Kona Community Hospital

All Charges

Charge

Type

Setting

Price

OTHER CARDIOTHORACIC PROCEDURES WITH MCC

Facility

$114,604.68

Service Code	MSDRG 228
Min. Negotiated Rate	$65,071.99
Max. Negotiated Rate	$114,604.68
Rate for Payer: AlohaCare Medicare	$65,071.99
Rate for Payer: Devoted Health Medicare	$71,579.19
Rate for Payer: Hawaii Medical Service Association Commercial	$114,604.68
Rate for Payer: Hawaii Medical Service Association Medicare	$65,071.99
Rate for Payer: Humana Medicare	$65,071.99
Rate for Payer: Kaiser Permanente Commercial	$85,342.65
Rate for Payer: Kaiser Permanente Medicare	$65,071.99
Rate for Payer: Ohana Health Plan Medicare	$65,071.99
Rate for Payer: UnitedHealthcare Medicare	$65,071.99

OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC

Facility

$114,604.68

Service Code	MSDRG 229
Min. Negotiated Rate	$41,424.65
Max. Negotiated Rate	$114,604.68
Rate for Payer: AlohaCare Medicare	$41,424.65
Rate for Payer: Devoted Health Medicare	$45,567.11
Rate for Payer: Hawaii Medical Service Association Commercial	$114,604.68
Rate for Payer: Hawaii Medical Service Association Medicare	$41,424.65
Rate for Payer: Humana Medicare	$41,424.65
Rate for Payer: Kaiser Permanente Commercial	$54,328.88
Rate for Payer: Kaiser Permanente Medicare	$41,424.65
Rate for Payer: Ohana Health Plan Medicare	$41,424.65
Rate for Payer: UnitedHealthcare Medicare	$41,424.65

OTHER CARDIOTHORACIC & THORACIC VASCULAR PROCEDURES

Facility

$20,666.17

Service Code	APR-DRG 1673
Min. Negotiated Rate	$20,666.17
Max. Negotiated Rate	$20,666.17
Rate for Payer: AlohaCare Medicaid	$20,666.17
Rate for Payer: Hawaii Medical Service Association ABD	$20,666.17
Rate for Payer: Hawaii Medical Service Association Non-ABD	$20,666.17
Rate for Payer: Kaiser Permanente Medicaid	$20,666.17
Rate for Payer: Ohana Health Plan Medicaid	$20,666.17
Rate for Payer: UnitedHealthcare Medicaid	$20,666.17

OTHER CARDIOTHORACIC & THORACIC VASCULAR PROCEDURES

Facility

$36,777.92

Service Code	APR-DRG 1674
Min. Negotiated Rate	$36,777.92
Max. Negotiated Rate	$36,777.92
Rate for Payer: AlohaCare Medicaid	$36,777.92
Rate for Payer: Hawaii Medical Service Association ABD	$36,777.92
Rate for Payer: Hawaii Medical Service Association Non-ABD	$36,777.92
Rate for Payer: Kaiser Permanente Medicaid	$36,777.92
Rate for Payer: Ohana Health Plan Medicaid	$36,777.92
Rate for Payer: UnitedHealthcare Medicaid	$36,777.92

OTHER CARDIOTHORACIC & THORACIC VASCULAR PROCEDURES

Facility

$14,389.84

Service Code	APR-DRG 1671
Min. Negotiated Rate	$14,389.84
Max. Negotiated Rate	$14,389.84
Rate for Payer: AlohaCare Medicaid	$14,389.84
Rate for Payer: Hawaii Medical Service Association ABD	$14,389.84
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14,389.84
Rate for Payer: Kaiser Permanente Medicaid	$14,389.84
Rate for Payer: Ohana Health Plan Medicaid	$14,389.84
Rate for Payer: UnitedHealthcare Medicaid	$14,389.84

OTHER CARDIOTHORACIC & THORACIC VASCULAR PROCEDURES

Facility

$14,514.65

Service Code	APR-DRG 1672
Min. Negotiated Rate	$14,514.65
Max. Negotiated Rate	$14,514.65
Rate for Payer: AlohaCare Medicaid	$14,514.65
Rate for Payer: Hawaii Medical Service Association ABD	$14,514.65
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14,514.65
Rate for Payer: Kaiser Permanente Medicaid	$14,514.65
Rate for Payer: Ohana Health Plan Medicaid	$14,514.65
Rate for Payer: UnitedHealthcare Medicaid	$14,514.65

OTHER CEREBROVASCULAR DISORDERS WITH CC

Facility

$26,686.45

Service Code	MSDRG 071
Min. Negotiated Rate	$13,494.74
Max. Negotiated Rate	$26,686.45
Rate for Payer: AlohaCare Medicare	$13,494.74
Rate for Payer: Devoted Health Medicare	$14,844.21
Rate for Payer: Hawaii Medical Service Association Commercial	$26,686.45
Rate for Payer: Hawaii Medical Service Association Medicare	$13,494.74
Rate for Payer: Humana Medicare	$13,494.74
Rate for Payer: Kaiser Permanente Commercial	$17,698.50
Rate for Payer: Kaiser Permanente Medicare	$13,494.74
Rate for Payer: Ohana Health Plan Medicare	$13,494.74
Rate for Payer: UnitedHealthcare Medicare	$13,494.74

OTHER CEREBROVASCULAR DISORDERS WITH MCC

Facility

$28,717.80

Service Code	MSDRG 070
Min. Negotiated Rate	$21,896.71
Max. Negotiated Rate	$28,717.80
Rate for Payer: AlohaCare Medicare	$21,896.71
Rate for Payer: Devoted Health Medicare	$24,086.38
Rate for Payer: Hawaii Medical Service Association Commercial	$28,446.26
Rate for Payer: Hawaii Medical Service Association Medicare	$21,896.71
Rate for Payer: Humana Medicare	$21,896.71
Rate for Payer: Kaiser Permanente Commercial	$28,717.80
Rate for Payer: Kaiser Permanente Medicare	$21,896.71
Rate for Payer: Ohana Health Plan Medicare	$21,896.71
Rate for Payer: UnitedHealthcare Medicare	$21,896.71

OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC

Facility

$16,513.29

Service Code	MSDRG 072
Min. Negotiated Rate	$9,946.13
Max. Negotiated Rate	$16,513.29
Rate for Payer: AlohaCare Medicare	$9,946.13
Rate for Payer: Devoted Health Medicare	$10,940.74
Rate for Payer: Hawaii Medical Service Association Commercial	$16,513.29
Rate for Payer: Hawaii Medical Service Association Medicare	$9,946.13
Rate for Payer: Humana Medicare	$9,946.13
Rate for Payer: Kaiser Permanente Commercial	$13,044.45
Rate for Payer: Kaiser Permanente Medicare	$9,946.13
Rate for Payer: Ohana Health Plan Medicare	$9,946.13
Rate for Payer: UnitedHealthcare Medicare	$9,946.13

OTHER CHEMOTHERAPY

Facility

$4,823.15

Service Code	APR-DRG 6962
Min. Negotiated Rate	$4,823.15
Max. Negotiated Rate	$4,823.15
Rate for Payer: AlohaCare Medicaid	$4,823.15
Rate for Payer: Hawaii Medical Service Association ABD	$4,823.15
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,823.15
Rate for Payer: Kaiser Permanente Medicaid	$4,823.15
Rate for Payer: Ohana Health Plan Medicaid	$4,823.15
Rate for Payer: UnitedHealthcare Medicaid	$4,823.15

OTHER CHEMOTHERAPY

Facility

$13,740.94

Service Code	APR-DRG 6964
Min. Negotiated Rate	$13,740.94
Max. Negotiated Rate	$13,740.94
Rate for Payer: AlohaCare Medicaid	$13,740.94
Rate for Payer: Hawaii Medical Service Association ABD	$13,740.94
Rate for Payer: Hawaii Medical Service Association Non-ABD	$13,740.94
Rate for Payer: Kaiser Permanente Medicaid	$13,740.94
Rate for Payer: Ohana Health Plan Medicaid	$13,740.94
Rate for Payer: UnitedHealthcare Medicaid	$13,740.94

OTHER CHEMOTHERAPY

Facility

$3,660.34

Service Code	APR-DRG 6961
Min. Negotiated Rate	$3,660.34
Max. Negotiated Rate	$3,660.34
Rate for Payer: AlohaCare Medicaid	$3,660.34
Rate for Payer: Hawaii Medical Service Association ABD	$3,660.34
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,660.34
Rate for Payer: Kaiser Permanente Medicaid	$3,660.34
Rate for Payer: Ohana Health Plan Medicaid	$3,660.34
Rate for Payer: UnitedHealthcare Medicaid	$3,660.34

OTHER CHEMOTHERAPY

Facility

$7,094.62

Service Code	APR-DRG 6963
Min. Negotiated Rate	$7,094.62
Max. Negotiated Rate	$7,094.62
Rate for Payer: AlohaCare Medicaid	$7,094.62
Rate for Payer: Hawaii Medical Service Association ABD	$7,094.62
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,094.62
Rate for Payer: Kaiser Permanente Medicaid	$7,094.62
Rate for Payer: Ohana Health Plan Medicaid	$7,094.62
Rate for Payer: UnitedHealthcare Medicaid	$7,094.62

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$4,747.37

Service Code	APR-DRG 2073
Min. Negotiated Rate	$4,747.37
Max. Negotiated Rate	$4,747.37
Rate for Payer: AlohaCare Medicaid	$4,747.37
Rate for Payer: Hawaii Medical Service Association ABD	$4,747.37
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,747.37
Rate for Payer: Kaiser Permanente Medicaid	$4,747.37
Rate for Payer: Ohana Health Plan Medicaid	$4,747.37
Rate for Payer: UnitedHealthcare Medicaid	$4,747.37

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$8,407.71

Service Code	APR-DRG 2074
Min. Negotiated Rate	$8,407.71
Max. Negotiated Rate	$8,407.71
Rate for Payer: AlohaCare Medicaid	$8,407.71
Rate for Payer: Hawaii Medical Service Association ABD	$8,407.71
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,407.71
Rate for Payer: Kaiser Permanente Medicaid	$8,407.71
Rate for Payer: Ohana Health Plan Medicaid	$8,407.71
Rate for Payer: UnitedHealthcare Medicaid	$8,407.71

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$2,796.20

Service Code	APR-DRG 2071
Min. Negotiated Rate	$2,796.20
Max. Negotiated Rate	$2,796.20
Rate for Payer: AlohaCare Medicaid	$2,796.20
Rate for Payer: Hawaii Medical Service Association ABD	$2,796.20
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,796.20
Rate for Payer: Kaiser Permanente Medicaid	$2,796.20
Rate for Payer: Ohana Health Plan Medicaid	$2,796.20
Rate for Payer: UnitedHealthcare Medicaid	$2,796.20

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$3,452.75

Service Code	APR-DRG 2072
Min. Negotiated Rate	$3,452.75
Max. Negotiated Rate	$3,452.75
Rate for Payer: AlohaCare Medicaid	$3,452.75
Rate for Payer: Hawaii Medical Service Association ABD	$3,452.75
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,452.75
Rate for Payer: Kaiser Permanente Medicaid	$3,452.75
Rate for Payer: Ohana Health Plan Medicaid	$3,452.75
Rate for Payer: UnitedHealthcare Medicaid	$3,452.75

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC

Facility

$27,096.27

Service Code	MSDRG 315
Min. Negotiated Rate	$12,670.06
Max. Negotiated Rate	$27,096.27
Rate for Payer: AlohaCare Medicare	$12,670.06
Rate for Payer: Devoted Health Medicare	$13,937.07
Rate for Payer: Hawaii Medical Service Association Commercial	$27,096.27
Rate for Payer: Hawaii Medical Service Association Medicare	$12,670.06
Rate for Payer: Humana Medicare	$12,670.06
Rate for Payer: Kaiser Permanente Commercial	$16,616.92
Rate for Payer: Kaiser Permanente Medicare	$12,670.06
Rate for Payer: Ohana Health Plan Medicare	$12,670.06
Rate for Payer: UnitedHealthcare Medicare	$12,670.06

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC

Facility

$40,403.33

Service Code	MSDRG 314
Min. Negotiated Rate	$27,426.15
Max. Negotiated Rate	$40,403.33
Rate for Payer: AlohaCare Medicare	$27,426.15
Rate for Payer: Devoted Health Medicare	$30,168.76
Rate for Payer: Hawaii Medical Service Association Commercial	$40,403.33
Rate for Payer: Hawaii Medical Service Association Medicare	$27,426.15
Rate for Payer: Humana Medicare	$27,426.15
Rate for Payer: Kaiser Permanente Commercial	$35,969.70
Rate for Payer: Kaiser Permanente Medicare	$27,426.15
Rate for Payer: Ohana Health Plan Medicare	$27,426.15
Rate for Payer: UnitedHealthcare Medicare	$27,426.15

OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$17,284.72

Service Code	MSDRG 316
Min. Negotiated Rate	$8,971.50
Max. Negotiated Rate	$17,284.72
Rate for Payer: AlohaCare Medicare	$8,971.50
Rate for Payer: Devoted Health Medicare	$9,868.65
Rate for Payer: Hawaii Medical Service Association Commercial	$17,284.72
Rate for Payer: Hawaii Medical Service Association Medicare	$8,971.50
Rate for Payer: Humana Medicare	$8,971.50
Rate for Payer: Kaiser Permanente Commercial	$11,766.23
Rate for Payer: Kaiser Permanente Medicare	$8,971.50
Rate for Payer: Ohana Health Plan Medicare	$8,971.50
Rate for Payer: UnitedHealthcare Medicare	$8,971.50

OTHER CIRCULATORY SYSTEM O.R. PROCEDURES

Facility

$164,506.17

Service Code	MSDRG 264
Min. Negotiated Rate	$43,938.14
Max. Negotiated Rate	$164,506.17
Rate for Payer: AlohaCare Medicare	$43,938.14
Rate for Payer: Devoted Health Medicare	$48,331.95
Rate for Payer: Hawaii Medical Service Association Commercial	$164,506.17
Rate for Payer: Hawaii Medical Service Association Medicare	$43,938.14
Rate for Payer: Humana Medicare	$43,938.14
Rate for Payer: Kaiser Permanente Commercial	$57,625.35
Rate for Payer: Kaiser Permanente Medicare	$43,938.14
Rate for Payer: Ohana Health Plan Medicare	$43,938.14
Rate for Payer: UnitedHealthcare Medicare	$43,938.14

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$6,247.04

Service Code	APR-DRG 1801
Min. Negotiated Rate	$6,247.04
Max. Negotiated Rate	$6,247.04
Rate for Payer: AlohaCare Medicaid	$6,247.04
Rate for Payer: Hawaii Medical Service Association ABD	$6,247.04
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6,247.04
Rate for Payer: Kaiser Permanente Medicaid	$6,247.04
Rate for Payer: Ohana Health Plan Medicaid	$6,247.04
Rate for Payer: UnitedHealthcare Medicaid	$6,247.04

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$7,416.84

Service Code	APR-DRG 1802
Min. Negotiated Rate	$7,416.84
Max. Negotiated Rate	$7,416.84
Rate for Payer: AlohaCare Medicaid	$7,416.84
Rate for Payer: Hawaii Medical Service Association ABD	$7,416.84
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,416.84
Rate for Payer: Kaiser Permanente Medicaid	$7,416.84
Rate for Payer: Ohana Health Plan Medicaid	$7,416.84
Rate for Payer: UnitedHealthcare Medicaid	$7,416.84

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$10,356.96

Service Code	APR-DRG 1803
Min. Negotiated Rate	$10,356.96
Max. Negotiated Rate	$10,356.96
Rate for Payer: AlohaCare Medicaid	$10,356.96
Rate for Payer: Hawaii Medical Service Association ABD	$10,356.96
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10,356.96
Rate for Payer: Kaiser Permanente Medicaid	$10,356.96
Rate for Payer: Ohana Health Plan Medicaid	$10,356.96
Rate for Payer: UnitedHealthcare Medicaid	$10,356.96

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$18,388.32

Service Code	APR-DRG 1804
Min. Negotiated Rate	$18,388.32
Max. Negotiated Rate	$18,388.32
Rate for Payer: AlohaCare Medicaid	$18,388.32
Rate for Payer: Hawaii Medical Service Association ABD	$18,388.32
Rate for Payer: Hawaii Medical Service Association Non-ABD	$18,388.32
Rate for Payer: Kaiser Permanente Medicaid	$18,388.32
Rate for Payer: Ohana Health Plan Medicaid	$18,388.32
Rate for Payer: UnitedHealthcare Medicaid	$18,388.32

Know your out-of-pocket cost for care.

All Charges