Kona Community Hospital

All Charges

Charge

Type

Setting

Price

NATALIZUMAB 300 MG/15 ML IV SOLN

Facility

$11,773.47

Service Code	HCPCS J2323
Hospital Revenue Code	250
Min. Negotiated Rate	$10,007.45
Max. Negotiated Rate	$11,420.27
Rate for Payer: Cash Price	$7,652.76
Rate for Payer: Health Management Network Commercial	$10,007.45
Rate for Payer: MDX Hawaii PPO	$11,420.27

N-Compass Nitinol Stone Extractor G36251 [3642780]

Facility

$2,040.13

Hospital Charge Code	3642780
Hospital Revenue Code	272
Min. Negotiated Rate	$1,040.47
Max. Negotiated Rate	$1,978.93
Rate for Payer: Cash Price	$1,326.08
Rate for Payer: Hawaii Western Management Group Commercial	$1,938.12
Rate for Payer: Health Management Network Commercial	$1,734.11
Rate for Payer: Kaiser Permanente Commercial	$1,285.28
Rate for Payer: Kaiser Permanente Medicaid	$1,040.47
Rate for Payer: MDX Hawaii PPO	$1,978.93
Rate for Payer: University Health Alliance Commercial	$1,487.05

N-Compass Nitinol Stone Extractor G36251 [3642780]

Facility

$2,040.13

Hospital Charge Code	3642780
Hospital Revenue Code	272
Min. Negotiated Rate	$1,734.11
Max. Negotiated Rate	$1,978.93
Rate for Payer: Cash Price	$1,326.08
Rate for Payer: Health Management Network Commercial	$1,734.11
Rate for Payer: MDX Hawaii PPO	$1,978.93

NEEDLE BIOPSEY TRU CUT 14GA 4.5 INCH [2701404]

Facility

$303.80

Hospital Charge Code	2701404
Hospital Revenue Code	272
Min. Negotiated Rate	$154.94
Max. Negotiated Rate	$294.69
Rate for Payer: Cash Price	$197.47
Rate for Payer: Hawaii Western Management Group Commercial	$288.61
Rate for Payer: Health Management Network Commercial	$258.23
Rate for Payer: Kaiser Permanente Commercial	$191.39
Rate for Payer: Kaiser Permanente Medicaid	$154.94
Rate for Payer: MDX Hawaii PPO	$294.69
Rate for Payer: University Health Alliance Commercial	$221.44

NEEDLE BIOPSEY TRU CUT 14GA 4.5 INCH [2701404]

Facility

$303.80

Hospital Charge Code	2701404
Hospital Revenue Code	272
Min. Negotiated Rate	$258.23
Max. Negotiated Rate	$294.69
Rate for Payer: Cash Price	$197.47
Rate for Payer: Health Management Network Commercial	$258.23
Rate for Payer: MDX Hawaii PPO	$294.69

NEEDLE BIOPSEY TRU CUT 14GA 6 INCH [2701405]

Facility

$134.72

Hospital Charge Code	2701405
Hospital Revenue Code	272
Min. Negotiated Rate	$68.71
Max. Negotiated Rate	$130.68
Rate for Payer: Cash Price	$87.57
Rate for Payer: Hawaii Western Management Group Commercial	$127.98
Rate for Payer: Health Management Network Commercial	$114.51
Rate for Payer: Kaiser Permanente Commercial	$84.87
Rate for Payer: Kaiser Permanente Medicaid	$68.71
Rate for Payer: MDX Hawaii PPO	$130.68
Rate for Payer: University Health Alliance Commercial	$98.20

NEEDLE BIOPSEY TRU CUT 14GA 6 INCH [2701405]

Facility

$134.72

Hospital Charge Code	2701405
Hospital Revenue Code	272
Min. Negotiated Rate	$114.51
Max. Negotiated Rate	$130.68
Rate for Payer: Cash Price	$87.57
Rate for Payer: Health Management Network Commercial	$114.51
Rate for Payer: MDX Hawaii PPO	$130.68

Needle Breast Local 20G x 7cm Kopans G09984 [3640561]

Facility

$239.48

Hospital Charge Code	3640561
Hospital Revenue Code	272
Min. Negotiated Rate	$122.13
Max. Negotiated Rate	$232.30
Rate for Payer: Cash Price	$155.66
Rate for Payer: Hawaii Western Management Group Commercial	$227.51
Rate for Payer: Health Management Network Commercial	$203.56
Rate for Payer: Kaiser Permanente Commercial	$150.87
Rate for Payer: Kaiser Permanente Medicaid	$122.13
Rate for Payer: MDX Hawaii PPO	$232.30
Rate for Payer: University Health Alliance Commercial	$174.56

Needle Breast Local 20G x 7cm Kopans G09984 [3640561]

Facility

$239.48

Hospital Charge Code	3640561
Hospital Revenue Code	272
Min. Negotiated Rate	$203.56
Max. Negotiated Rate	$232.30
Rate for Payer: Cash Price	$155.66
Rate for Payer: Health Management Network Commercial	$203.56
Rate for Payer: MDX Hawaii PPO	$232.30

NEEDLE FILTER 18GA x 1.5" 305211 [2702367]

Facility

$189.84

Hospital Charge Code	2702367
Hospital Revenue Code	272
Min. Negotiated Rate	$96.82
Max. Negotiated Rate	$184.14
Rate for Payer: Cash Price	$123.40
Rate for Payer: Hawaii Western Management Group Commercial	$180.35
Rate for Payer: Health Management Network Commercial	$161.36
Rate for Payer: Kaiser Permanente Commercial	$119.60
Rate for Payer: Kaiser Permanente Medicaid	$96.82
Rate for Payer: MDX Hawaii PPO	$184.14
Rate for Payer: University Health Alliance Commercial	$138.37

NEEDLE FILTER 18GA x 1.5" 305211 [2702367]

Facility

$189.84

Hospital Charge Code	2702367
Hospital Revenue Code	272
Min. Negotiated Rate	$161.36
Max. Negotiated Rate	$184.14
Rate for Payer: Cash Price	$123.40
Rate for Payer: Health Management Network Commercial	$161.36
Rate for Payer: MDX Hawaii PPO	$184.14

Needle Flexcysto Injector Set NM-221C-0427 [3642602]

Facility

$425.43

Hospital Charge Code	3642602
Hospital Revenue Code	272
Min. Negotiated Rate	$216.97
Max. Negotiated Rate	$412.67
Rate for Payer: Cash Price	$276.53
Rate for Payer: Hawaii Western Management Group Commercial	$404.16
Rate for Payer: Health Management Network Commercial	$361.62
Rate for Payer: Kaiser Permanente Commercial	$268.02
Rate for Payer: Kaiser Permanente Medicaid	$216.97
Rate for Payer: MDX Hawaii PPO	$412.67
Rate for Payer: University Health Alliance Commercial	$310.10

Needle Flexcysto Injector Set NM-221C-0427 [3642602]

Facility

$425.43

Hospital Charge Code	3642602
Hospital Revenue Code	272
Min. Negotiated Rate	$361.62
Max. Negotiated Rate	$412.67
Rate for Payer: Cash Price	$276.53
Rate for Payer: Health Management Network Commercial	$361.62
Rate for Payer: MDX Hawaii PPO	$412.67

Needle Intraosseous 25mm [2706576]

Facility

$858.49

Hospital Charge Code	2706576
Hospital Revenue Code	272
Min. Negotiated Rate	$437.83
Max. Negotiated Rate	$832.74
Rate for Payer: Cash Price	$558.02
Rate for Payer: Hawaii Western Management Group Commercial	$815.57
Rate for Payer: Health Management Network Commercial	$729.72
Rate for Payer: Kaiser Permanente Commercial	$540.85
Rate for Payer: Kaiser Permanente Medicaid	$437.83
Rate for Payer: MDX Hawaii PPO	$832.74
Rate for Payer: University Health Alliance Commercial	$625.75

Needle Intraosseous 25mm [2706576]

Facility

$858.49

Hospital Charge Code	2706576
Hospital Revenue Code	272
Min. Negotiated Rate	$729.72
Max. Negotiated Rate	$832.74
Rate for Payer: Cash Price	$558.02
Rate for Payer: Health Management Network Commercial	$729.72
Rate for Payer: MDX Hawaii PPO	$832.74

Needle Kopans Breast Local 21G x7CM DKBL2170A G03507 [3601176]

Facility

$205.60

Hospital Charge Code	3601176
Hospital Revenue Code	272
Min. Negotiated Rate	$174.76
Max. Negotiated Rate	$199.43
Rate for Payer: Cash Price	$133.64
Rate for Payer: Health Management Network Commercial	$174.76
Rate for Payer: MDX Hawaii PPO	$199.43

Needle Kopans Breast Local 21G x7CM DKBL2170A G03507 [3601176]

Facility

$205.60

Hospital Charge Code	3601176
Hospital Revenue Code	272
Min. Negotiated Rate	$104.86
Max. Negotiated Rate	$199.43
Rate for Payer: Cash Price	$133.64
Rate for Payer: Hawaii Western Management Group Commercial	$195.32
Rate for Payer: Health Management Network Commercial	$174.76
Rate for Payer: Kaiser Permanente Commercial	$129.53
Rate for Payer: Kaiser Permanente Medicaid	$104.86
Rate for Payer: MDX Hawaii PPO	$199.43
Rate for Payer: University Health Alliance Commercial	$149.86

Needle Multifire Scorpion AR13995N [3641052]

Facility

$1,428.27

Hospital Charge Code	3641052
Hospital Revenue Code	272
Min. Negotiated Rate	$1,214.03
Max. Negotiated Rate	$1,385.42
Rate for Payer: Cash Price	$928.38
Rate for Payer: Health Management Network Commercial	$1,214.03
Rate for Payer: MDX Hawaii PPO	$1,385.42

Needle Multifire Scorpion AR13995N [3641052]

Facility

$1,428.27

Hospital Charge Code	3641052
Hospital Revenue Code	272
Min. Negotiated Rate	$728.42
Max. Negotiated Rate	$1,385.42
Rate for Payer: Cash Price	$928.38
Rate for Payer: Hawaii Western Management Group Commercial	$1,356.86
Rate for Payer: Health Management Network Commercial	$1,214.03
Rate for Payer: Kaiser Permanente Commercial	$899.81
Rate for Payer: Kaiser Permanente Medicaid	$728.42
Rate for Payer: MDX Hawaii PPO	$1,385.42
Rate for Payer: University Health Alliance Commercial	$1,041.07

Needle Port-A-Cath 20ga 1 Inch [2701455]

Facility

$39.27

Hospital Charge Code	2701455
Hospital Revenue Code	272
Min. Negotiated Rate	$33.38
Max. Negotiated Rate	$38.09
Rate for Payer: Cash Price	$25.53
Rate for Payer: Health Management Network Commercial	$33.38
Rate for Payer: MDX Hawaii PPO	$38.09

Needle Port-A-Cath 20ga 1 Inch [2701455]

Facility

$39.27

Hospital Charge Code	2701455
Hospital Revenue Code	272
Min. Negotiated Rate	$20.03
Max. Negotiated Rate	$38.09
Rate for Payer: Cash Price	$25.53
Rate for Payer: Hawaii Western Management Group Commercial	$37.31
Rate for Payer: Health Management Network Commercial	$33.38
Rate for Payer: Kaiser Permanente Commercial	$24.74
Rate for Payer: Kaiser Permanente Medicaid	$20.03
Rate for Payer: MDX Hawaii PPO	$38.09
Rate for Payer: University Health Alliance Commercial	$28.62

Needle Port-A-Cath 20ga .75 Inch [2701454]

Facility

$41.23

Hospital Charge Code	2701454
Hospital Revenue Code	272
Min. Negotiated Rate	$21.03
Max. Negotiated Rate	$39.99
Rate for Payer: Cash Price	$26.80
Rate for Payer: Hawaii Western Management Group Commercial	$39.17
Rate for Payer: Health Management Network Commercial	$35.05
Rate for Payer: Kaiser Permanente Commercial	$25.97
Rate for Payer: Kaiser Permanente Medicaid	$21.03
Rate for Payer: MDX Hawaii PPO	$39.99
Rate for Payer: University Health Alliance Commercial	$30.05

Needle Port-A-Cath 20ga .75 Inch [2701454]

Facility

$41.23

Hospital Charge Code	2701454
Hospital Revenue Code	272
Min. Negotiated Rate	$35.05
Max. Negotiated Rate	$39.99
Rate for Payer: Cash Price	$26.80
Rate for Payer: Health Management Network Commercial	$35.05
Rate for Payer: MDX Hawaii PPO	$39.99

Needle Port-A-Cath 22ga .75 Inch [2702243]

Facility

$41.23

Hospital Charge Code	2702243
Hospital Revenue Code	272
Min. Negotiated Rate	$21.03
Max. Negotiated Rate	$39.99
Rate for Payer: Cash Price	$26.80
Rate for Payer: Hawaii Western Management Group Commercial	$39.17
Rate for Payer: Health Management Network Commercial	$35.05
Rate for Payer: Kaiser Permanente Commercial	$25.97
Rate for Payer: Kaiser Permanente Medicaid	$21.03
Rate for Payer: MDX Hawaii PPO	$39.99
Rate for Payer: University Health Alliance Commercial	$30.05

Needle Port-A-Cath 22ga .75 Inch [2702243]

Facility

$41.23

Hospital Charge Code	2702243
Hospital Revenue Code	272
Min. Negotiated Rate	$35.05
Max. Negotiated Rate	$39.99
Rate for Payer: Cash Price	$26.80
Rate for Payer: Health Management Network Commercial	$35.05
Rate for Payer: MDX Hawaii PPO	$39.99

Know your out-of-pocket cost for care.

All Charges