Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Lap Cautery Ligasure Blunt 5MM LF1837 [3600546]

Facility

$2,819.15

Hospital Charge Code	3600546
Hospital Revenue Code	272
Min. Negotiated Rate	$2,396.28
Max. Negotiated Rate	$2,734.58
Rate for Payer: Cash Price	$1,832.45
Rate for Payer: Health Management Network Commercial	$2,396.28
Rate for Payer: MDX Hawaii PPO	$2,734.58

Lap Cautery Ligasure Blunt 5MM LF1837 [3600546]

Facility

$2,819.15

Hospital Charge Code	3600546
Hospital Revenue Code	272
Min. Negotiated Rate	$1,437.77
Max. Negotiated Rate	$2,734.58
Rate for Payer: Cash Price	$1,832.45
Rate for Payer: Hawaii Western Management Group Commercial	$2,678.19
Rate for Payer: Health Management Network Commercial	$2,396.28
Rate for Payer: Kaiser Permanente Commercial	$1,776.06
Rate for Payer: Kaiser Permanente Medicaid	$1,437.77
Rate for Payer: MDX Hawaii PPO	$2,734.58
Rate for Payer: University Health Alliance Commercial	$2,054.88

Lap Cautery Ligasure L-Hook 37cm LF5637 [3642884]

Facility

$3,236.84

Hospital Charge Code	3642884
Hospital Revenue Code	272
Min. Negotiated Rate	$1,650.79
Max. Negotiated Rate	$3,139.73
Rate for Payer: Cash Price	$2,103.95
Rate for Payer: Hawaii Western Management Group Commercial	$3,075.00
Rate for Payer: Health Management Network Commercial	$2,751.31
Rate for Payer: Kaiser Permanente Commercial	$2,039.21
Rate for Payer: Kaiser Permanente Medicaid	$1,650.79
Rate for Payer: MDX Hawaii PPO	$3,139.73
Rate for Payer: University Health Alliance Commercial	$2,359.33

Lap Cautery Ligasure L-Hook 37cm LF5637 [3642884]

Facility

$3,236.84

Hospital Charge Code	3642884
Hospital Revenue Code	272
Min. Negotiated Rate	$2,751.31
Max. Negotiated Rate	$3,139.73
Rate for Payer: Cash Price	$2,103.95
Rate for Payer: Health Management Network Commercial	$2,751.31
Rate for Payer: MDX Hawaii PPO	$3,139.73

Lap Cautery Ligasure L-Hook 44cm LF5644 [3640868]

Facility

$3,523.85

Hospital Charge Code	3640868
Hospital Revenue Code	272
Min. Negotiated Rate	$1,797.16
Max. Negotiated Rate	$3,418.13
Rate for Payer: Cash Price	$2,290.50
Rate for Payer: Hawaii Western Management Group Commercial	$3,347.66
Rate for Payer: Health Management Network Commercial	$2,995.27
Rate for Payer: Kaiser Permanente Commercial	$2,220.03
Rate for Payer: Kaiser Permanente Medicaid	$1,797.16
Rate for Payer: MDX Hawaii PPO	$3,418.13
Rate for Payer: University Health Alliance Commercial	$2,568.53

Lap Cautery Ligasure L-Hook 44cm LF5644 [3640868]

Facility

$3,523.85

Hospital Charge Code	3640868
Hospital Revenue Code	272
Min. Negotiated Rate	$2,995.27
Max. Negotiated Rate	$3,418.13
Rate for Payer: Cash Price	$2,290.50
Rate for Payer: Health Management Network Commercial	$2,995.27
Rate for Payer: MDX Hawaii PPO	$3,418.13

Lap Dolphin Nose Dissector Tip 3312 [3640703]

Facility

$268.38

Hospital Charge Code	3640703
Hospital Revenue Code	272
Min. Negotiated Rate	$228.12
Max. Negotiated Rate	$260.33
Rate for Payer: Cash Price	$174.45
Rate for Payer: Health Management Network Commercial	$228.12
Rate for Payer: MDX Hawaii PPO	$260.33

Lap Dolphin Nose Dissector Tip 3312 [3640703]

Facility

$268.38

Hospital Charge Code	3640703
Hospital Revenue Code	272
Min. Negotiated Rate	$136.87
Max. Negotiated Rate	$260.33
Rate for Payer: Cash Price	$174.45
Rate for Payer: Hawaii Western Management Group Commercial	$254.96
Rate for Payer: Health Management Network Commercial	$228.12
Rate for Payer: Kaiser Permanente Commercial	$169.08
Rate for Payer: Kaiser Permanente Medicaid	$136.87
Rate for Payer: MDX Hawaii PPO	$260.33
Rate for Payer: University Health Alliance Commercial	$195.62

Lap Endoclip 5Mm 176630 [3602922]

Facility

$886.55

Hospital Charge Code	3602922
Hospital Revenue Code	272
Min. Negotiated Rate	$753.57
Max. Negotiated Rate	$859.95
Rate for Payer: Cash Price	$576.26
Rate for Payer: Health Management Network Commercial	$753.57
Rate for Payer: MDX Hawaii PPO	$859.95

Lap Endoclip 5Mm 176630 [3602922]

Facility

$886.55

Hospital Charge Code	3602922
Hospital Revenue Code	272
Min. Negotiated Rate	$452.14
Max. Negotiated Rate	$859.95
Rate for Payer: Cash Price	$576.26
Rate for Payer: Hawaii Western Management Group Commercial	$842.22
Rate for Payer: Health Management Network Commercial	$753.57
Rate for Payer: Kaiser Permanente Commercial	$558.53
Rate for Payer: Kaiser Permanente Medicaid	$452.14
Rate for Payer: MDX Hawaii PPO	$859.95
Rate for Payer: University Health Alliance Commercial	$646.21

Lap Endoloop 0 Pds EZ10G [3603029]

Facility

$1,122.50

Hospital Charge Code	3603029
Hospital Revenue Code	272
Min. Negotiated Rate	$954.12
Max. Negotiated Rate	$1,088.83
Rate for Payer: Cash Price	$729.62
Rate for Payer: Health Management Network Commercial	$954.12
Rate for Payer: MDX Hawaii PPO	$1,088.83

Lap Endoloop 0 Pds EZ10G [3603029]

Facility

$1,122.50

Hospital Charge Code	3603029
Hospital Revenue Code	272
Min. Negotiated Rate	$572.48
Max. Negotiated Rate	$1,088.83
Rate for Payer: Cash Price	$729.62
Rate for Payer: Hawaii Western Management Group Commercial	$1,066.38
Rate for Payer: Health Management Network Commercial	$954.12
Rate for Payer: Kaiser Permanente Commercial	$707.17
Rate for Payer: Kaiser Permanente Medicaid	$572.48
Rate for Payer: MDX Hawaii PPO	$1,088.83
Rate for Payer: University Health Alliance Commercial	$818.19

Lap Endostitch Polysorb 2-0 170053 [3603090]

Facility

$173.36

Hospital Charge Code	3603090
Hospital Revenue Code	272
Min. Negotiated Rate	$88.41
Max. Negotiated Rate	$168.16
Rate for Payer: Cash Price	$112.68
Rate for Payer: Hawaii Western Management Group Commercial	$164.69
Rate for Payer: Health Management Network Commercial	$147.36
Rate for Payer: Kaiser Permanente Commercial	$109.22
Rate for Payer: Kaiser Permanente Medicaid	$88.41
Rate for Payer: MDX Hawaii PPO	$168.16
Rate for Payer: University Health Alliance Commercial	$126.36

Lap Endostitch Polysorb 2-0 170053 [3603090]

Facility

$173.36

Hospital Charge Code	3603090
Hospital Revenue Code	272
Min. Negotiated Rate	$147.36
Max. Negotiated Rate	$168.16
Rate for Payer: Cash Price	$112.68
Rate for Payer: Health Management Network Commercial	$147.36
Rate for Payer: MDX Hawaii PPO	$168.16

Lap Endostitch Surgidac 2-0 173023 [3602981]

Facility

$174.16

Hospital Charge Code	3602981
Hospital Revenue Code	272
Min. Negotiated Rate	$148.04
Max. Negotiated Rate	$168.94
Rate for Payer: Cash Price	$113.20
Rate for Payer: Health Management Network Commercial	$148.04
Rate for Payer: MDX Hawaii PPO	$168.94

Lap Endostitch Surgidac 2-0 173023 [3602981]

Facility

$174.16

Hospital Charge Code	3602981
Hospital Revenue Code	272
Min. Negotiated Rate	$88.82
Max. Negotiated Rate	$168.94
Rate for Payer: Cash Price	$113.20
Rate for Payer: Hawaii Western Management Group Commercial	$165.45
Rate for Payer: Health Management Network Commercial	$148.04
Rate for Payer: Kaiser Permanente Commercial	$109.72
Rate for Payer: Kaiser Permanente Medicaid	$88.82
Rate for Payer: MDX Hawaii PPO	$168.94
Rate for Payer: University Health Alliance Commercial	$126.95

Lap Endostitch Suturing Device 173016 [3603089]

Facility

$739.24

Hospital Charge Code	3603089
Hospital Revenue Code	272
Min. Negotiated Rate	$377.01
Max. Negotiated Rate	$717.06
Rate for Payer: Cash Price	$480.51
Rate for Payer: Hawaii Western Management Group Commercial	$702.28
Rate for Payer: Health Management Network Commercial	$628.35
Rate for Payer: Kaiser Permanente Commercial	$465.72
Rate for Payer: Kaiser Permanente Medicaid	$377.01
Rate for Payer: MDX Hawaii PPO	$717.06
Rate for Payer: University Health Alliance Commercial	$538.83

Lap Endostitch Suturing Device 173016 [3603089]

Facility

$739.24

Hospital Charge Code	3603089
Hospital Revenue Code	272
Min. Negotiated Rate	$628.35
Max. Negotiated Rate	$717.06
Rate for Payer: Cash Price	$480.51
Rate for Payer: Health Management Network Commercial	$628.35
Rate for Payer: MDX Hawaii PPO	$717.06

Lap Gelport Device C8XX2 [3602944]

Facility

$3,653.00

Hospital Charge Code	3602944
Hospital Revenue Code	272
Min. Negotiated Rate	$1,863.03
Max. Negotiated Rate	$3,543.41
Rate for Payer: Cash Price	$2,374.45
Rate for Payer: Hawaii Western Management Group Commercial	$3,470.35
Rate for Payer: Health Management Network Commercial	$3,105.05
Rate for Payer: Kaiser Permanente Commercial	$2,301.39
Rate for Payer: Kaiser Permanente Medicaid	$1,863.03
Rate for Payer: MDX Hawaii PPO	$3,543.41
Rate for Payer: University Health Alliance Commercial	$2,662.67

Lap Gelport Device C8XX2 [3602944]

Facility

$3,653.00

Hospital Charge Code	3602944
Hospital Revenue Code	272
Min. Negotiated Rate	$3,105.05
Max. Negotiated Rate	$3,543.41
Rate for Payer: Cash Price	$2,374.45
Rate for Payer: Health Management Network Commercial	$3,105.05
Rate for Payer: MDX Hawaii PPO	$3,543.41

Lap Hook Scissors Tip Disp 3132 [3602051]

Facility

$382.25

Hospital Charge Code	3602051
Hospital Revenue Code	272
Min. Negotiated Rate	$324.91
Max. Negotiated Rate	$370.78
Rate for Payer: Cash Price	$248.46
Rate for Payer: Health Management Network Commercial	$324.91
Rate for Payer: MDX Hawaii PPO	$370.78

Lap Hook Scissors Tip Disp 3132 [3602051]

Facility

$382.25

Hospital Charge Code	3602051
Hospital Revenue Code	272
Min. Negotiated Rate	$194.95
Max. Negotiated Rate	$370.78
Rate for Payer: Cash Price	$248.46
Rate for Payer: Hawaii Western Management Group Commercial	$363.14
Rate for Payer: Health Management Network Commercial	$324.91
Rate for Payer: Kaiser Permanente Commercial	$240.82
Rate for Payer: Kaiser Permanente Medicaid	$194.95
Rate for Payer: MDX Hawaii PPO	$370.78
Rate for Payer: University Health Alliance Commercial	$278.62

Lap Insufflation Ndle Long VS150000 [3603143]

Facility

$136.48

Hospital Charge Code	3603143
Hospital Revenue Code	272
Min. Negotiated Rate	$69.60
Max. Negotiated Rate	$132.39
Rate for Payer: Cash Price	$88.71
Rate for Payer: Hawaii Western Management Group Commercial	$129.66
Rate for Payer: Health Management Network Commercial	$116.01
Rate for Payer: Kaiser Permanente Commercial	$85.98
Rate for Payer: Kaiser Permanente Medicaid	$69.60
Rate for Payer: MDX Hawaii PPO	$132.39
Rate for Payer: University Health Alliance Commercial	$99.48

Lap Insufflation Ndle Long VS150000 [3603143]

Facility

$136.48

Hospital Charge Code	3603143
Hospital Revenue Code	272
Min. Negotiated Rate	$116.01
Max. Negotiated Rate	$132.39
Rate for Payer: Cash Price	$88.71
Rate for Payer: Health Management Network Commercial	$116.01
Rate for Payer: MDX Hawaii PPO	$132.39

Lap Insufflation Needle 13g x 150mm C2202 [3644634]

Facility

$184.00

Hospital Charge Code	3644634
Hospital Revenue Code	272
Min. Negotiated Rate	$93.84
Max. Negotiated Rate	$178.48
Rate for Payer: Cash Price	$119.60
Rate for Payer: Hawaii Western Management Group Commercial	$174.80
Rate for Payer: Health Management Network Commercial	$156.40
Rate for Payer: Kaiser Permanente Commercial	$115.92
Rate for Payer: Kaiser Permanente Medicaid	$93.84
Rate for Payer: MDX Hawaii PPO	$178.48
Rate for Payer: University Health Alliance Commercial	$134.12

Know your out-of-pocket cost for care.

All Charges