Kona Community Hospital

All Charges

Charge

Type

Setting

Price

NEONATE BIRTHWT 1000-1249G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$55,906.21

Service Code	APR-DRG 6032
Min. Negotiated Rate	$55,906.21
Max. Negotiated Rate	$55,906.21
Rate for Payer: AlohaCare Medicaid	$55,906.21
Rate for Payer: Hawaii Medical Service Association ABD	$55,906.21
Rate for Payer: Hawaii Medical Service Association Non-ABD	$55,906.21
Rate for Payer: Kaiser Permanente Medicaid	$55,906.21
Rate for Payer: Ohana Health Plan Medicaid	$55,906.21
Rate for Payer: UnitedHealthcare Medicaid	$55,906.21

NEONATE BIRTHWT 1000-1249G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$17,833.92

Service Code	APR-DRG 6031
Min. Negotiated Rate	$17,833.92
Max. Negotiated Rate	$17,833.92
Rate for Payer: AlohaCare Medicaid	$17,833.92
Rate for Payer: Hawaii Medical Service Association ABD	$17,833.92
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17,833.92
Rate for Payer: Kaiser Permanente Medicaid	$17,833.92
Rate for Payer: Ohana Health Plan Medicaid	$17,833.92
Rate for Payer: UnitedHealthcare Medicaid	$17,833.92

NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION

Facility

$55,383.08

Service Code	APR-DRG 6134
Min. Negotiated Rate	$55,383.08
Max. Negotiated Rate	$55,383.08
Rate for Payer: AlohaCare Medicaid	$55,383.08
Rate for Payer: Hawaii Medical Service Association ABD	$55,383.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$55,383.08
Rate for Payer: Kaiser Permanente Medicaid	$55,383.08
Rate for Payer: Ohana Health Plan Medicaid	$55,383.08
Rate for Payer: UnitedHealthcare Medicaid	$55,383.08

NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION

Facility

$30,801.72

Service Code	APR-DRG 6132
Min. Negotiated Rate	$30,801.72
Max. Negotiated Rate	$30,801.72
Rate for Payer: AlohaCare Medicaid	$30,801.72
Rate for Payer: Hawaii Medical Service Association ABD	$30,801.72
Rate for Payer: Hawaii Medical Service Association Non-ABD	$30,801.72
Rate for Payer: Kaiser Permanente Medicaid	$30,801.72
Rate for Payer: Ohana Health Plan Medicaid	$30,801.72
Rate for Payer: UnitedHealthcare Medicaid	$30,801.72

NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION

Facility

$18,934.48

Service Code	APR-DRG 6131
Min. Negotiated Rate	$18,934.48
Max. Negotiated Rate	$18,934.48
Rate for Payer: AlohaCare Medicaid	$18,934.48
Rate for Payer: Hawaii Medical Service Association ABD	$18,934.48
Rate for Payer: Hawaii Medical Service Association Non-ABD	$18,934.48
Rate for Payer: Kaiser Permanente Medicaid	$18,934.48
Rate for Payer: Ohana Health Plan Medicaid	$18,934.48
Rate for Payer: UnitedHealthcare Medicaid	$18,934.48

NEONATE BIRTHWT 1500-1999G W CONGENITAL/PERINATAL INFECTION

Facility

$47,722.62

Service Code	APR-DRG 6133
Min. Negotiated Rate	$47,722.62
Max. Negotiated Rate	$47,722.62
Rate for Payer: AlohaCare Medicaid	$47,722.62
Rate for Payer: Hawaii Medical Service Association ABD	$47,722.62
Rate for Payer: Hawaii Medical Service Association Non-ABD	$47,722.62
Rate for Payer: Kaiser Permanente Medicaid	$47,722.62
Rate for Payer: Ohana Health Plan Medicaid	$47,722.62
Rate for Payer: UnitedHealthcare Medicaid	$47,722.62

NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY

Facility

$83,297.69

Service Code	APR-DRG 6114
Min. Negotiated Rate	$83,297.69
Max. Negotiated Rate	$83,297.69
Rate for Payer: AlohaCare Medicaid	$83,297.69
Rate for Payer: Hawaii Medical Service Association ABD	$83,297.69
Rate for Payer: Hawaii Medical Service Association Non-ABD	$83,297.69
Rate for Payer: Kaiser Permanente Medicaid	$83,297.69
Rate for Payer: Ohana Health Plan Medicaid	$83,297.69
Rate for Payer: UnitedHealthcare Medicaid	$83,297.69

NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY

Facility

$29,669.58

Service Code	APR-DRG 6112
Min. Negotiated Rate	$29,669.58
Max. Negotiated Rate	$29,669.58
Rate for Payer: AlohaCare Medicaid	$29,669.58
Rate for Payer: Hawaii Medical Service Association ABD	$29,669.58
Rate for Payer: Hawaii Medical Service Association Non-ABD	$29,669.58
Rate for Payer: Kaiser Permanente Medicaid	$29,669.58
Rate for Payer: Ohana Health Plan Medicaid	$29,669.58
Rate for Payer: UnitedHealthcare Medicaid	$29,669.58

NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY

Facility

$14,467.11

Service Code	APR-DRG 6111
Min. Negotiated Rate	$14,467.11
Max. Negotiated Rate	$14,467.11
Rate for Payer: AlohaCare Medicaid	$14,467.11
Rate for Payer: Hawaii Medical Service Association ABD	$14,467.11
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14,467.11
Rate for Payer: Kaiser Permanente Medicaid	$14,467.11
Rate for Payer: Ohana Health Plan Medicaid	$14,467.11
Rate for Payer: UnitedHealthcare Medicaid	$14,467.11

NEONATE BIRTHWT 1500-1999G W MAJOR ANOMALY

Facility

$50,096.46

Service Code	APR-DRG 6113
Min. Negotiated Rate	$50,096.46
Max. Negotiated Rate	$50,096.46
Rate for Payer: AlohaCare Medicaid	$50,096.46
Rate for Payer: Hawaii Medical Service Association ABD	$50,096.46
Rate for Payer: Hawaii Medical Service Association Non-ABD	$50,096.46
Rate for Payer: Kaiser Permanente Medicaid	$50,096.46
Rate for Payer: Ohana Health Plan Medicaid	$50,096.46
Rate for Payer: UnitedHealthcare Medicaid	$50,096.46

NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$1,170.99

Service Code	APR-DRG 6402
Min. Negotiated Rate	$1,170.99
Max. Negotiated Rate	$1,170.99
Rate for Payer: AlohaCare Medicaid	$1,170.99
Rate for Payer: Hawaii Medical Service Association ABD	$1,170.99
Rate for Payer: Hawaii Medical Service Association Non-ABD	$1,170.99
Rate for Payer: Kaiser Permanente Medicaid	$1,170.99
Rate for Payer: Ohana Health Plan Medicaid	$1,170.99
Rate for Payer: UnitedHealthcare Medicaid	$1,170.99

NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$19,238.87

Service Code	APR-DRG 6404
Min. Negotiated Rate	$19,238.87
Max. Negotiated Rate	$19,238.87
Rate for Payer: AlohaCare Medicaid	$19,238.87
Rate for Payer: Hawaii Medical Service Association ABD	$19,238.87
Rate for Payer: Hawaii Medical Service Association Non-ABD	$19,238.87
Rate for Payer: Kaiser Permanente Medicaid	$19,238.87
Rate for Payer: Ohana Health Plan Medicaid	$19,238.87
Rate for Payer: UnitedHealthcare Medicaid	$19,238.87

NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$854.62

Service Code	APR-DRG 6401
Min. Negotiated Rate	$854.62
Max. Negotiated Rate	$854.62
Rate for Payer: AlohaCare Medicaid	$854.62
Rate for Payer: Hawaii Medical Service Association ABD	$854.62
Rate for Payer: Hawaii Medical Service Association Non-ABD	$854.62
Rate for Payer: Kaiser Permanente Medicaid	$854.62
Rate for Payer: Ohana Health Plan Medicaid	$854.62
Rate for Payer: UnitedHealthcare Medicaid	$854.62

NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$2,266.54

Service Code	APR-DRG 6403
Min. Negotiated Rate	$2,266.54
Max. Negotiated Rate	$2,266.54
Rate for Payer: AlohaCare Medicaid	$2,266.54
Rate for Payer: Hawaii Medical Service Association ABD	$2,266.54
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,266.54
Rate for Payer: Kaiser Permanente Medicaid	$2,266.54
Rate for Payer: Ohana Health Plan Medicaid	$2,266.54
Rate for Payer: UnitedHealthcare Medicaid	$2,266.54

NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION

Facility

$6,175.94

Service Code	APR-DRG 6361
Min. Negotiated Rate	$6,175.94
Max. Negotiated Rate	$6,175.94
Rate for Payer: AlohaCare Medicaid	$6,175.94
Rate for Payer: Hawaii Medical Service Association ABD	$6,175.94
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6,175.94
Rate for Payer: Kaiser Permanente Medicaid	$6,175.94
Rate for Payer: Ohana Health Plan Medicaid	$6,175.94
Rate for Payer: UnitedHealthcare Medicaid	$6,175.94

NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION

Facility

$18,908.81

Service Code	APR-DRG 6363
Min. Negotiated Rate	$18,908.81
Max. Negotiated Rate	$18,908.81
Rate for Payer: AlohaCare Medicaid	$18,908.81
Rate for Payer: Hawaii Medical Service Association ABD	$18,908.81
Rate for Payer: Hawaii Medical Service Association Non-ABD	$18,908.81
Rate for Payer: Kaiser Permanente Medicaid	$18,908.81
Rate for Payer: Ohana Health Plan Medicaid	$18,908.81
Rate for Payer: UnitedHealthcare Medicaid	$18,908.81

NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION

Facility

$9,343.36

Service Code	APR-DRG 6362
Min. Negotiated Rate	$9,343.36
Max. Negotiated Rate	$9,343.36
Rate for Payer: AlohaCare Medicaid	$9,343.36
Rate for Payer: Hawaii Medical Service Association ABD	$9,343.36
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,343.36
Rate for Payer: Kaiser Permanente Medicaid	$9,343.36
Rate for Payer: Ohana Health Plan Medicaid	$9,343.36
Rate for Payer: UnitedHealthcare Medicaid	$9,343.36

NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION

Facility

$28,290.67

Service Code	APR-DRG 6364
Min. Negotiated Rate	$28,290.67
Max. Negotiated Rate	$28,290.67
Rate for Payer: AlohaCare Medicaid	$28,290.67
Rate for Payer: Hawaii Medical Service Association ABD	$28,290.67
Rate for Payer: Hawaii Medical Service Association Non-ABD	$28,290.67
Rate for Payer: Kaiser Permanente Medicaid	$28,290.67
Rate for Payer: Ohana Health Plan Medicaid	$28,290.67
Rate for Payer: UnitedHealthcare Medicaid	$28,290.67

NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$51,922.50

Service Code	APR-DRG 6334
Min. Negotiated Rate	$51,922.50
Max. Negotiated Rate	$51,922.50
Rate for Payer: AlohaCare Medicaid	$51,922.50
Rate for Payer: Hawaii Medical Service Association ABD	$51,922.50
Rate for Payer: Hawaii Medical Service Association Non-ABD	$51,922.50
Rate for Payer: Kaiser Permanente Medicaid	$51,922.50
Rate for Payer: Ohana Health Plan Medicaid	$51,922.50
Rate for Payer: UnitedHealthcare Medicaid	$51,922.50

NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$2,964.10

Service Code	APR-DRG 6331
Min. Negotiated Rate	$2,964.10
Max. Negotiated Rate	$2,964.10
Rate for Payer: AlohaCare Medicaid	$2,964.10
Rate for Payer: Hawaii Medical Service Association ABD	$2,964.10
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,964.10
Rate for Payer: Kaiser Permanente Medicaid	$2,964.10
Rate for Payer: Ohana Health Plan Medicaid	$2,964.10
Rate for Payer: UnitedHealthcare Medicaid	$2,964.10

NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$9,470.69

Service Code	APR-DRG 6332
Min. Negotiated Rate	$9,470.69
Max. Negotiated Rate	$9,470.69
Rate for Payer: AlohaCare Medicaid	$9,470.69
Rate for Payer: Hawaii Medical Service Association ABD	$9,470.69
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,470.69
Rate for Payer: Kaiser Permanente Medicaid	$9,470.69
Rate for Payer: Ohana Health Plan Medicaid	$9,470.69
Rate for Payer: UnitedHealthcare Medicaid	$9,470.69

NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$23,777.91

Service Code	APR-DRG 6333
Min. Negotiated Rate	$23,777.91
Max. Negotiated Rate	$23,777.91
Rate for Payer: AlohaCare Medicaid	$23,777.91
Rate for Payer: Hawaii Medical Service Association ABD	$23,777.91
Rate for Payer: Hawaii Medical Service Association Non-ABD	$23,777.91
Rate for Payer: Kaiser Permanente Medicaid	$23,777.91
Rate for Payer: Ohana Health Plan Medicaid	$23,777.91
Rate for Payer: UnitedHealthcare Medicaid	$23,777.91

NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE

Facility

$125,080.27

Service Code	APR-DRG 6304
Min. Negotiated Rate	$125,080.27
Max. Negotiated Rate	$125,080.27
Rate for Payer: AlohaCare Medicaid	$125,080.27
Rate for Payer: Hawaii Medical Service Association ABD	$125,080.27
Rate for Payer: Hawaii Medical Service Association Non-ABD	$125,080.27
Rate for Payer: Kaiser Permanente Medicaid	$125,080.27
Rate for Payer: Ohana Health Plan Medicaid	$125,080.27
Rate for Payer: UnitedHealthcare Medicaid	$125,080.27

NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE

Facility

$42,629.47

Service Code	APR-DRG 6302
Min. Negotiated Rate	$42,629.47
Max. Negotiated Rate	$42,629.47
Rate for Payer: AlohaCare Medicaid	$42,629.47
Rate for Payer: Hawaii Medical Service Association ABD	$42,629.47
Rate for Payer: Hawaii Medical Service Association Non-ABD	$42,629.47
Rate for Payer: Kaiser Permanente Medicaid	$42,629.47
Rate for Payer: Ohana Health Plan Medicaid	$42,629.47
Rate for Payer: UnitedHealthcare Medicaid	$42,629.47

NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE

Facility

$71,970.36

Service Code	APR-DRG 6303
Min. Negotiated Rate	$71,970.36
Max. Negotiated Rate	$71,970.36
Rate for Payer: AlohaCare Medicaid	$71,970.36
Rate for Payer: Hawaii Medical Service Association ABD	$71,970.36
Rate for Payer: Hawaii Medical Service Association Non-ABD	$71,970.36
Rate for Payer: Kaiser Permanente Medicaid	$71,970.36
Rate for Payer: Ohana Health Plan Medicaid	$71,970.36
Rate for Payer: UnitedHealthcare Medicaid	$71,970.36

Know your out-of-pocket cost for care.

All Charges