Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Suture Ethibond 5 Lr Da B499t [3642546]

Facility

$85.00

Hospital Charge Code	3642546
Hospital Revenue Code	272
Min. Negotiated Rate	$43.35
Max. Negotiated Rate	$82.45
Rate for Payer: Cash Price	$55.25
Rate for Payer: Hawaii Western Management Group Commercial	$80.75
Rate for Payer: Health Management Network Commercial	$72.25
Rate for Payer: Kaiser Permanente Commercial	$53.55
Rate for Payer: Kaiser Permanente Medicaid	$43.35
Rate for Payer: MDX Hawaii PPO	$82.45
Rate for Payer: University Health Alliance Commercial	$61.96

Suture Ethibond 5 Lr Da B499t [3642546]

Facility

$85.00

Hospital Charge Code	3642546
Hospital Revenue Code	272
Min. Negotiated Rate	$72.25
Max. Negotiated Rate	$82.45
Rate for Payer: Cash Price	$55.25
Rate for Payer: Health Management Network Commercial	$72.25
Rate for Payer: MDX Hawaii PPO	$82.45

Suture Ethibond Excel 1 CT-1 CR D7716 [3642850]

Facility

$686.33

Hospital Charge Code	3642850
Hospital Revenue Code	272
Min. Negotiated Rate	$350.03
Max. Negotiated Rate	$665.74
Rate for Payer: Cash Price	$446.11
Rate for Payer: Hawaii Western Management Group Commercial	$652.01
Rate for Payer: Health Management Network Commercial	$583.38
Rate for Payer: Kaiser Permanente Commercial	$432.39
Rate for Payer: Kaiser Permanente Medicaid	$350.03
Rate for Payer: MDX Hawaii PPO	$665.74
Rate for Payer: University Health Alliance Commercial	$500.27

Suture Ethibond Excel 1 CT-1 CR D7716 [3642850]

Facility

$686.33

Hospital Charge Code	3642850
Hospital Revenue Code	272
Min. Negotiated Rate	$583.38
Max. Negotiated Rate	$665.74
Rate for Payer: Cash Price	$446.11
Rate for Payer: Health Management Network Commercial	$583.38
Rate for Payer: MDX Hawaii PPO	$665.74

Suture Ethibond Excel 48" 2-0 SH D9999 [3642903]

Facility

$219.23

Hospital Charge Code	3642903
Hospital Revenue Code	272
Min. Negotiated Rate	$111.81
Max. Negotiated Rate	$212.65
Rate for Payer: Cash Price	$142.50
Rate for Payer: Hawaii Western Management Group Commercial	$208.27
Rate for Payer: Health Management Network Commercial	$186.35
Rate for Payer: Kaiser Permanente Commercial	$138.11
Rate for Payer: Kaiser Permanente Medicaid	$111.81
Rate for Payer: MDX Hawaii PPO	$212.65
Rate for Payer: University Health Alliance Commercial	$159.80

Suture Ethibond Excel 48" 2-0 SH D9999 [3642903]

Facility

$219.23

Hospital Charge Code	3642903
Hospital Revenue Code	272
Min. Negotiated Rate	$186.35
Max. Negotiated Rate	$212.65
Rate for Payer: Cash Price	$142.50
Rate for Payer: Health Management Network Commercial	$186.35
Rate for Payer: MDX Hawaii PPO	$212.65

Suture Ethilon 10-0 Cs160-6 9061G [3644766]

Facility

$156.48

Hospital Charge Code	3644766
Hospital Revenue Code	272
Min. Negotiated Rate	$79.80
Max. Negotiated Rate	$151.79
Rate for Payer: Cash Price	$101.71
Rate for Payer: Hawaii Western Management Group Commercial	$148.66
Rate for Payer: Health Management Network Commercial	$133.01
Rate for Payer: Kaiser Permanente Commercial	$98.58
Rate for Payer: Kaiser Permanente Medicaid	$79.80
Rate for Payer: MDX Hawaii PPO	$151.79
Rate for Payer: University Health Alliance Commercial	$114.06

Suture Ethilon 10-0 Cs160-6 9061G [3644766]

Facility

$156.48

Hospital Charge Code	3644766
Hospital Revenue Code	272
Min. Negotiated Rate	$133.01
Max. Negotiated Rate	$151.79
Rate for Payer: Cash Price	$101.71
Rate for Payer: Health Management Network Commercial	$133.01
Rate for Payer: MDX Hawaii PPO	$151.79

Suture Ethilon 8-0 BV130-4 2815G [3607205]

Facility

$173.12

Hospital Charge Code	3607205
Hospital Revenue Code	272
Min. Negotiated Rate	$147.15
Max. Negotiated Rate	$167.93
Rate for Payer: Cash Price	$112.53
Rate for Payer: Health Management Network Commercial	$147.15
Rate for Payer: MDX Hawaii PPO	$167.93

Suture Ethilon 8-0 BV130-4 2815G [3607205]

Facility

$173.12

Hospital Charge Code	3607205
Hospital Revenue Code	272
Min. Negotiated Rate	$88.29
Max. Negotiated Rate	$167.93
Rate for Payer: Cash Price	$112.53
Rate for Payer: Hawaii Western Management Group Commercial	$164.46
Rate for Payer: Health Management Network Commercial	$147.15
Rate for Payer: Kaiser Permanente Commercial	$109.07
Rate for Payer: Kaiser Permanente Medicaid	$88.29
Rate for Payer: MDX Hawaii PPO	$167.93
Rate for Payer: University Health Alliance Commercial	$126.19

Suture Ethilon 9-0 Black 12" TG140 7717G [3643114]

Facility

$145.92

Hospital Charge Code	3643114
Hospital Revenue Code	272
Min. Negotiated Rate	$124.03
Max. Negotiated Rate	$141.54
Rate for Payer: Cash Price	$94.85
Rate for Payer: Health Management Network Commercial	$124.03
Rate for Payer: MDX Hawaii PPO	$141.54

Suture Ethilon 9-0 Black 12" TG140 7717G [3643114]

Facility

$145.92

Hospital Charge Code	3643114
Hospital Revenue Code	272
Min. Negotiated Rate	$74.42
Max. Negotiated Rate	$141.54
Rate for Payer: Cash Price	$94.85
Rate for Payer: Hawaii Western Management Group Commercial	$138.62
Rate for Payer: Health Management Network Commercial	$124.03
Rate for Payer: Kaiser Permanente Commercial	$91.93
Rate for Payer: Kaiser Permanente Medicaid	$74.42
Rate for Payer: MDX Hawaii PPO	$141.54
Rate for Payer: University Health Alliance Commercial	$106.36

SutureLasso 25 Deg Tight Curve Lt AR406825TL [3621579]

Facility

$1,198.00

Hospital Charge Code	3621579
Hospital Revenue Code	272
Min. Negotiated Rate	$610.98
Max. Negotiated Rate	$1,162.06
Rate for Payer: Cash Price	$778.70
Rate for Payer: Hawaii Western Management Group Commercial	$1,138.10
Rate for Payer: Health Management Network Commercial	$1,018.30
Rate for Payer: Kaiser Permanente Commercial	$754.74
Rate for Payer: Kaiser Permanente Medicaid	$610.98
Rate for Payer: MDX Hawaii PPO	$1,162.06
Rate for Payer: University Health Alliance Commercial	$873.22

SutureLasso 25 Deg Tight Curve Lt AR406825TL [3621579]

Facility

$1,198.00

Hospital Charge Code	3621579
Hospital Revenue Code	272
Min. Negotiated Rate	$1,018.30
Max. Negotiated Rate	$1,162.06
Rate for Payer: Cash Price	$778.70
Rate for Payer: Health Management Network Commercial	$1,018.30
Rate for Payer: MDX Hawaii PPO	$1,162.06

SutureLasso 25 Deg Tight Curve Rt AR406825TR [3641509]

Facility

$1,198.00

Hospital Charge Code	3641509
Hospital Revenue Code	272
Min. Negotiated Rate	$610.98
Max. Negotiated Rate	$1,162.06
Rate for Payer: Cash Price	$778.70
Rate for Payer: Hawaii Western Management Group Commercial	$1,138.10
Rate for Payer: Health Management Network Commercial	$1,018.30
Rate for Payer: Kaiser Permanente Commercial	$754.74
Rate for Payer: Kaiser Permanente Medicaid	$610.98
Rate for Payer: MDX Hawaii PPO	$1,162.06
Rate for Payer: University Health Alliance Commercial	$873.22

SutureLasso 25 Deg Tight Curve Rt AR406825TR [3641509]

Facility

$1,198.00

Hospital Charge Code	3641509
Hospital Revenue Code	272
Min. Negotiated Rate	$1,018.30
Max. Negotiated Rate	$1,162.06
Rate for Payer: Cash Price	$778.70
Rate for Payer: Health Management Network Commercial	$1,018.30
Rate for Payer: MDX Hawaii PPO	$1,162.06

SutureLasso 45 Deg Curve LT AR406845L [3641249]

Facility

$1,198.00

Hospital Charge Code	3641249
Hospital Revenue Code	272
Min. Negotiated Rate	$1,018.30
Max. Negotiated Rate	$1,162.06
Rate for Payer: Cash Price	$778.70
Rate for Payer: Health Management Network Commercial	$1,018.30
Rate for Payer: MDX Hawaii PPO	$1,162.06

SutureLasso 45 Deg Curve LT AR406845L [3641249]

Facility

$1,198.00

Hospital Charge Code	3641249
Hospital Revenue Code	272
Min. Negotiated Rate	$610.98
Max. Negotiated Rate	$1,162.06
Rate for Payer: Cash Price	$778.70
Rate for Payer: Hawaii Western Management Group Commercial	$1,138.10
Rate for Payer: Health Management Network Commercial	$1,018.30
Rate for Payer: Kaiser Permanente Commercial	$754.74
Rate for Payer: Kaiser Permanente Medicaid	$610.98
Rate for Payer: MDX Hawaii PPO	$1,162.06
Rate for Payer: University Health Alliance Commercial	$873.22

SutureLasso 45 Deg Curve RT AR406845R [3641250]

Facility

$1,198.00

Hospital Charge Code	3641250
Hospital Revenue Code	272
Min. Negotiated Rate	$1,018.30
Max. Negotiated Rate	$1,162.06
Rate for Payer: Cash Price	$778.70
Rate for Payer: Health Management Network Commercial	$1,018.30
Rate for Payer: MDX Hawaii PPO	$1,162.06

SutureLasso 45 Deg Curve RT AR406845R [3641250]

Facility

$1,198.00

Hospital Charge Code	3641250
Hospital Revenue Code	272
Min. Negotiated Rate	$610.98
Max. Negotiated Rate	$1,162.06
Rate for Payer: Cash Price	$778.70
Rate for Payer: Hawaii Western Management Group Commercial	$1,138.10
Rate for Payer: Health Management Network Commercial	$1,018.30
Rate for Payer: Kaiser Permanente Commercial	$754.74
Rate for Payer: Kaiser Permanente Medicaid	$610.98
Rate for Payer: MDX Hawaii PPO	$1,162.06
Rate for Payer: University Health Alliance Commercial	$873.22

SutureLasso 90 Deg Straight AR406890 [3621619]

Facility

$1,198.00

Hospital Charge Code	3621619
Hospital Revenue Code	272
Min. Negotiated Rate	$1,018.30
Max. Negotiated Rate	$1,162.06
Rate for Payer: Cash Price	$778.70
Rate for Payer: Health Management Network Commercial	$1,018.30
Rate for Payer: MDX Hawaii PPO	$1,162.06

SutureLasso 90 Deg Straight AR406890 [3621619]

Facility

$1,198.00

Hospital Charge Code	3621619
Hospital Revenue Code	272
Min. Negotiated Rate	$610.98
Max. Negotiated Rate	$1,162.06
Rate for Payer: Cash Price	$778.70
Rate for Payer: Hawaii Western Management Group Commercial	$1,138.10
Rate for Payer: Health Management Network Commercial	$1,018.30
Rate for Payer: Kaiser Permanente Commercial	$754.74
Rate for Payer: Kaiser Permanente Medicaid	$610.98
Rate for Payer: MDX Hawaii PPO	$1,162.06
Rate for Payer: University Health Alliance Commercial	$873.22

SutureLasso Micro Straight AR8703 [3641193]

Facility

$1,198.00

Hospital Charge Code	3641193
Hospital Revenue Code	272
Min. Negotiated Rate	$1,018.30
Max. Negotiated Rate	$1,162.06
Rate for Payer: Cash Price	$778.70
Rate for Payer: Health Management Network Commercial	$1,018.30
Rate for Payer: MDX Hawaii PPO	$1,162.06

SutureLasso Micro Straight AR8703 [3641193]

Facility

$1,198.00

Hospital Charge Code	3641193
Hospital Revenue Code	272
Min. Negotiated Rate	$610.98
Max. Negotiated Rate	$1,162.06
Rate for Payer: Cash Price	$778.70
Rate for Payer: Hawaii Western Management Group Commercial	$1,138.10
Rate for Payer: Health Management Network Commercial	$1,018.30
Rate for Payer: Kaiser Permanente Commercial	$754.74
Rate for Payer: Kaiser Permanente Medicaid	$610.98
Rate for Payer: MDX Hawaii PPO	$1,162.06
Rate for Payer: University Health Alliance Commercial	$873.22

Suturelasso SD Wire Loop AR-4068-05SD [3643911]

Facility

$356.25

Hospital Charge Code	3643911
Hospital Revenue Code	272
Min. Negotiated Rate	$302.81
Max. Negotiated Rate	$345.56
Rate for Payer: Cash Price	$231.56
Rate for Payer: Health Management Network Commercial	$302.81
Rate for Payer: MDX Hawaii PPO	$345.56

Know your out-of-pocket cost for care.

All Charges