Kona Community Hospital

All Charges

Charge

Type

Setting

Price

KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC

Facility

$44,019.38

Service Code	MSDRG 658
Min. Negotiated Rate	$20,410.46
Max. Negotiated Rate	$44,019.38
Rate for Payer: AlohaCare Medicare	$20,410.46
Rate for Payer: Devoted Health Medicare	$22,451.51
Rate for Payer: Hawaii Medical Service Association Commercial	$44,019.38
Rate for Payer: Hawaii Medical Service Association Medicare	$20,410.46
Rate for Payer: Humana Medicare	$20,410.46
Rate for Payer: Kaiser Permanente Commercial	$26,768.55
Rate for Payer: Kaiser Permanente Medicare	$20,410.46
Rate for Payer: Ohana Health Plan Medicare	$20,410.46
Rate for Payer: UnitedHealthcare Medicare	$20,410.46

KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC

Facility

$46,839.90

Service Code	MSDRG 660
Min. Negotiated Rate	$17,384.01
Max. Negotiated Rate	$46,839.90
Rate for Payer: AlohaCare Medicare	$17,384.01
Rate for Payer: Devoted Health Medicare	$19,122.41
Rate for Payer: Hawaii Medical Service Association Commercial	$46,839.90
Rate for Payer: Hawaii Medical Service Association Medicare	$17,384.01
Rate for Payer: Humana Medicare	$17,384.01
Rate for Payer: Kaiser Permanente Commercial	$22,799.33
Rate for Payer: Kaiser Permanente Medicare	$17,384.01
Rate for Payer: Ohana Health Plan Medicare	$17,384.01
Rate for Payer: UnitedHealthcare Medicare	$17,384.01

KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC

Facility

$48,575.61

Service Code	MSDRG 659
Min. Negotiated Rate	$33,419.86
Max. Negotiated Rate	$48,575.61
Rate for Payer: AlohaCare Medicare	$33,419.86
Rate for Payer: Devoted Health Medicare	$36,761.85
Rate for Payer: Hawaii Medical Service Association Commercial	$48,575.61
Rate for Payer: Hawaii Medical Service Association Medicare	$33,419.86
Rate for Payer: Humana Medicare	$33,419.86
Rate for Payer: Kaiser Permanente Commercial	$43,830.53
Rate for Payer: Kaiser Permanente Medicare	$33,419.86
Rate for Payer: Ohana Health Plan Medicare	$33,419.86
Rate for Payer: UnitedHealthcare Medicare	$33,419.86

KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC

Facility

$31,676.60

Service Code	MSDRG 661
Min. Negotiated Rate	$13,618.37
Max. Negotiated Rate	$31,676.60
Rate for Payer: AlohaCare Medicare	$13,618.37
Rate for Payer: Devoted Health Medicare	$14,980.21
Rate for Payer: Hawaii Medical Service Association Commercial	$31,676.60
Rate for Payer: Hawaii Medical Service Association Medicare	$13,618.37
Rate for Payer: Humana Medicare	$13,618.37
Rate for Payer: Kaiser Permanente Commercial	$17,860.65
Rate for Payer: Kaiser Permanente Medicare	$13,618.37
Rate for Payer: Ohana Health Plan Medicare	$13,618.37
Rate for Payer: UnitedHealthcare Medicare	$13,618.37

KIDNEY AND URINARY TRACT INFECTIONS WITH MCC

Facility

$20,015.17

Service Code	MSDRG 689
Min. Negotiated Rate	$15,261.17
Max. Negotiated Rate	$20,015.17
Rate for Payer: AlohaCare Medicare	$15,261.17
Rate for Payer: Devoted Health Medicare	$16,787.29
Rate for Payer: Hawaii Medical Service Association Commercial	$17,839.18
Rate for Payer: Hawaii Medical Service Association Medicare	$15,261.17
Rate for Payer: Humana Medicare	$15,261.17
Rate for Payer: Kaiser Permanente Commercial	$20,015.17
Rate for Payer: Kaiser Permanente Medicare	$15,261.17
Rate for Payer: Ohana Health Plan Medicare	$15,261.17
Rate for Payer: UnitedHealthcare Medicare	$15,261.17

KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC

Facility

$15,235.62

Service Code	MSDRG 690
Min. Negotiated Rate	$10,647.16
Max. Negotiated Rate	$15,235.62
Rate for Payer: AlohaCare Medicare	$10,647.16
Rate for Payer: Devoted Health Medicare	$11,711.88
Rate for Payer: Hawaii Medical Service Association Commercial	$15,235.62
Rate for Payer: Hawaii Medical Service Association Medicare	$10,647.16
Rate for Payer: Humana Medicare	$10,647.16
Rate for Payer: Kaiser Permanente Commercial	$13,963.88
Rate for Payer: Kaiser Permanente Medicare	$10,647.16
Rate for Payer: Ohana Health Plan Medicare	$10,647.16
Rate for Payer: UnitedHealthcare Medicare	$10,647.16

KIDNEY AND URINARY TRACT NEOPLASMS WITH CC

Facility

$31,459.63

Service Code	MSDRG 687
Min. Negotiated Rate	$13,781.45
Max. Negotiated Rate	$31,459.63
Rate for Payer: AlohaCare Medicare	$13,781.45
Rate for Payer: Devoted Health Medicare	$15,159.59
Rate for Payer: Hawaii Medical Service Association Commercial	$31,459.63
Rate for Payer: Hawaii Medical Service Association Medicare	$13,781.45
Rate for Payer: Humana Medicare	$13,781.45
Rate for Payer: Kaiser Permanente Commercial	$18,074.55
Rate for Payer: Kaiser Permanente Medicare	$13,781.45
Rate for Payer: Ohana Health Plan Medicare	$13,781.45
Rate for Payer: UnitedHealthcare Medicare	$13,781.45

KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC

Facility

$31,459.63

Service Code	MSDRG 686
Min. Negotiated Rate	$23,723.65
Max. Negotiated Rate	$31,459.63
Rate for Payer: AlohaCare Medicare	$23,723.65
Rate for Payer: Devoted Health Medicare	$26,096.01
Rate for Payer: Hawaii Medical Service Association Commercial	$31,459.63
Rate for Payer: Hawaii Medical Service Association Medicare	$23,723.65
Rate for Payer: Humana Medicare	$23,723.65
Rate for Payer: Kaiser Permanente Commercial	$31,113.83
Rate for Payer: Kaiser Permanente Medicare	$23,723.65
Rate for Payer: Ohana Health Plan Medicare	$23,723.65
Rate for Payer: UnitedHealthcare Medicare	$23,723.65

KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC

Facility

$31,459.63

Service Code	MSDRG 688
Min. Negotiated Rate	$10,394.63
Max. Negotiated Rate	$31,459.63
Rate for Payer: AlohaCare Medicare	$10,394.63
Rate for Payer: Devoted Health Medicare	$11,434.09
Rate for Payer: Hawaii Medical Service Association Commercial	$31,459.63
Rate for Payer: Hawaii Medical Service Association Medicare	$10,394.63
Rate for Payer: Humana Medicare	$10,394.63
Rate for Payer: Kaiser Permanente Commercial	$13,632.67
Rate for Payer: Kaiser Permanente Medicare	$10,394.63
Rate for Payer: Ohana Health Plan Medicare	$10,394.63
Rate for Payer: UnitedHealthcare Medicare	$10,394.63

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC

Facility

$20,876.66

Service Code	MSDRG 695
Min. Negotiated Rate	$15,044.14
Max. Negotiated Rate	$20,876.66
Rate for Payer: AlohaCare Medicare	$15,044.14
Rate for Payer: Devoted Health Medicare	$16,548.55
Rate for Payer: Hawaii Medical Service Association Commercial	$20,876.66
Rate for Payer: Hawaii Medical Service Association Medicare	$15,044.14
Rate for Payer: Humana Medicare	$15,044.14
Rate for Payer: Kaiser Permanente Commercial	$19,730.55
Rate for Payer: Kaiser Permanente Medicare	$15,044.14
Rate for Payer: Ohana Health Plan Medicare	$15,044.14
Rate for Payer: UnitedHealthcare Medicare	$15,044.14

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC

Facility

$20,876.66

Service Code	MSDRG 696
Min. Negotiated Rate	$9,062.24
Max. Negotiated Rate	$20,876.66
Rate for Payer: AlohaCare Medicare	$9,062.24
Rate for Payer: Devoted Health Medicare	$9,968.46
Rate for Payer: Hawaii Medical Service Association Commercial	$20,876.66
Rate for Payer: Hawaii Medical Service Association Medicare	$9,062.24
Rate for Payer: Humana Medicare	$9,062.24
Rate for Payer: Kaiser Permanente Commercial	$11,885.25
Rate for Payer: Kaiser Permanente Medicare	$9,062.24
Rate for Payer: Ohana Health Plan Medicare	$9,062.24
Rate for Payer: UnitedHealthcare Medicare	$9,062.24

KIDNEY TRANSPLANT

Facility

$26,553.41

Service Code	APR-DRG 4402
Min. Negotiated Rate	$26,553.41
Max. Negotiated Rate	$26,553.41
Rate for Payer: AlohaCare Medicaid	$26,553.41
Rate for Payer: Hawaii Medical Service Association ABD	$26,553.41
Rate for Payer: Hawaii Medical Service Association Non-ABD	$26,553.41
Rate for Payer: Kaiser Permanente Medicaid	$26,553.41
Rate for Payer: Ohana Health Plan Medicaid	$26,553.41
Rate for Payer: UnitedHealthcare Medicaid	$26,553.41

KIDNEY TRANSPLANT

Facility

$23,903.67

Service Code	APR-DRG 4401
Min. Negotiated Rate	$23,903.67
Max. Negotiated Rate	$23,903.67
Rate for Payer: AlohaCare Medicaid	$23,903.67
Rate for Payer: Hawaii Medical Service Association ABD	$23,903.67
Rate for Payer: Hawaii Medical Service Association Non-ABD	$23,903.67
Rate for Payer: Kaiser Permanente Medicaid	$23,903.67
Rate for Payer: Ohana Health Plan Medicaid	$23,903.67
Rate for Payer: UnitedHealthcare Medicaid	$23,903.67

KIDNEY TRANSPLANT

Facility

$31,781.56

Service Code	APR-DRG 4403
Min. Negotiated Rate	$31,781.56
Max. Negotiated Rate	$31,781.56
Rate for Payer: AlohaCare Medicaid	$31,781.56
Rate for Payer: Hawaii Medical Service Association ABD	$31,781.56
Rate for Payer: Hawaii Medical Service Association Non-ABD	$31,781.56
Rate for Payer: Kaiser Permanente Medicaid	$31,781.56
Rate for Payer: Ohana Health Plan Medicaid	$31,781.56
Rate for Payer: UnitedHealthcare Medicaid	$31,781.56

KIDNEY TRANSPLANT

Facility

$46,777.64

Service Code	APR-DRG 4404
Min. Negotiated Rate	$46,777.64
Max. Negotiated Rate	$46,777.64
Rate for Payer: AlohaCare Medicaid	$46,777.64
Rate for Payer: Hawaii Medical Service Association ABD	$46,777.64
Rate for Payer: Hawaii Medical Service Association Non-ABD	$46,777.64
Rate for Payer: Kaiser Permanente Medicaid	$46,777.64
Rate for Payer: Ohana Health Plan Medicaid	$46,777.64
Rate for Payer: UnitedHealthcare Medicaid	$46,777.64

KIDNEY TRANSPLANT

Facility

$157,370.50

Service Code	MSDRG 652
Min. Negotiated Rate	$42,476.85
Max. Negotiated Rate	$157,370.50
Rate for Payer: AlohaCare Medicare	$42,476.85
Rate for Payer: Devoted Health Medicare	$46,724.54
Rate for Payer: Hawaii Medical Service Association Commercial	$157,370.50
Rate for Payer: Hawaii Medical Service Association Medicare	$42,476.85
Rate for Payer: Kaiser Permanente Commercial	$55,708.88
Rate for Payer: Kaiser Permanente Medicare	$42,476.85
Rate for Payer: Ohana Health Plan Medicare	$42,476.85
Rate for Payer: UnitedHealthcare Medicare	$42,476.85

KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC

Facility

$157,370.50

Service Code	MSDRG 650
Min. Negotiated Rate	$61,836.41
Max. Negotiated Rate	$157,370.50
Rate for Payer: AlohaCare Medicare	$61,836.41
Rate for Payer: Devoted Health Medicare	$68,020.05
Rate for Payer: Hawaii Medical Service Association Commercial	$157,370.50
Rate for Payer: Hawaii Medical Service Association Medicare	$61,836.41
Rate for Payer: Humana Medicare	$61,836.41
Rate for Payer: Kaiser Permanente Commercial	$81,099.15
Rate for Payer: Kaiser Permanente Medicare	$61,836.41
Rate for Payer: Ohana Health Plan Medicare	$61,836.41
Rate for Payer: UnitedHealthcare Medicare	$61,836.41

KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC

Facility

$157,370.50

Service Code	MSDRG 651
Min. Negotiated Rate	$48,741.51
Max. Negotiated Rate	$157,370.50
Rate for Payer: AlohaCare Medicare	$48,741.51
Rate for Payer: Devoted Health Medicare	$53,615.66
Rate for Payer: Hawaii Medical Service Association Commercial	$157,370.50
Rate for Payer: Hawaii Medical Service Association Medicare	$48,741.51
Rate for Payer: Humana Medicare	$48,741.51
Rate for Payer: Kaiser Permanente Commercial	$63,925.05
Rate for Payer: Kaiser Permanente Medicare	$48,741.51
Rate for Payer: Ohana Health Plan Medicare	$48,741.51
Rate for Payer: UnitedHealthcare Medicare	$48,741.51

KIDNEY & URINARY TRACT INFECTIONS

Facility

$6,708.72

Service Code	APR-DRG 4634
Min. Negotiated Rate	$6,708.72
Max. Negotiated Rate	$6,708.72
Rate for Payer: AlohaCare Medicaid	$6,708.72
Rate for Payer: Hawaii Medical Service Association ABD	$6,708.72
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6,708.72
Rate for Payer: Kaiser Permanente Medicaid	$6,708.72
Rate for Payer: Ohana Health Plan Medicaid	$6,708.72
Rate for Payer: UnitedHealthcare Medicaid	$6,708.72

KIDNEY & URINARY TRACT INFECTIONS

Facility

$2,453.60

Service Code	APR-DRG 4631
Min. Negotiated Rate	$2,453.60
Max. Negotiated Rate	$2,453.60
Rate for Payer: AlohaCare Medicaid	$2,453.60
Rate for Payer: Hawaii Medical Service Association ABD	$2,453.60
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,453.60
Rate for Payer: Kaiser Permanente Medicaid	$2,453.60
Rate for Payer: Ohana Health Plan Medicaid	$2,453.60
Rate for Payer: UnitedHealthcare Medicaid	$2,453.60

KIDNEY & URINARY TRACT INFECTIONS

Facility

$4,045.61

Service Code	APR-DRG 4633
Min. Negotiated Rate	$4,045.61
Max. Negotiated Rate	$4,045.61
Rate for Payer: AlohaCare Medicaid	$4,045.61
Rate for Payer: Hawaii Medical Service Association ABD	$4,045.61
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,045.61
Rate for Payer: Kaiser Permanente Medicaid	$4,045.61
Rate for Payer: Ohana Health Plan Medicaid	$4,045.61
Rate for Payer: UnitedHealthcare Medicaid	$4,045.61

KIDNEY & URINARY TRACT INFECTIONS

Facility

$3,040.10

Service Code	APR-DRG 4632
Min. Negotiated Rate	$3,040.10
Max. Negotiated Rate	$3,040.10
Rate for Payer: AlohaCare Medicaid	$3,040.10
Rate for Payer: Hawaii Medical Service Association ABD	$3,040.10
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,040.10
Rate for Payer: Kaiser Permanente Medicaid	$3,040.10
Rate for Payer: Ohana Health Plan Medicaid	$3,040.10
Rate for Payer: UnitedHealthcare Medicaid	$3,040.10

KIDNEY & URINARY TRACT MALIGNANCY

Facility

$9,279.49

Service Code	APR-DRG 4614
Min. Negotiated Rate	$9,279.49
Max. Negotiated Rate	$9,279.49
Rate for Payer: AlohaCare Medicaid	$9,279.49
Rate for Payer: Hawaii Medical Service Association ABD	$9,279.49
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,279.49
Rate for Payer: Kaiser Permanente Medicaid	$9,279.49
Rate for Payer: Ohana Health Plan Medicaid	$9,279.49
Rate for Payer: UnitedHealthcare Medicaid	$9,279.49

KIDNEY & URINARY TRACT MALIGNANCY

Facility

$3,561.00

Service Code	APR-DRG 4611
Min. Negotiated Rate	$3,561.00
Max. Negotiated Rate	$3,561.00
Rate for Payer: AlohaCare Medicaid	$3,561.00
Rate for Payer: Hawaii Medical Service Association ABD	$3,561.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,561.00
Rate for Payer: Kaiser Permanente Medicaid	$3,561.00
Rate for Payer: Ohana Health Plan Medicaid	$3,561.00
Rate for Payer: UnitedHealthcare Medicaid	$3,561.00

KIDNEY & URINARY TRACT MALIGNANCY

Facility

$3,995.30

Service Code	APR-DRG 4612
Min. Negotiated Rate	$3,995.30
Max. Negotiated Rate	$3,995.30
Rate for Payer: AlohaCare Medicaid	$3,995.30
Rate for Payer: Hawaii Medical Service Association ABD	$3,995.30
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,995.30
Rate for Payer: Kaiser Permanente Medicaid	$3,995.30
Rate for Payer: Ohana Health Plan Medicaid	$3,995.30
Rate for Payer: UnitedHealthcare Medicaid	$3,995.30

Know your out-of-pocket cost for care.

All Charges