Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Trimed IM Nail Thrd Ti 2.4 x 30mm IMN2.4-30T [3644947]

Facility

$7,208.00

Service Code	HCPCS C1713
Hospital Charge Code	3644947
Hospital Revenue Code	278
Min. Negotiated Rate	$3,676.08
Max. Negotiated Rate	$6,991.76
Rate for Payer: Cash Price	$4,685.20
Rate for Payer: Hawaii Western Management Group Commercial	$5,045.60
Rate for Payer: Health Management Network Commercial	$6,126.80
Rate for Payer: Kaiser Permanente Commercial	$4,541.04
Rate for Payer: Kaiser Permanente Medicaid	$3,676.08
Rate for Payer: MDX Hawaii PPO	$6,991.76
Rate for Payer: University Health Alliance Commercial	$4,036.48

Trimed IM Nail Thrd Ti 2.4 x 30mm IMN2.4-30T [3644947]

Facility

$7,208.00

Service Code	HCPCS C1713
Hospital Charge Code	3644947
Hospital Revenue Code	278
Min. Negotiated Rate	$4,036.48
Max. Negotiated Rate	$6,991.76
Rate for Payer: Cash Price	$4,685.20
Rate for Payer: Hawaii Western Management Group Commercial	$5,045.60
Rate for Payer: Health Management Network Commercial	$6,126.80
Rate for Payer: MDX Hawaii PPO	$6,991.76
Rate for Payer: University Health Alliance Commercial	$4,036.48

Trimed IM Nail Thrd Ti 2.4 x 45mm IMN2.4-45T [3644948]

Facility

$7,208.00

Service Code	HCPCS C1713
Hospital Charge Code	3644948
Hospital Revenue Code	278
Min. Negotiated Rate	$3,676.08
Max. Negotiated Rate	$6,991.76
Rate for Payer: Cash Price	$4,685.20
Rate for Payer: Hawaii Western Management Group Commercial	$5,045.60
Rate for Payer: Health Management Network Commercial	$6,126.80
Rate for Payer: Kaiser Permanente Commercial	$4,541.04
Rate for Payer: Kaiser Permanente Medicaid	$3,676.08
Rate for Payer: MDX Hawaii PPO	$6,991.76
Rate for Payer: University Health Alliance Commercial	$4,036.48

Trimed IM Nail Thrd Ti 2.4 x 45mm IMN2.4-45T [3644948]

Facility

$7,208.00

Service Code	HCPCS C1713
Hospital Charge Code	3644948
Hospital Revenue Code	278
Min. Negotiated Rate	$4,036.48
Max. Negotiated Rate	$6,991.76
Rate for Payer: Cash Price	$4,685.20
Rate for Payer: Hawaii Western Management Group Commercial	$5,045.60
Rate for Payer: Health Management Network Commercial	$6,126.80
Rate for Payer: MDX Hawaii PPO	$6,991.76
Rate for Payer: University Health Alliance Commercial	$4,036.48

Trimed K Wire 1.1 x 120mm WIRE-1.1/120 [3644945]

Facility

$228.00

Hospital Charge Code	3644945
Hospital Revenue Code	272
Min. Negotiated Rate	$116.28
Max. Negotiated Rate	$221.16
Rate for Payer: Cash Price	$148.20
Rate for Payer: Hawaii Western Management Group Commercial	$216.60
Rate for Payer: Health Management Network Commercial	$193.80
Rate for Payer: Kaiser Permanente Commercial	$143.64
Rate for Payer: Kaiser Permanente Medicaid	$116.28
Rate for Payer: MDX Hawaii PPO	$221.16
Rate for Payer: University Health Alliance Commercial	$166.19

Trimed K Wire 1.1 x 120mm WIRE-1.1/120 [3644945]

Facility

$228.00

Hospital Charge Code	3644945
Hospital Revenue Code	272
Min. Negotiated Rate	$193.80
Max. Negotiated Rate	$221.16
Rate for Payer: Cash Price	$148.20
Rate for Payer: Health Management Network Commercial	$193.80
Rate for Payer: MDX Hawaii PPO	$221.16

Trimed Peg Locking Thread 2.3mmx12mm Tpeg-12 [3644412]

Facility

$689.28

Service Code	HCPCS C1713
Hospital Charge Code	3644412
Hospital Revenue Code	278
Min. Negotiated Rate	$351.53
Max. Negotiated Rate	$668.60
Rate for Payer: Cash Price	$448.03
Rate for Payer: Hawaii Western Management Group Commercial	$482.50
Rate for Payer: Health Management Network Commercial	$585.89
Rate for Payer: Kaiser Permanente Commercial	$434.25
Rate for Payer: Kaiser Permanente Medicaid	$351.53
Rate for Payer: MDX Hawaii PPO	$668.60
Rate for Payer: University Health Alliance Commercial	$386.00

Trimed Peg Locking Thread 2.3mmx12mm Tpeg-12 [3644412]

Facility

$689.28

Service Code	HCPCS C1713
Hospital Charge Code	3644412
Hospital Revenue Code	278
Min. Negotiated Rate	$386.00
Max. Negotiated Rate	$668.60
Rate for Payer: Cash Price	$448.03
Rate for Payer: Hawaii Western Management Group Commercial	$482.50
Rate for Payer: Health Management Network Commercial	$585.89
Rate for Payer: MDX Hawaii PPO	$668.60
Rate for Payer: University Health Alliance Commercial	$386.00

Trimed Peg Locking Threaded 2.3mmX14mm TPEG-14 [3642475]

Facility

$849.93

Service Code	HCPCS C1713
Hospital Charge Code	3642475
Hospital Revenue Code	278
Min. Negotiated Rate	$433.46
Max. Negotiated Rate	$824.43
Rate for Payer: Cash Price	$552.45
Rate for Payer: Hawaii Western Management Group Commercial	$594.95
Rate for Payer: Health Management Network Commercial	$722.44
Rate for Payer: Kaiser Permanente Commercial	$535.46
Rate for Payer: Kaiser Permanente Medicaid	$433.46
Rate for Payer: MDX Hawaii PPO	$824.43
Rate for Payer: University Health Alliance Commercial	$475.96

Trimed Peg Locking Threaded 2.3mmX14mm TPEG-14 [3642475]

Facility

$849.93

Service Code	HCPCS C1713
Hospital Charge Code	3642475
Hospital Revenue Code	278
Min. Negotiated Rate	$475.96
Max. Negotiated Rate	$824.43
Rate for Payer: Cash Price	$552.45
Rate for Payer: Hawaii Western Management Group Commercial	$594.95
Rate for Payer: Health Management Network Commercial	$722.44
Rate for Payer: MDX Hawaii PPO	$824.43
Rate for Payer: University Health Alliance Commercial	$475.96

Trimed Peg Locking Threaded 2.3mm x 16mm TPEG-16 [3641940]

Facility

$849.93

Service Code	HCPCS C1713
Hospital Charge Code	3641940
Hospital Revenue Code	278
Min. Negotiated Rate	$433.46
Max. Negotiated Rate	$824.43
Rate for Payer: Cash Price	$552.45
Rate for Payer: Hawaii Western Management Group Commercial	$594.95
Rate for Payer: Health Management Network Commercial	$722.44
Rate for Payer: Kaiser Permanente Commercial	$535.46
Rate for Payer: Kaiser Permanente Medicaid	$433.46
Rate for Payer: MDX Hawaii PPO	$824.43
Rate for Payer: University Health Alliance Commercial	$475.96

Trimed Peg Locking Threaded 2.3mm x 16mm TPEG-16 [3641940]

Facility

$849.93

Service Code	HCPCS C1713
Hospital Charge Code	3641940
Hospital Revenue Code	278
Min. Negotiated Rate	$475.96
Max. Negotiated Rate	$824.43
Rate for Payer: Cash Price	$552.45
Rate for Payer: Hawaii Western Management Group Commercial	$594.95
Rate for Payer: Health Management Network Commercial	$722.44
Rate for Payer: MDX Hawaii PPO	$824.43
Rate for Payer: University Health Alliance Commercial	$475.96

Trimed Peg Locking Threaded 2.3mm x 18mm TPEG-18 [3640326]

Facility

$849.93

Service Code	HCPCS C1713
Hospital Charge Code	3640326
Hospital Revenue Code	278
Min. Negotiated Rate	$475.96
Max. Negotiated Rate	$824.43
Rate for Payer: Cash Price	$552.45
Rate for Payer: Hawaii Western Management Group Commercial	$594.95
Rate for Payer: Health Management Network Commercial	$722.44
Rate for Payer: MDX Hawaii PPO	$824.43
Rate for Payer: University Health Alliance Commercial	$475.96

Trimed Peg Locking Threaded 2.3mm x 18mm TPEG-18 [3640326]

Facility

$849.93

Service Code	HCPCS C1713
Hospital Charge Code	3640326
Hospital Revenue Code	278
Min. Negotiated Rate	$433.46
Max. Negotiated Rate	$824.43
Rate for Payer: Cash Price	$552.45
Rate for Payer: Hawaii Western Management Group Commercial	$594.95
Rate for Payer: Health Management Network Commercial	$722.44
Rate for Payer: Kaiser Permanente Commercial	$535.46
Rate for Payer: Kaiser Permanente Medicaid	$433.46
Rate for Payer: MDX Hawaii PPO	$824.43
Rate for Payer: University Health Alliance Commercial	$475.96

Trimed Peg Locking Threaded 2.3mmX20mm TPEG-20 [3640326A]

Facility

$849.93

Service Code	HCPCS C1713
Hospital Charge Code	3640326A
Hospital Revenue Code	278
Min. Negotiated Rate	$433.46
Max. Negotiated Rate	$824.43
Rate for Payer: Cash Price	$552.45
Rate for Payer: Hawaii Western Management Group Commercial	$594.95
Rate for Payer: Health Management Network Commercial	$722.44
Rate for Payer: Kaiser Permanente Commercial	$535.46
Rate for Payer: Kaiser Permanente Medicaid	$433.46
Rate for Payer: MDX Hawaii PPO	$824.43
Rate for Payer: University Health Alliance Commercial	$475.96

Trimed Peg Locking Threaded 2.3mmX20mm TPEG-20 [3640326A]

Facility

$849.93

Service Code	HCPCS C1713
Hospital Charge Code	3640326A
Hospital Revenue Code	278
Min. Negotiated Rate	$475.96
Max. Negotiated Rate	$824.43
Rate for Payer: Cash Price	$552.45
Rate for Payer: Hawaii Western Management Group Commercial	$594.95
Rate for Payer: Health Management Network Commercial	$722.44
Rate for Payer: MDX Hawaii PPO	$824.43
Rate for Payer: University Health Alliance Commercial	$475.96

Trimed Peg Locking Threaded 2.3mmX22mm TPEG-22 [3640326B]

Facility

$689.28

Service Code	HCPCS C1713
Hospital Charge Code	3640326B
Hospital Revenue Code	278
Min. Negotiated Rate	$351.53
Max. Negotiated Rate	$668.60
Rate for Payer: Cash Price	$448.03
Rate for Payer: Hawaii Western Management Group Commercial	$482.50
Rate for Payer: Health Management Network Commercial	$585.89
Rate for Payer: Kaiser Permanente Commercial	$434.25
Rate for Payer: Kaiser Permanente Medicaid	$351.53
Rate for Payer: MDX Hawaii PPO	$668.60
Rate for Payer: University Health Alliance Commercial	$386.00

Trimed Peg Locking Threaded 2.3mmX22mm TPEG-22 [3640326B]

Facility

$689.28

Service Code	HCPCS C1713
Hospital Charge Code	3640326B
Hospital Revenue Code	278
Min. Negotiated Rate	$386.00
Max. Negotiated Rate	$668.60
Rate for Payer: Cash Price	$448.03
Rate for Payer: Hawaii Western Management Group Commercial	$482.50
Rate for Payer: Health Management Network Commercial	$585.89
Rate for Payer: MDX Hawaii PPO	$668.60
Rate for Payer: University Health Alliance Commercial	$386.00

Trimed Peg Locking Threaded 2.3mm x 24mm TPEG-24 [3640326C]

Facility

$689.28

Service Code	HCPCS C1713
Hospital Charge Code	3640326C
Hospital Revenue Code	278
Min. Negotiated Rate	$351.53
Max. Negotiated Rate	$668.60
Rate for Payer: Cash Price	$448.03
Rate for Payer: Hawaii Western Management Group Commercial	$482.50
Rate for Payer: Health Management Network Commercial	$585.89
Rate for Payer: Kaiser Permanente Commercial	$434.25
Rate for Payer: Kaiser Permanente Medicaid	$351.53
Rate for Payer: MDX Hawaii PPO	$668.60
Rate for Payer: University Health Alliance Commercial	$386.00

Trimed Peg Locking Threaded 2.3mm x 24mm TPEG-24 [3640326C]

Facility

$689.28

Service Code	HCPCS C1713
Hospital Charge Code	3640326C
Hospital Revenue Code	278
Min. Negotiated Rate	$386.00
Max. Negotiated Rate	$668.60
Rate for Payer: Cash Price	$448.03
Rate for Payer: Hawaii Western Management Group Commercial	$482.50
Rate for Payer: Health Management Network Commercial	$585.89
Rate for Payer: MDX Hawaii PPO	$668.60
Rate for Payer: University Health Alliance Commercial	$386.00

Trimed Pin Plate Radial 5 Hole Rcp5 [3643895]

Facility

$2,170.00

Service Code	HCPCS C1713
Hospital Charge Code	3643895
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.70
Max. Negotiated Rate	$2,104.90
Rate for Payer: Cash Price	$1,410.50
Rate for Payer: Hawaii Western Management Group Commercial	$1,519.00
Rate for Payer: Health Management Network Commercial	$1,844.50
Rate for Payer: Kaiser Permanente Commercial	$1,367.10
Rate for Payer: Kaiser Permanente Medicaid	$1,106.70
Rate for Payer: MDX Hawaii PPO	$2,104.90
Rate for Payer: University Health Alliance Commercial	$1,215.20

Trimed Pin Plate Radial 5 Hole Rcp5 [3643895]

Facility

$2,170.00

Service Code	HCPCS C1713
Hospital Charge Code	3643895
Hospital Revenue Code	278
Min. Negotiated Rate	$1,215.20
Max. Negotiated Rate	$2,104.90
Rate for Payer: Cash Price	$1,410.50
Rate for Payer: Hawaii Western Management Group Commercial	$1,519.00
Rate for Payer: Health Management Network Commercial	$1,844.50
Rate for Payer: MDX Hawaii PPO	$2,104.90
Rate for Payer: University Health Alliance Commercial	$1,215.20

Trimed Plate Fixed Angle 3H 7 Peg Lt VPPL-3-7 [3644817]

Facility

$4,395.50

Service Code	HCPCS C1713
Hospital Charge Code	3644817
Hospital Revenue Code	278
Min. Negotiated Rate	$2,461.48
Max. Negotiated Rate	$4,263.64
Rate for Payer: Cash Price	$2,857.08
Rate for Payer: Hawaii Western Management Group Commercial	$3,076.85
Rate for Payer: Health Management Network Commercial	$3,736.18
Rate for Payer: MDX Hawaii PPO	$4,263.64
Rate for Payer: University Health Alliance Commercial	$2,461.48

Trimed Plate Fixed Angle 3H 7 Peg Lt VPPL-3-7 [3644817]

Facility

$4,395.50

Service Code	HCPCS C1713
Hospital Charge Code	3644817
Hospital Revenue Code	278
Min. Negotiated Rate	$2,241.70
Max. Negotiated Rate	$4,263.64
Rate for Payer: Cash Price	$2,857.08
Rate for Payer: Hawaii Western Management Group Commercial	$3,076.85
Rate for Payer: Health Management Network Commercial	$3,736.18
Rate for Payer: Kaiser Permanente Commercial	$2,769.16
Rate for Payer: Kaiser Permanente Medicaid	$2,241.70
Rate for Payer: MDX Hawaii PPO	$4,263.64
Rate for Payer: University Health Alliance Commercial	$2,461.48

Trimed Plate Fixed Angle 3h 7peg Rt VPPR-3-7 [3644382]

Facility

$3,563.00

Service Code	HCPCS C1713
Hospital Charge Code	3644382
Hospital Revenue Code	278
Min. Negotiated Rate	$1,995.28
Max. Negotiated Rate	$3,456.11
Rate for Payer: Cash Price	$2,315.95
Rate for Payer: Hawaii Western Management Group Commercial	$2,494.10
Rate for Payer: Health Management Network Commercial	$3,028.55
Rate for Payer: MDX Hawaii PPO	$3,456.11
Rate for Payer: University Health Alliance Commercial	$1,995.28

Know your out-of-pocket cost for care.

All Charges