Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Acumed .059mm x 5 inch St Guidewire WS-1505ST [3644065]

Facility

$161.00

Hospital Charge Code	3644065
Hospital Revenue Code	272
Min. Negotiated Rate	$136.85
Max. Negotiated Rate	$156.17
Rate for Payer: Cash Price	$104.65
Rate for Payer: Health Management Network Commercial	$136.85
Rate for Payer: MDX Hawaii PPO	$156.17

Acumed .059mm x 5 inch St Guidewire WS-1505ST [3644065]

Facility

$161.00

Hospital Charge Code	3644065
Hospital Revenue Code	272
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$156.17
Rate for Payer: Cash Price	$104.65
Rate for Payer: Hawaii Western Management Group Commercial	$152.95
Rate for Payer: Health Management Network Commercial	$136.85
Rate for Payer: Kaiser Permanente Commercial	$101.43
Rate for Payer: Kaiser Permanente Medicaid	$82.11
Rate for Payer: MDX Hawaii PPO	$156.17
Rate for Payer: University Health Alliance Commercial	$117.35

Acumed Drill 2.0mm Qr W/depth Marks 80-2378 [3644063]

Facility

$1,093.13

Hospital Charge Code	3644063
Hospital Revenue Code	272
Min. Negotiated Rate	$557.50
Max. Negotiated Rate	$1,060.34
Rate for Payer: Cash Price	$710.53
Rate for Payer: Hawaii Western Management Group Commercial	$1,038.47
Rate for Payer: Health Management Network Commercial	$929.16
Rate for Payer: Kaiser Permanente Commercial	$688.67
Rate for Payer: Kaiser Permanente Medicaid	$557.50
Rate for Payer: MDX Hawaii PPO	$1,060.34
Rate for Payer: University Health Alliance Commercial	$796.78

Acumed Drill 2.0mm Qr W/depth Marks 80-2378 [3644063]

Facility

$1,093.13

Hospital Charge Code	3644063
Hospital Revenue Code	272
Min. Negotiated Rate	$929.16
Max. Negotiated Rate	$1,060.34
Rate for Payer: Cash Price	$710.53
Rate for Payer: Health Management Network Commercial	$929.16
Rate for Payer: MDX Hawaii PPO	$1,060.34

Acumed Drill 2.0mm x 5 inch Qr MS-DC5020 [3644054]

Facility

$651.88

Hospital Charge Code	3644054
Hospital Revenue Code	272
Min. Negotiated Rate	$332.46
Max. Negotiated Rate	$632.32
Rate for Payer: Cash Price	$423.72
Rate for Payer: Hawaii Western Management Group Commercial	$619.29
Rate for Payer: Health Management Network Commercial	$554.10
Rate for Payer: Kaiser Permanente Commercial	$410.68
Rate for Payer: Kaiser Permanente Medicaid	$332.46
Rate for Payer: MDX Hawaii PPO	$632.32
Rate for Payer: University Health Alliance Commercial	$475.16

Acumed Drill 2.0mm x 5 inch Qr MS-DC5020 [3644054]

Facility

$651.88

Hospital Charge Code	3644054
Hospital Revenue Code	272
Min. Negotiated Rate	$554.10
Max. Negotiated Rate	$632.32
Rate for Payer: Cash Price	$423.72
Rate for Payer: Health Management Network Commercial	$554.10
Rate for Payer: MDX Hawaii PPO	$632.32

Acumed Drill 2.8mm Quick Release 80-0387 [3641748]

Facility

$1,001.88

Hospital Charge Code	3641748
Hospital Revenue Code	272
Min. Negotiated Rate	$851.60
Max. Negotiated Rate	$971.82
Rate for Payer: Cash Price	$651.22
Rate for Payer: Health Management Network Commercial	$851.60
Rate for Payer: MDX Hawaii PPO	$971.82

Acumed Drill 2.8mm Quick Release 80-0387 [3641748]

Facility

$1,001.88

Hospital Charge Code	3641748
Hospital Revenue Code	272
Min. Negotiated Rate	$510.96
Max. Negotiated Rate	$971.82
Rate for Payer: Cash Price	$651.22
Rate for Payer: Hawaii Western Management Group Commercial	$951.79
Rate for Payer: Health Management Network Commercial	$851.60
Rate for Payer: Kaiser Permanente Commercial	$631.18
Rate for Payer: Kaiser Permanente Medicaid	$510.96
Rate for Payer: MDX Hawaii PPO	$971.82
Rate for Payer: University Health Alliance Commercial	$730.27

Acumed Drill 2.8mm x 5 inch Qr MS-DC28 [3644066]

Facility

$651.88

Hospital Charge Code	3644066
Hospital Revenue Code	272
Min. Negotiated Rate	$332.46
Max. Negotiated Rate	$632.32
Rate for Payer: Cash Price	$423.72
Rate for Payer: Hawaii Western Management Group Commercial	$619.29
Rate for Payer: Health Management Network Commercial	$554.10
Rate for Payer: Kaiser Permanente Commercial	$410.68
Rate for Payer: Kaiser Permanente Medicaid	$332.46
Rate for Payer: MDX Hawaii PPO	$632.32
Rate for Payer: University Health Alliance Commercial	$475.16

Acumed Drill 2.8mm x 5 inch Qr MS-DC28 [3644066]

Facility

$651.88

Hospital Charge Code	3644066
Hospital Revenue Code	272
Min. Negotiated Rate	$554.10
Max. Negotiated Rate	$632.32
Rate for Payer: Cash Price	$423.72
Rate for Payer: Health Management Network Commercial	$554.10
Rate for Payer: MDX Hawaii PPO	$632.32

Acumed Drill 3.5mm x 5 Inch Qr MS-DC35 [3644048]

Facility

$651.88

Hospital Charge Code	3644048
Hospital Revenue Code	272
Min. Negotiated Rate	$554.10
Max. Negotiated Rate	$632.32
Rate for Payer: Cash Price	$423.72
Rate for Payer: Health Management Network Commercial	$554.10
Rate for Payer: MDX Hawaii PPO	$632.32

Acumed Drill 3.5mm x 5 Inch Qr MS-DC35 [3644048]

Facility

$651.88

Hospital Charge Code	3644048
Hospital Revenue Code	272
Min. Negotiated Rate	$332.46
Max. Negotiated Rate	$632.32
Rate for Payer: Cash Price	$423.72
Rate for Payer: Hawaii Western Management Group Commercial	$619.29
Rate for Payer: Health Management Network Commercial	$554.10
Rate for Payer: Kaiser Permanente Commercial	$410.68
Rate for Payer: Kaiser Permanente Medicaid	$332.46
Rate for Payer: MDX Hawaii PPO	$632.32
Rate for Payer: University Health Alliance Commercial	$475.16

Acumed Driver Hexalobe T15 Stick Fit 80-0760 [3644049]

Facility

$1,970.50

Hospital Charge Code	3644049
Hospital Revenue Code	272
Min. Negotiated Rate	$1,674.92
Max. Negotiated Rate	$1,911.38
Rate for Payer: Cash Price	$1,280.82
Rate for Payer: Health Management Network Commercial	$1,674.92
Rate for Payer: MDX Hawaii PPO	$1,911.38

Acumed Driver Hexalobe T15 Stick Fit 80-0760 [3644049]

Facility

$1,970.50

Hospital Charge Code	3644049
Hospital Revenue Code	272
Min. Negotiated Rate	$1,004.96
Max. Negotiated Rate	$1,911.38
Rate for Payer: Cash Price	$1,280.82
Rate for Payer: Hawaii Western Management Group Commercial	$1,871.97
Rate for Payer: Health Management Network Commercial	$1,674.92
Rate for Payer: Kaiser Permanente Commercial	$1,241.41
Rate for Payer: Kaiser Permanente Medicaid	$1,004.96
Rate for Payer: MDX Hawaii PPO	$1,911.38
Rate for Payer: University Health Alliance Commercial	$1,436.30

Acumed Driver Hexalobe T8 Stick Fit 80-0759 [3644064]

Facility

$840.00

Hospital Charge Code	3644064
Hospital Revenue Code	272
Min. Negotiated Rate	$428.40
Max. Negotiated Rate	$814.80
Rate for Payer: Cash Price	$546.00
Rate for Payer: Hawaii Western Management Group Commercial	$798.00
Rate for Payer: Health Management Network Commercial	$714.00
Rate for Payer: Kaiser Permanente Commercial	$529.20
Rate for Payer: Kaiser Permanente Medicaid	$428.40
Rate for Payer: MDX Hawaii PPO	$814.80
Rate for Payer: University Health Alliance Commercial	$612.28

Acumed Driver Hexalobe T8 Stick Fit 80-0759 [3644064]

Facility

$840.00

Hospital Charge Code	3644064
Hospital Revenue Code	272
Min. Negotiated Rate	$714.00
Max. Negotiated Rate	$814.80
Rate for Payer: Cash Price	$546.00
Rate for Payer: Health Management Network Commercial	$714.00
Rate for Payer: MDX Hawaii PPO	$814.80

Acumed Guide Wire St 2.0mm x 6 inch 35-0015 [3644053]

Facility

$161.00

Hospital Charge Code	3644053
Hospital Revenue Code	272
Min. Negotiated Rate	$136.85
Max. Negotiated Rate	$156.17
Rate for Payer: Cash Price	$104.65
Rate for Payer: Health Management Network Commercial	$136.85
Rate for Payer: MDX Hawaii PPO	$156.17

Acumed Guide Wire St 2.0mm x 6 inch 35-0015 [3644053]

Facility

$161.00

Hospital Charge Code	3644053
Hospital Revenue Code	272
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$156.17
Rate for Payer: Cash Price	$104.65
Rate for Payer: Hawaii Western Management Group Commercial	$152.95
Rate for Payer: Health Management Network Commercial	$136.85
Rate for Payer: Kaiser Permanente Commercial	$101.43
Rate for Payer: Kaiser Permanente Medicaid	$82.11
Rate for Payer: MDX Hawaii PPO	$156.17
Rate for Payer: University Health Alliance Commercial	$117.35

Acumed Plate 6h Scapula Acromion Lt PL-SA06L [3644052]

Facility

$7,442.50

Service Code	HCPCS C1713
Hospital Charge Code	3644052
Hospital Revenue Code	278
Min. Negotiated Rate	$3,795.68
Max. Negotiated Rate	$7,219.23
Rate for Payer: Cash Price	$4,837.62
Rate for Payer: Hawaii Western Management Group Commercial	$5,209.75
Rate for Payer: Health Management Network Commercial	$6,326.12
Rate for Payer: Kaiser Permanente Commercial	$4,688.77
Rate for Payer: Kaiser Permanente Medicaid	$3,795.68
Rate for Payer: MDX Hawaii PPO	$7,219.23
Rate for Payer: University Health Alliance Commercial	$4,167.80

Acumed Plate 6h Scapula Acromion Lt PL-SA06L [3644052]

Facility

$7,442.50

Service Code	HCPCS C1713
Hospital Charge Code	3644052
Hospital Revenue Code	278
Min. Negotiated Rate	$4,167.80
Max. Negotiated Rate	$7,219.23
Rate for Payer: Cash Price	$4,837.62
Rate for Payer: Hawaii Western Management Group Commercial	$5,209.75
Rate for Payer: Health Management Network Commercial	$6,326.12
Rate for Payer: MDX Hawaii PPO	$7,219.23
Rate for Payer: University Health Alliance Commercial	$4,167.80

Acumed Plate L Fragment 2.7mm Rt 7010-0107R [3644058]

Facility

$1,911.00

Service Code	HCPCS C1713
Hospital Charge Code	3644058
Hospital Revenue Code	278
Min. Negotiated Rate	$974.61
Max. Negotiated Rate	$1,853.67
Rate for Payer: Cash Price	$1,242.15
Rate for Payer: Hawaii Western Management Group Commercial	$1,337.70
Rate for Payer: Health Management Network Commercial	$1,624.35
Rate for Payer: Kaiser Permanente Commercial	$1,203.93
Rate for Payer: Kaiser Permanente Medicaid	$974.61
Rate for Payer: MDX Hawaii PPO	$1,853.67
Rate for Payer: University Health Alliance Commercial	$1,070.16

Acumed Plate L Fragment 2.7mm Rt 7010-0107R [3644058]

Facility

$1,911.00

Service Code	HCPCS C1713
Hospital Charge Code	3644058
Hospital Revenue Code	278
Min. Negotiated Rate	$1,070.16
Max. Negotiated Rate	$1,853.67
Rate for Payer: Cash Price	$1,242.15
Rate for Payer: Hawaii Western Management Group Commercial	$1,337.70
Rate for Payer: Health Management Network Commercial	$1,624.35
Rate for Payer: MDX Hawaii PPO	$1,853.67
Rate for Payer: University Health Alliance Commercial	$1,070.16

Acumed Plate Tack PL-PTACK [3641842]

Facility

$450.63

Service Code	HCPCS C1713
Hospital Charge Code	3641842
Hospital Revenue Code	278
Min. Negotiated Rate	$252.35
Max. Negotiated Rate	$437.11
Rate for Payer: Cash Price	$292.91
Rate for Payer: Hawaii Western Management Group Commercial	$315.44
Rate for Payer: Health Management Network Commercial	$383.04
Rate for Payer: MDX Hawaii PPO	$437.11
Rate for Payer: University Health Alliance Commercial	$252.35

Acumed Plate Tack PL-PTACK [3641842]

Facility

$450.63

Service Code	HCPCS C1713
Hospital Charge Code	3641842
Hospital Revenue Code	278
Min. Negotiated Rate	$229.82
Max. Negotiated Rate	$437.11
Rate for Payer: Cash Price	$292.91
Rate for Payer: Hawaii Western Management Group Commercial	$315.44
Rate for Payer: Health Management Network Commercial	$383.04
Rate for Payer: Kaiser Permanente Commercial	$283.90
Rate for Payer: Kaiser Permanente Medicaid	$229.82
Rate for Payer: MDX Hawaii PPO	$437.11
Rate for Payer: University Health Alliance Commercial	$252.35

Acumed Screw Lock Hex 2.7mm x 10mm 30-0325 [3644059]

Facility

$1,071.88

Service Code	HCPCS C1713
Hospital Charge Code	3644059
Hospital Revenue Code	278
Min. Negotiated Rate	$600.25
Max. Negotiated Rate	$1,039.72
Rate for Payer: Cash Price	$696.72
Rate for Payer: Hawaii Western Management Group Commercial	$750.32
Rate for Payer: Health Management Network Commercial	$911.10
Rate for Payer: MDX Hawaii PPO	$1,039.72
Rate for Payer: University Health Alliance Commercial	$600.25

Know your out-of-pocket cost for care.

All Charges