Kona Community Hospital

All Charges

Charge

Type

Setting

Price

MAJOR CHEST TRAUMA WITH CC

Facility

$20,105.24

Service Code	MSDRG 184
Min. Negotiated Rate	$13,995.86
Max. Negotiated Rate	$20,105.24
Rate for Payer: AlohaCare Medicare	$13,995.86
Rate for Payer: Devoted Health Medicare	$15,395.45
Rate for Payer: Hawaii Medical Service Association Commercial	$20,105.24
Rate for Payer: Hawaii Medical Service Association Medicare	$13,995.86
Rate for Payer: Humana Medicare	$13,995.86
Rate for Payer: Kaiser Permanente Commercial	$18,355.72
Rate for Payer: Kaiser Permanente Medicare	$13,995.86
Rate for Payer: Ohana Health Plan Medicare	$13,995.86
Rate for Payer: UnitedHealthcare Medicare	$13,995.86

MAJOR CHEST TRAUMA WITH MCC

Facility

$26,390.78

Service Code	MSDRG 183
Min. Negotiated Rate	$20,122.41
Max. Negotiated Rate	$26,390.78
Rate for Payer: AlohaCare Medicare	$20,122.41
Rate for Payer: Devoted Health Medicare	$22,134.65
Rate for Payer: Hawaii Medical Service Association Commercial	$21,889.16
Rate for Payer: Hawaii Medical Service Association Medicare	$20,122.41
Rate for Payer: Humana Medicare	$20,122.41
Rate for Payer: Kaiser Permanente Commercial	$26,390.78
Rate for Payer: Kaiser Permanente Medicare	$20,122.41
Rate for Payer: Ohana Health Plan Medicare	$20,122.41
Rate for Payer: UnitedHealthcare Medicare	$20,122.41

MAJOR CHEST TRAUMA WITHOUT CC/MCC

Facility

$19,213.28

Service Code	MSDRG 185
Min. Negotiated Rate	$10,344.65
Max. Negotiated Rate	$19,213.28
Rate for Payer: AlohaCare Medicare	$10,344.65
Rate for Payer: Devoted Health Medicare	$11,379.11
Rate for Payer: Hawaii Medical Service Association Commercial	$19,213.28
Rate for Payer: Hawaii Medical Service Association Medicare	$10,344.65
Rate for Payer: Humana Medicare	$10,344.65
Rate for Payer: Kaiser Permanente Commercial	$13,567.12
Rate for Payer: Kaiser Permanente Medicare	$10,344.65
Rate for Payer: Ohana Health Plan Medicare	$10,344.65
Rate for Payer: UnitedHealthcare Medicare	$10,344.65

MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility

$30,534.70

Service Code	APR-DRG 0894
Min. Negotiated Rate	$30,534.70
Max. Negotiated Rate	$30,534.70
Rate for Payer: AlohaCare Medicaid	$30,534.70
Rate for Payer: Hawaii Medical Service Association ABD	$30,534.70
Rate for Payer: Hawaii Medical Service Association Non-ABD	$30,534.70
Rate for Payer: Kaiser Permanente Medicaid	$30,534.70
Rate for Payer: Ohana Health Plan Medicaid	$30,534.70
Rate for Payer: UnitedHealthcare Medicaid	$30,534.70

MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility

$8,656.06

Service Code	APR-DRG 0891
Min. Negotiated Rate	$8,656.06
Max. Negotiated Rate	$8,656.06
Rate for Payer: AlohaCare Medicaid	$8,656.06
Rate for Payer: Hawaii Medical Service Association ABD	$8,656.06
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,656.06
Rate for Payer: Kaiser Permanente Medicaid	$8,656.06
Rate for Payer: Ohana Health Plan Medicaid	$8,656.06
Rate for Payer: UnitedHealthcare Medicaid	$8,656.06

MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility

$11,175.89

Service Code	APR-DRG 0892
Min. Negotiated Rate	$11,175.89
Max. Negotiated Rate	$11,175.89
Rate for Payer: AlohaCare Medicaid	$11,175.89
Rate for Payer: Hawaii Medical Service Association ABD	$11,175.89
Rate for Payer: Hawaii Medical Service Association Non-ABD	$11,175.89
Rate for Payer: Kaiser Permanente Medicaid	$11,175.89
Rate for Payer: Ohana Health Plan Medicaid	$11,175.89
Rate for Payer: UnitedHealthcare Medicaid	$11,175.89

MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility

$18,310.00

Service Code	APR-DRG 0893
Min. Negotiated Rate	$18,310.00
Max. Negotiated Rate	$18,310.00
Rate for Payer: AlohaCare Medicaid	$18,310.00
Rate for Payer: Hawaii Medical Service Association ABD	$18,310.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$18,310.00
Rate for Payer: Kaiser Permanente Medicaid	$18,310.00
Rate for Payer: Ohana Health Plan Medicaid	$18,310.00
Rate for Payer: UnitedHealthcare Medicaid	$18,310.00

MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES

Facility

$2,850.94

Service Code	APR-DRG 7511
Min. Negotiated Rate	$2,850.94
Max. Negotiated Rate	$2,850.94
Rate for Payer: AlohaCare Medicaid	$2,850.94
Rate for Payer: Hawaii Medical Service Association ABD	$2,850.94
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,850.94
Rate for Payer: Kaiser Permanente Medicaid	$2,850.94
Rate for Payer: Ohana Health Plan Medicaid	$2,850.94
Rate for Payer: UnitedHealthcare Medicaid	$2,850.94

MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES

Facility

$3,340.13

Service Code	APR-DRG 7512
Min. Negotiated Rate	$3,340.13
Max. Negotiated Rate	$3,340.13
Rate for Payer: AlohaCare Medicaid	$3,340.13
Rate for Payer: Hawaii Medical Service Association ABD	$3,340.13
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,340.13
Rate for Payer: Kaiser Permanente Medicaid	$3,340.13
Rate for Payer: Ohana Health Plan Medicaid	$3,340.13
Rate for Payer: UnitedHealthcare Medicaid	$3,340.13

MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES

Facility

$13,769.15

Service Code	APR-DRG 7514
Min. Negotiated Rate	$13,769.15
Max. Negotiated Rate	$13,769.15
Rate for Payer: AlohaCare Medicaid	$13,769.15
Rate for Payer: Hawaii Medical Service Association ABD	$13,769.15
Rate for Payer: Hawaii Medical Service Association Non-ABD	$13,769.15
Rate for Payer: Kaiser Permanente Medicaid	$13,769.15
Rate for Payer: Ohana Health Plan Medicaid	$13,769.15
Rate for Payer: UnitedHealthcare Medicaid	$13,769.15

MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES

Facility

$5,386.97

Service Code	APR-DRG 7513
Min. Negotiated Rate	$5,386.97
Max. Negotiated Rate	$5,386.97
Rate for Payer: AlohaCare Medicaid	$5,386.97
Rate for Payer: Hawaii Medical Service Association ABD	$5,386.97
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,386.97
Rate for Payer: Kaiser Permanente Medicaid	$5,386.97
Rate for Payer: Ohana Health Plan Medicaid	$5,386.97
Rate for Payer: UnitedHealthcare Medicaid	$5,386.97

MAJOR ESOPHAGEAL DISORDERS

Facility

$5,404.55

Service Code	APR-DRG 2423
Min. Negotiated Rate	$5,404.55
Max. Negotiated Rate	$5,404.55
Rate for Payer: AlohaCare Medicaid	$5,404.55
Rate for Payer: Hawaii Medical Service Association ABD	$5,404.55
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,404.55
Rate for Payer: Kaiser Permanente Medicaid	$5,404.55
Rate for Payer: Ohana Health Plan Medicaid	$5,404.55
Rate for Payer: UnitedHealthcare Medicaid	$5,404.55

MAJOR ESOPHAGEAL DISORDERS

Facility

$3,768.60

Service Code	APR-DRG 2422
Min. Negotiated Rate	$3,768.60
Max. Negotiated Rate	$3,768.60
Rate for Payer: AlohaCare Medicaid	$3,768.60
Rate for Payer: Hawaii Medical Service Association ABD	$3,768.60
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,768.60
Rate for Payer: Kaiser Permanente Medicaid	$3,768.60
Rate for Payer: Ohana Health Plan Medicaid	$3,768.60
Rate for Payer: UnitedHealthcare Medicaid	$3,768.60

MAJOR ESOPHAGEAL DISORDERS

Facility

$10,719.94

Service Code	APR-DRG 2424
Min. Negotiated Rate	$10,719.94
Max. Negotiated Rate	$10,719.94
Rate for Payer: AlohaCare Medicaid	$10,719.94
Rate for Payer: Hawaii Medical Service Association ABD	$10,719.94
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10,719.94
Rate for Payer: Kaiser Permanente Medicaid	$10,719.94
Rate for Payer: Ohana Health Plan Medicaid	$10,719.94
Rate for Payer: UnitedHealthcare Medicaid	$10,719.94

MAJOR ESOPHAGEAL DISORDERS

Facility

$2,933.75

Service Code	APR-DRG 2421
Min. Negotiated Rate	$2,933.75
Max. Negotiated Rate	$2,933.75
Rate for Payer: AlohaCare Medicaid	$2,933.75
Rate for Payer: Hawaii Medical Service Association ABD	$2,933.75
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,933.75
Rate for Payer: Kaiser Permanente Medicaid	$2,933.75
Rate for Payer: Ohana Health Plan Medicaid	$2,933.75
Rate for Payer: UnitedHealthcare Medicaid	$2,933.75

MAJOR ESOPHAGEAL DISORDERS WITH CC

Facility

$19,671.31

Service Code	MSDRG 369
Min. Negotiated Rate	$13,155.40
Max. Negotiated Rate	$19,671.31
Rate for Payer: AlohaCare Medicare	$13,155.40
Rate for Payer: Devoted Health Medicare	$14,470.94
Rate for Payer: Hawaii Medical Service Association Commercial	$19,671.31
Rate for Payer: Hawaii Medical Service Association Medicare	$13,155.40
Rate for Payer: Humana Medicare	$13,155.40
Rate for Payer: Kaiser Permanente Commercial	$17,253.45
Rate for Payer: Kaiser Permanente Medicare	$13,155.40
Rate for Payer: Ohana Health Plan Medicare	$13,155.40
Rate for Payer: UnitedHealthcare Medicare	$13,155.40

MAJOR ESOPHAGEAL DISORDERS WITH MCC

Facility

$27,460.28

Service Code	MSDRG 368
Min. Negotiated Rate	$19,671.31
Max. Negotiated Rate	$27,460.28
Rate for Payer: AlohaCare Medicare	$20,937.89
Rate for Payer: Devoted Health Medicare	$23,031.68
Rate for Payer: Hawaii Medical Service Association Commercial	$19,671.31
Rate for Payer: Hawaii Medical Service Association Medicare	$20,937.89
Rate for Payer: Humana Medicare	$20,937.89
Rate for Payer: Kaiser Permanente Commercial	$27,460.28
Rate for Payer: Kaiser Permanente Medicare	$20,937.89
Rate for Payer: Ohana Health Plan Medicare	$20,937.89
Rate for Payer: UnitedHealthcare Medicare	$20,937.89

MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC

Facility

$19,671.31

Service Code	MSDRG 370
Min. Negotiated Rate	$9,217.45
Max. Negotiated Rate	$19,671.31
Rate for Payer: AlohaCare Medicare	$9,217.45
Rate for Payer: Devoted Health Medicare	$10,139.19
Rate for Payer: Hawaii Medical Service Association Commercial	$19,671.31
Rate for Payer: Hawaii Medical Service Association Medicare	$9,217.45
Rate for Payer: Humana Medicare	$9,217.45
Rate for Payer: Kaiser Permanente Commercial	$12,088.80
Rate for Payer: Kaiser Permanente Medicare	$9,217.45
Rate for Payer: Ohana Health Plan Medicare	$9,217.45
Rate for Payer: UnitedHealthcare Medicare	$9,217.45

MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC

Facility

$22,371.30

Service Code	MSDRG 372
Min. Negotiated Rate	$13,428.96
Max. Negotiated Rate	$22,371.30
Rate for Payer: AlohaCare Medicare	$13,428.96
Rate for Payer: Devoted Health Medicare	$14,771.86
Rate for Payer: Hawaii Medical Service Association Commercial	$22,371.30
Rate for Payer: Hawaii Medical Service Association Medicare	$13,428.96
Rate for Payer: Humana Medicare	$13,428.96
Rate for Payer: Kaiser Permanente Commercial	$17,612.25
Rate for Payer: Kaiser Permanente Medicare	$13,428.96
Rate for Payer: Ohana Health Plan Medicare	$13,428.96
Rate for Payer: UnitedHealthcare Medicare	$13,428.96

MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC

Facility

$30,585.97

Service Code	MSDRG 371
Min. Negotiated Rate	$22,371.30
Max. Negotiated Rate	$30,585.97
Rate for Payer: AlohaCare Medicare	$23,321.15
Rate for Payer: Devoted Health Medicare	$25,653.26
Rate for Payer: Hawaii Medical Service Association Commercial	$22,371.30
Rate for Payer: Hawaii Medical Service Association Medicare	$23,321.15
Rate for Payer: Humana Medicare	$23,321.15
Rate for Payer: Kaiser Permanente Commercial	$30,585.97
Rate for Payer: Kaiser Permanente Medicare	$23,321.15
Rate for Payer: Ohana Health Plan Medicare	$23,321.15
Rate for Payer: UnitedHealthcare Medicare	$23,321.15

MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC

Facility

$22,371.30

Service Code	MSDRG 373
Min. Negotiated Rate	$9,567.33
Max. Negotiated Rate	$22,371.30
Rate for Payer: AlohaCare Medicare	$9,567.33
Rate for Payer: Devoted Health Medicare	$10,524.06
Rate for Payer: Hawaii Medical Service Association Commercial	$22,371.30
Rate for Payer: Hawaii Medical Service Association Medicare	$9,567.33
Rate for Payer: Humana Medicare	$9,567.33
Rate for Payer: Kaiser Permanente Commercial	$12,547.65
Rate for Payer: Kaiser Permanente Medicare	$9,567.33
Rate for Payer: Ohana Health Plan Medicare	$9,567.33
Rate for Payer: UnitedHealthcare Medicare	$9,567.33

MAJOR GASTROINTESTINAL & PERITONEAL INFECTIONS

Facility

$9,613.81

Service Code	APR-DRG 2484
Min. Negotiated Rate	$9,613.81
Max. Negotiated Rate	$9,613.81
Rate for Payer: AlohaCare Medicaid	$9,613.81
Rate for Payer: Hawaii Medical Service Association ABD	$9,613.81
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,613.81
Rate for Payer: Kaiser Permanente Medicaid	$9,613.81
Rate for Payer: Ohana Health Plan Medicaid	$9,613.81
Rate for Payer: UnitedHealthcare Medicaid	$9,613.81

MAJOR GASTROINTESTINAL & PERITONEAL INFECTIONS

Facility

$2,793.02

Service Code	APR-DRG 2481
Min. Negotiated Rate	$2,793.02
Max. Negotiated Rate	$2,793.02
Rate for Payer: AlohaCare Medicaid	$2,793.02
Rate for Payer: Hawaii Medical Service Association ABD	$2,793.02
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,793.02
Rate for Payer: Kaiser Permanente Medicaid	$2,793.02
Rate for Payer: Ohana Health Plan Medicaid	$2,793.02
Rate for Payer: UnitedHealthcare Medicaid	$2,793.02

MAJOR GASTROINTESTINAL & PERITONEAL INFECTIONS

Facility

$5,249.80

Service Code	APR-DRG 2483
Min. Negotiated Rate	$5,249.80
Max. Negotiated Rate	$5,249.80
Rate for Payer: AlohaCare Medicaid	$5,249.80
Rate for Payer: Hawaii Medical Service Association ABD	$5,249.80
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,249.80
Rate for Payer: Kaiser Permanente Medicaid	$5,249.80
Rate for Payer: Ohana Health Plan Medicaid	$5,249.80
Rate for Payer: UnitedHealthcare Medicaid	$5,249.80

MAJOR GASTROINTESTINAL & PERITONEAL INFECTIONS

Facility

$3,720.84

Service Code	APR-DRG 2482
Min. Negotiated Rate	$3,720.84
Max. Negotiated Rate	$3,720.84
Rate for Payer: AlohaCare Medicaid	$3,720.84
Rate for Payer: Hawaii Medical Service Association ABD	$3,720.84
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,720.84
Rate for Payer: Kaiser Permanente Medicaid	$3,720.84
Rate for Payer: Ohana Health Plan Medicaid	$3,720.84
Rate for Payer: UnitedHealthcare Medicaid	$3,720.84

Know your out-of-pocket cost for care.

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