiser Permanente Commercial	$869.44
Rate for Payer: Kaiser Permanente Medicaid	$703.84
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw VAL Ti 2.4 x 14mm AR-18724V-14 [3644590]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644590
Hospital Revenue Code	278
Min. Negotiated Rate	$772.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw VAL Ti 2.4 x 16mm AR-18724V-16 [3644591]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644591
Hospital Revenue Code	278
Min. Negotiated Rate	$772.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw VAL Ti 2.4 x 16mm AR-18724V-16 [3644591]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644591
Hospital Revenue Code	278
Min. Negotiated Rate	$703.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: Kaiser Permanente Commercial	$869.44
Rate for Payer: Kaiser Permanente Medicaid	$703.84
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw VAL Ti 2.4 x 18mm AR-18724V-18 [3644592]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644592
Hospital Revenue Code	278
Min. Negotiated Rate	$772.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw VAL Ti 2.4 x 18mm AR-18724V-18 [3644592]

Facility

$1,380.07

Service Code	HCPCS C1713
Hospital Charge Code	3644592
Hospital Revenue Code	278
Min. Negotiated Rate	$703.84
Max. Negotiated Rate	$1,338.67
Rate for Payer: Cash Price	$897.05
Rate for Payer: Hawaii Western Management Group Commercial	$966.05
Rate for Payer: Health Management Network Commercial	$1,173.06
Rate for Payer: Kaiser Permanente Commercial	$869.44
Rate for Payer: Kaiser Permanente Medicaid	$703.84
Rate for Payer: MDX Hawaii PPO	$1,338.67
Rate for Payer: University Health Alliance Commercial	$772.84

Screw Volt Cortex T8 2.4mmx14mm 02.424.114 [3645064]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645064
Hospital Revenue Code	278
Min. Negotiated Rate	$413.25
Max. Negotiated Rate	$785.99
Rate for Payer: Cash Price	$526.69
Rate for Payer: Hawaii Western Management Group Commercial	$567.21
Rate for Payer: Health Management Network Commercial	$688.75
Rate for Payer: Kaiser Permanente Commercial	$510.49
Rate for Payer: Kaiser Permanente Medicaid	$413.25
Rate for Payer: MDX Hawaii PPO	$785.99
Rate for Payer: University Health Alliance Commercial	$453.77

Screw Volt Cortex T8 2.4mmx14mm 02.424.114 [3645064]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645064
Hospital Revenue Code	278
Min. Negotiated Rate	$453.77
Max. Negotiated Rate	$785.99
Rate for Payer: Cash Price	$526.69
Rate for Payer: Hawaii Western Management Group Commercial	$567.21
Rate for Payer: Health Management Network Commercial	$688.75
Rate for Payer: MDX Hawaii PPO	$785.99
Rate for Payer: University Health Alliance Commercial	$453.77

Screw Volt Cortex T8 2.7mm x 10mm 02.527.110 [3645136]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645136
Hospital Revenue Code	278
Min. Negotiated Rate	$413.25
Max. Negotiated Rate	$785.99
Rate for Payer: Cash Price	$526.69
Rate for Payer: Hawaii Western Management Group Commercial	$567.21
Rate for Payer: Health Management Network Commercial	$688.75
Rate for Payer: Kaiser Permanente Commercial	$510.49
Rate for Payer: Kaiser Permanente Medicaid	$413.25
Rate for Payer: MDX Hawaii PPO	$785.99
Rate for Payer: University Health Alliance Commercial	$453.77

Screw Volt Cortex T8 2.7mm x 10mm 02.527.110 [3645136]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645136
Hospital Revenue Code	278
Min. Negotiated Rate	$453.77
Max. Negotiated Rate	$785.99
Rate for Payer: Cash Price	$526.69
Rate for Payer: Hawaii Western Management Group Commercial	$567.21
Rate for Payer: Health Management Network Commercial	$688.75
Rate for Payer: MDX Hawaii PPO	$785.99
Rate for Payer: University Health Alliance Commercial	$453.77

Screw Volt Cortex T8 2.7mm x 13mm 02.527.113 [3645139]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645139
Hospital Revenue Code	278
Min. Negotiated Rate	$413.25
Max. Negotiated Rate	$785.99
Rate for Payer: Cash Price	$526.69
Rate for Payer: Hawaii Western Management Group Commercial	$567.21
Rate for Payer: Health Management Network Commercial	$688.75
Rate for Payer: Kaiser Permanente Commercial	$510.49
Rate for Payer: Kaiser Permanente Medicaid	$413.25
Rate for Payer: MDX Hawaii PPO	$785.99
Rate for Payer: University Health Alliance Commercial	$453.77

Screw Volt Cortex T8 2.7mm x 13mm 02.527.113 [3645139]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645139
Hospital Revenue Code	278
Min. Negotiated Rate	$453.77
Max. Negotiated Rate	$785.99
Rate for Payer: Cash Price	$526.69
Rate for Payer: Hawaii Western Management Group Commercial	$567.21
Rate for Payer: Health Management Network Commercial	$688.75
Rate for Payer: MDX Hawaii PPO	$785.99
Rate for Payer: University Health Alliance Commercial	$453.77

Screw Volt Cortex T8 2.7mm x 14mm 02.527.114 [3645140]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645140
Hospital Revenue Code	278
Min. Negotiated Rate	$413.25
Max. Negotiated Rate	$785.99
Rate for Payer: Cash Price	$526.69
Rate for Payer: Hawaii Western Management Group Commercial	$567.21
Rate for Payer: Health Management Network Commercial	$688.75
Rate for Payer: Kaiser Permanente Commercial	$510.49
Rate for Payer: Kaiser Permanente Medicaid	$413.25
Rate for Payer: MDX Hawaii PPO	$785.99
Rate for Payer: University Health Alliance Commercial	$453.77

Screw Volt Cortex T8 2.7mm x 14mm 02.527.114 [3645140]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645140
Hospital Revenue Code	278
Min. Negotiated Rate	$453.77
Max. Negotiated Rate	$785.99
Rate for Payer: Cash Price	$526.69
Rate for Payer: Hawaii Western Management Group Commercial	$567.21
Rate for Payer: Health Management Network Commercial	$688.75
Rate for Payer: MDX Hawaii PPO	$785.99
Rate for Payer: University Health Alliance Commercial	$453.77

Screw Volt Cortex T8 2.7mm x 16mm 02.527.116 [3645142]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645142
Hospital Revenue Code	278
Min. Negotiated Rate	$413.25
Max. Negotiated Rate	$785.99
Rate for Payer: Cash Price	$526.69
Rate for Payer: Hawaii Western Management Group Commercial	$567.21
Rate for Payer: Health Management Network Commercial	$688.75
Rate for Payer: Kaiser Permanente Commercial	$510.49
Rate for Payer: Kaiser Permanente Medicaid	$413.25
Rate for Payer: MDX Hawaii PPO	$785.99
Rate for Payer: University Health Alliance Commercial	$453.77

Screw Volt Cortex T8 2.7mm x 16mm 02.527.116 [3645142]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645142
Hospital Revenue Code	278
Min. Negotiated Rate	$453.77
Max. Negotiated Rate	$785.99
Rate for Payer: Cash Price	$526.69
Rate for Payer: Hawaii Western Management Group Commercial	$567.21
Rate for Payer: Health Management Network Commercial	$688.75
Rate for Payer: MDX Hawaii PPO	$785.99
Rate for Payer: University Health Alliance Commercial	$453.77

Screw Volt Cortex T8 2.7mmx17mm 02.257.117 [3645143]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645143
Hospital Revenue Code	278
Min. Negotiated Rate	$453.77
Max. Negotiated Rate	$785.99
Rate for Payer: Cash Price	$526.69
Rate for Payer: Hawaii Western Management Group Commercial	$567.21
Rate for Payer: Health Management Network Commercial	$688.75
Rate for Payer: MDX Hawaii PPO	$785.99
Rate for Payer: University Health Alliance Commercial	$453.77

Know your out-of-pocket cost for care.

All Charges