Kona Community Hospital

All Charges

Charge

Type

Setting

Price

MAJOR SMALL BOWEL PROCEDURES

Facility

$9,952.59

Service Code	APR-DRG 2302
Min. Negotiated Rate	$9,952.59
Max. Negotiated Rate	$9,952.59
Rate for Payer: AlohaCare Medicaid	$9,952.59
Rate for Payer: Hawaii Medical Service Association ABD	$9,952.59
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,952.59
Rate for Payer: Kaiser Permanente Medicaid	$9,952.59
Rate for Payer: Ohana Health Plan Medicaid	$9,952.59
Rate for Payer: UnitedHealthcare Medicaid	$9,952.59

MAJOR SMALL BOWEL PROCEDURES

Facility

$25,997.48

Service Code	APR-DRG 2304
Min. Negotiated Rate	$25,997.48
Max. Negotiated Rate	$25,997.48
Rate for Payer: AlohaCare Medicaid	$25,997.48
Rate for Payer: Hawaii Medical Service Association ABD	$25,997.48
Rate for Payer: Hawaii Medical Service Association Non-ABD	$25,997.48
Rate for Payer: Kaiser Permanente Medicaid	$25,997.48
Rate for Payer: Ohana Health Plan Medicaid	$25,997.48
Rate for Payer: UnitedHealthcare Medicaid	$25,997.48

MAJOR SMALL BOWEL PROCEDURES

Facility

$7,287.57

Service Code	APR-DRG 2301
Min. Negotiated Rate	$7,287.57
Max. Negotiated Rate	$7,287.57
Rate for Payer: AlohaCare Medicaid	$7,287.57
Rate for Payer: Hawaii Medical Service Association ABD	$7,287.57
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,287.57
Rate for Payer: Kaiser Permanente Medicaid	$7,287.57
Rate for Payer: Ohana Health Plan Medicaid	$7,287.57
Rate for Payer: UnitedHealthcare Medicaid	$7,287.57

MAJOR SMALL BOWEL PROCEDURES

Facility

$14,747.08

Service Code	APR-DRG 2303
Min. Negotiated Rate	$14,747.08
Max. Negotiated Rate	$14,747.08
Rate for Payer: AlohaCare Medicaid	$14,747.08
Rate for Payer: Hawaii Medical Service Association ABD	$14,747.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14,747.08
Rate for Payer: Kaiser Permanente Medicaid	$14,747.08
Rate for Payer: Ohana Health Plan Medicaid	$14,747.08
Rate for Payer: UnitedHealthcare Medicaid	$14,747.08

MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility

$10,368.43

Service Code	APR-DRG 2202
Min. Negotiated Rate	$10,368.43
Max. Negotiated Rate	$10,368.43
Rate for Payer: AlohaCare Medicaid	$10,368.43
Rate for Payer: Hawaii Medical Service Association ABD	$10,368.43
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10,368.43
Rate for Payer: Kaiser Permanente Medicaid	$10,368.43
Rate for Payer: Ohana Health Plan Medicaid	$10,368.43
Rate for Payer: UnitedHealthcare Medicaid	$10,368.43

MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility

$16,310.44

Service Code	APR-DRG 2203
Min. Negotiated Rate	$16,310.44
Max. Negotiated Rate	$16,310.44
Rate for Payer: AlohaCare Medicaid	$16,310.44
Rate for Payer: Hawaii Medical Service Association ABD	$16,310.44
Rate for Payer: Hawaii Medical Service Association Non-ABD	$16,310.44
Rate for Payer: Kaiser Permanente Medicaid	$16,310.44
Rate for Payer: Ohana Health Plan Medicaid	$16,310.44
Rate for Payer: UnitedHealthcare Medicaid	$16,310.44

MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility

$28,375.94

Service Code	APR-DRG 2204
Min. Negotiated Rate	$28,375.94
Max. Negotiated Rate	$28,375.94
Rate for Payer: AlohaCare Medicaid	$28,375.94
Rate for Payer: Hawaii Medical Service Association ABD	$28,375.94
Rate for Payer: Hawaii Medical Service Association Non-ABD	$28,375.94
Rate for Payer: Kaiser Permanente Medicaid	$28,375.94
Rate for Payer: Ohana Health Plan Medicaid	$28,375.94
Rate for Payer: UnitedHealthcare Medicaid	$28,375.94

MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility

$7,207.97

Service Code	APR-DRG 2201
Min. Negotiated Rate	$7,207.97
Max. Negotiated Rate	$7,207.97
Rate for Payer: AlohaCare Medicaid	$7,207.97
Rate for Payer: Hawaii Medical Service Association ABD	$7,207.97
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,207.97
Rate for Payer: Kaiser Permanente Medicaid	$7,207.97
Rate for Payer: Ohana Health Plan Medicaid	$7,207.97
Rate for Payer: UnitedHealthcare Medicaid	$7,207.97

MAJOR THUMB OR JOINT PROCEDURES

Facility

$35,461.40

Service Code	MSDRG 506
Min. Negotiated Rate	$17,745.70
Max. Negotiated Rate	$35,461.40
Rate for Payer: AlohaCare Medicare	$17,745.70
Rate for Payer: Devoted Health Medicare	$19,520.27
Rate for Payer: Hawaii Medical Service Association Commercial	$35,461.40
Rate for Payer: Hawaii Medical Service Association Medicare	$17,745.70
Rate for Payer: Humana Medicare	$17,745.70
Rate for Payer: Kaiser Permanente Commercial	$20,693.10
Rate for Payer: Kaiser Permanente Medicare	$17,745.70
Rate for Payer: Ohana Health Plan Medicare	$17,745.70
Rate for Payer: UnitedHealthcare Medicare	$17,745.70

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$3,031.82

Service Code	APR-DRG 5012
Min. Negotiated Rate	$3,031.82
Max. Negotiated Rate	$3,031.82
Rate for Payer: AlohaCare Medicaid	$3,031.82
Rate for Payer: Hawaii Medical Service Association ABD	$3,031.82
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,031.82
Rate for Payer: Kaiser Permanente Medicaid	$3,031.82
Rate for Payer: Ohana Health Plan Medicaid	$3,031.82
Rate for Payer: UnitedHealthcare Medicaid	$3,031.82

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$4,527.03

Service Code	APR-DRG 5013
Min. Negotiated Rate	$4,527.03
Max. Negotiated Rate	$4,527.03
Rate for Payer: AlohaCare Medicaid	$4,527.03
Rate for Payer: Hawaii Medical Service Association ABD	$4,527.03
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,527.03
Rate for Payer: Kaiser Permanente Medicaid	$4,527.03
Rate for Payer: Ohana Health Plan Medicaid	$4,527.03
Rate for Payer: UnitedHealthcare Medicaid	$4,527.03

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$9,397.94

Service Code	APR-DRG 5014
Min. Negotiated Rate	$9,397.94
Max. Negotiated Rate	$9,397.94
Rate for Payer: AlohaCare Medicaid	$9,397.94
Rate for Payer: Hawaii Medical Service Association ABD	$9,397.94
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,397.94
Rate for Payer: Kaiser Permanente Medicaid	$9,397.94
Rate for Payer: Ohana Health Plan Medicaid	$9,397.94
Rate for Payer: UnitedHealthcare Medicaid	$9,397.94

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$2,375.28

Service Code	APR-DRG 5011
Min. Negotiated Rate	$2,375.28
Max. Negotiated Rate	$2,375.28
Rate for Payer: AlohaCare Medicaid	$2,375.28
Rate for Payer: Hawaii Medical Service Association ABD	$2,375.28
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,375.28
Rate for Payer: Kaiser Permanente Medicaid	$2,375.28
Rate for Payer: Ohana Health Plan Medicaid	$2,375.28
Rate for Payer: UnitedHealthcare Medicaid	$2,375.28

MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE

Facility

$3,156.63

Service Code	APR-DRG 2061
Min. Negotiated Rate	$3,156.63
Max. Negotiated Rate	$3,156.63
Rate for Payer: AlohaCare Medicaid	$3,156.63
Rate for Payer: Hawaii Medical Service Association ABD	$3,156.63
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,156.63
Rate for Payer: Kaiser Permanente Medicaid	$3,156.63
Rate for Payer: Ohana Health Plan Medicaid	$3,156.63
Rate for Payer: UnitedHealthcare Medicaid	$3,156.63

MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE

Facility

$3,296.73

Service Code	APR-DRG 2062
Min. Negotiated Rate	$3,296.73
Max. Negotiated Rate	$3,296.73
Rate for Payer: AlohaCare Medicaid	$3,296.73
Rate for Payer: Hawaii Medical Service Association ABD	$3,296.73
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,296.73
Rate for Payer: Kaiser Permanente Medicaid	$3,296.73
Rate for Payer: Ohana Health Plan Medicaid	$3,296.73
Rate for Payer: UnitedHealthcare Medicaid	$3,296.73

MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE

Facility

$5,012.91

Service Code	APR-DRG 2063
Min. Negotiated Rate	$5,012.91
Max. Negotiated Rate	$5,012.91
Rate for Payer: AlohaCare Medicaid	$5,012.91
Rate for Payer: Hawaii Medical Service Association ABD	$5,012.91
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,012.91
Rate for Payer: Kaiser Permanente Medicaid	$5,012.91
Rate for Payer: Ohana Health Plan Medicaid	$5,012.91
Rate for Payer: UnitedHealthcare Medicaid	$5,012.91

MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE

Facility

$9,584.52

Service Code	APR-DRG 2064
Min. Negotiated Rate	$9,584.52
Max. Negotiated Rate	$9,584.52
Rate for Payer: AlohaCare Medicaid	$9,584.52
Rate for Payer: Hawaii Medical Service Association ABD	$9,584.52
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,584.52
Rate for Payer: Kaiser Permanente Medicaid	$9,584.52
Rate for Payer: Ohana Health Plan Medicaid	$9,584.52
Rate for Payer: UnitedHealthcare Medicaid	$9,584.52

MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE

Facility

$5,056.85

Service Code	APR-DRG 2523
Min. Negotiated Rate	$5,056.85
Max. Negotiated Rate	$5,056.85
Rate for Payer: AlohaCare Medicaid	$5,056.85
Rate for Payer: Hawaii Medical Service Association ABD	$5,056.85
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,056.85
Rate for Payer: Kaiser Permanente Medicaid	$5,056.85
Rate for Payer: Ohana Health Plan Medicaid	$5,056.85
Rate for Payer: UnitedHealthcare Medicaid	$5,056.85

MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE

Facility

$3,512.61

Service Code	APR-DRG 2522
Min. Negotiated Rate	$3,512.61
Max. Negotiated Rate	$3,512.61
Rate for Payer: AlohaCare Medicaid	$3,512.61
Rate for Payer: Hawaii Medical Service Association ABD	$3,512.61
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,512.61
Rate for Payer: Kaiser Permanente Medicaid	$3,512.61
Rate for Payer: Ohana Health Plan Medicaid	$3,512.61
Rate for Payer: UnitedHealthcare Medicaid	$3,512.61

MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE

Facility

$2,908.28

Service Code	APR-DRG 2521
Min. Negotiated Rate	$2,908.28
Max. Negotiated Rate	$2,908.28
Rate for Payer: AlohaCare Medicaid	$2,908.28
Rate for Payer: Hawaii Medical Service Association ABD	$2,908.28
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,908.28
Rate for Payer: Kaiser Permanente Medicaid	$2,908.28
Rate for Payer: Ohana Health Plan Medicaid	$2,908.28
Rate for Payer: UnitedHealthcare Medicaid	$2,908.28

MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE

Facility

$9,769.19

Service Code	APR-DRG 2524
Min. Negotiated Rate	$9,769.19
Max. Negotiated Rate	$9,769.19
Rate for Payer: AlohaCare Medicaid	$9,769.19
Rate for Payer: Hawaii Medical Service Association ABD	$9,769.19
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,769.19
Rate for Payer: Kaiser Permanente Medicaid	$9,769.19
Rate for Payer: Ohana Health Plan Medicaid	$9,769.19
Rate for Payer: UnitedHealthcare Medicaid	$9,769.19

MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$3,183.38

Service Code	APR-DRG 4662
Min. Negotiated Rate	$3,183.38
Max. Negotiated Rate	$3,183.38
Rate for Payer: AlohaCare Medicaid	$3,183.38
Rate for Payer: Hawaii Medical Service Association ABD	$3,183.38
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,183.38
Rate for Payer: Kaiser Permanente Medicaid	$3,183.38
Rate for Payer: Ohana Health Plan Medicaid	$3,183.38
Rate for Payer: UnitedHealthcare Medicaid	$3,183.38

MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$7,576.05

Service Code	APR-DRG 4664
Min. Negotiated Rate	$7,576.05
Max. Negotiated Rate	$7,576.05
Rate for Payer: AlohaCare Medicaid	$7,576.05
Rate for Payer: Hawaii Medical Service Association ABD	$7,576.05
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,576.05
Rate for Payer: Kaiser Permanente Medicaid	$7,576.05
Rate for Payer: Ohana Health Plan Medicaid	$7,576.05
Rate for Payer: UnitedHealthcare Medicaid	$7,576.05

MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$4,588.17

Service Code	APR-DRG 4663
Min. Negotiated Rate	$4,588.17
Max. Negotiated Rate	$4,588.17
Rate for Payer: AlohaCare Medicaid	$4,588.17
Rate for Payer: Hawaii Medical Service Association ABD	$4,588.17
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,588.17
Rate for Payer: Kaiser Permanente Medicaid	$4,588.17
Rate for Payer: Ohana Health Plan Medicaid	$4,588.17
Rate for Payer: UnitedHealthcare Medicaid	$4,588.17

MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$2,259.38

Service Code	APR-DRG 4661
Min. Negotiated Rate	$2,259.38
Max. Negotiated Rate	$2,259.38
Rate for Payer: AlohaCare Medicaid	$2,259.38
Rate for Payer: Hawaii Medical Service Association ABD	$2,259.38
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,259.38
Rate for Payer: Kaiser Permanente Medicaid	$2,259.38
Rate for Payer: Ohana Health Plan Medicaid	$2,259.38
Rate for Payer: UnitedHealthcare Medicaid	$2,259.38

Know your out-of-pocket cost for care.

All Charges