Kona Community Hospital

All Charges

Charge

Type

Setting

Price

Lap Kii 5mmX150mm Optical Access System CFR01 [3642931]

Facility

$606.50

Hospital Charge Code	3642931
Hospital Revenue Code	272
Min. Negotiated Rate	$309.31
Max. Negotiated Rate	$588.30
Rate for Payer: Cash Price	$394.22
Rate for Payer: Hawaii Western Management Group Commercial	$576.17
Rate for Payer: Health Management Network Commercial	$515.52
Rate for Payer: Kaiser Permanente Commercial	$382.10
Rate for Payer: Kaiser Permanente Medicaid	$309.31
Rate for Payer: MDX Hawaii PPO	$588.30
Rate for Payer: University Health Alliance Commercial	$442.08

Lap Kii 5mmX150mm Optical Access System CFR01 [3642931]

Facility

$606.50

Hospital Charge Code	3642931
Hospital Revenue Code	272
Min. Negotiated Rate	$515.52
Max. Negotiated Rate	$588.30
Rate for Payer: Cash Price	$394.22
Rate for Payer: Health Management Network Commercial	$515.52
Rate for Payer: MDX Hawaii PPO	$588.30

Lap Kii Optical Access 8mm x 100mm COQ19 [3641107]

Facility

$434.00

Hospital Charge Code	3641107
Hospital Revenue Code	272
Min. Negotiated Rate	$221.34
Max. Negotiated Rate	$420.98
Rate for Payer: Cash Price	$282.10
Rate for Payer: Hawaii Western Management Group Commercial	$412.30
Rate for Payer: Health Management Network Commercial	$368.90
Rate for Payer: Kaiser Permanente Commercial	$273.42
Rate for Payer: Kaiser Permanente Medicaid	$221.34
Rate for Payer: MDX Hawaii PPO	$420.98
Rate for Payer: University Health Alliance Commercial	$316.34

Lap Kii Optical Access 8mm x 100mm COQ19 [3641107]

Facility

$434.00

Hospital Charge Code	3641107
Hospital Revenue Code	272
Min. Negotiated Rate	$368.90
Max. Negotiated Rate	$420.98
Rate for Payer: Cash Price	$282.10
Rate for Payer: Health Management Network Commercial	$368.90
Rate for Payer: MDX Hawaii PPO	$420.98

Lap Ligasure Maryland Xp 37cm LXMJ37L [3643869]

Facility

$2,942.23

Hospital Charge Code	3643869
Hospital Revenue Code	272
Min. Negotiated Rate	$1,500.54
Max. Negotiated Rate	$2,853.96
Rate for Payer: Cash Price	$1,912.45
Rate for Payer: Hawaii Western Management Group Commercial	$2,795.12
Rate for Payer: Health Management Network Commercial	$2,500.90
Rate for Payer: Kaiser Permanente Commercial	$1,853.60
Rate for Payer: Kaiser Permanente Medicaid	$1,500.54
Rate for Payer: MDX Hawaii PPO	$2,853.96
Rate for Payer: University Health Alliance Commercial	$2,144.59

Lap Ligasure Maryland Xp 37cm LXMJ37L [3643869]

Facility

$2,942.23

Hospital Charge Code	3643869
Hospital Revenue Code	272
Min. Negotiated Rate	$2,500.90
Max. Negotiated Rate	$2,853.96
Rate for Payer: Cash Price	$1,912.45
Rate for Payer: Health Management Network Commercial	$2,500.90
Rate for Payer: MDX Hawaii PPO	$2,853.96

Lap Nezhat Dorsey Suction Tubing 5102710 [3603075]

Facility

$210.45

Hospital Charge Code	3603075
Hospital Revenue Code	272
Min. Negotiated Rate	$178.88
Max. Negotiated Rate	$204.14
Rate for Payer: Cash Price	$136.79
Rate for Payer: Health Management Network Commercial	$178.88
Rate for Payer: MDX Hawaii PPO	$204.14

Lap Nezhat Dorsey Suction Tubing 5102710 [3603075]

Facility

$210.45

Hospital Charge Code	3603075
Hospital Revenue Code	272
Min. Negotiated Rate	$107.33
Max. Negotiated Rate	$204.14
Rate for Payer: Cash Price	$136.79
Rate for Payer: Hawaii Western Management Group Commercial	$199.93
Rate for Payer: Health Management Network Commercial	$178.88
Rate for Payer: Kaiser Permanente Commercial	$132.58
Rate for Payer: Kaiser Permanente Medicaid	$107.33
Rate for Payer: MDX Hawaii PPO	$204.14
Rate for Payer: University Health Alliance Commercial	$153.40

Lap Slv Xcel Optiview 12mm 2CB12LT [3640195]

Facility

$700.31

Hospital Charge Code	3640195
Hospital Revenue Code	272
Min. Negotiated Rate	$595.26
Max. Negotiated Rate	$679.30
Rate for Payer: Cash Price	$455.20
Rate for Payer: Health Management Network Commercial	$595.26
Rate for Payer: MDX Hawaii PPO	$679.30

Lap Slv Xcel Optiview 12mm 2CB12LT [3640195]

Facility

$700.31

Hospital Charge Code	3640195
Hospital Revenue Code	272
Min. Negotiated Rate	$357.16
Max. Negotiated Rate	$679.30
Rate for Payer: Cash Price	$455.20
Rate for Payer: Hawaii Western Management Group Commercial	$665.29
Rate for Payer: Health Management Network Commercial	$595.26
Rate for Payer: Kaiser Permanente Commercial	$441.20
Rate for Payer: Kaiser Permanente Medicaid	$357.16
Rate for Payer: MDX Hawaii PPO	$679.30
Rate for Payer: University Health Alliance Commercial	$510.46

Lap Slv Xcel Optiview 5mm 2CB5LT [3640126]

Facility

$700.31

Hospital Charge Code	3640126
Hospital Revenue Code	272
Min. Negotiated Rate	$595.26
Max. Negotiated Rate	$679.30
Rate for Payer: Cash Price	$455.20
Rate for Payer: Health Management Network Commercial	$595.26
Rate for Payer: MDX Hawaii PPO	$679.30

Lap Slv Xcel Optiview 5mm 2CB5LT [3640126]

Facility

$700.31

Hospital Charge Code	3640126
Hospital Revenue Code	272
Min. Negotiated Rate	$357.16
Max. Negotiated Rate	$679.30
Rate for Payer: Cash Price	$455.20
Rate for Payer: Hawaii Western Management Group Commercial	$665.29
Rate for Payer: Health Management Network Commercial	$595.26
Rate for Payer: Kaiser Permanente Commercial	$441.20
Rate for Payer: Kaiser Permanente Medicaid	$357.16
Rate for Payer: MDX Hawaii PPO	$679.30
Rate for Payer: University Health Alliance Commercial	$510.46

Lap Tacker Absorba ABSTACK15 [3640632]

Facility

$1,876.35

Hospital Charge Code	3640632
Hospital Revenue Code	272
Min. Negotiated Rate	$1,594.90
Max. Negotiated Rate	$1,820.06
Rate for Payer: Cash Price	$1,219.63
Rate for Payer: Health Management Network Commercial	$1,594.90
Rate for Payer: MDX Hawaii PPO	$1,820.06

Lap Tacker Absorba ABSTACK15 [3640632]

Facility

$1,876.35

Hospital Charge Code	3640632
Hospital Revenue Code	272
Min. Negotiated Rate	$956.94
Max. Negotiated Rate	$1,820.06
Rate for Payer: Cash Price	$1,219.63
Rate for Payer: Hawaii Western Management Group Commercial	$1,782.53
Rate for Payer: Health Management Network Commercial	$1,594.90
Rate for Payer: Kaiser Permanente Commercial	$1,182.10
Rate for Payer: Kaiser Permanente Medicaid	$956.94
Rate for Payer: MDX Hawaii PPO	$1,820.06
Rate for Payer: University Health Alliance Commercial	$1,367.67

Lap Tacker Absorba ABSTACK30X [3602947]

Facility

$3,721.36

Hospital Charge Code	3602947
Hospital Revenue Code	272
Min. Negotiated Rate	$1,897.89
Max. Negotiated Rate	$3,609.72
Rate for Payer: Cash Price	$2,418.88
Rate for Payer: Hawaii Western Management Group Commercial	$3,535.29
Rate for Payer: Health Management Network Commercial	$3,163.16
Rate for Payer: Kaiser Permanente Commercial	$2,344.46
Rate for Payer: Kaiser Permanente Medicaid	$1,897.89
Rate for Payer: MDX Hawaii PPO	$3,609.72
Rate for Payer: University Health Alliance Commercial	$2,712.50

Lap Tacker Absorba ABSTACK30X [3602947]

Facility

$3,721.36

Hospital Charge Code	3602947
Hospital Revenue Code	272
Min. Negotiated Rate	$3,163.16
Max. Negotiated Rate	$3,609.72
Rate for Payer: Cash Price	$2,418.88
Rate for Payer: Health Management Network Commercial	$3,163.16
Rate for Payer: MDX Hawaii PPO	$3,609.72

Lap Tacker Articul Reliatack Reload RELTACK5RSW [3640631]

Facility

$810.35

Hospital Charge Code	3640631
Hospital Revenue Code	272
Min. Negotiated Rate	$413.28
Max. Negotiated Rate	$786.04
Rate for Payer: Cash Price	$526.73
Rate for Payer: Hawaii Western Management Group Commercial	$769.83
Rate for Payer: Health Management Network Commercial	$688.80
Rate for Payer: Kaiser Permanente Commercial	$510.52
Rate for Payer: Kaiser Permanente Medicaid	$413.28
Rate for Payer: MDX Hawaii PPO	$786.04
Rate for Payer: University Health Alliance Commercial	$590.66

Lap Tacker Articul Reliatack Reload RELTACK5RSW [3640631]

Facility

$810.35

Hospital Charge Code	3640631
Hospital Revenue Code	272
Min. Negotiated Rate	$688.80
Max. Negotiated Rate	$786.04
Rate for Payer: Cash Price	$526.73
Rate for Payer: Health Management Network Commercial	$688.80
Rate for Payer: MDX Hawaii PPO	$786.04

Lap Tacker Articul Reliatack RELTACK3X10SW [3640630]

Facility

$4,350.23

Hospital Charge Code	3640630
Hospital Revenue Code	272
Min. Negotiated Rate	$3,697.70
Max. Negotiated Rate	$4,219.72
Rate for Payer: Cash Price	$2,827.65
Rate for Payer: Health Management Network Commercial	$3,697.70
Rate for Payer: MDX Hawaii PPO	$4,219.72

Lap Tacker Articul Reliatack RELTACK3X10SW [3640630]

Facility

$4,350.23

Hospital Charge Code	3640630
Hospital Revenue Code	272
Min. Negotiated Rate	$2,218.62
Max. Negotiated Rate	$4,219.72
Rate for Payer: Cash Price	$2,827.65
Rate for Payer: Hawaii Western Management Group Commercial	$4,132.72
Rate for Payer: Health Management Network Commercial	$3,697.70
Rate for Payer: Kaiser Permanente Commercial	$2,740.64
Rate for Payer: Kaiser Permanente Medicaid	$2,218.62
Rate for Payer: MDX Hawaii PPO	$4,219.72
Rate for Payer: University Health Alliance Commercial	$3,170.88

Lap Tacker Protack 5mm 174006 [3602932]

Facility

$2,706.13

Hospital Charge Code	3602932
Hospital Revenue Code	272
Min. Negotiated Rate	$2,300.21
Max. Negotiated Rate	$2,624.95
Rate for Payer: Cash Price	$1,758.98
Rate for Payer: Health Management Network Commercial	$2,300.21
Rate for Payer: MDX Hawaii PPO	$2,624.95

Lap Tacker Protack 5mm 174006 [3602932]

Facility

$2,706.13

Hospital Charge Code	3602932
Hospital Revenue Code	272
Min. Negotiated Rate	$1,380.13
Max. Negotiated Rate	$2,624.95
Rate for Payer: Cash Price	$1,758.98
Rate for Payer: Hawaii Western Management Group Commercial	$2,570.82
Rate for Payer: Health Management Network Commercial	$2,300.21
Rate for Payer: Kaiser Permanente Commercial	$1,704.86
Rate for Payer: Kaiser Permanente Medicaid	$1,380.13
Rate for Payer: MDX Hawaii PPO	$2,624.95
Rate for Payer: University Health Alliance Commercial	$1,972.50

Lap Tip Babcock 5mm Grasper 3302 [3640480]

Facility

$413.88

Hospital Charge Code	3640480
Hospital Revenue Code	272
Min. Negotiated Rate	$351.80
Max. Negotiated Rate	$401.46
Rate for Payer: Cash Price	$269.02
Rate for Payer: Health Management Network Commercial	$351.80
Rate for Payer: MDX Hawaii PPO	$401.46

Lap Tip Babcock 5mm Grasper 3302 [3640480]

Facility

$413.88

Hospital Charge Code	3640480
Hospital Revenue Code	272
Min. Negotiated Rate	$211.08
Max. Negotiated Rate	$401.46
Rate for Payer: Cash Price	$269.02
Rate for Payer: Hawaii Western Management Group Commercial	$393.19
Rate for Payer: Health Management Network Commercial	$351.80
Rate for Payer: Kaiser Permanente Commercial	$260.74
Rate for Payer: Kaiser Permanente Medicaid	$211.08
Rate for Payer: MDX Hawaii PPO	$401.46
Rate for Payer: University Health Alliance Commercial	$301.68

Lap Tip Clinch Grasper 3252 [3640644]

Facility

$413.88

Hospital Charge Code	3640644
Hospital Revenue Code	272
Min. Negotiated Rate	$351.80
Max. Negotiated Rate	$401.46
Rate for Payer: Cash Price	$269.02
Rate for Payer: Health Management Network Commercial	$351.80
Rate for Payer: MDX Hawaii PPO	$401.46

Know your out-of-pocket cost for care.

All Charges