Kona Community Hospital

All Charges

Charge

Type

Setting

Price

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

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

Facility

$31,917.84

Service Code	APR-DRG 6804
Min. Negotiated Rate	$31,917.84
Max. Negotiated Rate	$31,917.84
Rate for Payer: AlohaCare Medicaid	$31,917.84
Rate for Payer: Hawaii Medical Service Association ABD	$31,917.84
Rate for Payer: Hawaii Medical Service Association Non-ABD	$31,917.84
Rate for Payer: Kaiser Permanente Medicaid	$31,917.84
Rate for Payer: Ohana Health Plan Medicaid	$31,917.84
Rate for Payer: UnitedHealthcare Medicaid	$31,917.84

MAJOR PANCREAS, LIVER & SHUNT PROCEDURES

Facility

$11,956.61

Service Code	APR-DRG 2602
Min. Negotiated Rate	$11,956.61
Max. Negotiated Rate	$11,956.61
Rate for Payer: AlohaCare Medicaid	$11,956.61
Rate for Payer: Hawaii Medical Service Association ABD	$11,956.61
Rate for Payer: Hawaii Medical Service Association Non-ABD	$11,956.61
Rate for Payer: Kaiser Permanente Medicaid	$11,956.61
Rate for Payer: Ohana Health Plan Medicaid	$11,956.61
Rate for Payer: UnitedHealthcare Medicaid	$11,956.61

MAJOR PANCREAS, LIVER & SHUNT PROCEDURES

Facility

$31,233.28

Service Code	APR-DRG 2604
Min. Negotiated Rate	$31,233.28
Max. Negotiated Rate	$31,233.28
Rate for Payer: AlohaCare Medicaid	$31,233.28
Rate for Payer: Hawaii Medical Service Association ABD	$31,233.28
Rate for Payer: Hawaii Medical Service Association Non-ABD	$31,233.28
Rate for Payer: Kaiser Permanente Medicaid	$31,233.28
Rate for Payer: Ohana Health Plan Medicaid	$31,233.28
Rate for Payer: UnitedHealthcare Medicaid	$31,233.28

MAJOR PANCREAS, LIVER & SHUNT PROCEDURES

Facility

$17,153.56

Service Code	APR-DRG 2603
Min. Negotiated Rate	$17,153.56
Max. Negotiated Rate	$17,153.56
Rate for Payer: AlohaCare Medicaid	$17,153.56
Rate for Payer: Hawaii Medical Service Association ABD	$17,153.56
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17,153.56
Rate for Payer: Kaiser Permanente Medicaid	$17,153.56
Rate for Payer: Ohana Health Plan Medicaid	$17,153.56
Rate for Payer: UnitedHealthcare Medicaid	$17,153.56

MAJOR PANCREAS, LIVER & SHUNT PROCEDURES

Facility

$9,327.89

Service Code	APR-DRG 2601
Min. Negotiated Rate	$9,327.89
Max. Negotiated Rate	$9,327.89
Rate for Payer: AlohaCare Medicaid	$9,327.89
Rate for Payer: Hawaii Medical Service Association ABD	$9,327.89
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,327.89
Rate for Payer: Kaiser Permanente Medicaid	$9,327.89
Rate for Payer: Ohana Health Plan Medicaid	$9,327.89
Rate for Payer: UnitedHealthcare Medicaid	$9,327.89

MAJOR RESPIRATORY & CHEST PROCEDURES

Facility

$16,913.49

Service Code	APR-DRG 1203
Min. Negotiated Rate	$16,913.49
Max. Negotiated Rate	$16,913.49
Rate for Payer: AlohaCare Medicaid	$16,913.49
Rate for Payer: Hawaii Medical Service Association ABD	$16,913.49
Rate for Payer: Hawaii Medical Service Association Non-ABD	$16,913.49
Rate for Payer: Kaiser Permanente Medicaid	$16,913.49
Rate for Payer: Ohana Health Plan Medicaid	$16,913.49
Rate for Payer: UnitedHealthcare Medicaid	$16,913.49

MAJOR RESPIRATORY & CHEST PROCEDURES

Facility

$9,676.22

Service Code	APR-DRG 1201
Min. Negotiated Rate	$9,676.22
Max. Negotiated Rate	$9,676.22
Rate for Payer: AlohaCare Medicaid	$9,676.22
Rate for Payer: Hawaii Medical Service Association ABD	$9,676.22
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,676.22
Rate for Payer: Kaiser Permanente Medicaid	$9,676.22
Rate for Payer: Ohana Health Plan Medicaid	$9,676.22
Rate for Payer: UnitedHealthcare Medicaid	$9,676.22

MAJOR RESPIRATORY & CHEST PROCEDURES

Facility

$30,099.13

Service Code	APR-DRG 1204
Min. Negotiated Rate	$30,099.13
Max. Negotiated Rate	$30,099.13
Rate for Payer: AlohaCare Medicaid	$30,099.13
Rate for Payer: Hawaii Medical Service Association ABD	$30,099.13
Rate for Payer: Hawaii Medical Service Association Non-ABD	$30,099.13
Rate for Payer: Kaiser Permanente Medicaid	$30,099.13
Rate for Payer: Ohana Health Plan Medicaid	$30,099.13
Rate for Payer: UnitedHealthcare Medicaid	$30,099.13

MAJOR RESPIRATORY & CHEST PROCEDURES

Facility

$11,882.11

Service Code	APR-DRG 1202
Min. Negotiated Rate	$11,882.11
Max. Negotiated Rate	$11,882.11
Rate for Payer: AlohaCare Medicaid	$11,882.11
Rate for Payer: Hawaii Medical Service Association ABD	$11,882.11
Rate for Payer: Hawaii Medical Service Association Non-ABD	$11,882.11
Rate for Payer: Kaiser Permanente Medicaid	$11,882.11
Rate for Payer: Ohana Health Plan Medicaid	$11,882.11
Rate for Payer: UnitedHealthcare Medicaid	$11,882.11

MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS

Facility

$8,054.92

Service Code	APR-DRG 1374
Min. Negotiated Rate	$8,054.92
Max. Negotiated Rate	$8,054.92
Rate for Payer: AlohaCare Medicaid	$8,054.92
Rate for Payer: Hawaii Medical Service Association ABD	$8,054.92
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,054.92
Rate for Payer: Kaiser Permanente Medicaid	$8,054.92
Rate for Payer: Ohana Health Plan Medicaid	$8,054.92
Rate for Payer: UnitedHealthcare Medicaid	$8,054.92

MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS

Facility

$3,334.30

Service Code	APR-DRG 1371
Min. Negotiated Rate	$3,334.30
Max. Negotiated Rate	$3,334.30
Rate for Payer: AlohaCare Medicaid	$3,334.30
Rate for Payer: Hawaii Medical Service Association ABD	$3,334.30
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,334.30
Rate for Payer: Kaiser Permanente Medicaid	$3,334.30
Rate for Payer: Ohana Health Plan Medicaid	$3,334.30
Rate for Payer: UnitedHealthcare Medicaid	$3,334.30

MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS

Facility

$4,174.88

Service Code	APR-DRG 1372
Min. Negotiated Rate	$4,174.88
Max. Negotiated Rate	$4,174.88
Rate for Payer: AlohaCare Medicaid	$4,174.88
Rate for Payer: Hawaii Medical Service Association ABD	$4,174.88
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,174.88
Rate for Payer: Kaiser Permanente Medicaid	$4,174.88
Rate for Payer: Ohana Health Plan Medicaid	$4,174.88
Rate for Payer: UnitedHealthcare Medicaid	$4,174.88

MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS

Facility

$5,713.40

Service Code	APR-DRG 1373
Min. Negotiated Rate	$5,713.40
Max. Negotiated Rate	$5,713.40
Rate for Payer: AlohaCare Medicaid	$5,713.40
Rate for Payer: Hawaii Medical Service Association ABD	$5,713.40
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,713.40
Rate for Payer: Kaiser Permanente Medicaid	$5,713.40
Rate for Payer: Ohana Health Plan Medicaid	$5,713.40
Rate for Payer: UnitedHealthcare Medicaid	$5,713.40

MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC

Facility

$31,160.40

Service Code	MSDRG 507
Min. Negotiated Rate	$23,576.65
Max. Negotiated Rate	$31,160.40
Rate for Payer: AlohaCare Medicare	$23,759.16
Rate for Payer: Devoted Health Medicare	$26,135.08
Rate for Payer: Hawaii Medical Service Association Commercial	$23,576.65
Rate for Payer: Hawaii Medical Service Association Medicare	$23,759.16
Rate for Payer: Humana Medicare	$23,759.16
Rate for Payer: Kaiser Permanente Commercial	$31,160.40
Rate for Payer: Kaiser Permanente Medicare	$23,759.16
Rate for Payer: Ohana Health Plan Medicare	$23,759.16
Rate for Payer: UnitedHealthcare Medicare	$23,759.16

MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC

Facility

$26,123.40

Service Code	MSDRG 508
Min. Negotiated Rate	$19,918.54
Max. Negotiated Rate	$26,123.40
Rate for Payer: AlohaCare Medicare	$19,918.54
Rate for Payer: Devoted Health Medicare	$21,910.39
Rate for Payer: Hawaii Medical Service Association Commercial	$23,576.65
Rate for Payer: Hawaii Medical Service Association Medicare	$19,918.54
Rate for Payer: Humana Medicare	$19,918.54
Rate for Payer: Kaiser Permanente Commercial	$26,123.40
Rate for Payer: Kaiser Permanente Medicare	$19,918.54
Rate for Payer: Ohana Health Plan Medicare	$19,918.54
Rate for Payer: UnitedHealthcare Medicare	$19,918.54

MAJOR SKIN DISORDERS

Facility

$12,970.40

Service Code	APR-DRG 3814
Min. Negotiated Rate	$12,970.40
Max. Negotiated Rate	$12,970.40
Rate for Payer: AlohaCare Medicaid	$12,970.40
Rate for Payer: Hawaii Medical Service Association ABD	$12,970.40
Rate for Payer: Hawaii Medical Service Association Non-ABD	$12,970.40
Rate for Payer: Kaiser Permanente Medicaid	$12,970.40
Rate for Payer: Ohana Health Plan Medicaid	$12,970.40
Rate for Payer: UnitedHealthcare Medicaid	$12,970.40

MAJOR SKIN DISORDERS

Facility

$2,119.28

Service Code	APR-DRG 3811
Min. Negotiated Rate	$2,119.28
Max. Negotiated Rate	$2,119.28
Rate for Payer: AlohaCare Medicaid	$2,119.28
Rate for Payer: Hawaii Medical Service Association ABD	$2,119.28
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,119.28
Rate for Payer: Kaiser Permanente Medicaid	$2,119.28
Rate for Payer: Ohana Health Plan Medicaid	$2,119.28
Rate for Payer: UnitedHealthcare Medicaid	$2,119.28

MAJOR SKIN DISORDERS

Facility

$3,199.30

Service Code	APR-DRG 3812
Min. Negotiated Rate	$3,199.30
Max. Negotiated Rate	$3,199.30
Rate for Payer: AlohaCare Medicaid	$3,199.30
Rate for Payer: Hawaii Medical Service Association ABD	$3,199.30
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,199.30
Rate for Payer: Kaiser Permanente Medicaid	$3,199.30
Rate for Payer: Ohana Health Plan Medicaid	$3,199.30
Rate for Payer: UnitedHealthcare Medicaid	$3,199.30

MAJOR SKIN DISORDERS

Facility

$5,924.82

Service Code	APR-DRG 3813
Min. Negotiated Rate	$5,924.82
Max. Negotiated Rate	$5,924.82
Rate for Payer: AlohaCare Medicaid	$5,924.82
Rate for Payer: Hawaii Medical Service Association ABD	$5,924.82
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,924.82
Rate for Payer: Kaiser Permanente Medicaid	$5,924.82
Rate for Payer: Ohana Health Plan Medicaid	$5,924.82
Rate for Payer: UnitedHealthcare Medicaid	$5,924.82

MAJOR SKIN DISORDERS WITH MCC

Facility

$41,198.86

Service Code	MSDRG 595
Min. Negotiated Rate	$27,893.08
Max. Negotiated Rate	$41,198.86
Rate for Payer: AlohaCare Medicare	$27,893.08
Rate for Payer: Devoted Health Medicare	$30,682.39
Rate for Payer: Hawaii Medical Service Association Commercial	$41,198.86
Rate for Payer: Hawaii Medical Service Association Medicare	$27,893.08
Rate for Payer: Humana Medicare	$27,893.08
Rate for Payer: Kaiser Permanente Commercial	$36,582.07
Rate for Payer: Kaiser Permanente Medicare	$27,893.08
Rate for Payer: Ohana Health Plan Medicare	$27,893.08
Rate for Payer: UnitedHealthcare Medicare	$27,893.08

MAJOR SKIN DISORDERS WITHOUT MCC

Facility

$33,050.70

Service Code	MSDRG 596
Min. Negotiated Rate	$14,237.87
Max. Negotiated Rate	$33,050.70
Rate for Payer: AlohaCare Medicare	$14,237.87
Rate for Payer: Devoted Health Medicare	$15,661.66
Rate for Payer: Hawaii Medical Service Association Commercial	$33,050.70
Rate for Payer: Hawaii Medical Service Association Medicare	$14,237.87
Rate for Payer: Humana Medicare	$14,237.87
Rate for Payer: Kaiser Permanente Commercial	$18,673.12
Rate for Payer: Kaiser Permanente Medicare	$14,237.87
Rate for Payer: Ohana Health Plan Medicare	$14,237.87
Rate for Payer: UnitedHealthcare Medicare	$14,237.87

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$66,342.46

Service Code	MSDRG 330
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$66,342.46
Rate for Payer: AlohaCare Medicare	$31,529.81
Rate for Payer: Devoted Health Medicare	$34,682.79
Rate for Payer: Hawaii Medical Service Association Commercial	$66,342.46
Rate for Payer: Hawaii Medical Service Association Medicare	$31,529.81
Rate for Payer: Humana Medicare	$31,529.81
Rate for Payer: Kaiser Permanente Commercial	$41,351.70
Rate for Payer: Kaiser Permanente Medicare	$31,529.81
Rate for Payer: Ohana Health Plan Medicare	$31,529.81
Rate for Payer: UnitedHealthcare Medicare	$31,529.81
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$81,939.69

Service Code	MSDRG 329
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$81,939.69
Rate for Payer: AlohaCare Medicare	$60,456.69
Rate for Payer: Devoted Health Medicare	$66,502.36
Rate for Payer: Hawaii Medical Service Association Commercial	$81,939.69
Rate for Payer: Hawaii Medical Service Association Medicare	$60,456.69
Rate for Payer: Humana Medicare	$60,456.69
Rate for Payer: Kaiser Permanente Commercial	$79,289.62
Rate for Payer: Kaiser Permanente Medicare	$60,456.69
Rate for Payer: Ohana Health Plan Medicare	$60,456.69
Rate for Payer: UnitedHealthcare Medicare	$60,456.69
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$37,148.89

Service Code	MSDRG 331
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$37,148.89
Rate for Payer: AlohaCare Medicare	$22,134.79
Rate for Payer: Devoted Health Medicare	$24,348.27
Rate for Payer: Hawaii Medical Service Association Commercial	$37,148.89
Rate for Payer: Hawaii Medical Service Association Medicare	$22,134.79
Rate for Payer: Humana Medicare	$22,134.79
Rate for Payer: Kaiser Permanente Commercial	$29,030.03
Rate for Payer: Kaiser Permanente Medicare	$22,134.79
Rate for Payer: Ohana Health Plan Medicare	$22,134.79
Rate for Payer: UnitedHealthcare Medicare	$22,134.79
Rate for Payer: University Health Alliance Commercial	$10,400.00

Know your out-of-pocket cost for care.

All Charges