Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Gelpoint Advanced Access Platform CNGL2 [3645039]

Facility

$3,878.00

Hospital Charge Code	3645039
Hospital Revenue Code	272
Min. Negotiated Rate	$3,296.30
Max. Negotiated Rate	$3,761.66
Rate for Payer: Cash Price	$2,520.70
Rate for Payer: Health Management Network Commercial	$3,296.30
Rate for Payer: MDX Hawaii PPO	$3,761.66

Gelpoint Advanced Access Platform CNGL2 [3645039]

Facility

$3,878.00

Hospital Charge Code	3645039
Hospital Revenue Code	272
Min. Negotiated Rate	$1,977.78
Max. Negotiated Rate	$3,761.66
Rate for Payer: Cash Price	$2,520.70
Rate for Payer: Hawaii Western Management Group Commercial	$3,684.10
Rate for Payer: Health Management Network Commercial	$3,296.30
Rate for Payer: Kaiser Permanente Commercial	$2,443.14
Rate for Payer: Kaiser Permanente Medicaid	$1,977.78
Rate for Payer: MDX Hawaii PPO	$3,761.66
Rate for Payer: University Health Alliance Commercial	$2,826.67

Gelpoint Mini Advanced Access Platform CNGL3 [3645040]

Facility

$3,878.00

Hospital Charge Code	3645040
Hospital Revenue Code	272
Min. Negotiated Rate	$3,296.30
Max. Negotiated Rate	$3,761.66
Rate for Payer: Cash Price	$2,520.70
Rate for Payer: Health Management Network Commercial	$3,296.30
Rate for Payer: MDX Hawaii PPO	$3,761.66

Gelpoint Mini Advanced Access Platform CNGL3 [3645040]

Facility

$3,878.00

Hospital Charge Code	3645040
Hospital Revenue Code	272
Min. Negotiated Rate	$1,977.78
Max. Negotiated Rate	$3,761.66
Rate for Payer: Cash Price	$2,520.70
Rate for Payer: Hawaii Western Management Group Commercial	$3,684.10
Rate for Payer: Health Management Network Commercial	$3,296.30
Rate for Payer: Kaiser Permanente Commercial	$2,443.14
Rate for Payer: Kaiser Permanente Medicaid	$1,977.78
Rate for Payer: MDX Hawaii PPO	$3,761.66
Rate for Payer: University Health Alliance Commercial	$2,826.67

Gelpoint Path Transanal Acces Platform CNB10 [3644019]

Facility

$4,440.50

Hospital Charge Code	3644019
Hospital Revenue Code	272
Min. Negotiated Rate	$3,774.43
Max. Negotiated Rate	$4,307.28
Rate for Payer: Cash Price	$2,886.32
Rate for Payer: Health Management Network Commercial	$3,774.43
Rate for Payer: MDX Hawaii PPO	$4,307.28

Gelpoint Path Transanal Acces Platform CNB10 [3644019]

Facility

$4,440.50

Hospital Charge Code	3644019
Hospital Revenue Code	272
Min. Negotiated Rate	$2,264.66
Max. Negotiated Rate	$4,307.28
Rate for Payer: Cash Price	$2,886.32
Rate for Payer: Hawaii Western Management Group Commercial	$4,218.48
Rate for Payer: Health Management Network Commercial	$3,774.43
Rate for Payer: Kaiser Permanente Commercial	$2,797.51
Rate for Payer: Kaiser Permanente Medicaid	$2,264.66
Rate for Payer: MDX Hawaii PPO	$4,307.28
Rate for Payer: University Health Alliance Commercial	$3,236.68

GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN

Facility

$205.50

Service Code	HCPCS J9201
Hospital Revenue Code	250
Min. Negotiated Rate	$174.68
Max. Negotiated Rate	$199.34
Rate for Payer: Cash Price	$133.58
Rate for Payer: Health Management Network Commercial	$174.68
Rate for Payer: MDX Hawaii PPO	$199.34

GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN

Facility

$205.50

Service Code	HCPCS J9201
Hospital Revenue Code	636
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$199.34
Rate for Payer: Cash Price	$133.58
Rate for Payer: Cash Price	$133.58
Rate for Payer: Hawaii Medical Service Association ABD	$2.96
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2.96
Rate for Payer: Hawaii Western Management Group Commercial	$195.22
Rate for Payer: Health Management Network Commercial	$174.68
Rate for Payer: Kaiser Permanente Commercial	$129.47
Rate for Payer: Kaiser Permanente Medicaid	$104.81
Rate for Payer: MDX Hawaii PPO	$199.34
Rate for Payer: UnitedHealthcare Medicaid	$123.30
Rate for Payer: University Health Alliance Commercial	$149.79

GEMCITABINE 200 MG/5.26 ML (38 MG/ML) IV SOLN

Facility

$54.73

Service Code	HCPCS J9201
Hospital Revenue Code	250
Min. Negotiated Rate	$46.52
Max. Negotiated Rate	$53.09
Rate for Payer: Cash Price	$35.57
Rate for Payer: Health Management Network Commercial	$46.52
Rate for Payer: MDX Hawaii PPO	$53.09

GEMCITABINE 200 MG/5.26 ML (38 MG/ML) IV SOLN

Facility

$54.73

Service Code	HCPCS J9201
Hospital Revenue Code	636
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$53.09
Rate for Payer: Cash Price	$35.57
Rate for Payer: Cash Price	$35.57
Rate for Payer: Hawaii Medical Service Association ABD	$2.96
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2.96
Rate for Payer: Hawaii Western Management Group Commercial	$51.99
Rate for Payer: Health Management Network Commercial	$46.52
Rate for Payer: Kaiser Permanente Commercial	$34.48
Rate for Payer: Kaiser Permanente Medicaid	$27.91
Rate for Payer: MDX Hawaii PPO	$53.09
Rate for Payer: UnitedHealthcare Medicaid	$32.84
Rate for Payer: University Health Alliance Commercial	$39.89

GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) IV SOLN

Facility

$412.64

Service Code	HCPCS J9201
Hospital Revenue Code	250
Min. Negotiated Rate	$350.74
Max. Negotiated Rate	$400.26
Rate for Payer: Cash Price	$268.22
Rate for Payer: Health Management Network Commercial	$350.74
Rate for Payer: MDX Hawaii PPO	$400.26

GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) IV SOLN

Facility

$412.64

Service Code	HCPCS J9201
Hospital Revenue Code	636
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$400.26
Rate for Payer: Cash Price	$268.22
Rate for Payer: Cash Price	$268.22
Rate for Payer: Hawaii Medical Service Association ABD	$2.96
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2.96
Rate for Payer: Hawaii Western Management Group Commercial	$392.01
Rate for Payer: Health Management Network Commercial	$350.74
Rate for Payer: Kaiser Permanente Commercial	$259.96
Rate for Payer: Kaiser Permanente Medicaid	$210.45
Rate for Payer: MDX Hawaii PPO	$400.26
Rate for Payer: UnitedHealthcare Medicaid	$247.58
Rate for Payer: University Health Alliance Commercial	$300.77

GEMFIBROZIL 600 MG PO TABLET

Facility

$13.42

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$13.02
Rate for Payer: Cash Price	$8.72
Rate for Payer: Cash Price	$8.31
Rate for Payer: Hawaii Western Management Group Commercial	$12.75
Rate for Payer: Hawaii Western Management Group Commercial	$12.14
Rate for Payer: Health Management Network Commercial	$10.86
Rate for Payer: Health Management Network Commercial	$11.41
Rate for Payer: Kaiser Permanente Commercial	$8.45
Rate for Payer: Kaiser Permanente Commercial	$8.05
Rate for Payer: Kaiser Permanente Medicaid	$6.52
Rate for Payer: Kaiser Permanente Medicaid	$6.84
Rate for Payer: MDX Hawaii PPO	$12.40
Rate for Payer: MDX Hawaii PPO	$13.02
Rate for Payer: UnitedHealthcare Medicaid	$8.05
Rate for Payer: UnitedHealthcare Medicaid	$7.67
Rate for Payer: University Health Alliance Commercial	$9.32
Rate for Payer: University Health Alliance Commercial	$9.78

GEMFIBROZIL 600 MG PO TABLET

Facility

$12.78

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$10.86
Max. Negotiated Rate	$12.40
Rate for Payer: Cash Price	$8.31
Rate for Payer: Cash Price	$8.72
Rate for Payer: Health Management Network Commercial	$10.86
Rate for Payer: Health Management Network Commercial	$11.41
Rate for Payer: MDX Hawaii PPO	$12.40
Rate for Payer: MDX Hawaii PPO	$13.02

Geminus Volar Distal Radius Plate Narrow 160mm Lt GMN-LTN-160 [3644424]

Facility

$10,095.50

Service Code	HCPCS C1713
Hospital Charge Code	3644424
Hospital Revenue Code	278
Min. Negotiated Rate	$5,653.48
Max. Negotiated Rate	$9,792.64
Rate for Payer: Cash Price	$6,562.08
Rate for Payer: Hawaii Western Management Group Commercial	$7,066.85
Rate for Payer: Health Management Network Commercial	$8,581.17
Rate for Payer: MDX Hawaii PPO	$9,792.64
Rate for Payer: University Health Alliance Commercial	$5,653.48

Geminus Volar Distal Radius Plate Narrow 160mm Lt GMN-LTN-160 [3644424]

Facility

$10,095.50

Service Code	HCPCS C1713
Hospital Charge Code	3644424
Hospital Revenue Code	278
Min. Negotiated Rate	$5,148.70
Max. Negotiated Rate	$9,792.64
Rate for Payer: Cash Price	$6,562.08
Rate for Payer: Hawaii Western Management Group Commercial	$7,066.85
Rate for Payer: Health Management Network Commercial	$8,581.17
Rate for Payer: Kaiser Permanente Commercial	$6,360.16
Rate for Payer: Kaiser Permanente Medicaid	$5,148.70
Rate for Payer: MDX Hawaii PPO	$9,792.64
Rate for Payer: University Health Alliance Commercial	$5,653.48

Geminus Volar Distal Radius Plate Narrow 3H Lt GMNLTN3HL [3642990]

Facility

$3,213.00

Service Code	HCPCS C1713
Hospital Charge Code	3642990
Hospital Revenue Code	278
Min. Negotiated Rate	$1,638.63
Max. Negotiated Rate	$3,116.61
Rate for Payer: Cash Price	$2,088.45
Rate for Payer: Hawaii Western Management Group Commercial	$2,249.10
Rate for Payer: Health Management Network Commercial	$2,731.05
Rate for Payer: Kaiser Permanente Commercial	$2,024.19
Rate for Payer: Kaiser Permanente Medicaid	$1,638.63
Rate for Payer: MDX Hawaii PPO	$3,116.61
Rate for Payer: University Health Alliance Commercial	$1,799.28

Geminus Volar Distal Radius Plate Narrow 3H Lt GMNLTN3HL [3642990]

Facility

$3,213.00

Service Code	HCPCS C1713
Hospital Charge Code	3642990
Hospital Revenue Code	278
Min. Negotiated Rate	$1,799.28
Max. Negotiated Rate	$3,116.61
Rate for Payer: Cash Price	$2,088.45
Rate for Payer: Hawaii Western Management Group Commercial	$2,249.10
Rate for Payer: Health Management Network Commercial	$2,731.05
Rate for Payer: MDX Hawaii PPO	$3,116.61
Rate for Payer: University Health Alliance Commercial	$1,799.28

Geminus Volar Distal Radius Plate Narrow 3H Rt GMNRTN3HL [3643419]

Facility

$3,374.00

Service Code	HCPCS C1713
Hospital Charge Code	3643419
Hospital Revenue Code	278
Min. Negotiated Rate	$1,889.44
Max. Negotiated Rate	$3,272.78
Rate for Payer: Cash Price	$2,193.10
Rate for Payer: Hawaii Western Management Group Commercial	$2,361.80
Rate for Payer: Health Management Network Commercial	$2,867.90
Rate for Payer: MDX Hawaii PPO	$3,272.78
Rate for Payer: University Health Alliance Commercial	$1,889.44

Geminus Volar Distal Radius Plate Narrow 3H Rt GMNRTN3HL [3643419]

Facility

$3,374.00

Service Code	HCPCS C1713
Hospital Charge Code	3643419
Hospital Revenue Code	278
Min. Negotiated Rate	$1,720.74
Max. Negotiated Rate	$3,272.78
Rate for Payer: Cash Price	$2,193.10
Rate for Payer: Hawaii Western Management Group Commercial	$2,361.80
Rate for Payer: Health Management Network Commercial	$2,867.90
Rate for Payer: Kaiser Permanente Commercial	$2,125.62
Rate for Payer: Kaiser Permanente Medicaid	$1,720.74
Rate for Payer: MDX Hawaii PPO	$3,272.78
Rate for Payer: University Health Alliance Commercial	$1,889.44

Geminus Volar Distal Radius Plate Narrow 4H Lt GMN-LTN-4HL [3643093]

Facility

$4,818.50

Service Code	HCPCS C1713
Hospital Charge Code	3643093
Hospital Revenue Code	278
Min. Negotiated Rate	$2,457.43
Max. Negotiated Rate	$4,673.94
Rate for Payer: Cash Price	$3,132.02
Rate for Payer: Hawaii Western Management Group Commercial	$3,372.95
Rate for Payer: Health Management Network Commercial	$4,095.72
Rate for Payer: Kaiser Permanente Commercial	$3,035.66
Rate for Payer: Kaiser Permanente Medicaid	$2,457.43
Rate for Payer: MDX Hawaii PPO	$4,673.94
Rate for Payer: University Health Alliance Commercial	$2,698.36

Geminus Volar Distal Radius Plate Narrow 4H Lt GMN-LTN-4HL [3643093]

Facility

$4,818.50

Service Code	HCPCS C1713
Hospital Charge Code	3643093
Hospital Revenue Code	278
Min. Negotiated Rate	$2,698.36
Max. Negotiated Rate	$4,673.94
Rate for Payer: Cash Price	$3,132.02
Rate for Payer: Hawaii Western Management Group Commercial	$3,372.95
Rate for Payer: Health Management Network Commercial	$4,095.72
Rate for Payer: MDX Hawaii PPO	$4,673.94
Rate for Payer: University Health Alliance Commercial	$2,698.36

Geminus Volar Distal Radius Plate Narrow 4H Rt GMNRTN4HL [3642645]

Facility

$4,818.50

Service Code	HCPCS C1713
Hospital Charge Code	3642645
Hospital Revenue Code	278
Min. Negotiated Rate	$2,698.36
Max. Negotiated Rate	$4,673.94
Rate for Payer: Cash Price	$3,132.02
Rate for Payer: Hawaii Western Management Group Commercial	$3,372.95
Rate for Payer: Health Management Network Commercial	$4,095.72
Rate for Payer: MDX Hawaii PPO	$4,673.94
Rate for Payer: University Health Alliance Commercial	$2,698.36

Geminus Volar Distal Radius Plate Narrow 4H Rt GMNRTN4HL [3642645]

Facility

$4,818.50

Service Code	HCPCS C1713
Hospital Charge Code	3642645
Hospital Revenue Code	278
Min. Negotiated Rate	$2,457.43
Max. Negotiated Rate	$4,673.94
Rate for Payer: Cash Price	$3,132.02
Rate for Payer: Hawaii Western Management Group Commercial	$3,372.95
Rate for Payer: Health Management Network Commercial	$4,095.72
Rate for Payer: Kaiser Permanente Commercial	$3,035.66
Rate for Payer: Kaiser Permanente Medicaid	$2,457.43
Rate for Payer: MDX Hawaii PPO	$4,673.94
Rate for Payer: University Health Alliance Commercial	$2,698.36

Geminus Volar Distal Radius Plate Stnd 3H Lt GMNLTS3HL [3642909]

Facility

$4,634.00

Service Code	HCPCS C1713
Hospital Charge Code	3642909
Hospital Revenue Code	278
Min. Negotiated Rate	$2,595.04
Max. Negotiated Rate	$4,494.98
Rate for Payer: Cash Price	$3,012.10
Rate for Payer: Hawaii Western Management Group Commercial	$3,243.80
Rate for Payer: Health Management Network Commercial	$3,938.90
Rate for Payer: MDX Hawaii PPO	$4,494.98
Rate for Payer: University Health Alliance Commercial	$2,595.04

Know your out-of-pocket cost for care.

All Charges