Kona Community Hospital

All Charges

Charge

Type

Setting

Price

MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$4,995.08

Service Code	APR-DRG 3493
Min. Negotiated Rate	$4,995.08
Max. Negotiated Rate	$4,995.08
Rate for Payer: AlohaCare Medicaid	$4,995.08
Rate for Payer: Hawaii Medical Service Association ABD	$4,995.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,995.08
Rate for Payer: Kaiser Permanente Medicaid	$4,995.08
Rate for Payer: Ohana Health Plan Medicaid	$4,995.08
Rate for Payer: UnitedHealthcare Medicaid	$4,995.08

MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$8,631.86

Service Code	APR-DRG 3494
Min. Negotiated Rate	$8,631.86
Max. Negotiated Rate	$8,631.86
Rate for Payer: AlohaCare Medicaid	$8,631.86
Rate for Payer: Hawaii Medical Service Association ABD	$8,631.86
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,631.86
Rate for Payer: Kaiser Permanente Medicaid	$8,631.86
Rate for Payer: Ohana Health Plan Medicaid	$8,631.86
Rate for Payer: UnitedHealthcare Medicaid	$8,631.86

MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$2,440.87

Service Code	APR-DRG 3491
Min. Negotiated Rate	$2,440.87
Max. Negotiated Rate	$2,440.87
Rate for Payer: AlohaCare Medicaid	$2,440.87
Rate for Payer: Hawaii Medical Service Association ABD	$2,440.87
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,440.87
Rate for Payer: Kaiser Permanente Medicaid	$2,440.87
Rate for Payer: Ohana Health Plan Medicaid	$2,440.87
Rate for Payer: UnitedHealthcare Medicaid	$2,440.87

MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$3,422.18

Service Code	APR-DRG 3492
Min. Negotiated Rate	$3,422.18
Max. Negotiated Rate	$3,422.18
Rate for Payer: AlohaCare Medicaid	$3,422.18
Rate for Payer: Hawaii Medical Service Association ABD	$3,422.18
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,422.18
Rate for Payer: Kaiser Permanente Medicaid	$3,422.18
Rate for Payer: Ohana Health Plan Medicaid	$3,422.18
Rate for Payer: UnitedHealthcare Medicaid	$3,422.18

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC

Facility

$58,363.05

Service Code	MSDRG 755
Min. Negotiated Rate	$14,307.59
Max. Negotiated Rate	$58,363.05
Rate for Payer: AlohaCare Medicare	$14,307.59
Rate for Payer: Devoted Health Medicare	$15,738.35
Rate for Payer: Hawaii Medical Service Association Commercial	$58,363.05
Rate for Payer: Hawaii Medical Service Association Medicare	$14,307.59
Rate for Payer: Humana Medicare	$14,307.59
Rate for Payer: Kaiser Permanente Commercial	$18,764.55
Rate for Payer: Kaiser Permanente Medicare	$14,307.59
Rate for Payer: Ohana Health Plan Medicare	$14,307.59
Rate for Payer: UnitedHealthcare Medicare	$14,307.59

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$58,363.05

Service Code	MSDRG 754
Min. Negotiated Rate	$24,223.46
Max. Negotiated Rate	$58,363.05
Rate for Payer: AlohaCare Medicare	$24,223.46
Rate for Payer: Devoted Health Medicare	$26,645.81
Rate for Payer: Hawaii Medical Service Association Commercial	$58,363.05
Rate for Payer: Hawaii Medical Service Association Medicare	$24,223.46
Rate for Payer: Humana Medicare	$24,223.46
Rate for Payer: Kaiser Permanente Commercial	$31,769.33
Rate for Payer: Kaiser Permanente Medicare	$24,223.46
Rate for Payer: Ohana Health Plan Medicare	$24,223.46
Rate for Payer: UnitedHealthcare Medicare	$24,223.46

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$21,913.26

Service Code	MSDRG 756
Min. Negotiated Rate	$12,633.21
Max. Negotiated Rate	$21,913.26
Rate for Payer: AlohaCare Medicare	$12,633.21
Rate for Payer: Devoted Health Medicare	$13,896.53
Rate for Payer: Hawaii Medical Service Association Commercial	$21,913.26
Rate for Payer: Hawaii Medical Service Association Medicare	$12,633.21
Rate for Payer: Humana Medicare	$12,633.21
Rate for Payer: Kaiser Permanente Commercial	$16,568.62
Rate for Payer: Kaiser Permanente Medicare	$12,633.21
Rate for Payer: Ohana Health Plan Medicare	$12,633.21
Rate for Payer: UnitedHealthcare Medicare	$12,633.21

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$5,120.53

Service Code	APR-DRG 5003
Min. Negotiated Rate	$5,120.53
Max. Negotiated Rate	$5,120.53
Rate for Payer: AlohaCare Medicaid	$5,120.53
Rate for Payer: Hawaii Medical Service Association ABD	$5,120.53
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,120.53
Rate for Payer: Kaiser Permanente Medicaid	$5,120.53
Rate for Payer: Ohana Health Plan Medicaid	$5,120.53
Rate for Payer: UnitedHealthcare Medicaid	$5,120.53

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$7,904.64

Service Code	APR-DRG 5004
Min. Negotiated Rate	$7,904.64
Max. Negotiated Rate	$7,904.64
Rate for Payer: AlohaCare Medicaid	$7,904.64
Rate for Payer: Hawaii Medical Service Association ABD	$7,904.64
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,904.64
Rate for Payer: Kaiser Permanente Medicaid	$7,904.64
Rate for Payer: Ohana Health Plan Medicaid	$7,904.64
Rate for Payer: UnitedHealthcare Medicaid	$7,904.64

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$3,541.90

Service Code	APR-DRG 5002
Min. Negotiated Rate	$3,541.90
Max. Negotiated Rate	$3,541.90
Rate for Payer: AlohaCare Medicaid	$3,541.90
Rate for Payer: Hawaii Medical Service Association ABD	$3,541.90
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,541.90
Rate for Payer: Kaiser Permanente Medicaid	$3,541.90
Rate for Payer: Ohana Health Plan Medicaid	$3,541.90
Rate for Payer: UnitedHealthcare Medicaid	$3,541.90

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$2,815.31

Service Code	APR-DRG 5001
Min. Negotiated Rate	$2,815.31
Max. Negotiated Rate	$2,815.31
Rate for Payer: AlohaCare Medicaid	$2,815.31
Rate for Payer: Hawaii Medical Service Association ABD	$2,815.31
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,815.31
Rate for Payer: Kaiser Permanente Medicaid	$2,815.31
Rate for Payer: Ohana Health Plan Medicaid	$2,815.31
Rate for Payer: UnitedHealthcare Medicaid	$2,815.31

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC

Facility

$44,091.70

Service Code	MSDRG 723
Min. Negotiated Rate	$15,029.67
Max. Negotiated Rate	$44,091.70
Rate for Payer: AlohaCare Medicare	$15,029.67
Rate for Payer: Devoted Health Medicare	$16,532.64
Rate for Payer: Hawaii Medical Service Association Commercial	$44,091.70
Rate for Payer: Hawaii Medical Service Association Medicare	$15,029.67
Rate for Payer: Humana Medicare	$15,029.67
Rate for Payer: Kaiser Permanente Commercial	$19,711.58
Rate for Payer: Kaiser Permanente Medicare	$15,029.67
Rate for Payer: Ohana Health Plan Medicare	$15,029.67
Rate for Payer: UnitedHealthcare Medicare	$15,029.67

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$44,091.70

Service Code	MSDRG 722
Min. Negotiated Rate	$23,802.55
Max. Negotiated Rate	$44,091.70
Rate for Payer: AlohaCare Medicare	$23,802.55
Rate for Payer: Devoted Health Medicare	$26,182.81
Rate for Payer: Hawaii Medical Service Association Commercial	$44,091.70
Rate for Payer: Hawaii Medical Service Association Medicare	$23,802.55
Rate for Payer: Humana Medicare	$23,802.55
Rate for Payer: Kaiser Permanente Commercial	$31,217.33
Rate for Payer: Kaiser Permanente Medicare	$23,802.55
Rate for Payer: Ohana Health Plan Medicare	$23,802.55
Rate for Payer: UnitedHealthcare Medicare	$23,802.55

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$30,664.10

Service Code	MSDRG 724
Min. Negotiated Rate	$8,624.27
Max. Negotiated Rate	$30,664.10
Rate for Payer: AlohaCare Medicare	$8,624.27
Rate for Payer: Devoted Health Medicare	$9,486.70
Rate for Payer: Hawaii Medical Service Association Commercial	$30,664.10
Rate for Payer: Hawaii Medical Service Association Medicare	$8,624.27
Rate for Payer: Humana Medicare	$8,624.27
Rate for Payer: Kaiser Permanente Commercial	$10,551.83
Rate for Payer: Kaiser Permanente Medicare	$8,624.27
Rate for Payer: Ohana Health Plan Medicare	$8,624.27
Rate for Payer: UnitedHealthcare Medicare	$8,624.27

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC

Facility

$39,294.41

Service Code	MSDRG 436
Min. Negotiated Rate	$14,877.10
Max. Negotiated Rate	$39,294.41
Rate for Payer: AlohaCare Medicare	$14,877.10
Rate for Payer: Devoted Health Medicare	$16,364.81
Rate for Payer: Hawaii Medical Service Association Commercial	$39,294.41
Rate for Payer: Hawaii Medical Service Association Medicare	$14,877.10
Rate for Payer: Humana Medicare	$14,877.10
Rate for Payer: Kaiser Permanente Commercial	$19,511.47
Rate for Payer: Kaiser Permanente Medicare	$14,877.10
Rate for Payer: Ohana Health Plan Medicare	$14,877.10
Rate for Payer: UnitedHealthcare Medicare	$14,877.10

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC

Facility

$39,294.41

Service Code	MSDRG 435
Min. Negotiated Rate	$24,157.69
Max. Negotiated Rate	$39,294.41
Rate for Payer: AlohaCare Medicare	$24,157.69
Rate for Payer: Devoted Health Medicare	$26,573.46
Rate for Payer: Hawaii Medical Service Association Commercial	$39,294.41
Rate for Payer: Hawaii Medical Service Association Medicare	$24,157.69
Rate for Payer: Humana Medicare	$24,157.69
Rate for Payer: Kaiser Permanente Commercial	$31,683.08
Rate for Payer: Kaiser Permanente Medicare	$24,157.69
Rate for Payer: Ohana Health Plan Medicare	$24,157.69
Rate for Payer: UnitedHealthcare Medicare	$24,157.69

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC

Facility

$39,294.41

Service Code	MSDRG 437
Min. Negotiated Rate	$11,223.26
Max. Negotiated Rate	$39,294.41
Rate for Payer: AlohaCare Medicare	$11,223.26
Rate for Payer: Devoted Health Medicare	$12,345.59
Rate for Payer: Hawaii Medical Service Association Commercial	$39,294.41
Rate for Payer: Hawaii Medical Service Association Medicare	$11,223.26
Rate for Payer: Humana Medicare	$11,223.26
Rate for Payer: Kaiser Permanente Commercial	$14,719.42
Rate for Payer: Kaiser Permanente Medicare	$11,223.26
Rate for Payer: Ohana Health Plan Medicare	$11,223.26
Rate for Payer: UnitedHealthcare Medicare	$11,223.26

MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS

Facility

$5,556.11

Service Code	APR-DRG 2813
Min. Negotiated Rate	$5,556.11
Max. Negotiated Rate	$5,556.11
Rate for Payer: AlohaCare Medicaid	$5,556.11
Rate for Payer: Hawaii Medical Service Association ABD	$5,556.11
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,556.11
Rate for Payer: Kaiser Permanente Medicaid	$5,556.11
Rate for Payer: Ohana Health Plan Medicaid	$5,556.11
Rate for Payer: UnitedHealthcare Medicaid	$5,556.11

MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS

Facility

$8,467.57

Service Code	APR-DRG 2814
Min. Negotiated Rate	$8,467.57
Max. Negotiated Rate	$8,467.57
Rate for Payer: AlohaCare Medicaid	$8,467.57
Rate for Payer: Hawaii Medical Service Association ABD	$8,467.57
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,467.57
Rate for Payer: Kaiser Permanente Medicaid	$8,467.57
Rate for Payer: Ohana Health Plan Medicaid	$8,467.57
Rate for Payer: UnitedHealthcare Medicaid	$8,467.57

MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS

Facility

$4,281.23

Service Code	APR-DRG 2812
Min. Negotiated Rate	$4,281.23
Max. Negotiated Rate	$4,281.23
Rate for Payer: AlohaCare Medicaid	$4,281.23
Rate for Payer: Hawaii Medical Service Association ABD	$4,281.23
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,281.23
Rate for Payer: Kaiser Permanente Medicaid	$4,281.23
Rate for Payer: Ohana Health Plan Medicaid	$4,281.23
Rate for Payer: UnitedHealthcare Medicaid	$4,281.23

MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS

Facility

$3,529.80

Service Code	APR-DRG 2811
Min. Negotiated Rate	$3,529.80
Max. Negotiated Rate	$3,529.80
Rate for Payer: AlohaCare Medicaid	$3,529.80
Rate for Payer: Hawaii Medical Service Association ABD	$3,529.80
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,529.80
Rate for Payer: Kaiser Permanente Medicaid	$3,529.80
Rate for Payer: Ohana Health Plan Medicaid	$3,529.80
Rate for Payer: UnitedHealthcare Medicaid	$3,529.80

MALIGNANT BREAST DISORDERS

Facility

$3,721.48

Service Code	APR-DRG 3822
Min. Negotiated Rate	$3,721.48
Max. Negotiated Rate	$3,721.48
Rate for Payer: AlohaCare Medicaid	$3,721.48
Rate for Payer: Hawaii Medical Service Association ABD	$3,721.48
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,721.48
Rate for Payer: Kaiser Permanente Medicaid	$3,721.48
Rate for Payer: Ohana Health Plan Medicaid	$3,721.48
Rate for Payer: UnitedHealthcare Medicaid	$3,721.48

MALIGNANT BREAST DISORDERS

Facility

$3,147.72

Service Code	APR-DRG 3821
Min. Negotiated Rate	$3,147.72
Max. Negotiated Rate	$3,147.72
Rate for Payer: AlohaCare Medicaid	$3,147.72
Rate for Payer: Hawaii Medical Service Association ABD	$3,147.72
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,147.72
Rate for Payer: Kaiser Permanente Medicaid	$3,147.72
Rate for Payer: Ohana Health Plan Medicaid	$3,147.72
Rate for Payer: UnitedHealthcare Medicaid	$3,147.72

MALIGNANT BREAST DISORDERS

Facility

$5,437.66

Service Code	APR-DRG 3823
Min. Negotiated Rate	$5,437.66
Max. Negotiated Rate	$5,437.66
Rate for Payer: AlohaCare Medicaid	$5,437.66
Rate for Payer: Hawaii Medical Service Association ABD	$5,437.66
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,437.66
Rate for Payer: Kaiser Permanente Medicaid	$5,437.66
Rate for Payer: Ohana Health Plan Medicaid	$5,437.66
Rate for Payer: UnitedHealthcare Medicaid	$5,437.66

MALIGNANT BREAST DISORDERS

Facility

$8,212.85

Service Code	APR-DRG 3824
Min. Negotiated Rate	$8,212.85
Max. Negotiated Rate	$8,212.85
Rate for Payer: AlohaCare Medicaid	$8,212.85
Rate for Payer: Hawaii Medical Service Association ABD	$8,212.85
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,212.85
Rate for Payer: Kaiser Permanente Medicaid	$8,212.85
Rate for Payer: Ohana Health Plan Medicaid	$8,212.85
Rate for Payer: UnitedHealthcare Medicaid	$8,212.85

Know your out-of-pocket cost for care.

All Charges