Kona Community Hospital

All Charges

Charge

Type

Setting

Price

HCHG SURGERY LEVEL 2 EACH ADDITIONAL 15 MIN

Facility

$1,057.00

Hospital Charge Code	K3600009
Hospital Revenue Code	360
Min. Negotiated Rate	$898.45
Max. Negotiated Rate	$1,025.29
Rate for Payer: Cash Price	$687.05
Rate for Payer: Health Management Network Commercial	$898.45
Rate for Payer: MDX Hawaii PPO	$1,025.29

HCHG SURGERY LEVEL 2 EACH ADDITIONAL 15 MIN

Facility

$1,057.00

Hospital Charge Code	K3600009
Hospital Revenue Code	360
Min. Negotiated Rate	$665.91
Max. Negotiated Rate	$2,837.00
Rate for Payer: Cash Price	$687.05
Rate for Payer: Cash Price	$687.05
Rate for Payer: Health Management Network Commercial	$898.45
Rate for Payer: Kaiser Permanente Commercial	$665.91
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: MDX Hawaii PPO	$1,025.29
Rate for Payer: University Health Alliance Commercial	$770.45

HCHG SURGERY LEVEL 2 FIRST 15 MIN

Facility

$1,901.00

Hospital Charge Code	K3600008
Hospital Revenue Code	360
Min. Negotiated Rate	$1,197.63
Max. Negotiated Rate	$2,837.00
Rate for Payer: Cash Price	$1,235.65
Rate for Payer: Cash Price	$1,235.65
Rate for Payer: Health Management Network Commercial	$1,615.85
Rate for Payer: Kaiser Permanente Commercial	$1,197.63
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: MDX Hawaii PPO	$1,843.97
Rate for Payer: University Health Alliance Commercial	$1,385.64

HCHG SURGERY LEVEL 2 FIRST 15 MIN

Facility

$1,901.00

Hospital Charge Code	K3600008
Hospital Revenue Code	360
Min. Negotiated Rate	$1,615.85
Max. Negotiated Rate	$1,843.97
Rate for Payer: Cash Price	$1,235.65
Rate for Payer: Health Management Network Commercial	$1,615.85
Rate for Payer: MDX Hawaii PPO	$1,843.97

HCHG SURGERY LEVEL 3 EACH 15 MIN

Facility

$1,086.00

Hospital Charge Code	K3600002
Hospital Revenue Code	360
Min. Negotiated Rate	$923.10
Max. Negotiated Rate	$1,053.42
Rate for Payer: Cash Price	$705.90
Rate for Payer: Health Management Network Commercial	$923.10
Rate for Payer: MDX Hawaii PPO	$1,053.42

HCHG SURGERY LEVEL 3 EACH 15 MIN

Facility

$1,086.00

Hospital Charge Code	K3600002
Hospital Revenue Code	360
Min. Negotiated Rate	$684.18
Max. Negotiated Rate	$2,837.00
Rate for Payer: Cash Price	$705.90
Rate for Payer: Cash Price	$705.90
Rate for Payer: Health Management Network Commercial	$923.10
Rate for Payer: Kaiser Permanente Commercial	$684.18
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: MDX Hawaii PPO	$1,053.42
Rate for Payer: University Health Alliance Commercial	$791.59

HCHG SURGERY LEVEL 3 EACH ADDITIONAL 15 MIN

Facility

$1,374.00

Hospital Charge Code	K3600011
Hospital Revenue Code	360
Min. Negotiated Rate	$865.62
Max. Negotiated Rate	$2,837.00
Rate for Payer: Cash Price	$893.10
Rate for Payer: Cash Price	$893.10
Rate for Payer: Health Management Network Commercial	$1,167.90
Rate for Payer: Kaiser Permanente Commercial	$865.62
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: MDX Hawaii PPO	$1,332.78
Rate for Payer: University Health Alliance Commercial	$1,001.51

HCHG SURGERY LEVEL 3 EACH ADDITIONAL 15 MIN

Facility

$1,374.00

Hospital Charge Code	K3600011
Hospital Revenue Code	360
Min. Negotiated Rate	$1,167.90
Max. Negotiated Rate	$1,332.78
Rate for Payer: Cash Price	$893.10
Rate for Payer: Health Management Network Commercial	$1,167.90
Rate for Payer: MDX Hawaii PPO	$1,332.78

HCHG SURGERY LEVEL 3 FIRST 15 MIN

Facility

$2,642.00

Hospital Charge Code	K3600010
Hospital Revenue Code	360
Min. Negotiated Rate	$1,664.46
Max. Negotiated Rate	$2,837.00
Rate for Payer: Cash Price	$1,717.30
Rate for Payer: Cash Price	$1,717.30
Rate for Payer: Health Management Network Commercial	$2,245.70
Rate for Payer: Kaiser Permanente Commercial	$1,664.46
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: MDX Hawaii PPO	$2,562.74
Rate for Payer: University Health Alliance Commercial	$1,925.75

HCHG SURGERY LEVEL 3 FIRST 15 MIN

Facility

$2,642.00

Hospital Charge Code	K3600010
Hospital Revenue Code	360
Min. Negotiated Rate	$2,245.70
Max. Negotiated Rate	$2,562.74
Rate for Payer: Cash Price	$1,717.30
Rate for Payer: Health Management Network Commercial	$2,245.70
Rate for Payer: MDX Hawaii PPO	$2,562.74

HCHG SURGERY LEVEL 4 EACH 15 MIN

Facility

$1,169.00

Hospital Charge Code	K3600003
Hospital Revenue Code	360
Min. Negotiated Rate	$993.65
Max. Negotiated Rate	$1,133.93
Rate for Payer: Cash Price	$759.85
Rate for Payer: Health Management Network Commercial	$993.65
Rate for Payer: MDX Hawaii PPO	$1,133.93

HCHG SURGERY LEVEL 4 EACH 15 MIN

Facility

$1,169.00

Hospital Charge Code	K3600003
Hospital Revenue Code	360
Min. Negotiated Rate	$736.47
Max. Negotiated Rate	$2,837.00
Rate for Payer: Cash Price	$759.85
Rate for Payer: Cash Price	$759.85
Rate for Payer: Health Management Network Commercial	$993.65
Rate for Payer: Kaiser Permanente Commercial	$736.47
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: MDX Hawaii PPO	$1,133.93
Rate for Payer: University Health Alliance Commercial	$852.08

HCHG SURGERY LEVEL 4 EACH ADDITIONAL 15 MIN

Facility

$1,479.00

Hospital Charge Code	K3600013
Hospital Revenue Code	360
Min. Negotiated Rate	$931.77
Max. Negotiated Rate	$2,837.00
Rate for Payer: Cash Price	$961.35
Rate for Payer: Cash Price	$961.35
Rate for Payer: Health Management Network Commercial	$1,257.15
Rate for Payer: Kaiser Permanente Commercial	$931.77
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: MDX Hawaii PPO	$1,434.63
Rate for Payer: University Health Alliance Commercial	$1,078.04

HCHG SURGERY LEVEL 4 EACH ADDITIONAL 15 MIN

Facility

$1,479.00

Hospital Charge Code	K3600013
Hospital Revenue Code	360
Min. Negotiated Rate	$1,257.15
Max. Negotiated Rate	$1,434.63
Rate for Payer: Cash Price	$961.35
Rate for Payer: Health Management Network Commercial	$1,257.15
Rate for Payer: MDX Hawaii PPO	$1,434.63

HCHG SURGERY LEVEL 4 FIRST 15 MIN

Facility

$3,169.00

Hospital Charge Code	K3600012
Hospital Revenue Code	360
Min. Negotiated Rate	$2,693.65
Max. Negotiated Rate	$3,073.93
Rate for Payer: Cash Price	$2,059.85
Rate for Payer: Health Management Network Commercial	$2,693.65
Rate for Payer: MDX Hawaii PPO	$3,073.93

HCHG SURGERY LEVEL 4 FIRST 15 MIN

Facility

$3,169.00

Hospital Charge Code	K3600012
Hospital Revenue Code	360
Min. Negotiated Rate	$1,996.47
Max. Negotiated Rate	$3,073.93
Rate for Payer: Cash Price	$2,059.85
Rate for Payer: Cash Price	$2,059.85
Rate for Payer: Health Management Network Commercial	$2,693.65
Rate for Payer: Kaiser Permanente Commercial	$1,996.47
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: MDX Hawaii PPO	$3,073.93
Rate for Payer: University Health Alliance Commercial	$2,309.88

HCHG SURGERY LEVEL 5 EACH 15 MIN

Facility

$1,335.00

Hospital Charge Code	K3600004
Hospital Revenue Code	360
Min. Negotiated Rate	$1,134.75
Max. Negotiated Rate	$1,294.95
Rate for Payer: Cash Price	$867.75
Rate for Payer: Health Management Network Commercial	$1,134.75
Rate for Payer: MDX Hawaii PPO	$1,294.95

HCHG SURGERY LEVEL 5 EACH 15 MIN

Facility

$1,335.00

Hospital Charge Code	K3600004
Hospital Revenue Code	360
Min. Negotiated Rate	$841.05
Max. Negotiated Rate	$2,837.00
Rate for Payer: Cash Price	$867.75
Rate for Payer: Cash Price	$867.75
Rate for Payer: Health Management Network Commercial	$1,134.75
Rate for Payer: Kaiser Permanente Commercial	$841.05
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: MDX Hawaii PPO	$1,294.95
Rate for Payer: University Health Alliance Commercial	$973.08

HCHG SURGERY LEVEL 5 EACH ADDITIONAL 15 MIN

Facility

$1,689.00

Hospital Charge Code	K3600015
Hospital Revenue Code	360
Min. Negotiated Rate	$1,435.65
Max. Negotiated Rate	$1,638.33
Rate for Payer: Cash Price	$1,097.85
Rate for Payer: Health Management Network Commercial	$1,435.65
Rate for Payer: MDX Hawaii PPO	$1,638.33

HCHG SURGERY LEVEL 5 EACH ADDITIONAL 15 MIN

Facility

$1,689.00

Hospital Charge Code	K3600015
Hospital Revenue Code	360
Min. Negotiated Rate	$1,064.07
Max. Negotiated Rate	$2,837.00
Rate for Payer: Cash Price	$1,097.85
Rate for Payer: Cash Price	$1,097.85
Rate for Payer: Health Management Network Commercial	$1,435.65
Rate for Payer: Kaiser Permanente Commercial	$1,064.07
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: MDX Hawaii PPO	$1,638.33
Rate for Payer: University Health Alliance Commercial	$1,231.11

HCHG SURGERY LEVEL 5 FIRST 15 MIN

Facility

$3,591.00

Hospital Charge Code	K3600014
Hospital Revenue Code	360
Min. Negotiated Rate	$2,262.33
Max. Negotiated Rate	$3,483.27
Rate for Payer: Cash Price	$2,334.15
Rate for Payer: Cash Price	$2,334.15
Rate for Payer: Health Management Network Commercial	$3,052.35
Rate for Payer: Kaiser Permanente Commercial	$2,262.33
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: MDX Hawaii PPO	$3,483.27
Rate for Payer: University Health Alliance Commercial	$2,617.48

HCHG SURGERY LEVEL 5 FIRST 15 MIN

Facility

$3,591.00

Hospital Charge Code	K3600014
Hospital Revenue Code	360
Min. Negotiated Rate	$3,052.35
Max. Negotiated Rate	$3,483.27
Rate for Payer: Cash Price	$2,334.15
Rate for Payer: Health Management Network Commercial	$3,052.35
Rate for Payer: MDX Hawaii PPO	$3,483.27

HCHG SURGERY LEVEL 6 EACH 15 MIN

Facility

$2,004.00

Hospital Charge Code	K3600005
Hospital Revenue Code	360
Min. Negotiated Rate	$1,262.52
Max. Negotiated Rate	$2,837.00
Rate for Payer: Cash Price	$1,302.60
Rate for Payer: Cash Price	$1,302.60
Rate for Payer: Health Management Network Commercial	$1,703.40
Rate for Payer: Kaiser Permanente Commercial	$1,262.52
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: MDX Hawaii PPO	$1,943.88
Rate for Payer: University Health Alliance Commercial	$1,460.72

HCHG SURGERY LEVEL 6 EACH 15 MIN

Facility

$2,004.00

Hospital Charge Code	K3600005
Hospital Revenue Code	360
Min. Negotiated Rate	$1,703.40
Max. Negotiated Rate	$1,943.88
Rate for Payer: Cash Price	$1,302.60
Rate for Payer: Health Management Network Commercial	$1,703.40
Rate for Payer: MDX Hawaii PPO	$1,943.88

HCHG SURGERY LEVEL 6 EACH ADDITIONAL 15 MIN

Facility

$2,535.00

Hospital Charge Code	K3600017
Hospital Revenue Code	360
Min. Negotiated Rate	$2,154.75
Max. Negotiated Rate	$2,458.95
Rate for Payer: Cash Price	$1,647.75
Rate for Payer: Health Management Network Commercial	$2,154.75
Rate for Payer: MDX Hawaii PPO	$2,458.95

Know your out-of-pocket cost for care.

All Charges