Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Suture Prolene Blue 6-0 C-1 DA EP8726H [3642567]

Facility

$225.98

Hospital Charge Code	3642567
Hospital Revenue Code	272
Min. Negotiated Rate	$115.25
Max. Negotiated Rate	$219.20
Rate for Payer: Cash Price	$146.89
Rate for Payer: Hawaii Western Management Group Commercial	$214.68
Rate for Payer: Health Management Network Commercial	$192.08
Rate for Payer: Kaiser Permanente Commercial	$142.37
Rate for Payer: Kaiser Permanente Medicaid	$115.25
Rate for Payer: MDX Hawaii PPO	$219.20
Rate for Payer: University Health Alliance Commercial	$164.72

Suture Retriever Hoffee 710000 [3645363]

Facility

$804.57

Hospital Charge Code	3645363
Hospital Revenue Code	272
Min. Negotiated Rate	$410.33
Max. Negotiated Rate	$780.43
Rate for Payer: Cash Price	$522.97
Rate for Payer: Hawaii Western Management Group Commercial	$764.34
Rate for Payer: Health Management Network Commercial	$683.88
Rate for Payer: Kaiser Permanente Commercial	$506.88
Rate for Payer: Kaiser Permanente Medicaid	$410.33
Rate for Payer: MDX Hawaii PPO	$780.43
Rate for Payer: University Health Alliance Commercial	$586.45

Suture Retriever Hoffee 710000 [3645363]

Facility

$804.57

Hospital Charge Code	3645363
Hospital Revenue Code	272
Min. Negotiated Rate	$683.88
Max. Negotiated Rate	$780.43
Rate for Payer: Cash Price	$522.97
Rate for Payer: Health Management Network Commercial	$683.88
Rate for Payer: MDX Hawaii PPO	$780.43

Suture Stratafix Monocryl 2-0 27in CT-1 SXMP1B414 [3643049]

Facility

$217.94

Hospital Charge Code	3643049
Hospital Revenue Code	272
Min. Negotiated Rate	$111.15
Max. Negotiated Rate	$211.40
Rate for Payer: Cash Price	$141.66
Rate for Payer: Hawaii Western Management Group Commercial	$207.04
Rate for Payer: Health Management Network Commercial	$185.25
Rate for Payer: Kaiser Permanente Commercial	$137.30
Rate for Payer: Kaiser Permanente Medicaid	$111.15
Rate for Payer: MDX Hawaii PPO	$211.40
Rate for Payer: University Health Alliance Commercial	$158.86

Suture Stratafix Monocryl 2-0 27in CT-1 SXMP1B414 [3643049]

Facility

$217.94

Hospital Charge Code	3643049
Hospital Revenue Code	272
Min. Negotiated Rate	$185.25
Max. Negotiated Rate	$211.40
Rate for Payer: Cash Price	$141.66
Rate for Payer: Health Management Network Commercial	$185.25
Rate for Payer: MDX Hawaii PPO	$211.40

Suture Stratafix Monocryl 3-0 30cm PS-2 SXMP1B101 [3642557]

Facility

$160.08

Hospital Charge Code	3642557
Hospital Revenue Code	272
Min. Negotiated Rate	$81.64
Max. Negotiated Rate	$155.28
Rate for Payer: Cash Price	$104.05
Rate for Payer: Hawaii Western Management Group Commercial	$152.08
Rate for Payer: Health Management Network Commercial	$136.07
Rate for Payer: Kaiser Permanente Commercial	$100.85
Rate for Payer: Kaiser Permanente Medicaid	$81.64
Rate for Payer: MDX Hawaii PPO	$155.28
Rate for Payer: University Health Alliance Commercial	$116.68

Suture Stratafix Monocryl 3-0 30cm PS-2 SXMP1B101 [3642557]

Facility

$160.08

Hospital Charge Code	3642557
Hospital Revenue Code	272
Min. Negotiated Rate	$136.07
Max. Negotiated Rate	$155.28
Rate for Payer: Cash Price	$104.05
Rate for Payer: Health Management Network Commercial	$136.07
Rate for Payer: MDX Hawaii PPO	$155.28

Suture Stratafix Monocryl 3-0 60cm PS-2 SXMP1B103 [3642560]

Facility

$162.56

Hospital Charge Code	3642560
Hospital Revenue Code	272
Min. Negotiated Rate	$138.18
Max. Negotiated Rate	$157.68
Rate for Payer: Cash Price	$105.66
Rate for Payer: Health Management Network Commercial	$138.18
Rate for Payer: MDX Hawaii PPO	$157.68

Suture Stratafix Monocryl 3-0 60cm PS-2 SXMP1B103 [3642560]

Facility

$162.56

Hospital Charge Code	3642560
Hospital Revenue Code	272
Min. Negotiated Rate	$82.91
Max. Negotiated Rate	$157.68
Rate for Payer: Cash Price	$105.66
Rate for Payer: Hawaii Western Management Group Commercial	$154.43
Rate for Payer: Health Management Network Commercial	$138.18
Rate for Payer: Kaiser Permanente Commercial	$102.41
Rate for Payer: Kaiser Permanente Medicaid	$82.91
Rate for Payer: MDX Hawaii PPO	$157.68
Rate for Payer: University Health Alliance Commercial	$118.49

Suture Stratafix Monocryl 4-0 70cm PS-2 SXMP1B116 [3642561]

Facility

$253.72

Hospital Charge Code	3642561
Hospital Revenue Code	272
Min. Negotiated Rate	$129.40
Max. Negotiated Rate	$246.11
Rate for Payer: Cash Price	$164.92
Rate for Payer: Hawaii Western Management Group Commercial	$241.03
Rate for Payer: Health Management Network Commercial	$215.66
Rate for Payer: Kaiser Permanente Commercial	$159.84
Rate for Payer: Kaiser Permanente Medicaid	$129.40
Rate for Payer: MDX Hawaii PPO	$246.11
Rate for Payer: University Health Alliance Commercial	$184.94

Suture Stratafix Monocryl 4-0 70cm PS-2 SXMP1B116 [3642561]

Facility

$253.72

Hospital Charge Code	3642561
Hospital Revenue Code	272
Min. Negotiated Rate	$215.66
Max. Negotiated Rate	$246.11
Rate for Payer: Cash Price	$164.92
Rate for Payer: Health Management Network Commercial	$215.66
Rate for Payer: MDX Hawaii PPO	$246.11

Suture Stratafix PDS 0 23cm CT-1 SXPP1B455 [3642552]

Facility

$211.73

Hospital Charge Code	3642552
Hospital Revenue Code	272
Min. Negotiated Rate	$107.98
Max. Negotiated Rate	$205.38
Rate for Payer: Cash Price	$137.62
Rate for Payer: Hawaii Western Management Group Commercial	$201.14
Rate for Payer: Health Management Network Commercial	$179.97
Rate for Payer: Kaiser Permanente Commercial	$133.39
Rate for Payer: Kaiser Permanente Medicaid	$107.98
Rate for Payer: MDX Hawaii PPO	$205.38
Rate for Payer: University Health Alliance Commercial	$154.33

Suture Stratafix PDS 0 23cm CT-1 SXPP1B455 [3642552]

Facility

$211.73

Hospital Charge Code	3642552
Hospital Revenue Code	272
Min. Negotiated Rate	$179.97
Max. Negotiated Rate	$205.38
Rate for Payer: Cash Price	$137.62
Rate for Payer: Health Management Network Commercial	$179.97
Rate for Payer: MDX Hawaii PPO	$205.38

Suture Stratafix PDS Plus 0 70cm CT-1 SXPP1B408 [3642577]

Facility

$153.30

Hospital Charge Code	3642577
Hospital Revenue Code	272
Min. Negotiated Rate	$130.31
Max. Negotiated Rate	$148.70
Rate for Payer: Cash Price	$99.65
Rate for Payer: Health Management Network Commercial	$130.31
Rate for Payer: MDX Hawaii PPO	$148.70

Suture Stratafix PDS Plus 0 70cm CT-1 SXPP1B408 [3642577]

Facility

$153.30

Hospital Charge Code	3642577
Hospital Revenue Code	272
Min. Negotiated Rate	$78.18
Max. Negotiated Rate	$148.70
Rate for Payer: Cash Price	$99.65
Rate for Payer: Hawaii Western Management Group Commercial	$145.63
Rate for Payer: Health Management Network Commercial	$130.31
Rate for Payer: Kaiser Permanente Commercial	$96.58
Rate for Payer: Kaiser Permanente Medicaid	$78.18
Rate for Payer: MDX Hawaii PPO	$148.70
Rate for Payer: University Health Alliance Commercial	$111.74

Suture Stratafix Pds Plus 0 9" Ct-2 Sxpp1a446 [3643638]

Facility

$219.23

Hospital Charge Code	3643638
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 Stratafix Pds Plus 0 9" Ct-2 Sxpp1a446 [3643638]

Facility

$219.23

Hospital Charge Code	3643638
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 Stratafix PDS Plus 2-0 23cm CT-2 SXPP1B432 [3642555]

Facility

$219.23

Hospital Charge Code	3642555
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 Stratafix PDS Plus 2-0 23cm CT-2 SXPP1B432 [3642555]

Facility

$219.23

Hospital Charge Code	3642555
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 Stratafix PDS Plus 2-0 30cm CT-1 SXPP1B410 [3642556]

Facility

$167.44

Hospital Charge Code	3642556
Hospital Revenue Code	272
Min. Negotiated Rate	$85.39
Max. Negotiated Rate	$162.42
Rate for Payer: Cash Price	$108.84
Rate for Payer: Hawaii Western Management Group Commercial	$159.07
Rate for Payer: Health Management Network Commercial	$142.32
Rate for Payer: Kaiser Permanente Commercial	$105.49
Rate for Payer: Kaiser Permanente Medicaid	$85.39
Rate for Payer: MDX Hawaii PPO	$162.42
Rate for Payer: University Health Alliance Commercial	$122.05

Suture Stratafix PDS Plus 2-0 30cm CT-1 SXPP1B410 [3642556]

Facility

$167.44

Hospital Charge Code	3642556
Hospital Revenue Code	272
Min. Negotiated Rate	$142.32
Max. Negotiated Rate	$162.42
Rate for Payer: Cash Price	$108.84
Rate for Payer: Health Management Network Commercial	$142.32
Rate for Payer: MDX Hawaii PPO	$162.42

Suture Stratafix PDS Plus 2-0 70cm CT-1 SXPP1B412 [3642554]

Facility

$217.94

Hospital Charge Code	3642554
Hospital Revenue Code	272
Min. Negotiated Rate	$111.15
Max. Negotiated Rate	$211.40
Rate for Payer: Cash Price	$141.66
Rate for Payer: Hawaii Western Management Group Commercial	$207.04
Rate for Payer: Health Management Network Commercial	$185.25
Rate for Payer: Kaiser Permanente Commercial	$137.30
Rate for Payer: Kaiser Permanente Medicaid	$111.15
Rate for Payer: MDX Hawaii PPO	$211.40
Rate for Payer: University Health Alliance Commercial	$158.86

Suture Stratafix PDS Plus 2-0 70cm CT-1 SXPP1B412 [3642554]

Facility

$217.94

Hospital Charge Code	3642554
Hospital Revenue Code	272
Min. Negotiated Rate	$185.25
Max. Negotiated Rate	$211.40
Rate for Payer: Cash Price	$141.66
Rate for Payer: Health Management Network Commercial	$185.25
Rate for Payer: MDX Hawaii PPO	$211.40

Suture Stratafix PDS Plus 3-0 15cm SH SXPP1B420 [3642558]

Facility

$251.29

Hospital Charge Code	3642558
Hospital Revenue Code	272
Min. Negotiated Rate	$213.60
Max. Negotiated Rate	$243.75
Rate for Payer: Cash Price	$163.34
Rate for Payer: Health Management Network Commercial	$213.60
Rate for Payer: MDX Hawaii PPO	$243.75

Suture Stratafix PDS Plus 3-0 15cm SH SXPP1B420 [3642558]

Facility

$251.29

Hospital Charge Code	3642558
Hospital Revenue Code	272
Min. Negotiated Rate	$128.16
Max. Negotiated Rate	$243.75
Rate for Payer: Cash Price	$163.34
Rate for Payer: Hawaii Western Management Group Commercial	$238.73
Rate for Payer: Health Management Network Commercial	$213.60
Rate for Payer: Kaiser Permanente Commercial	$158.31
Rate for Payer: Kaiser Permanente Medicaid	$128.16
Rate for Payer: MDX Hawaii PPO	$243.75
Rate for Payer: University Health Alliance Commercial	$183.17

Know your out-of-pocket cost for care.

All Charges