Kona Community Hospital

All Charges

Charge

Type

Setting

Price

OTHER COMPLICATIONS OF TREATMENT

Facility

$9,031.14

Service Code	APR-DRG 8134
Min. Negotiated Rate	$9,031.14
Max. Negotiated Rate	$9,031.14
Rate for Payer: AlohaCare Medicaid	$9,031.14
Rate for Payer: Hawaii Medical Service Association ABD	$9,031.14
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,031.14
Rate for Payer: Kaiser Permanente Medicaid	$9,031.14
Rate for Payer: Ohana Health Plan Medicaid	$9,031.14
Rate for Payer: UnitedHealthcare Medicaid	$9,031.14

OTHER COMPLICATIONS OF TREATMENT

Facility

$3,446.38

Service Code	APR-DRG 8132
Min. Negotiated Rate	$3,446.38
Max. Negotiated Rate	$3,446.38
Rate for Payer: AlohaCare Medicaid	$3,446.38
Rate for Payer: Hawaii Medical Service Association ABD	$3,446.38
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,446.38
Rate for Payer: Kaiser Permanente Medicaid	$3,446.38
Rate for Payer: Ohana Health Plan Medicaid	$3,446.38
Rate for Payer: UnitedHealthcare Medicaid	$3,446.38

OTHER COMPLICATIONS OF TREATMENT

Facility

$4,965.15

Service Code	APR-DRG 8133
Min. Negotiated Rate	$4,965.15
Max. Negotiated Rate	$4,965.15
Rate for Payer: AlohaCare Medicaid	$4,965.15
Rate for Payer: Hawaii Medical Service Association ABD	$4,965.15
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,965.15
Rate for Payer: Kaiser Permanente Medicaid	$4,965.15
Rate for Payer: Ohana Health Plan Medicaid	$4,965.15
Rate for Payer: UnitedHealthcare Medicaid	$4,965.15

OTHER COMPLICATIONS OF TREATMENT

Facility

$2,754.81

Service Code	APR-DRG 8131
Min. Negotiated Rate	$2,754.81
Max. Negotiated Rate	$2,754.81
Rate for Payer: AlohaCare Medicaid	$2,754.81
Rate for Payer: Hawaii Medical Service Association ABD	$2,754.81
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,754.81
Rate for Payer: Kaiser Permanente Medicaid	$2,754.81
Rate for Payer: Ohana Health Plan Medicaid	$2,754.81
Rate for Payer: UnitedHealthcare Medicaid	$2,754.81

OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES

Facility

$7,269.74

Service Code	APR-DRG 2292
Min. Negotiated Rate	$7,269.74
Max. Negotiated Rate	$7,269.74
Rate for Payer: AlohaCare Medicaid	$7,269.74
Rate for Payer: Hawaii Medical Service Association ABD	$7,269.74
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,269.74
Rate for Payer: Kaiser Permanente Medicaid	$7,269.74
Rate for Payer: Ohana Health Plan Medicaid	$7,269.74
Rate for Payer: UnitedHealthcare Medicaid	$7,269.74

OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES

Facility

$10,286.28

Service Code	APR-DRG 2293
Min. Negotiated Rate	$10,286.28
Max. Negotiated Rate	$10,286.28
Rate for Payer: AlohaCare Medicaid	$10,286.28
Rate for Payer: Hawaii Medical Service Association ABD	$10,286.28
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10,286.28
Rate for Payer: Kaiser Permanente Medicaid	$10,286.28
Rate for Payer: Ohana Health Plan Medicaid	$10,286.28
Rate for Payer: UnitedHealthcare Medicaid	$10,286.28

OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES

Facility

$18,120.23

Service Code	APR-DRG 2294
Min. Negotiated Rate	$18,120.23
Max. Negotiated Rate	$18,120.23
Rate for Payer: AlohaCare Medicaid	$18,120.23
Rate for Payer: Hawaii Medical Service Association ABD	$18,120.23
Rate for Payer: Hawaii Medical Service Association Non-ABD	$18,120.23
Rate for Payer: Kaiser Permanente Medicaid	$18,120.23
Rate for Payer: Ohana Health Plan Medicaid	$18,120.23
Rate for Payer: UnitedHealthcare Medicaid	$18,120.23

OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES

Facility

$5,894.25

Service Code	APR-DRG 2291
Min. Negotiated Rate	$5,894.25
Max. Negotiated Rate	$5,894.25
Rate for Payer: AlohaCare Medicaid	$5,894.25
Rate for Payer: Hawaii Medical Service Association ABD	$5,894.25
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,894.25
Rate for Payer: Kaiser Permanente Medicaid	$5,894.25
Rate for Payer: Ohana Health Plan Medicaid	$5,894.25
Rate for Payer: UnitedHealthcare Medicaid	$5,894.25

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$9,015.22

Service Code	APR-DRG 2544
Min. Negotiated Rate	$9,015.22
Max. Negotiated Rate	$9,015.22
Rate for Payer: AlohaCare Medicaid	$9,015.22
Rate for Payer: Hawaii Medical Service Association ABD	$9,015.22
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,015.22
Rate for Payer: Kaiser Permanente Medicaid	$9,015.22
Rate for Payer: Ohana Health Plan Medicaid	$9,015.22
Rate for Payer: UnitedHealthcare Medicaid	$9,015.22

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$5,048.57

Service Code	APR-DRG 2543
Min. Negotiated Rate	$5,048.57
Max. Negotiated Rate	$5,048.57
Rate for Payer: AlohaCare Medicaid	$5,048.57
Rate for Payer: Hawaii Medical Service Association ABD	$5,048.57
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,048.57
Rate for Payer: Kaiser Permanente Medicaid	$5,048.57
Rate for Payer: Ohana Health Plan Medicaid	$5,048.57
Rate for Payer: UnitedHealthcare Medicaid	$5,048.57

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$3,489.04

Service Code	APR-DRG 2542
Min. Negotiated Rate	$3,489.04
Max. Negotiated Rate	$3,489.04
Rate for Payer: AlohaCare Medicaid	$3,489.04
Rate for Payer: Hawaii Medical Service Association ABD	$3,489.04
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,489.04
Rate for Payer: Kaiser Permanente Medicaid	$3,489.04
Rate for Payer: Ohana Health Plan Medicaid	$3,489.04
Rate for Payer: UnitedHealthcare Medicaid	$3,489.04

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$2,537.02

Service Code	APR-DRG 2541
Min. Negotiated Rate	$2,537.02
Max. Negotiated Rate	$2,537.02
Rate for Payer: AlohaCare Medicaid	$2,537.02
Rate for Payer: Hawaii Medical Service Association ABD	$2,537.02
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,537.02
Rate for Payer: Kaiser Permanente Medicaid	$2,537.02
Rate for Payer: Ohana Health Plan Medicaid	$2,537.02
Rate for Payer: UnitedHealthcare Medicaid	$2,537.02

OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC

Facility

$18,634.71

Service Code	MSDRG 394
Min. Negotiated Rate	$12,307.04
Max. Negotiated Rate	$18,634.71
Rate for Payer: AlohaCare Medicare	$12,307.04
Rate for Payer: Devoted Health Medicare	$13,537.74
Rate for Payer: Hawaii Medical Service Association Commercial	$18,634.71
Rate for Payer: Hawaii Medical Service Association Medicare	$12,307.04
Rate for Payer: Humana Medicare	$12,307.04
Rate for Payer: Kaiser Permanente Commercial	$16,140.83
Rate for Payer: Kaiser Permanente Medicare	$12,307.04
Rate for Payer: Ohana Health Plan Medicare	$12,307.04
Rate for Payer: UnitedHealthcare Medicare	$12,307.04

OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC

Facility

$27,587.92

Service Code	MSDRG 393
Min. Negotiated Rate	$21,035.23
Max. Negotiated Rate	$27,587.92
Rate for Payer: AlohaCare Medicare	$21,035.23
Rate for Payer: Devoted Health Medicare	$23,138.75
Rate for Payer: Hawaii Medical Service Association Commercial	$25,698.06
Rate for Payer: Hawaii Medical Service Association Medicare	$21,035.23
Rate for Payer: Humana Medicare	$21,035.23
Rate for Payer: Kaiser Permanente Commercial	$27,587.92
Rate for Payer: Kaiser Permanente Medicare	$21,035.23
Rate for Payer: Ohana Health Plan Medicare	$21,035.23
Rate for Payer: UnitedHealthcare Medicare	$21,035.23

OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$16,971.33

Service Code	MSDRG 395
Min. Negotiated Rate	$8,536.15
Max. Negotiated Rate	$16,971.33
Rate for Payer: AlohaCare Medicare	$8,536.15
Rate for Payer: Devoted Health Medicare	$9,389.76
Rate for Payer: Hawaii Medical Service Association Commercial	$16,971.33
Rate for Payer: Hawaii Medical Service Association Medicare	$8,536.15
Rate for Payer: Humana Medicare	$8,536.15
Rate for Payer: Kaiser Permanente Commercial	$11,195.25
Rate for Payer: Kaiser Permanente Medicare	$8,536.15
Rate for Payer: Ohana Health Plan Medicare	$8,536.15
Rate for Payer: UnitedHealthcare Medicare	$8,536.15

OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC

Facility

$59,013.94

Service Code	MSDRG 357
Min. Negotiated Rate	$30,586.75
Max. Negotiated Rate	$59,013.94
Rate for Payer: AlohaCare Medicare	$30,586.75
Rate for Payer: Devoted Health Medicare	$33,645.43
Rate for Payer: Hawaii Medical Service Association Commercial	$59,013.94
Rate for Payer: Hawaii Medical Service Association Medicare	$30,586.75
Rate for Payer: Humana Medicare	$30,586.75
Rate for Payer: Kaiser Permanente Commercial	$40,114.88
Rate for Payer: Kaiser Permanente Medicare	$30,586.75
Rate for Payer: Ohana Health Plan Medicare	$30,586.75
Rate for Payer: UnitedHealthcare Medicare	$30,586.75

OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC

Facility

$75,775.80

Service Code	MSDRG 356
Min. Negotiated Rate	$57,777.47
Max. Negotiated Rate	$75,775.80
Rate for Payer: AlohaCare Medicare	$57,777.47
Rate for Payer: Devoted Health Medicare	$63,555.22
Rate for Payer: Hawaii Medical Service Association Commercial	$64,100.51
Rate for Payer: Hawaii Medical Service Association Medicare	$57,777.47
Rate for Payer: Humana Medicare	$57,777.47
Rate for Payer: Kaiser Permanente Commercial	$75,775.80
Rate for Payer: Kaiser Permanente Medicare	$57,777.47
Rate for Payer: Ohana Health Plan Medicare	$57,777.47
Rate for Payer: UnitedHealthcare Medicare	$57,777.47

OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$33,002.48

Service Code	MSDRG 358
Min. Negotiated Rate	$18,386.23
Max. Negotiated Rate	$33,002.48
Rate for Payer: AlohaCare Medicare	$18,386.23
Rate for Payer: Devoted Health Medicare	$20,224.85
Rate for Payer: Hawaii Medical Service Association Commercial	$33,002.48
Rate for Payer: Hawaii Medical Service Association Medicare	$18,386.23
Rate for Payer: Humana Medicare	$18,386.23
Rate for Payer: Kaiser Permanente Commercial	$24,113.78
Rate for Payer: Kaiser Permanente Medicare	$18,386.23
Rate for Payer: Ohana Health Plan Medicare	$18,386.23
Rate for Payer: UnitedHealthcare Medicare	$18,386.23

OTHER DISORDERS OF NERVOUS SYSTEM

Facility

$3,234.96

Service Code	APR-DRG 0581
Min. Negotiated Rate	$3,234.96
Max. Negotiated Rate	$3,234.96
Rate for Payer: AlohaCare Medicaid	$3,234.96
Rate for Payer: Hawaii Medical Service Association ABD	$3,234.96
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,234.96
Rate for Payer: Kaiser Permanente Medicaid	$3,234.96
Rate for Payer: Ohana Health Plan Medicaid	$3,234.96
Rate for Payer: UnitedHealthcare Medicaid	$3,234.96

OTHER DISORDERS OF NERVOUS SYSTEM

Facility

$5,590.49

Service Code	APR-DRG 0583
Min. Negotiated Rate	$5,590.49
Max. Negotiated Rate	$5,590.49
Rate for Payer: AlohaCare Medicaid	$5,590.49
Rate for Payer: Hawaii Medical Service Association ABD	$5,590.49
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,590.49
Rate for Payer: Kaiser Permanente Medicaid	$5,590.49
Rate for Payer: Ohana Health Plan Medicaid	$5,590.49
Rate for Payer: UnitedHealthcare Medicaid	$5,590.49

OTHER DISORDERS OF NERVOUS SYSTEM

Facility

$4,138.58

Service Code	APR-DRG 0582
Min. Negotiated Rate	$4,138.58
Max. Negotiated Rate	$4,138.58
Rate for Payer: AlohaCare Medicaid	$4,138.58
Rate for Payer: Hawaii Medical Service Association ABD	$4,138.58
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,138.58
Rate for Payer: Kaiser Permanente Medicaid	$4,138.58
Rate for Payer: Ohana Health Plan Medicaid	$4,138.58
Rate for Payer: UnitedHealthcare Medicaid	$4,138.58

OTHER DISORDERS OF NERVOUS SYSTEM

Facility

$9,838.61

Service Code	APR-DRG 0584
Min. Negotiated Rate	$9,838.61
Max. Negotiated Rate	$9,838.61
Rate for Payer: AlohaCare Medicaid	$9,838.61
Rate for Payer: Hawaii Medical Service Association ABD	$9,838.61
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,838.61
Rate for Payer: Kaiser Permanente Medicaid	$9,838.61
Rate for Payer: Ohana Health Plan Medicaid	$9,838.61
Rate for Payer: UnitedHealthcare Medicaid	$9,838.61

OTHER DISORDERS OF NERVOUS SYSTEM WITH CC

Facility

$21,238.27

Service Code	MSDRG 092
Min. Negotiated Rate	$13,455.28
Max. Negotiated Rate	$21,238.27
Rate for Payer: AlohaCare Medicare	$13,455.28
Rate for Payer: Devoted Health Medicare	$14,800.81
Rate for Payer: Hawaii Medical Service Association Commercial	$21,238.27
Rate for Payer: Hawaii Medical Service Association Medicare	$13,455.28
Rate for Payer: Humana Medicare	$13,455.28
Rate for Payer: Kaiser Permanente Commercial	$17,646.75
Rate for Payer: Kaiser Permanente Medicare	$13,455.28
Rate for Payer: Ohana Health Plan Medicare	$13,455.28
Rate for Payer: UnitedHealthcare Medicare	$13,455.28

OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC

Facility

$30,294.45

Service Code	MSDRG 091
Min. Negotiated Rate	$23,098.90
Max. Negotiated Rate	$30,294.45
Rate for Payer: AlohaCare Medicare	$23,098.90
Rate for Payer: Devoted Health Medicare	$25,408.79
Rate for Payer: Hawaii Medical Service Association Commercial	$25,384.67
Rate for Payer: Hawaii Medical Service Association Medicare	$23,098.90
Rate for Payer: Humana Medicare	$23,098.90
Rate for Payer: Kaiser Permanente Commercial	$30,294.45
Rate for Payer: Kaiser Permanente Medicare	$23,098.90
Rate for Payer: Ohana Health Plan Medicare	$23,098.90
Rate for Payer: UnitedHealthcare Medicare	$23,098.90

OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC

Facility

$17,598.11

Service Code	MSDRG 093
Min. Negotiated Rate	$10,473.55
Max. Negotiated Rate	$17,598.11
Rate for Payer: AlohaCare Medicare	$10,473.55
Rate for Payer: Devoted Health Medicare	$11,520.91
Rate for Payer: Hawaii Medical Service Association Commercial	$17,598.11
Rate for Payer: Hawaii Medical Service Association Medicare	$10,473.55
Rate for Payer: Humana Medicare	$10,473.55
Rate for Payer: Kaiser Permanente Commercial	$13,736.17
Rate for Payer: Kaiser Permanente Medicare	$10,473.55
Rate for Payer: Ohana Health Plan Medicare	$10,473.55
Rate for Payer: UnitedHealthcare Medicare	$10,473.55

Know your out-of-pocket cost for care.

All Charges