Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Suture Vicryl Plus 0 CT-1 CR VCPP31D [3642566]

Facility

$143.04

Hospital Charge Code	3642566
Hospital Revenue Code	272
Min. Negotiated Rate	$121.58
Max. Negotiated Rate	$138.75
Rate for Payer: Cash Price	$92.98
Rate for Payer: Health Management Network Commercial	$121.58
Rate for Payer: MDX Hawaii PPO	$138.75

Suture Vicryl Plus 0 CT CR VCP752D [3642569]

Facility

$147.60

Hospital Charge Code	3642569
Hospital Revenue Code	272
Min. Negotiated Rate	$75.28
Max. Negotiated Rate	$143.17
Rate for Payer: Cash Price	$95.94
Rate for Payer: Hawaii Western Management Group Commercial	$140.22
Rate for Payer: Health Management Network Commercial	$125.46
Rate for Payer: Kaiser Permanente Commercial	$92.99
Rate for Payer: Kaiser Permanente Medicaid	$75.28
Rate for Payer: MDX Hawaii PPO	$143.17
Rate for Payer: University Health Alliance Commercial	$107.59

Suture Vicryl Plus 0 CT CR VCP752D [3642569]

Facility

$147.60

Hospital Charge Code	3642569
Hospital Revenue Code	272
Min. Negotiated Rate	$125.46
Max. Negotiated Rate	$143.17
Rate for Payer: Cash Price	$95.94
Rate for Payer: Health Management Network Commercial	$125.46
Rate for Payer: MDX Hawaii PPO	$143.17

Suture Vicryl Plus 1 CT CR VCP753D [3642568]

Facility

$147.60

Hospital Charge Code	3642568
Hospital Revenue Code	272
Min. Negotiated Rate	$125.46
Max. Negotiated Rate	$143.17
Rate for Payer: Cash Price	$95.94
Rate for Payer: Health Management Network Commercial	$125.46
Rate for Payer: MDX Hawaii PPO	$143.17

Suture Vicryl Plus 1 CT CR VCP753D [3642568]

Facility

$147.60

Hospital Charge Code	3642568
Hospital Revenue Code	272
Min. Negotiated Rate	$75.28
Max. Negotiated Rate	$143.17
Rate for Payer: Cash Price	$95.94
Rate for Payer: Hawaii Western Management Group Commercial	$140.22
Rate for Payer: Health Management Network Commercial	$125.46
Rate for Payer: Kaiser Permanente Commercial	$92.99
Rate for Payer: Kaiser Permanente Medicaid	$75.28
Rate for Payer: MDX Hawaii PPO	$143.17
Rate for Payer: University Health Alliance Commercial	$107.59

Suture Vicryl Plus 1 CTX CR VCP765D [3642485]

Facility

$144.24

Hospital Charge Code	3642485
Hospital Revenue Code	272
Min. Negotiated Rate	$122.60
Max. Negotiated Rate	$139.91
Rate for Payer: Cash Price	$93.76
Rate for Payer: Health Management Network Commercial	$122.60
Rate for Payer: MDX Hawaii PPO	$139.91

Suture Vicryl Plus 1 CTX CR VCP765D [3642485]

Facility

$144.24

Hospital Charge Code	3642485
Hospital Revenue Code	272
Min. Negotiated Rate	$73.56
Max. Negotiated Rate	$139.91
Rate for Payer: Cash Price	$93.76
Rate for Payer: Hawaii Western Management Group Commercial	$137.03
Rate for Payer: Health Management Network Commercial	$122.60
Rate for Payer: Kaiser Permanente Commercial	$90.87
Rate for Payer: Kaiser Permanente Medicaid	$73.56
Rate for Payer: MDX Hawaii PPO	$139.91
Rate for Payer: University Health Alliance Commercial	$105.14

Suture Vicryl Plus 2-0 CP-2 VCP266H [3641004]

Facility

$20.66

Hospital Charge Code	3641004
Hospital Revenue Code	272
Min. Negotiated Rate	$17.56
Max. Negotiated Rate	$20.04
Rate for Payer: Cash Price	$13.43
Rate for Payer: Health Management Network Commercial	$17.56
Rate for Payer: MDX Hawaii PPO	$20.04

Suture Vicryl Plus 2-0 CP-2 VCP266H [3641004]

Facility

$20.66

Hospital Charge Code	3641004
Hospital Revenue Code	272
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$20.04
Rate for Payer: Cash Price	$13.43
Rate for Payer: Hawaii Western Management Group Commercial	$19.63
Rate for Payer: Health Management Network Commercial	$17.56
Rate for Payer: Kaiser Permanente Commercial	$13.02
Rate for Payer: Kaiser Permanente Medicaid	$10.54
Rate for Payer: MDX Hawaii PPO	$20.04
Rate for Payer: University Health Alliance Commercial	$15.06

Suture Vicryl Plus 2-0 SH CR VCP785D [3642570]

Facility

$149.04

Hospital Charge Code	3642570
Hospital Revenue Code	272
Min. Negotiated Rate	$76.01
Max. Negotiated Rate	$144.57
Rate for Payer: Cash Price	$96.88
Rate for Payer: Hawaii Western Management Group Commercial	$141.59
Rate for Payer: Health Management Network Commercial	$126.68
Rate for Payer: Kaiser Permanente Commercial	$93.90
Rate for Payer: Kaiser Permanente Medicaid	$76.01
Rate for Payer: MDX Hawaii PPO	$144.57
Rate for Payer: University Health Alliance Commercial	$108.64

Suture Vicryl Plus 2-0 SH CR VCP785D [3642570]

Facility

$149.04

Hospital Charge Code	3642570
Hospital Revenue Code	272
Min. Negotiated Rate	$126.68
Max. Negotiated Rate	$144.57
Rate for Payer: Cash Price	$96.88
Rate for Payer: Health Management Network Commercial	$126.68
Rate for Payer: MDX Hawaii PPO	$144.57

Suture Vicryl Plus 2-0 UR-6 VCP602H [3641001]

Facility

$23.97

Hospital Charge Code	3641001
Hospital Revenue Code	272
Min. Negotiated Rate	$12.22
Max. Negotiated Rate	$23.25
Rate for Payer: Cash Price	$15.58
Rate for Payer: Hawaii Western Management Group Commercial	$22.77
Rate for Payer: Health Management Network Commercial	$20.37
Rate for Payer: Kaiser Permanente Commercial	$15.10
Rate for Payer: Kaiser Permanente Medicaid	$12.22
Rate for Payer: MDX Hawaii PPO	$23.25
Rate for Payer: University Health Alliance Commercial	$17.47

Suture Vicryl Plus 2-0 UR-6 VCP602H [3641001]

Facility

$23.97

Hospital Charge Code	3641001
Hospital Revenue Code	272
Min. Negotiated Rate	$20.37
Max. Negotiated Rate	$23.25
Rate for Payer: Cash Price	$15.58
Rate for Payer: Health Management Network Commercial	$20.37
Rate for Payer: MDX Hawaii PPO	$23.25

Suture Vicryl Plus 3-0 SH CR VCP784D [3642574]

Facility

$147.44

Hospital Charge Code	3642574
Hospital Revenue Code	272
Min. Negotiated Rate	$75.19
Max. Negotiated Rate	$143.02
Rate for Payer: Cash Price	$95.84
Rate for Payer: Hawaii Western Management Group Commercial	$140.07
Rate for Payer: Health Management Network Commercial	$125.32
Rate for Payer: Kaiser Permanente Commercial	$92.89
Rate for Payer: Kaiser Permanente Medicaid	$75.19
Rate for Payer: MDX Hawaii PPO	$143.02
Rate for Payer: University Health Alliance Commercial	$107.47

Suture Vicryl Plus 3-0 SH CR VCP784D [3642574]

Facility

$147.44

Hospital Charge Code	3642574
Hospital Revenue Code	272
Min. Negotiated Rate	$125.32
Max. Negotiated Rate	$143.02
Rate for Payer: Cash Price	$95.84
Rate for Payer: Health Management Network Commercial	$125.32
Rate for Payer: MDX Hawaii PPO	$143.02

Suture Vicryl Plus 3-0 VCP265H [3641002]

Facility

$43.01

Hospital Charge Code	3641002
Hospital Revenue Code	272
Min. Negotiated Rate	$36.56
Max. Negotiated Rate	$41.72
Rate for Payer: Cash Price	$27.96
Rate for Payer: Health Management Network Commercial	$36.56
Rate for Payer: MDX Hawaii PPO	$41.72

Suture Vicryl Plus 3-0 VCP265H [3641002]

Facility

$43.01

Hospital Charge Code	3641002
Hospital Revenue Code	272
Min. Negotiated Rate	$21.94
Max. Negotiated Rate	$41.72
Rate for Payer: Kaiser Permanente Medicaid	$21.94
Rate for Payer: Cash Price	$27.96
Rate for Payer: Hawaii Western Management Group Commercial	$40.86
Rate for Payer: Health Management Network Commercial	$36.56
Rate for Payer: Kaiser Permanente Commercial	$27.10
Rate for Payer: MDX Hawaii PPO	$41.72
Rate for Payer: University Health Alliance Commercial	$31.35

Suture VLOC 2-0 Estch Non Abs VLOCN206L [3640569]

Facility

$304.21

Hospital Charge Code	3640569
Hospital Revenue Code	272
Min. Negotiated Rate	$258.58
Max. Negotiated Rate	$295.08
Rate for Payer: Cash Price	$197.74
Rate for Payer: Health Management Network Commercial	$258.58
Rate for Payer: MDX Hawaii PPO	$295.08

Suture VLOC 2-0 Estch Non Abs VLOCN206L [3640569]

Facility

$304.21

Hospital Charge Code	3640569
Hospital Revenue Code	272
Min. Negotiated Rate	$155.15
Max. Negotiated Rate	$295.08
Rate for Payer: Cash Price	$197.74
Rate for Payer: Hawaii Western Management Group Commercial	$289.00
Rate for Payer: Health Management Network Commercial	$258.58
Rate for Payer: Kaiser Permanente Commercial	$191.65
Rate for Payer: Kaiser Permanente Medicaid	$155.15
Rate for Payer: MDX Hawaii PPO	$295.08
Rate for Payer: University Health Alliance Commercial	$221.74

Suture VLOC 3-0 12IN VLOCM0114 [3603176]

Facility

$288.01

Hospital Charge Code	3603176
Hospital Revenue Code	272
Min. Negotiated Rate	$146.89
Max. Negotiated Rate	$279.37
Rate for Payer: Cash Price	$187.21
Rate for Payer: Hawaii Western Management Group Commercial	$273.61
Rate for Payer: Health Management Network Commercial	$244.81
Rate for Payer: Kaiser Permanente Commercial	$181.45
Rate for Payer: Kaiser Permanente Medicaid	$146.89
Rate for Payer: MDX Hawaii PPO	$279.37
Rate for Payer: University Health Alliance Commercial	$209.93

Suture VLOC 3-0 12IN VLOCM0114 [3603176]

Facility

$288.01

Hospital Charge Code	3603176
Hospital Revenue Code	272
Min. Negotiated Rate	$244.81
Max. Negotiated Rate	$279.37
Rate for Payer: Cash Price	$187.21
Rate for Payer: Health Management Network Commercial	$244.81
Rate for Payer: MDX Hawaii PPO	$279.37

Suture VLOC 3-0 23IN VLOCM0134 [3603177]

Facility

$225.34

Hospital Charge Code	3603177
Hospital Revenue Code	272
Min. Negotiated Rate	$191.54
Max. Negotiated Rate	$218.58
Rate for Payer: Cash Price	$146.47
Rate for Payer: Health Management Network Commercial	$191.54
Rate for Payer: MDX Hawaii PPO	$218.58

Suture VLOC 3-0 23IN VLOCM0134 [3603177]

Facility

$225.34

Hospital Charge Code	3603177
Hospital Revenue Code	272
Min. Negotiated Rate	$114.92
Max. Negotiated Rate	$218.58
Rate for Payer: Cash Price	$146.47
Rate for Payer: Hawaii Western Management Group Commercial	$214.07
Rate for Payer: Health Management Network Commercial	$191.54
Rate for Payer: Kaiser Permanente Commercial	$141.96
Rate for Payer: Kaiser Permanente Medicaid	$114.92
Rate for Payer: MDX Hawaii PPO	$218.58
Rate for Payer: University Health Alliance Commercial	$164.25

Suture Xbraid S Sz2 W/B NON-N 3910-900-028 [3644271]

Facility

$268.43

Hospital Charge Code	3644271
Hospital Revenue Code	272
Min. Negotiated Rate	$136.90
Max. Negotiated Rate	$260.38
Rate for Payer: Cash Price	$174.48
Rate for Payer: Hawaii Western Management Group Commercial	$255.01
Rate for Payer: Health Management Network Commercial	$228.17
Rate for Payer: Kaiser Permanente Commercial	$169.11
Rate for Payer: Kaiser Permanente Medicaid	$136.90
Rate for Payer: MDX Hawaii PPO	$260.38
Rate for Payer: University Health Alliance Commercial	$195.66

Suture Xbraid S Sz2 W/B NON-N 3910-900-028 [3644271]

Facility

$268.43

Hospital Charge Code	3644271
Hospital Revenue Code	272
Min. Negotiated Rate	$228.17
Max. Negotiated Rate	$260.38
Rate for Payer: Cash Price	$174.48
Rate for Payer: Health Management Network Commercial	$228.17
Rate for Payer: MDX Hawaii PPO	$260.38

Know your out-of-pocket cost for care.

All Charges