Kona Community Hospital

All Charges

Charge

Type

Setting

Price

MAJOR ABDOMINAL VASCULAR PROCEDURES

Facility

$10,148.09

Service Code	APR-DRG 1691
Min. Negotiated Rate	$10,148.09
Max. Negotiated Rate	$10,148.09
Rate for Payer: AlohaCare Medicaid	$10,148.09
Rate for Payer: Hawaii Medical Service Association ABD	$10,148.09
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10,148.09
Rate for Payer: Kaiser Permanente Medicaid	$10,148.09
Rate for Payer: Ohana Health Plan Medicaid	$10,148.09
Rate for Payer: UnitedHealthcare Medicaid	$10,148.09

MAJOR ABDOMINAL VASCULAR PROCEDURES

Facility

$32,013.36

Service Code	APR-DRG 1694
Min. Negotiated Rate	$32,013.36
Max. Negotiated Rate	$32,013.36
Rate for Payer: AlohaCare Medicaid	$32,013.36
Rate for Payer: Hawaii Medical Service Association ABD	$32,013.36
Rate for Payer: Hawaii Medical Service Association Non-ABD	$32,013.36
Rate for Payer: Kaiser Permanente Medicaid	$32,013.36
Rate for Payer: Ohana Health Plan Medicaid	$32,013.36
Rate for Payer: UnitedHealthcare Medicaid	$32,013.36

MAJOR ABDOMINAL VASCULAR PROCEDURES

Facility

$19,508.46

Service Code	APR-DRG 1693
Min. Negotiated Rate	$19,508.46
Max. Negotiated Rate	$19,508.46
Rate for Payer: AlohaCare Medicaid	$19,508.46
Rate for Payer: Hawaii Medical Service Association ABD	$19,508.46
Rate for Payer: Hawaii Medical Service Association Non-ABD	$19,508.46
Rate for Payer: Kaiser Permanente Medicaid	$19,508.46
Rate for Payer: Ohana Health Plan Medicaid	$19,508.46
Rate for Payer: UnitedHealthcare Medicaid	$19,508.46

MAJOR BILIARY TRACT PROCEDURES

Facility

$24,996.43

Service Code	APR-DRG 2614
Min. Negotiated Rate	$24,996.43
Max. Negotiated Rate	$24,996.43
Rate for Payer: AlohaCare Medicaid	$24,996.43
Rate for Payer: Hawaii Medical Service Association ABD	$24,996.43
Rate for Payer: Hawaii Medical Service Association Non-ABD	$24,996.43
Rate for Payer: Kaiser Permanente Medicaid	$24,996.43
Rate for Payer: Ohana Health Plan Medicaid	$24,996.43
Rate for Payer: UnitedHealthcare Medicaid	$24,996.43

MAJOR BILIARY TRACT PROCEDURES

Facility

$14,866.80

Service Code	APR-DRG 2613
Min. Negotiated Rate	$14,866.80
Max. Negotiated Rate	$14,866.80
Rate for Payer: AlohaCare Medicaid	$14,866.80
Rate for Payer: Hawaii Medical Service Association ABD	$14,866.80
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14,866.80
Rate for Payer: Kaiser Permanente Medicaid	$14,866.80
Rate for Payer: Ohana Health Plan Medicaid	$14,866.80
Rate for Payer: UnitedHealthcare Medicaid	$14,866.80

MAJOR BILIARY TRACT PROCEDURES

Facility

$10,047.48

Service Code	APR-DRG 2612
Min. Negotiated Rate	$10,047.48
Max. Negotiated Rate	$10,047.48
Rate for Payer: AlohaCare Medicaid	$10,047.48
Rate for Payer: Hawaii Medical Service Association ABD	$10,047.48
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10,047.48
Rate for Payer: Kaiser Permanente Medicaid	$10,047.48
Rate for Payer: Ohana Health Plan Medicaid	$10,047.48
Rate for Payer: UnitedHealthcare Medicaid	$10,047.48

MAJOR BILIARY TRACT PROCEDURES

Facility

$7,404.75

Service Code	APR-DRG 2611
Min. Negotiated Rate	$7,404.75
Max. Negotiated Rate	$7,404.75
Rate for Payer: AlohaCare Medicaid	$7,404.75
Rate for Payer: Hawaii Medical Service Association ABD	$7,404.75
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,404.75
Rate for Payer: Kaiser Permanente Medicaid	$7,404.75
Rate for Payer: Ohana Health Plan Medicaid	$7,404.75
Rate for Payer: UnitedHealthcare Medicaid	$7,404.75

MAJOR BLADDER PROCEDURES

Facility

$7,603.43

Service Code	APR-DRG 4411
Min. Negotiated Rate	$7,603.43
Max. Negotiated Rate	$7,603.43
Rate for Payer: AlohaCare Medicaid	$7,603.43
Rate for Payer: Hawaii Medical Service Association ABD	$7,603.43
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,603.43
Rate for Payer: Kaiser Permanente Medicaid	$7,603.43
Rate for Payer: Ohana Health Plan Medicaid	$7,603.43
Rate for Payer: UnitedHealthcare Medicaid	$7,603.43

MAJOR BLADDER PROCEDURES

Facility

$15,527.17

Service Code	APR-DRG 4413
Min. Negotiated Rate	$15,527.17
Max. Negotiated Rate	$15,527.17
Rate for Payer: AlohaCare Medicaid	$15,527.17
Rate for Payer: Hawaii Medical Service Association ABD	$15,527.17
Rate for Payer: Hawaii Medical Service Association Non-ABD	$15,527.17
Rate for Payer: Kaiser Permanente Medicaid	$15,527.17
Rate for Payer: Ohana Health Plan Medicaid	$15,527.17
Rate for Payer: UnitedHealthcare Medicaid	$15,527.17

MAJOR BLADDER PROCEDURES

Facility

$12,110.08

Service Code	APR-DRG 4412
Min. Negotiated Rate	$12,110.08
Max. Negotiated Rate	$12,110.08
Rate for Payer: AlohaCare Medicaid	$12,110.08
Rate for Payer: Hawaii Medical Service Association ABD	$12,110.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$12,110.08
Rate for Payer: Kaiser Permanente Medicaid	$12,110.08
Rate for Payer: Ohana Health Plan Medicaid	$12,110.08
Rate for Payer: UnitedHealthcare Medicaid	$12,110.08

MAJOR BLADDER PROCEDURES

Facility

$30,639.14

Service Code	APR-DRG 4414
Min. Negotiated Rate	$30,639.14
Max. Negotiated Rate	$30,639.14
Rate for Payer: AlohaCare Medicaid	$30,639.14
Rate for Payer: Hawaii Medical Service Association ABD	$30,639.14
Rate for Payer: Hawaii Medical Service Association Non-ABD	$30,639.14
Rate for Payer: Kaiser Permanente Medicaid	$30,639.14
Rate for Payer: Ohana Health Plan Medicaid	$30,639.14
Rate for Payer: UnitedHealthcare Medicaid	$30,639.14

MAJOR BLADDER PROCEDURES WITH CC

Facility

$48,287.93

Service Code	MSDRG 654
Min. Negotiated Rate	$36,818.53
Max. Negotiated Rate	$48,287.93
Rate for Payer: AlohaCare Medicare	$36,818.53
Rate for Payer: Devoted Health Medicare	$40,500.38
Rate for Payer: Hawaii Medical Service Association Commercial	$46,574.72
Rate for Payer: Hawaii Medical Service Association Medicare	$36,818.53
Rate for Payer: Humana Medicare	$36,818.53
Rate for Payer: Kaiser Permanente Commercial	$48,287.93
Rate for Payer: Kaiser Permanente Medicare	$36,818.53
Rate for Payer: Ohana Health Plan Medicare	$36,818.53
Rate for Payer: UnitedHealthcare Medicare	$36,818.53

MAJOR BLADDER PROCEDURES WITH MCC

Facility

$89,637.90

Service Code	MSDRG 653
Min. Negotiated Rate	$46,574.72
Max. Negotiated Rate	$89,637.90
Rate for Payer: AlohaCare Medicare	$68,347.05
Rate for Payer: Devoted Health Medicare	$75,181.76
Rate for Payer: Hawaii Medical Service Association Commercial	$46,574.72
Rate for Payer: Hawaii Medical Service Association Medicare	$68,347.05
Rate for Payer: Humana Medicare	$68,347.05
Rate for Payer: Kaiser Permanente Commercial	$89,637.90
Rate for Payer: Kaiser Permanente Medicare	$68,347.05
Rate for Payer: Ohana Health Plan Medicare	$68,347.05
Rate for Payer: UnitedHealthcare Medicare	$68,347.05

MAJOR BLADDER PROCEDURES WITHOUT CC/MCC

Facility

$46,574.72

Service Code	MSDRG 655
Min. Negotiated Rate	$27,839.15
Max. Negotiated Rate	$46,574.72
Rate for Payer: AlohaCare Medicare	$27,839.15
Rate for Payer: Devoted Health Medicare	$30,623.06
Rate for Payer: Hawaii Medical Service Association Commercial	$46,574.72
Rate for Payer: Hawaii Medical Service Association Medicare	$27,839.15
Rate for Payer: Humana Medicare	$27,839.15
Rate for Payer: Kaiser Permanente Commercial	$36,511.35
Rate for Payer: Kaiser Permanente Medicare	$27,839.15
Rate for Payer: Ohana Health Plan Medicare	$27,839.15
Rate for Payer: UnitedHealthcare Medicare	$27,839.15

MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY

Facility

$19,981.60

Service Code	APR-DRG 1601
Min. Negotiated Rate	$19,981.60
Max. Negotiated Rate	$19,981.60
Rate for Payer: AlohaCare Medicaid	$19,981.60
Rate for Payer: Hawaii Medical Service Association ABD	$19,981.60
Rate for Payer: Hawaii Medical Service Association Non-ABD	$19,981.60
Rate for Payer: Kaiser Permanente Medicaid	$19,981.60
Rate for Payer: Ohana Health Plan Medicaid	$19,981.60
Rate for Payer: UnitedHealthcare Medicaid	$19,981.60

MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY

Facility

$52,292.35

Service Code	APR-DRG 1604
Min. Negotiated Rate	$52,292.35
Max. Negotiated Rate	$52,292.35
Rate for Payer: AlohaCare Medicaid	$52,292.35
Rate for Payer: Hawaii Medical Service Association ABD	$52,292.35
Rate for Payer: Hawaii Medical Service Association Non-ABD	$52,292.35
Rate for Payer: Kaiser Permanente Medicaid	$52,292.35
Rate for Payer: Ohana Health Plan Medicaid	$52,292.35
Rate for Payer: UnitedHealthcare Medicaid	$52,292.35

MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY

Facility

$22,964.39

Service Code	APR-DRG 1602
Min. Negotiated Rate	$22,964.39
Max. Negotiated Rate	$22,964.39
Rate for Payer: AlohaCare Medicaid	$22,964.39
Rate for Payer: Hawaii Medical Service Association ABD	$22,964.39
Rate for Payer: Hawaii Medical Service Association Non-ABD	$22,964.39
Rate for Payer: Kaiser Permanente Medicaid	$22,964.39
Rate for Payer: Ohana Health Plan Medicaid	$22,964.39
Rate for Payer: UnitedHealthcare Medicaid	$22,964.39

MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY

Facility

$30,038.00

Service Code	APR-DRG 1603
Min. Negotiated Rate	$30,038.00
Max. Negotiated Rate	$30,038.00
Rate for Payer: AlohaCare Medicaid	$30,038.00
Rate for Payer: Hawaii Medical Service Association ABD	$30,038.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$30,038.00
Rate for Payer: Kaiser Permanente Medicaid	$30,038.00
Rate for Payer: Ohana Health Plan Medicaid	$30,038.00
Rate for Payer: UnitedHealthcare Medicaid	$30,038.00

MAJOR CHEST PROCEDURES WITH CC

Facility

$64,293.37

Service Code	MSDRG 164
Min. Negotiated Rate	$33,197.58
Max. Negotiated Rate	$64,293.37
Rate for Payer: AlohaCare Medicare	$33,197.58
Rate for Payer: Devoted Health Medicare	$36,517.34
Rate for Payer: Hawaii Medical Service Association Commercial	$64,293.37
Rate for Payer: Hawaii Medical Service Association Medicare	$33,197.58
Rate for Payer: Humana Medicare	$33,197.58
Rate for Payer: Kaiser Permanente Commercial	$43,539.00
Rate for Payer: Kaiser Permanente Medicare	$33,197.58
Rate for Payer: Ohana Health Plan Medicare	$33,197.58
Rate for Payer: UnitedHealthcare Medicare	$33,197.58

MAJOR CHEST PROCEDURES WITH MCC

Facility

$77,311.05

Service Code	MSDRG 163
Min. Negotiated Rate	$58,948.07
Max. Negotiated Rate	$77,311.05
Rate for Payer: AlohaCare Medicare	$58,948.07
Rate for Payer: Devoted Health Medicare	$64,842.88
Rate for Payer: Hawaii Medical Service Association Commercial	$64,534.44
Rate for Payer: Hawaii Medical Service Association Medicare	$58,948.07
Rate for Payer: Humana Medicare	$58,948.07
Rate for Payer: Kaiser Permanente Commercial	$77,311.05
Rate for Payer: Kaiser Permanente Medicare	$58,948.07
Rate for Payer: Ohana Health Plan Medicare	$58,948.07
Rate for Payer: UnitedHealthcare Medicare	$58,948.07

MAJOR CHEST PROCEDURES WITHOUT CC/MCC

Facility

$46,213.12

Service Code	MSDRG 165
Min. Negotiated Rate	$25,177.03
Max. Negotiated Rate	$46,213.12
Rate for Payer: AlohaCare Medicare	$25,177.03
Rate for Payer: Devoted Health Medicare	$27,694.73
Rate for Payer: Hawaii Medical Service Association Commercial	$46,213.12
Rate for Payer: Hawaii Medical Service Association Medicare	$25,177.03
Rate for Payer: Humana Medicare	$25,177.03
Rate for Payer: Kaiser Permanente Commercial	$33,019.95
Rate for Payer: Kaiser Permanente Medicare	$25,177.03
Rate for Payer: Ohana Health Plan Medicare	$25,177.03
Rate for Payer: UnitedHealthcare Medicare	$25,177.03

MAJOR CHEST & RESPIRATORY TRAUMA

Facility

$11,407.40

Service Code	APR-DRG 1354
Min. Negotiated Rate	$11,407.40
Max. Negotiated Rate	$11,407.40
Rate for Payer: AlohaCare Medicaid	$11,407.40
Rate for Payer: Hawaii Medical Service Association ABD	$11,407.40
Rate for Payer: Hawaii Medical Service Association Non-ABD	$11,407.40
Rate for Payer: Kaiser Permanente Medicaid	$11,407.40
Rate for Payer: Ohana Health Plan Medicaid	$11,407.40
Rate for Payer: UnitedHealthcare Medicaid	$11,407.40

MAJOR CHEST & RESPIRATORY TRAUMA

Facility

$4,101.01

Service Code	APR-DRG 1351
Min. Negotiated Rate	$4,101.01
Max. Negotiated Rate	$4,101.01
Rate for Payer: AlohaCare Medicaid	$4,101.01
Rate for Payer: Hawaii Medical Service Association ABD	$4,101.01
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,101.01
Rate for Payer: Kaiser Permanente Medicaid	$4,101.01
Rate for Payer: Ohana Health Plan Medicaid	$4,101.01
Rate for Payer: UnitedHealthcare Medicaid	$4,101.01

MAJOR CHEST & RESPIRATORY TRAUMA

Facility

$4,670.03

Service Code	APR-DRG 1352
Min. Negotiated Rate	$4,670.03
Max. Negotiated Rate	$4,670.03
Rate for Payer: AlohaCare Medicaid	$4,670.03
Rate for Payer: Hawaii Medical Service Association ABD	$4,670.03
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,670.03
Rate for Payer: Kaiser Permanente Medicaid	$4,670.03
Rate for Payer: Ohana Health Plan Medicaid	$4,670.03
Rate for Payer: UnitedHealthcare Medicaid	$4,670.03

MAJOR CHEST & RESPIRATORY TRAUMA

Facility

$6,730.05

Service Code	APR-DRG 1353
Min. Negotiated Rate	$6,730.05
Max. Negotiated Rate	$6,730.05
Rate for Payer: AlohaCare Medicaid	$6,730.05
Rate for Payer: Hawaii Medical Service Association ABD	$6,730.05
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6,730.05
Rate for Payer: Kaiser Permanente Medicaid	$6,730.05
Rate for Payer: Ohana Health Plan Medicaid	$6,730.05
Rate for Payer: UnitedHealthcare Medicaid	$6,730.05

Know your out-of-pocket cost for care.

All Charges