Kona Community Hospital

All Charges

Charge

Type

Setting

Price

MORPHINE 15 MG PO TAB IR

Facility

$5.02

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$4.87
Rate for Payer: Cash Price	$3.26
Rate for Payer: Hawaii Western Management Group Commercial	$4.77
Rate for Payer: Health Management Network Commercial	$4.27
Rate for Payer: Kaiser Permanente Commercial	$3.16
Rate for Payer: Kaiser Permanente Medicaid	$2.56
Rate for Payer: MDX Hawaii PPO	$4.87
Rate for Payer: UnitedHealthcare Medicaid	$3.01
Rate for Payer: University Health Alliance Commercial	$3.66

MORPHINE 15 MG PO TAB IR

Facility

$5.02

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$4.27
Max. Negotiated Rate	$4.87
Rate for Payer: Cash Price	$3.26
Rate for Payer: Health Management Network Commercial	$4.27
Rate for Payer: MDX Hawaii PPO	$4.87

MORPHINE 15 MG PO TAB SR

Facility

$11.27

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$5.75
Max. Negotiated Rate	$10.93
Rate for Payer: Cash Price	$7.33
Rate for Payer: Hawaii Western Management Group Commercial	$10.71
Rate for Payer: Health Management Network Commercial	$9.58
Rate for Payer: Kaiser Permanente Commercial	$7.10
Rate for Payer: Kaiser Permanente Medicaid	$5.75
Rate for Payer: MDX Hawaii PPO	$10.93
Rate for Payer: UnitedHealthcare Medicaid	$6.76
Rate for Payer: University Health Alliance Commercial	$8.21

MORPHINE 15 MG PO TAB SR

Facility

$11.27

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$10.93
Rate for Payer: Cash Price	$7.33
Rate for Payer: Health Management Network Commercial	$9.58
Rate for Payer: MDX Hawaii PPO	$10.93

MORPHINE 2 MG/ML INJ 1 ML SYR

Facility

$15.85

Service Code	HCPCS J2272
Hospital Revenue Code	250
Min. Negotiated Rate	$13.47
Max. Negotiated Rate	$15.37
Rate for Payer: Cash Price	$10.30
Rate for Payer: Health Management Network Commercial	$13.47
Rate for Payer: MDX Hawaii PPO	$15.37

MORPHINE 2 MG/ML INJ 1 ML SYR

Facility

$15.85

Service Code	HCPCS J2272
Hospital Revenue Code	636
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$15.37
Rate for Payer: Cash Price	$10.30
Rate for Payer: Cash Price	$10.30
Rate for Payer: Hawaii Medical Service Association ABD	$8.13
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8.13
Rate for Payer: Hawaii Western Management Group Commercial	$15.06
Rate for Payer: Health Management Network Commercial	$13.47
Rate for Payer: Kaiser Permanente Commercial	$9.99
Rate for Payer: Kaiser Permanente Medicaid	$8.08
Rate for Payer: MDX Hawaii PPO	$15.37
Rate for Payer: UnitedHealthcare Medicaid	$9.51
Rate for Payer: University Health Alliance Commercial	$11.55

MORPHINE 2 MG/ML IV SYR

Facility

$11.76

Service Code	HCPCS J2270
Hospital Revenue Code	250
Min. Negotiated Rate	$10.00
Max. Negotiated Rate	$11.41
Rate for Payer: Cash Price	$7.64
Rate for Payer: Health Management Network Commercial	$10.00
Rate for Payer: MDX Hawaii PPO	$11.41

MORPHINE 2 MG/ML IV SYR

Facility

$11.76

Service Code	HCPCS J2270
Hospital Revenue Code	636
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$11.41
Rate for Payer: Cash Price	$7.64
Rate for Payer: Cash Price	$7.64
Rate for Payer: Hawaii Medical Service Association ABD	$4.55
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4.55
Rate for Payer: Hawaii Western Management Group Commercial	$11.17
Rate for Payer: Health Management Network Commercial	$10.00
Rate for Payer: Kaiser Permanente Commercial	$7.41
Rate for Payer: Kaiser Permanente Medicaid	$6.00
Rate for Payer: MDX Hawaii PPO	$11.41
Rate for Payer: UnitedHealthcare Medicaid	$7.06
Rate for Payer: University Health Alliance Commercial	$8.57

MORPHINE 30 MG PO TAB SR

Facility

$18.38

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$17.83
Rate for Payer: Cash Price	$11.95
Rate for Payer: Cash Price	$13.22
Rate for Payer: Cash Price	$11.38
Rate for Payer: Health Management Network Commercial	$14.88
Rate for Payer: Health Management Network Commercial	$15.62
Rate for Payer: Health Management Network Commercial	$17.29
Rate for Payer: MDX Hawaii PPO	$16.98
Rate for Payer: MDX Hawaii PPO	$19.73
Rate for Payer: MDX Hawaii PPO	$17.83

MORPHINE 30 MG PO TAB SR

Facility

$18.38

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$17.83
Rate for Payer: Cash Price	$11.95
Rate for Payer: Cash Price	$11.38
Rate for Payer: Cash Price	$13.22
Rate for Payer: Hawaii Western Management Group Commercial	$16.63
Rate for Payer: Hawaii Western Management Group Commercial	$19.32
Rate for Payer: Hawaii Western Management Group Commercial	$17.46
Rate for Payer: Health Management Network Commercial	$17.29
Rate for Payer: Health Management Network Commercial	$14.88
Rate for Payer: Health Management Network Commercial	$15.62
Rate for Payer: Kaiser Permanente Commercial	$11.03
Rate for Payer: Kaiser Permanente Commercial	$11.58
Rate for Payer: Kaiser Permanente Commercial	$12.81
Rate for Payer: Kaiser Permanente Medicaid	$10.37
Rate for Payer: Kaiser Permanente Medicaid	$9.37
Rate for Payer: Kaiser Permanente Medicaid	$8.93
Rate for Payer: MDX Hawaii PPO	$19.73
Rate for Payer: MDX Hawaii PPO	$16.98
Rate for Payer: MDX Hawaii PPO	$17.83
Rate for Payer: UnitedHealthcare Medicaid	$11.03
Rate for Payer: UnitedHealthcare Medicaid	$10.51
Rate for Payer: UnitedHealthcare Medicaid	$12.20
Rate for Payer: University Health Alliance Commercial	$14.83
Rate for Payer: University Health Alliance Commercial	$12.76
Rate for Payer: University Health Alliance Commercial	$13.40

MORPHINE 4 MG/ML INJ SYR

Facility

$15.85

Service Code	HCPCS J2272
Hospital Revenue Code	250
Min. Negotiated Rate	$13.47
Max. Negotiated Rate	$15.37
Rate for Payer: Cash Price	$10.30
Rate for Payer: Health Management Network Commercial	$13.47
Rate for Payer: MDX Hawaii PPO	$15.37

MORPHINE 4 MG/ML INJ SYR

Facility

$15.85

Service Code	HCPCS J2272
Hospital Revenue Code	636
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$15.37
Rate for Payer: Cash Price	$10.30
Rate for Payer: Cash Price	$10.30
Rate for Payer: Hawaii Medical Service Association ABD	$8.13
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8.13
Rate for Payer: Hawaii Western Management Group Commercial	$15.06
Rate for Payer: Health Management Network Commercial	$13.47
Rate for Payer: Kaiser Permanente Commercial	$9.99
Rate for Payer: Kaiser Permanente Medicaid	$8.08
Rate for Payer: MDX Hawaii PPO	$15.37
Rate for Payer: UnitedHealthcare Medicaid	$9.51
Rate for Payer: University Health Alliance Commercial	$11.55

MORPHINE 4 MG/ML IV SOLN

Facility

$13.79

Service Code	HCPCS J2270
Hospital Revenue Code	250
Min. Negotiated Rate	$11.72
Max. Negotiated Rate	$13.38
Rate for Payer: Cash Price	$8.96
Rate for Payer: Health Management Network Commercial	$11.72
Rate for Payer: MDX Hawaii PPO	$13.38

MORPHINE 4 MG/ML IV SOLN

Facility

$13.79

Service Code	HCPCS J2270
Hospital Revenue Code	636
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$13.38
Rate for Payer: Cash Price	$8.96
Rate for Payer: Cash Price	$8.96
Rate for Payer: Hawaii Medical Service Association ABD	$4.55
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4.55
Rate for Payer: Hawaii Western Management Group Commercial	$13.10
Rate for Payer: Health Management Network Commercial	$11.72
Rate for Payer: Kaiser Permanente Commercial	$8.69
Rate for Payer: Kaiser Permanente Medicaid	$7.03
Rate for Payer: MDX Hawaii PPO	$13.38
Rate for Payer: UnitedHealthcare Medicaid	$8.27
Rate for Payer: University Health Alliance Commercial	$10.05

MORPHINE 4 MG/ML IV SYR

Facility

$10.75

Service Code	HCPCS J2270
Hospital Revenue Code	250
Min. Negotiated Rate	$9.14
Max. Negotiated Rate	$10.43
Rate for Payer: Cash Price	$6.99
Rate for Payer: Health Management Network Commercial	$9.14
Rate for Payer: MDX Hawaii PPO	$10.43

MORPHINE 4 MG/ML IV SYR

Facility

$10.75

Service Code	HCPCS J2270
Hospital Revenue Code	636
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$10.43
Rate for Payer: Cash Price	$6.99
Rate for Payer: Cash Price	$6.99
Rate for Payer: Hawaii Medical Service Association ABD	$4.55
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4.55
Rate for Payer: Hawaii Western Management Group Commercial	$10.21
Rate for Payer: Health Management Network Commercial	$9.14
Rate for Payer: Kaiser Permanente Commercial	$6.77
Rate for Payer: Kaiser Permanente Medicaid	$5.48
Rate for Payer: MDX Hawaii PPO	$10.43
Rate for Payer: UnitedHealthcare Medicaid	$6.45
Rate for Payer: University Health Alliance Commercial	$7.84

MORPHINE CONCENTRATE 20 (20 MG/ML) PO SOLN

Facility

$2.07

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$2.01
Rate for Payer: Cash Price	$1.35
Rate for Payer: Hawaii Western Management Group Commercial	$1.97
Rate for Payer: Health Management Network Commercial	$1.76
Rate for Payer: Kaiser Permanente Commercial	$1.30
Rate for Payer: Kaiser Permanente Medicaid	$1.06
Rate for Payer: MDX Hawaii PPO	$2.01
Rate for Payer: UnitedHealthcare Medicaid	$1.24
Rate for Payer: University Health Alliance Commercial	$1.51

MORPHINE CONCENTRATE 20 (20 MG/ML) PO SOLN

Facility

$2.07

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$2.01
Rate for Payer: Cash Price	$1.35
Rate for Payer: Health Management Network Commercial	$1.76
Rate for Payer: MDX Hawaii PPO	$2.01

MORPHINE (PF) 1 MG/ML INJ SOLN

Facility

$104.86

Service Code	HCPCS J2274
Hospital Revenue Code	250
Min. Negotiated Rate	$89.13
Max. Negotiated Rate	$101.71
Rate for Payer: Cash Price	$68.16
Rate for Payer: Health Management Network Commercial	$89.13
Rate for Payer: MDX Hawaii PPO	$101.71

MORPHINE (PF) 1 MG/ML INJ SOLN

Facility

$104.86

Service Code	HCPCS J2274
Hospital Revenue Code	636
Min. Negotiated Rate	$10.79
Max. Negotiated Rate	$101.71
Rate for Payer: Cash Price	$68.16
Rate for Payer: Cash Price	$68.16
Rate for Payer: Hawaii Medical Service Association ABD	$10.79
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10.79
Rate for Payer: Hawaii Western Management Group Commercial	$99.62
Rate for Payer: Health Management Network Commercial	$89.13
Rate for Payer: Kaiser Permanente Commercial	$66.06
Rate for Payer: Kaiser Permanente Medicaid	$53.48
Rate for Payer: MDX Hawaii PPO	$101.71
Rate for Payer: UnitedHealthcare Medicaid	$62.92
Rate for Payer: University Health Alliance Commercial	$76.43

MORPHINE (PF) IN 0.9 % SOD CHL 50 MG/50 ML (1 MG/ML) IV PCA SYR

Facility

$65.20

Service Code	HCPCS J7999
Hospital Revenue Code	636
Min. Negotiated Rate	$33.25
Max. Negotiated Rate	$63.24
Rate for Payer: Cash Price	$42.38
Rate for Payer: Cash Price	$37.36
Rate for Payer: Hawaii Western Management Group Commercial	$54.61
Rate for Payer: Hawaii Western Management Group Commercial	$61.94
Rate for Payer: Health Management Network Commercial	$48.86
Rate for Payer: Health Management Network Commercial	$55.42
Rate for Payer: Kaiser Permanente Commercial	$36.21
Rate for Payer: Kaiser Permanente Commercial	$41.08
Rate for Payer: Kaiser Permanente Medicaid	$29.31
Rate for Payer: Kaiser Permanente Medicaid	$33.25
Rate for Payer: MDX Hawaii PPO	$55.76
Rate for Payer: MDX Hawaii PPO	$63.24
Rate for Payer: UnitedHealthcare Medicaid	$34.49
Rate for Payer: UnitedHealthcare Medicaid	$39.12
Rate for Payer: University Health Alliance Commercial	$47.52
Rate for Payer: University Health Alliance Commercial	$41.90

MORPHINE (PF) IN 0.9 % SOD CHL 50 MG/50 ML (1 MG/ML) IV PCA SYR

Facility

$57.48

Service Code	HCPCS J7999
Hospital Revenue Code	250
Min. Negotiated Rate	$48.86
Max. Negotiated Rate	$55.76
Rate for Payer: Cash Price	$37.36
Rate for Payer: Cash Price	$42.38
Rate for Payer: Health Management Network Commercial	$55.42
Rate for Payer: Health Management Network Commercial	$48.86
Rate for Payer: MDX Hawaii PPO	$55.76
Rate for Payer: MDX Hawaii PPO	$63.24

Motoband CP Non Lock Screw 3.5 x 20mm ST 1500-3520 [3644928]

Facility

$1,026.64

Service Code	HCPCS C1713
Hospital Charge Code	3644928
Hospital Revenue Code	278
Min. Negotiated Rate	$523.59
Max. Negotiated Rate	$995.84
Rate for Payer: Cash Price	$667.32
Rate for Payer: Hawaii Western Management Group Commercial	$718.65
Rate for Payer: Health Management Network Commercial	$872.64
Rate for Payer: Kaiser Permanente Commercial	$646.78
Rate for Payer: Kaiser Permanente Medicaid	$523.59
Rate for Payer: MDX Hawaii PPO	$995.84
Rate for Payer: University Health Alliance Commercial	$574.92

Motoband CP Non Lock Screw 3.5 x 20mm ST 1500-3520 [3644928]

Facility

$1,026.64

Service Code	HCPCS C1713
Hospital Charge Code	3644928
Hospital Revenue Code	278
Min. Negotiated Rate	$574.92
Max. Negotiated Rate	$995.84
Rate for Payer: Cash Price	$667.32
Rate for Payer: Hawaii Western Management Group Commercial	$718.65
Rate for Payer: Health Management Network Commercial	$872.64
Rate for Payer: MDX Hawaii PPO	$995.84
Rate for Payer: University Health Alliance Commercial	$574.92

Motoband CP Non Lock Screw 3.5 x 22mm ST 1500-3522 [3644930]

Facility

$1,026.64

Service Code	HCPCS C1713
Hospital Charge Code	3644930
Hospital Revenue Code	278
Min. Negotiated Rate	$574.92
Max. Negotiated Rate	$995.84
Rate for Payer: Cash Price	$667.32
Rate for Payer: Hawaii Western Management Group Commercial	$718.65
Rate for Payer: Health Management Network Commercial	$872.64
Rate for Payer: MDX Hawaii PPO	$995.84
Rate for Payer: University Health Alliance Commercial	$574.92

Know your out-of-pocket cost for care.

All Charges