Kona Community Hospital

All Charges

Charge

Type

Setting

Price

MAJOR HEAD AND NECK PROCEDURES WITH CC

Facility

$51,251.48

Service Code	MSDRG 141
Min. Negotiated Rate	$28,687.51
Max. Negotiated Rate	$51,251.48
Rate for Payer: AlohaCare Medicare	$28,687.51
Rate for Payer: Devoted Health Medicare	$31,556.26
Rate for Payer: Hawaii Medical Service Association Commercial	$51,251.48
Rate for Payer: Hawaii Medical Service Association Medicare	$28,687.51
Rate for Payer: Humana Medicare	$28,687.51
Rate for Payer: Kaiser Permanente Commercial	$37,623.97
Rate for Payer: Kaiser Permanente Medicare	$28,687.51
Rate for Payer: Ohana Health Plan Medicare	$28,687.51
Rate for Payer: UnitedHealthcare Medicare	$28,687.51

MAJOR HEAD AND NECK PROCEDURES WITH MCC

Facility

$73,576.43

Service Code	MSDRG 140
Min. Negotiated Rate	$56,100.49
Max. Negotiated Rate	$73,576.43
Rate for Payer: AlohaCare Medicare	$56,100.49
Rate for Payer: Devoted Health Medicare	$61,710.54
Rate for Payer: Hawaii Medical Service Association Commercial	$62,388.92
Rate for Payer: Hawaii Medical Service Association Medicare	$56,100.49
Rate for Payer: Humana Medicare	$56,100.49
Rate for Payer: Kaiser Permanente Commercial	$73,576.43
Rate for Payer: Kaiser Permanente Medicare	$56,100.49
Rate for Payer: Ohana Health Plan Medicare	$56,100.49
Rate for Payer: UnitedHealthcare Medicare	$56,100.49

MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC

Facility

$28,566.79

Service Code	MSDRG 142
Min. Negotiated Rate	$20,997.07
Max. Negotiated Rate	$28,566.79
Rate for Payer: AlohaCare Medicare	$20,997.07
Rate for Payer: Devoted Health Medicare	$23,096.78
Rate for Payer: Hawaii Medical Service Association Commercial	$28,566.79
Rate for Payer: Hawaii Medical Service Association Medicare	$20,997.07
Rate for Payer: Humana Medicare	$20,997.07
Rate for Payer: Kaiser Permanente Commercial	$27,537.90
Rate for Payer: Kaiser Permanente Medicare	$20,997.07
Rate for Payer: Ohana Health Plan Medicare	$20,997.07
Rate for Payer: UnitedHealthcare Medicare	$20,997.07

MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC

Facility

$35,509.61

Service Code	MSDRG 809
Min. Negotiated Rate	$16,650.08
Max. Negotiated Rate	$35,509.61
Rate for Payer: AlohaCare Medicare	$16,650.08
Rate for Payer: Devoted Health Medicare	$18,315.09
Rate for Payer: Hawaii Medical Service Association Commercial	$35,509.61
Rate for Payer: Hawaii Medical Service Association Medicare	$16,650.08
Rate for Payer: Humana Medicare	$16,650.08
Rate for Payer: Kaiser Permanente Commercial	$21,836.78
Rate for Payer: Kaiser Permanente Medicare	$16,650.08
Rate for Payer: Ohana Health Plan Medicare	$16,650.08
Rate for Payer: UnitedHealthcare Medicare	$16,650.08

MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC

Facility

$38,086.28

Service Code	MSDRG 808
Min. Negotiated Rate	$29,040.00
Max. Negotiated Rate	$38,086.28
Rate for Payer: AlohaCare Medicare	$29,040.00
Rate for Payer: Devoted Health Medicare	$31,944.00
Rate for Payer: Hawaii Medical Service Association Commercial	$35,509.61
Rate for Payer: Hawaii Medical Service Association Medicare	$29,040.00
Rate for Payer: Humana Medicare	$29,040.00
Rate for Payer: Kaiser Permanente Commercial	$38,086.28
Rate for Payer: Kaiser Permanente Medicare	$29,040.00
Rate for Payer: Ohana Health Plan Medicare	$29,040.00
Rate for Payer: UnitedHealthcare Medicare	$29,040.00

MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC

Facility

$35,509.61

Service Code	MSDRG 810
Min. Negotiated Rate	$13,765.68
Max. Negotiated Rate	$35,509.61
Rate for Payer: AlohaCare Medicare	$13,765.68
Rate for Payer: Devoted Health Medicare	$15,142.25
Rate for Payer: Hawaii Medical Service Association Commercial	$35,509.61
Rate for Payer: Hawaii Medical Service Association Medicare	$13,765.68
Rate for Payer: Humana Medicare	$13,765.68
Rate for Payer: Kaiser Permanente Commercial	$18,053.85
Rate for Payer: Kaiser Permanente Medicare	$13,765.68
Rate for Payer: Ohana Health Plan Medicare	$13,765.68
Rate for Payer: UnitedHealthcare Medicare	$13,765.68

MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL

Facility

$6,426.62

Service Code	APR-DRG 6603
Min. Negotiated Rate	$6,426.62
Max. Negotiated Rate	$6,426.62
Rate for Payer: AlohaCare Medicaid	$6,426.62
Rate for Payer: Hawaii Medical Service Association ABD	$6,426.62
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6,426.62
Rate for Payer: Kaiser Permanente Medicaid	$6,426.62
Rate for Payer: Ohana Health Plan Medicaid	$6,426.62
Rate for Payer: UnitedHealthcare Medicaid	$6,426.62

MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL

Facility

$3,211.40

Service Code	APR-DRG 6601
Min. Negotiated Rate	$3,211.40
Max. Negotiated Rate	$3,211.40
Rate for Payer: AlohaCare Medicaid	$3,211.40
Rate for Payer: Hawaii Medical Service Association ABD	$3,211.40
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,211.40
Rate for Payer: Kaiser Permanente Medicaid	$3,211.40
Rate for Payer: Ohana Health Plan Medicaid	$3,211.40
Rate for Payer: UnitedHealthcare Medicaid	$3,211.40

MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL

Facility

$4,014.41

Service Code	APR-DRG 6602
Min. Negotiated Rate	$4,014.41
Max. Negotiated Rate	$4,014.41
Rate for Payer: AlohaCare Medicaid	$4,014.41
Rate for Payer: Hawaii Medical Service Association ABD	$4,014.41
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,014.41
Rate for Payer: Kaiser Permanente Medicaid	$4,014.41
Rate for Payer: Ohana Health Plan Medicaid	$4,014.41
Rate for Payer: UnitedHealthcare Medicaid	$4,014.41

MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL

Facility

$14,160.59

Service Code	APR-DRG 6604
Min. Negotiated Rate	$14,160.59
Max. Negotiated Rate	$14,160.59
Rate for Payer: AlohaCare Medicaid	$14,160.59
Rate for Payer: Hawaii Medical Service Association ABD	$14,160.59
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14,160.59
Rate for Payer: Kaiser Permanente Medicaid	$14,160.59
Rate for Payer: Ohana Health Plan Medicaid	$14,160.59
Rate for Payer: UnitedHealthcare Medicaid	$14,160.59

MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT

Facility

$52,322.70

Service Code	MSDRG 469
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$52,322.70
Rate for Payer: AlohaCare Medicare	$39,894.97
Rate for Payer: Devoted Health Medicare	$43,884.47
Rate for Payer: Hawaii Medical Service Association Commercial	$41,656.90
Rate for Payer: Hawaii Medical Service Association Medicare	$39,894.97
Rate for Payer: Humana Medicare	$39,894.97
Rate for Payer: Kaiser Permanente Commercial	$52,322.70
Rate for Payer: Kaiser Permanente Medicare	$39,894.97
Rate for Payer: Ohana Health Plan Medicare	$39,894.97
Rate for Payer: UnitedHealthcare Medicare	$39,894.97
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC

Facility

$33,273.53

Service Code	MSDRG 470
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$33,273.53
Rate for Payer: AlohaCare Medicare	$25,370.36
Rate for Payer: Devoted Health Medicare	$27,907.40
Rate for Payer: Hawaii Medical Service Association Commercial	$28,277.51
Rate for Payer: Hawaii Medical Service Association Medicare	$25,370.36
Rate for Payer: Humana Medicare	$25,370.36
Rate for Payer: Kaiser Permanente Commercial	$33,273.53
Rate for Payer: Kaiser Permanente Medicare	$25,370.36
Rate for Payer: Ohana Health Plan Medicare	$25,370.36
Rate for Payer: UnitedHealthcare Medicare	$25,370.36
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES

Facility

$47,815.28

Service Code	MSDRG 483
Min. Negotiated Rate	$36,458.15
Max. Negotiated Rate	$47,815.28
Rate for Payer: AlohaCare Medicare	$36,458.15
Rate for Payer: Devoted Health Medicare	$40,103.96
Rate for Payer: Hawaii Medical Service Association Commercial	$37,510.49
Rate for Payer: Hawaii Medical Service Association Medicare	$36,458.15
Rate for Payer: Humana Medicare	$36,458.15
Rate for Payer: Kaiser Permanente Commercial	$47,815.28
Rate for Payer: Kaiser Permanente Medicare	$36,458.15
Rate for Payer: Ohana Health Plan Medicare	$36,458.15
Rate for Payer: UnitedHealthcare Medicare	$36,458.15

MAJOR LARGE BOWEL PROCEDURES

Facility

$14,242.74

Service Code	APR-DRG 2313
Min. Negotiated Rate	$14,242.74
Max. Negotiated Rate	$14,242.74
Rate for Payer: AlohaCare Medicaid	$14,242.74
Rate for Payer: Hawaii Medical Service Association ABD	$14,242.74
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14,242.74
Rate for Payer: Kaiser Permanente Medicaid	$14,242.74
Rate for Payer: Ohana Health Plan Medicaid	$14,242.74
Rate for Payer: UnitedHealthcare Medicaid	$14,242.74

MAJOR LARGE BOWEL PROCEDURES

Facility

$7,678.57

Service Code	APR-DRG 2311
Min. Negotiated Rate	$7,678.57
Max. Negotiated Rate	$7,678.57
Rate for Payer: AlohaCare Medicaid	$7,678.57
Rate for Payer: Hawaii Medical Service Association ABD	$7,678.57
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,678.57
Rate for Payer: Kaiser Permanente Medicaid	$7,678.57
Rate for Payer: Ohana Health Plan Medicaid	$7,678.57
Rate for Payer: UnitedHealthcare Medicaid	$7,678.57

MAJOR LARGE BOWEL PROCEDURES

Facility

$9,626.55

Service Code	APR-DRG 2312
Min. Negotiated Rate	$9,626.55
Max. Negotiated Rate	$9,626.55
Rate for Payer: AlohaCare Medicaid	$9,626.55
Rate for Payer: Hawaii Medical Service Association ABD	$9,626.55
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,626.55
Rate for Payer: Kaiser Permanente Medicaid	$9,626.55
Rate for Payer: Ohana Health Plan Medicaid	$9,626.55
Rate for Payer: UnitedHealthcare Medicaid	$9,626.55

MAJOR LARGE BOWEL PROCEDURES

Facility

$23,225.48

Service Code	APR-DRG 2314
Min. Negotiated Rate	$23,225.48
Max. Negotiated Rate	$23,225.48
Rate for Payer: AlohaCare Medicaid	$23,225.48
Rate for Payer: Hawaii Medical Service Association ABD	$23,225.48
Rate for Payer: Hawaii Medical Service Association Non-ABD	$23,225.48
Rate for Payer: Kaiser Permanente Medicaid	$23,225.48
Rate for Payer: Ohana Health Plan Medicaid	$23,225.48
Rate for Payer: UnitedHealthcare Medicaid	$23,225.48

MAJOR MALE PELVIC PROCEDURES

Facility

$7,391.37

Service Code	APR-DRG 4802
Min. Negotiated Rate	$7,391.37
Max. Negotiated Rate	$7,391.37
Rate for Payer: AlohaCare Medicaid	$7,391.37
Rate for Payer: Hawaii Medical Service Association ABD	$7,391.37
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,391.37
Rate for Payer: Kaiser Permanente Medicaid	$7,391.37
Rate for Payer: Ohana Health Plan Medicaid	$7,391.37
Rate for Payer: UnitedHealthcare Medicaid	$7,391.37

MAJOR MALE PELVIC PROCEDURES

Facility

$11,508.30

Service Code	APR-DRG 4803
Min. Negotiated Rate	$11,508.30
Max. Negotiated Rate	$11,508.30
Rate for Payer: AlohaCare Medicaid	$11,508.30
Rate for Payer: Hawaii Medical Service Association ABD	$11,508.30
Rate for Payer: Hawaii Medical Service Association Non-ABD	$11,508.30
Rate for Payer: Kaiser Permanente Medicaid	$11,508.30
Rate for Payer: Ohana Health Plan Medicaid	$11,508.30
Rate for Payer: UnitedHealthcare Medicaid	$11,508.30

MAJOR MALE PELVIC PROCEDURES

Facility

$20,381.52

Service Code	APR-DRG 4804
Min. Negotiated Rate	$20,381.52
Max. Negotiated Rate	$20,381.52
Rate for Payer: AlohaCare Medicaid	$20,381.52
Rate for Payer: Hawaii Medical Service Association ABD	$20,381.52
Rate for Payer: Hawaii Medical Service Association Non-ABD	$20,381.52
Rate for Payer: Kaiser Permanente Medicaid	$20,381.52
Rate for Payer: Ohana Health Plan Medicaid	$20,381.52
Rate for Payer: UnitedHealthcare Medicaid	$20,381.52

MAJOR MALE PELVIC PROCEDURES

Facility

$6,413.88

Service Code	APR-DRG 4801
Min. Negotiated Rate	$6,413.88
Max. Negotiated Rate	$6,413.88
Rate for Payer: AlohaCare Medicaid	$6,413.88
Rate for Payer: Hawaii Medical Service Association ABD	$6,413.88
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6,413.88
Rate for Payer: Kaiser Permanente Medicaid	$6,413.88
Rate for Payer: Ohana Health Plan Medicaid	$6,413.88
Rate for Payer: UnitedHealthcare Medicaid	$6,413.88

MAJOR MALE PELVIC PROCEDURES WITH CC/MCC

Facility

$34,505.18

Service Code	MSDRG 707
Min. Negotiated Rate	$26,309.49
Max. Negotiated Rate	$34,505.18
Rate for Payer: AlohaCare Medicare	$26,309.49
Rate for Payer: Devoted Health Medicare	$28,940.44
Rate for Payer: Hawaii Medical Service Association Commercial	$31,483.74
Rate for Payer: Hawaii Medical Service Association Medicare	$26,309.49
Rate for Payer: Humana Medicare	$26,309.49
Rate for Payer: Kaiser Permanente Commercial	$34,505.18
Rate for Payer: Kaiser Permanente Medicare	$26,309.49
Rate for Payer: Ohana Health Plan Medicare	$26,309.49
Rate for Payer: UnitedHealthcare Medicare	$26,309.49

MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC

Facility

$28,615.01

Service Code	MSDRG 708
Min. Negotiated Rate	$20,178.96
Max. Negotiated Rate	$28,615.01
Rate for Payer: AlohaCare Medicare	$20,178.96
Rate for Payer: Devoted Health Medicare	$22,196.86
Rate for Payer: Hawaii Medical Service Association Commercial	$28,615.01
Rate for Payer: Hawaii Medical Service Association Medicare	$20,178.96
Rate for Payer: Humana Medicare	$20,178.96
Rate for Payer: Kaiser Permanente Commercial	$26,464.95
Rate for Payer: Kaiser Permanente Medicare	$20,178.96
Rate for Payer: Ohana Health Plan Medicare	$20,178.96
Rate for Payer: UnitedHealthcare Medicare	$20,178.96

MAJOR O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS

Facility

$8,003.34

Service Code	APR-DRG 6801
Min. Negotiated Rate	$8,003.34
Max. Negotiated Rate	$8,003.34
Rate for Payer: AlohaCare Medicaid	$8,003.34
Rate for Payer: Hawaii Medical Service Association ABD	$8,003.34
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,003.34
Rate for Payer: Kaiser Permanente Medicaid	$8,003.34
Rate for Payer: Ohana Health Plan Medicaid	$8,003.34
Rate for Payer: UnitedHealthcare Medicaid	$8,003.34

MAJOR O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS

Facility

$17,186.68

Service Code	APR-DRG 6803
Min. Negotiated Rate	$17,186.68
Max. Negotiated Rate	$17,186.68
Rate for Payer: AlohaCare Medicaid	$17,186.68
Rate for Payer: Hawaii Medical Service Association ABD	$17,186.68
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17,186.68
Rate for Payer: Kaiser Permanente Medicaid	$17,186.68
Rate for Payer: Ohana Health Plan Medicaid	$17,186.68
Rate for Payer: UnitedHealthcare Medicaid	$17,186.68

Know your out-of-pocket cost for care.

All Charges