Kona Community Hospital

All Charges

Charge

Type

Setting

Price

ACUTE ANXIETY & DELIRIUM STATES

Facility

$7,850.51

Service Code	APR-DRG 7564
Min. Negotiated Rate	$7,850.51
Max. Negotiated Rate	$7,850.51
Rate for Payer: AlohaCare Medicaid	$7,850.51
Rate for Payer: Hawaii Medical Service Association ABD	$7,850.51
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,850.51
Rate for Payer: Kaiser Permanente Medicaid	$7,850.51
Rate for Payer: Ohana Health Plan Medicaid	$7,850.51
Rate for Payer: UnitedHealthcare Medicaid	$7,850.51

ACUTE ANXIETY & DELIRIUM STATES

Facility

$3,669.67

Service Code	APR-DRG 7563
Min. Negotiated Rate	$3,669.67
Max. Negotiated Rate	$3,669.67
Rate for Payer: AlohaCare Medicaid	$3,669.67
Rate for Payer: Hawaii Medical Service Association ABD	$3,669.67
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,669.67
Rate for Payer: Kaiser Permanente Medicaid	$3,669.67
Rate for Payer: Ohana Health Plan Medicaid	$3,669.67
Rate for Payer: UnitedHealthcare Medicaid	$3,669.67

ACUTE BRONCHITIS & RELATED SYMPTOMS

Facility

$3,027.36

Service Code	APR-DRG 1452
Min. Negotiated Rate	$3,027.36
Max. Negotiated Rate	$3,027.36
Rate for Payer: AlohaCare Medicaid	$3,027.36
Rate for Payer: Hawaii Medical Service Association ABD	$3,027.36
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,027.36
Rate for Payer: Kaiser Permanente Medicaid	$3,027.36
Rate for Payer: Ohana Health Plan Medicaid	$3,027.36
Rate for Payer: UnitedHealthcare Medicaid	$3,027.36

ACUTE BRONCHITIS & RELATED SYMPTOMS

Facility

$2,487.35

Service Code	APR-DRG 1451
Min. Negotiated Rate	$2,487.35
Max. Negotiated Rate	$2,487.35
Rate for Payer: AlohaCare Medicaid	$2,487.35
Rate for Payer: Hawaii Medical Service Association ABD	$2,487.35
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,487.35
Rate for Payer: Kaiser Permanente Medicaid	$2,487.35
Rate for Payer: Ohana Health Plan Medicaid	$2,487.35
Rate for Payer: UnitedHealthcare Medicaid	$2,487.35

ACUTE BRONCHITIS & RELATED SYMPTOMS

Facility

$4,039.88

Service Code	APR-DRG 1453
Min. Negotiated Rate	$4,039.88
Max. Negotiated Rate	$4,039.88
Rate for Payer: AlohaCare Medicaid	$4,039.88
Rate for Payer: Hawaii Medical Service Association ABD	$4,039.88
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,039.88
Rate for Payer: Kaiser Permanente Medicaid	$4,039.88
Rate for Payer: Ohana Health Plan Medicaid	$4,039.88
Rate for Payer: UnitedHealthcare Medicaid	$4,039.88

ACUTE BRONCHITIS & RELATED SYMPTOMS

Facility

$6,599.19

Service Code	APR-DRG 1454
Min. Negotiated Rate	$6,599.19
Max. Negotiated Rate	$6,599.19
Rate for Payer: AlohaCare Medicaid	$6,599.19
Rate for Payer: Hawaii Medical Service Association ABD	$6,599.19
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6,599.19
Rate for Payer: Kaiser Permanente Medicaid	$6,599.19
Rate for Payer: Ohana Health Plan Medicaid	$6,599.19
Rate for Payer: UnitedHealthcare Medicaid	$6,599.19

ACUTE KIDNEY INJURY

Facility

$3,165.55

Service Code	APR-DRG 4692
Min. Negotiated Rate	$3,165.55
Max. Negotiated Rate	$3,165.55
Rate for Payer: AlohaCare Medicaid	$3,165.55
Rate for Payer: Hawaii Medical Service Association ABD	$3,165.55
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,165.55
Rate for Payer: Kaiser Permanente Medicaid	$3,165.55
Rate for Payer: Ohana Health Plan Medicaid	$3,165.55
Rate for Payer: UnitedHealthcare Medicaid	$3,165.55

ACUTE KIDNEY INJURY

Facility

$4,812.96

Service Code	APR-DRG 4693
Min. Negotiated Rate	$4,812.96
Max. Negotiated Rate	$4,812.96
Rate for Payer: AlohaCare Medicaid	$4,812.96
Rate for Payer: Hawaii Medical Service Association ABD	$4,812.96
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,812.96
Rate for Payer: Kaiser Permanente Medicaid	$4,812.96
Rate for Payer: Ohana Health Plan Medicaid	$4,812.96
Rate for Payer: UnitedHealthcare Medicaid	$4,812.96

ACUTE KIDNEY INJURY

Facility

$2,465.70

Service Code	APR-DRG 4691
Min. Negotiated Rate	$2,465.70
Max. Negotiated Rate	$2,465.70
Rate for Payer: AlohaCare Medicaid	$2,465.70
Rate for Payer: Hawaii Medical Service Association ABD	$2,465.70
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,465.70
Rate for Payer: Kaiser Permanente Medicaid	$2,465.70
Rate for Payer: Ohana Health Plan Medicaid	$2,465.70
Rate for Payer: UnitedHealthcare Medicaid	$2,465.70

ACUTE KIDNEY INJURY

Facility

$8,812.08

Service Code	APR-DRG 4694
Min. Negotiated Rate	$8,812.08
Max. Negotiated Rate	$8,812.08
Rate for Payer: AlohaCare Medicaid	$8,812.08
Rate for Payer: Hawaii Medical Service Association ABD	$8,812.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,812.08
Rate for Payer: Kaiser Permanente Medicaid	$8,812.08
Rate for Payer: Ohana Health Plan Medicaid	$8,812.08
Rate for Payer: UnitedHealthcare Medicaid	$8,812.08

ACUTE LEUKEMIA

Facility

$8,466.30

Service Code	APR-DRG 6902
Min. Negotiated Rate	$8,466.30
Max. Negotiated Rate	$8,466.30
Rate for Payer: AlohaCare Medicaid	$8,466.30
Rate for Payer: Hawaii Medical Service Association ABD	$8,466.30
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,466.30
Rate for Payer: Kaiser Permanente Medicaid	$8,466.30
Rate for Payer: Ohana Health Plan Medicaid	$8,466.30
Rate for Payer: UnitedHealthcare Medicaid	$8,466.30

ACUTE LEUKEMIA

Facility

$14,838.78

Service Code	APR-DRG 6903
Min. Negotiated Rate	$14,838.78
Max. Negotiated Rate	$14,838.78
Rate for Payer: AlohaCare Medicaid	$14,838.78
Rate for Payer: Hawaii Medical Service Association ABD	$14,838.78
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14,838.78
Rate for Payer: Kaiser Permanente Medicaid	$14,838.78
Rate for Payer: Ohana Health Plan Medicaid	$14,838.78
Rate for Payer: UnitedHealthcare Medicaid	$14,838.78

ACUTE LEUKEMIA

Facility

$25,457.47

Service Code	APR-DRG 6904
Min. Negotiated Rate	$25,457.47
Max. Negotiated Rate	$25,457.47
Rate for Payer: AlohaCare Medicaid	$25,457.47
Rate for Payer: Hawaii Medical Service Association ABD	$25,457.47
Rate for Payer: Hawaii Medical Service Association Non-ABD	$25,457.47
Rate for Payer: Kaiser Permanente Medicaid	$25,457.47
Rate for Payer: Ohana Health Plan Medicaid	$25,457.47
Rate for Payer: UnitedHealthcare Medicaid	$25,457.47

ACUTE LEUKEMIA

Facility

$5,432.57

Service Code	APR-DRG 6901
Min. Negotiated Rate	$5,432.57
Max. Negotiated Rate	$5,432.57
Rate for Payer: AlohaCare Medicaid	$5,432.57
Rate for Payer: Hawaii Medical Service Association ABD	$5,432.57
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,432.57
Rate for Payer: Kaiser Permanente Medicaid	$5,432.57
Rate for Payer: Ohana Health Plan Medicaid	$5,432.57
Rate for Payer: UnitedHealthcare Medicaid	$5,432.57

ACUTE LEUKEMIA WITH CC

Facility

$142,086.66

Service Code	MSDRG 835
Min. Negotiated Rate	$27,434.04
Max. Negotiated Rate	$142,086.66
Rate for Payer: AlohaCare Medicare	$27,434.04
Rate for Payer: Devoted Health Medicare	$30,177.44
Rate for Payer: Hawaii Medical Service Association Commercial	$142,086.66
Rate for Payer: Hawaii Medical Service Association Medicare	$27,434.04
Rate for Payer: Humana Medicare	$27,434.04
Rate for Payer: Kaiser Permanente Commercial	$35,980.05
Rate for Payer: Kaiser Permanente Medicare	$27,434.04
Rate for Payer: Ohana Health Plan Medicare	$27,434.04
Rate for Payer: UnitedHealthcare Medicare	$27,434.04

ACUTE LEUKEMIA WITH MCC

Facility

$142,086.66

Service Code	MSDRG 834
Min. Negotiated Rate	$72,207.37
Max. Negotiated Rate	$142,086.66
Rate for Payer: AlohaCare Medicare	$72,207.37
Rate for Payer: Devoted Health Medicare	$79,428.11
Rate for Payer: Hawaii Medical Service Association Commercial	$142,086.66
Rate for Payer: Hawaii Medical Service Association Medicare	$72,207.37
Rate for Payer: Humana Medicare	$72,207.37
Rate for Payer: Kaiser Permanente Commercial	$94,700.77
Rate for Payer: Kaiser Permanente Medicare	$72,207.37
Rate for Payer: Ohana Health Plan Medicare	$72,207.37
Rate for Payer: UnitedHealthcare Medicare	$72,207.37

ACUTE LEUKEMIA WITH OTHER PROCEDURES

Facility

$149,376.38

Service Code	MSDRG 850
Min. Negotiated Rate	$113,896.38
Max. Negotiated Rate	$149,376.38
Rate for Payer: AlohaCare Medicare	$113,896.38
Rate for Payer: Devoted Health Medicare	$125,286.02
Rate for Payer: Hawaii Medical Service Association Commercial	$142,086.66
Rate for Payer: Hawaii Medical Service Association Medicare	$113,896.38
Rate for Payer: Humana Medicare	$113,896.38
Rate for Payer: Kaiser Permanente Commercial	$149,376.38
Rate for Payer: Kaiser Permanente Medicare	$113,896.38
Rate for Payer: Ohana Health Plan Medicare	$113,896.38
Rate for Payer: UnitedHealthcare Medicare	$113,896.38

ACUTE LEUKEMIA WITHOUT CC/MCC

Facility

$142,086.66

Service Code	MSDRG 836
Min. Negotiated Rate	$16,039.79
Max. Negotiated Rate	$142,086.66
Rate for Payer: AlohaCare Medicare	$16,039.79
Rate for Payer: Devoted Health Medicare	$17,643.77
Rate for Payer: Hawaii Medical Service Association Commercial	$142,086.66
Rate for Payer: Hawaii Medical Service Association Medicare	$16,039.79
Rate for Payer: Humana Medicare	$16,039.79
Rate for Payer: Kaiser Permanente Commercial	$21,036.38
Rate for Payer: Kaiser Permanente Medicare	$16,039.79
Rate for Payer: Ohana Health Plan Medicare	$16,039.79
Rate for Payer: UnitedHealthcare Medicare	$16,039.79

ACUTE MAJOR EYE INFECTIONS WITH CC/MCC

Facility

$20,066.92

Service Code	MSDRG 121
Min. Negotiated Rate	$9,281.19
Max. Negotiated Rate	$20,066.92
Rate for Payer: AlohaCare Medicare	$15,300.61
Rate for Payer: Devoted Health Medicare	$16,830.67
Rate for Payer: Hawaii Medical Service Association Commercial	$9,281.19
Rate for Payer: Hawaii Medical Service Association Medicare	$15,300.61
Rate for Payer: Humana Medicare	$15,300.61
Rate for Payer: Kaiser Permanente Commercial	$20,066.92
Rate for Payer: Kaiser Permanente Medicare	$15,300.61
Rate for Payer: Ohana Health Plan Medicare	$15,300.61
Rate for Payer: UnitedHealthcare Medicare	$15,300.61

ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC

Facility

$13,555.05

Service Code	MSDRG 122
Min. Negotiated Rate	$9,281.19
Max. Negotiated Rate	$13,555.05
Rate for Payer: AlohaCare Medicare	$10,335.44
Rate for Payer: Devoted Health Medicare	$11,368.98
Rate for Payer: Hawaii Medical Service Association Commercial	$9,281.19
Rate for Payer: Hawaii Medical Service Association Medicare	$10,335.44
Rate for Payer: Humana Medicare	$10,335.44
Rate for Payer: Kaiser Permanente Commercial	$13,555.05
Rate for Payer: Kaiser Permanente Medicare	$10,335.44
Rate for Payer: Ohana Health Plan Medicare	$10,335.44
Rate for Payer: UnitedHealthcare Medicare	$10,335.44

ACUTE MYOCARDIAL INFARCTION

Facility

$3,434.28

Service Code	APR-DRG 1901
Min. Negotiated Rate	$3,434.28
Max. Negotiated Rate	$3,434.28
Rate for Payer: AlohaCare Medicaid	$3,434.28
Rate for Payer: Hawaii Medical Service Association ABD	$3,434.28
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,434.28
Rate for Payer: Kaiser Permanente Medicaid	$3,434.28
Rate for Payer: Ohana Health Plan Medicaid	$3,434.28
Rate for Payer: UnitedHealthcare Medicaid	$3,434.28

ACUTE MYOCARDIAL INFARCTION

Facility

$4,080.63

Service Code	APR-DRG 1902
Min. Negotiated Rate	$4,080.63
Max. Negotiated Rate	$4,080.63
Rate for Payer: AlohaCare Medicaid	$4,080.63
Rate for Payer: Hawaii Medical Service Association ABD	$4,080.63
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,080.63
Rate for Payer: Kaiser Permanente Medicaid	$4,080.63
Rate for Payer: Ohana Health Plan Medicaid	$4,080.63
Rate for Payer: UnitedHealthcare Medicaid	$4,080.63

ACUTE MYOCARDIAL INFARCTION

Facility

$5,384.81

Service Code	APR-DRG 1903
Min. Negotiated Rate	$5,384.81
Max. Negotiated Rate	$5,384.81
Rate for Payer: AlohaCare Medicaid	$5,384.81
Rate for Payer: Hawaii Medical Service Association ABD	$5,384.81
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,384.81
Rate for Payer: Kaiser Permanente Medicaid	$5,384.81
Rate for Payer: Ohana Health Plan Medicaid	$5,384.81
Rate for Payer: UnitedHealthcare Medicaid	$5,384.81

ACUTE MYOCARDIAL INFARCTION

Facility

$7,588.78

Service Code	APR-DRG 1904
Min. Negotiated Rate	$7,588.78
Max. Negotiated Rate	$7,588.78
Rate for Payer: AlohaCare Medicaid	$7,588.78
Rate for Payer: Hawaii Medical Service Association ABD	$7,588.78
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,588.78
Rate for Payer: Kaiser Permanente Medicaid	$7,588.78
Rate for Payer: Ohana Health Plan Medicaid	$7,588.78
Rate for Payer: UnitedHealthcare Medicaid	$7,588.78

ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC

Facility

$29,434.65

Service Code	MSDRG 281
Min. Negotiated Rate	$12,088.70
Max. Negotiated Rate	$29,434.65
Rate for Payer: AlohaCare Medicare	$12,088.70
Rate for Payer: Devoted Health Medicare	$13,297.57
Rate for Payer: Hawaii Medical Service Association Commercial	$29,434.65
Rate for Payer: Hawaii Medical Service Association Medicare	$12,088.70
Rate for Payer: Humana Medicare	$12,088.70
Rate for Payer: Kaiser Permanente Commercial	$15,854.48
Rate for Payer: Kaiser Permanente Medicare	$12,088.70
Rate for Payer: Ohana Health Plan Medicare	$12,088.70
Rate for Payer: UnitedHealthcare Medicare	$12,088.70

Know your out-of-pocket cost for care.

All Charges