Kona Community Hospital

All Charges

Charge

Type

Setting

Price

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	$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 18mm 02.527.118 [3645144]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645144
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 18mm 02.527.118 [3645144]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645144
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 19mm 02.527.119 [3645145]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645145
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 19mm 02.527.119 [3645145]

Facility

$810.30

Service Code	HCPCS C1713
Hospital Charge Code	3645145
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 Locking T8 2.4mm x 10mm 02.424.310 [3645101]

Facility

$1,509.18

Service Code	HCPCS C1713
Hospital Charge Code	3645101
Hospital Revenue Code	278
Min. Negotiated Rate	$845.14
Max. Negotiated Rate	$1,463.90
Rate for Payer: Cash Price	$980.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,056.43
Rate for Payer: Health Management Network Commercial	$1,282.80
Rate for Payer: MDX Hawaii PPO	$1,463.90
Rate for Payer: University Health Alliance Commercial	$845.14

Screw Volt Locking T8 2.4mm x 10mm 02.424.310 [3645101]

Facility

$1,509.18

Service Code	HCPCS C1713
Hospital Charge Code	3645101
Hospital Revenue Code	278
Min. Negotiated Rate	$769.68
Max. Negotiated Rate	$1,463.90
Rate for Payer: Cash Price	$980.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,056.43
Rate for Payer: Health Management Network Commercial	$1,282.80
Rate for Payer: Kaiser Permanente Commercial	$950.78
Rate for Payer: Kaiser Permanente Medicaid	$769.68
Rate for Payer: MDX Hawaii PPO	$1,463.90
Rate for Payer: University Health Alliance Commercial	$845.14

Screw Volt Locking T8 2.4mm x 12mm 02.424.312 [3645103]

Facility

$1,509.18

Service Code	HCPCS C1713
Hospital Charge Code	3645103
Hospital Revenue Code	278
Min. Negotiated Rate	$845.14
Max. Negotiated Rate	$1,463.90
Rate for Payer: Cash Price	$980.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,056.43
Rate for Payer: Health Management Network Commercial	$1,282.80
Rate for Payer: MDX Hawaii PPO	$1,463.90
Rate for Payer: University Health Alliance Commercial	$845.14

Screw Volt Locking T8 2.4mm x 12mm 02.424.312 [3645103]

Facility

$1,509.18

Service Code	HCPCS C1713
Hospital Charge Code	3645103
Hospital Revenue Code	278
Min. Negotiated Rate	$769.68
Max. Negotiated Rate	$1,463.90
Rate for Payer: Cash Price	$980.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,056.43
Rate for Payer: Health Management Network Commercial	$1,282.80
Rate for Payer: Kaiser Permanente Commercial	$950.78
Rate for Payer: Kaiser Permanente Medicaid	$769.68
Rate for Payer: MDX Hawaii PPO	$1,463.90
Rate for Payer: University Health Alliance Commercial	$845.14

Screw Volt Locking T8 2.4mm x 17mm 02.424.317 [3645108]

Facility

$1,509.18

Service Code	HCPCS C1713
Hospital Charge Code	3645108
Hospital Revenue Code	278
Min. Negotiated Rate	$769.68
Max. Negotiated Rate	$1,463.90
Rate for Payer: Cash Price	$980.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,056.43
Rate for Payer: Health Management Network Commercial	$1,282.80
Rate for Payer: Kaiser Permanente Commercial	$950.78
Rate for Payer: Kaiser Permanente Medicaid	$769.68
Rate for Payer: MDX Hawaii PPO	$1,463.90
Rate for Payer: University Health Alliance Commercial	$845.14

Screw Volt Locking T8 2.4mm x 17mm 02.424.317 [3645108]

Facility

$1,509.18

Service Code	HCPCS C1713
Hospital Charge Code	3645108
Hospital Revenue Code	278
Min. Negotiated Rate	$845.14
Max. Negotiated Rate	$1,463.90
Rate for Payer: Cash Price	$980.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,056.43
Rate for Payer: Health Management Network Commercial	$1,282.80
Rate for Payer: MDX Hawaii PPO	$1,463.90
Rate for Payer: University Health Alliance Commercial	$845.14

Screw Volt Locking T8 2.4mm x 18mm 02.424.318 [3645109]

Facility

$1,509.18

Service Code	HCPCS C1713
Hospital Charge Code	3645109
Hospital Revenue Code	278
Min. Negotiated Rate	$845.14
Max. Negotiated Rate	$1,463.90
Rate for Payer: Cash Price	$980.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,056.43
Rate for Payer: Health Management Network Commercial	$1,282.80
Rate for Payer: MDX Hawaii PPO	$1,463.90
Rate for Payer: University Health Alliance Commercial	$845.14

Screw Volt Locking T8 2.4mm x 18mm 02.424.318 [3645109]

Facility

$1,509.18

Service Code	HCPCS C1713
Hospital Charge Code	3645109
Hospital Revenue Code	278
Min. Negotiated Rate	$769.68
Max. Negotiated Rate	$1,463.90
Rate for Payer: Cash Price	$980.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,056.43
Rate for Payer: Health Management Network Commercial	$1,282.80
Rate for Payer: Kaiser Permanente Commercial	$950.78
Rate for Payer: Kaiser Permanente Medicaid	$769.68
Rate for Payer: MDX Hawaii PPO	$1,463.90
Rate for Payer: University Health Alliance Commercial	$845.14

Screw Volt Locking T8 2.7mm x 14mm 02.527.314 [3645181]

Facility

$1,509.18

Service Code	HCPCS C1713
Hospital Charge Code	3645181
Hospital Revenue Code	278
Min. Negotiated Rate	$769.68
Max. Negotiated Rate	$1,463.90
Rate for Payer: Cash Price	$980.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,056.43
Rate for Payer: Health Management Network Commercial	$1,282.80
Rate for Payer: Kaiser Permanente Commercial	$950.78
Rate for Payer: Kaiser Permanente Medicaid	$769.68
Rate for Payer: MDX Hawaii PPO	$1,463.90
Rate for Payer: University Health Alliance Commercial	$845.14

Screw Volt Locking T8 2.7mm x 14mm 02.527.314 [3645181]

Facility

$1,509.18

Service Code	HCPCS C1713
Hospital Charge Code	3645181
Hospital Revenue Code	278
Min. Negotiated Rate	$845.14
Max. Negotiated Rate	$1,463.90
Rate for Payer: Cash Price	$980.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,056.43
Rate for Payer: Health Management Network Commercial	$1,282.80
Rate for Payer: MDX Hawaii PPO	$1,463.90
Rate for Payer: University Health Alliance Commercial	$845.14

Screw Volt Locking T8 2.7mmx16mm 02.527.316 [3645183]

Facility

$1,509.18

Service Code	HCPCS C1713
Hospital Charge Code	3645183
Hospital Revenue Code	278
Min. Negotiated Rate	$845.14
Max. Negotiated Rate	$1,463.90
Rate for Payer: Cash Price	$980.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,056.43
Rate for Payer: Health Management Network Commercial	$1,282.80
Rate for Payer: MDX Hawaii PPO	$1,463.90
Rate for Payer: University Health Alliance Commercial	$845.14

Screw Volt Locking T8 2.7mmx16mm 02.527.316 [3645183]

Facility

$1,509.18

Service Code	HCPCS C1713
Hospital Charge Code	3645183
Hospital Revenue Code	278
Min. Negotiated Rate	$769.68
Max. Negotiated Rate	$1,463.90
Rate for Payer: Cash Price	$980.97
Rate for Payer: Hawaii Western Management Group Commercial	$1,056.43
Rate for Payer: Health Management Network Commercial	$1,282.80
Rate for Payer: Kaiser Permanente Commercial	$950.78
Rate for Payer: Kaiser Permanente Medicaid	$769.68
Rate for Payer: MDX Hawaii PPO	$1,463.90
Rate for Payer: University Health Alliance Commercial	$845.14

Screw Vpc 2.5mmx12mm 233225012 [3643505]

Facility

$1,894.20

Service Code	HCPCS C1713
Hospital Charge Code	3643505
Hospital Revenue Code	278
Min. Negotiated Rate	$966.04
Max. Negotiated Rate	$1,837.37
Rate for Payer: Cash Price	$1,231.23
Rate for Payer: Hawaii Western Management Group Commercial	$1,325.94
Rate for Payer: Health Management Network Commercial	$1,610.07
Rate for Payer: Kaiser Permanente Commercial	$1,193.35
Rate for Payer: Kaiser Permanente Medicaid	$966.04
Rate for Payer: MDX Hawaii PPO	$1,837.37
Rate for Payer: University Health Alliance Commercial	$1,060.75

Screw Vpc 2.5mmx12mm 233225012 [3643505]

Facility

$1,894.20

Service Code	HCPCS C1713
Hospital Charge Code	3643505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,060.75
Max. Negotiated Rate	$1,837.37
Rate for Payer: Cash Price	$1,231.23
Rate for Payer: Hawaii Western Management Group Commercial	$1,325.94
Rate for Payer: Health Management Network Commercial	$1,610.07
Rate for Payer: MDX Hawaii PPO	$1,837.37
Rate for Payer: University Health Alliance Commercial	$1,060.75

Screw VPC 2.5mm X 14mm 233225014 [3644993]

Facility

$4,643.00

Service Code	HCPCS C1713
Hospital Charge Code	3644993
Hospital Revenue Code	278
Min. Negotiated Rate	$2,600.08
Max. Negotiated Rate	$4,503.71
Rate for Payer: Cash Price	$3,017.95
Rate for Payer: Hawaii Western Management Group Commercial	$3,250.10
Rate for Payer: Health Management Network Commercial	$3,946.55
Rate for Payer: MDX Hawaii PPO	$4,503.71
Rate for Payer: University Health Alliance Commercial	$2,600.08

Screw VPC 2.5mm X 14mm 233225014 [3644993]

Facility

$4,643.00

Service Code	HCPCS C1713
Hospital Charge Code	3644993
Hospital Revenue Code	278
Min. Negotiated Rate	$2,367.93
Max. Negotiated Rate	$4,503.71
Rate for Payer: Cash Price	$3,017.95
Rate for Payer: Hawaii Western Management Group Commercial	$3,250.10
Rate for Payer: Health Management Network Commercial	$3,946.55
Rate for Payer: Kaiser Permanente Commercial	$2,925.09
Rate for Payer: Kaiser Permanente Medicaid	$2,367.93
Rate for Payer: MDX Hawaii PPO	$4,503.71
Rate for Payer: University Health Alliance Commercial	$2,600.08

Screw VPC 2.5mm X 18mm 233225018 [3642278A]

Facility

$4,643.00

Service Code	HCPCS C1768
Hospital Charge Code	3642278A
Hospital Revenue Code	278
Min. Negotiated Rate	$2,367.93
Max. Negotiated Rate	$4,503.71
Rate for Payer: Cash Price	$3,017.95
Rate for Payer: Hawaii Western Management Group Commercial	$3,250.10
Rate for Payer: Health Management Network Commercial	$3,946.55
Rate for Payer: Kaiser Permanente Commercial	$2,925.09
Rate for Payer: Kaiser Permanente Medicaid	$2,367.93
Rate for Payer: MDX Hawaii PPO	$4,503.71
Rate for Payer: University Health Alliance Commercial	$2,600.08

Screw VPC 2.5mm X 18mm 233225018 [3642278A]

Facility

$4,643.00

Service Code	HCPCS C1768
Hospital Charge Code	3642278A
Hospital Revenue Code	278
Min. Negotiated Rate	$2,600.08
Max. Negotiated Rate	$4,503.71
Rate for Payer: Cash Price	$3,017.95
Rate for Payer: Hawaii Western Management Group Commercial	$3,250.10
Rate for Payer: Health Management Network Commercial	$3,946.55
Rate for Payer: MDX Hawaii PPO	$4,503.71
Rate for Payer: University Health Alliance Commercial	$2,600.08

Screw VPC 2.5mm x 30mm 233225030 [3644503]

Facility

$2,938.40

Service Code	HCPCS C1713
Hospital Charge Code	3644503
Hospital Revenue Code	278
Min. Negotiated Rate	$1,645.50
Max. Negotiated Rate	$2,850.25
Rate for Payer: Cash Price	$1,909.96
Rate for Payer: Hawaii Western Management Group Commercial	$2,056.88
Rate for Payer: Health Management Network Commercial	$2,497.64
Rate for Payer: MDX Hawaii PPO	$2,850.25
Rate for Payer: University Health Alliance Commercial	$1,645.50

Screw VPC 2.5mm x 30mm 233225030 [3644503]

Facility

$2,938.40

Service Code	HCPCS C1713
Hospital Charge Code	3644503
Hospital Revenue Code	278
Min. Negotiated Rate	$1,498.58
Max. Negotiated Rate	$2,850.25
Rate for Payer: Cash Price	$1,909.96
Rate for Payer: Hawaii Western Management Group Commercial	$2,056.88
Rate for Payer: Health Management Network Commercial	$2,497.64
Rate for Payer: Kaiser Permanente Commercial	$1,851.19
Rate for Payer: Kaiser Permanente Medicaid	$1,498.58
Rate for Payer: MDX Hawaii PPO	$2,850.25
Rate for Payer: University Health Alliance Commercial	$1,645.50

Know your out-of-pocket cost for care.

All Charges