Kona Community Hospital

All Charges

Charge

Type

Setting

Price

OTHER ENDOCRINE DISORDERS

Facility

$3,527.25

Service Code	APR-DRG 4242
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$3,527.25
Rate for Payer: AlohaCare Medicaid	$3,527.25
Rate for Payer: Hawaii Medical Service Association ABD	$3,527.25
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,527.25
Rate for Payer: Kaiser Permanente Medicaid	$3,527.25
Rate for Payer: Ohana Health Plan Medicaid	$3,527.25
Rate for Payer: UnitedHealthcare Medicaid	$3,527.25

OTHER ENDOCRINE DISORDERS

Facility

$9,749.45

Service Code	APR-DRG 4244
Min. Negotiated Rate	$9,749.45
Max. Negotiated Rate	$9,749.45
Rate for Payer: AlohaCare Medicaid	$9,749.45
Rate for Payer: Hawaii Medical Service Association ABD	$9,749.45
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,749.45
Rate for Payer: Kaiser Permanente Medicaid	$9,749.45
Rate for Payer: Ohana Health Plan Medicaid	$9,749.45
Rate for Payer: UnitedHealthcare Medicaid	$9,749.45

OTHER ENDOCRINE DISORDERS

Facility

$2,610.26

Service Code	APR-DRG 4241
Min. Negotiated Rate	$2,610.26
Max. Negotiated Rate	$2,610.26
Rate for Payer: AlohaCare Medicaid	$2,610.26
Rate for Payer: Hawaii Medical Service Association ABD	$2,610.26
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,610.26
Rate for Payer: Kaiser Permanente Medicaid	$2,610.26
Rate for Payer: Ohana Health Plan Medicaid	$2,610.26
Rate for Payer: UnitedHealthcare Medicaid	$2,610.26

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC

Facility

$37,584.30

Service Code	MSDRG 629
Min. Negotiated Rate	$28,325.72
Max. Negotiated Rate	$37,584.30
Rate for Payer: AlohaCare Medicare	$28,657.25
Rate for Payer: Devoted Health Medicare	$31,522.97
Rate for Payer: Hawaii Medical Service Association Commercial	$28,325.72
Rate for Payer: Hawaii Medical Service Association Medicare	$28,657.25
Rate for Payer: Humana Medicare	$28,657.25
Rate for Payer: Kaiser Permanente Commercial	$37,584.30
Rate for Payer: Kaiser Permanente Medicare	$28,657.25
Rate for Payer: Ohana Health Plan Medicare	$28,657.25
Rate for Payer: UnitedHealthcare Medicare	$28,657.25

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC

Facility

$64,287.30

Service Code	MSDRG 628
Min. Negotiated Rate	$39,872.98
Max. Negotiated Rate	$64,287.30
Rate for Payer: AlohaCare Medicare	$49,017.73
Rate for Payer: Devoted Health Medicare	$53,919.50
Rate for Payer: Hawaii Medical Service Association Commercial	$39,872.98
Rate for Payer: Hawaii Medical Service Association Medicare	$49,017.73
Rate for Payer: Humana Medicare	$49,017.73
Rate for Payer: Kaiser Permanente Commercial	$64,287.30
Rate for Payer: Kaiser Permanente Medicare	$49,017.73
Rate for Payer: Ohana Health Plan Medicare	$49,017.73
Rate for Payer: UnitedHealthcare Medicare	$49,017.73

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC

Facility

$26,951.63

Service Code	MSDRG 630
Min. Negotiated Rate	$19,196.46
Max. Negotiated Rate	$26,951.63
Rate for Payer: AlohaCare Medicare	$19,196.46
Rate for Payer: Devoted Health Medicare	$21,116.11
Rate for Payer: Hawaii Medical Service Association Commercial	$26,951.63
Rate for Payer: Hawaii Medical Service Association Medicare	$19,196.46
Rate for Payer: Humana Medicare	$19,196.46
Rate for Payer: Kaiser Permanente Commercial	$25,176.38
Rate for Payer: Kaiser Permanente Medicare	$19,196.46
Rate for Payer: Ohana Health Plan Medicare	$19,196.46
Rate for Payer: UnitedHealthcare Medicare	$19,196.46

OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC

Facility

$134,420.63

Service Code	MSDRG 319
Min. Negotiated Rate	$58,699.48
Max. Negotiated Rate	$134,420.63
Rate for Payer: AlohaCare Medicare	$58,699.48
Rate for Payer: Devoted Health Medicare	$64,569.43
Rate for Payer: Hawaii Medical Service Association Commercial	$134,420.63
Rate for Payer: Hawaii Medical Service Association Medicare	$58,699.48
Rate for Payer: Humana Medicare	$58,699.48
Rate for Payer: Kaiser Permanente Commercial	$76,985.02
Rate for Payer: Kaiser Permanente Medicare	$58,699.48
Rate for Payer: Ohana Health Plan Medicare	$58,699.48
Rate for Payer: UnitedHealthcare Medicare	$58,699.48

OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC

Facility

$134,420.63

Service Code	MSDRG 320
Min. Negotiated Rate	$31,636.34
Max. Negotiated Rate	$134,420.63
Rate for Payer: AlohaCare Medicare	$31,636.34
Rate for Payer: Devoted Health Medicare	$34,799.97
Rate for Payer: Hawaii Medical Service Association Commercial	$134,420.63
Rate for Payer: Hawaii Medical Service Association Medicare	$31,636.34
Rate for Payer: Humana Medicare	$31,636.34
Rate for Payer: Kaiser Permanente Commercial	$41,491.43
Rate for Payer: Kaiser Permanente Medicare	$31,636.34
Rate for Payer: Ohana Health Plan Medicare	$31,636.34
Rate for Payer: UnitedHealthcare Medicare	$31,636.34

OTHER ESOPHAGEAL DISORDERS

Facility

$2,586.06

Service Code	APR-DRG 2431
Min. Negotiated Rate	$2,586.06
Max. Negotiated Rate	$2,586.06
Rate for Payer: AlohaCare Medicaid	$2,586.06
Rate for Payer: Hawaii Medical Service Association ABD	$2,586.06
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,586.06
Rate for Payer: Kaiser Permanente Medicaid	$2,586.06
Rate for Payer: Ohana Health Plan Medicaid	$2,586.06
Rate for Payer: UnitedHealthcare Medicaid	$2,586.06

OTHER ESOPHAGEAL DISORDERS

Facility

$3,413.90

Service Code	APR-DRG 2432
Min. Negotiated Rate	$3,413.90
Max. Negotiated Rate	$3,413.90
Rate for Payer: AlohaCare Medicaid	$3,413.90
Rate for Payer: Hawaii Medical Service Association ABD	$3,413.90
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,413.90
Rate for Payer: Kaiser Permanente Medicaid	$3,413.90
Rate for Payer: Ohana Health Plan Medicaid	$3,413.90
Rate for Payer: UnitedHealthcare Medicaid	$3,413.90

OTHER ESOPHAGEAL DISORDERS

Facility

$5,027.56

Service Code	APR-DRG 2433
Min. Negotiated Rate	$5,027.56
Max. Negotiated Rate	$5,027.56
Rate for Payer: AlohaCare Medicaid	$5,027.56
Rate for Payer: Hawaii Medical Service Association ABD	$5,027.56
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,027.56
Rate for Payer: Kaiser Permanente Medicaid	$5,027.56
Rate for Payer: Ohana Health Plan Medicaid	$5,027.56
Rate for Payer: UnitedHealthcare Medicaid	$5,027.56

OTHER ESOPHAGEAL DISORDERS

Facility

$9,797.85

Service Code	APR-DRG 2434
Min. Negotiated Rate	$9,797.85
Max. Negotiated Rate	$9,797.85
Rate for Payer: UnitedHealthcare Medicaid	$9,797.85
Rate for Payer: AlohaCare Medicaid	$9,797.85
Rate for Payer: Hawaii Medical Service Association ABD	$9,797.85
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,797.85
Rate for Payer: Kaiser Permanente Medicaid	$9,797.85
Rate for Payer: Ohana Health Plan Medicaid	$9,797.85

OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$11,619.57

Service Code	MSDRG 951
Min. Negotiated Rate	$7,312.94
Max. Negotiated Rate	$11,619.57
Rate for Payer: AlohaCare Medicare	$7,312.94
Rate for Payer: Devoted Health Medicare	$8,044.23
Rate for Payer: Hawaii Medical Service Association Commercial	$11,619.57
Rate for Payer: Hawaii Medical Service Association Medicare	$7,312.94
Rate for Payer: Humana Medicare	$7,312.94
Rate for Payer: Kaiser Permanente Commercial	$9,591.00
Rate for Payer: Kaiser Permanente Medicare	$7,312.94
Rate for Payer: Ohana Health Plan Medicare	$7,312.94
Rate for Payer: UnitedHealthcare Medicare	$7,312.94

OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC

Facility

$44,291.10

Service Code	MSDRG 749
Min. Negotiated Rate	$33,629.26
Max. Negotiated Rate	$44,291.10
Rate for Payer: AlohaCare Medicare	$33,771.03
Rate for Payer: Devoted Health Medicare	$37,148.13
Rate for Payer: Hawaii Medical Service Association Commercial	$33,629.26
Rate for Payer: Hawaii Medical Service Association Medicare	$33,771.03
Rate for Payer: Humana Medicare	$33,771.03
Rate for Payer: Kaiser Permanente Commercial	$44,291.10
Rate for Payer: Kaiser Permanente Medicare	$33,771.03
Rate for Payer: Ohana Health Plan Medicare	$33,771.03
Rate for Payer: UnitedHealthcare Medicare	$33,771.03

OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$33,629.26

Service Code	MSDRG 750
Min. Negotiated Rate	$19,410.85
Max. Negotiated Rate	$33,629.26
Rate for Payer: AlohaCare Medicare	$19,410.85
Rate for Payer: Devoted Health Medicare	$21,351.94
Rate for Payer: Hawaii Medical Service Association Commercial	$33,629.26
Rate for Payer: Hawaii Medical Service Association Medicare	$19,410.85
Rate for Payer: Humana Medicare	$19,410.85
Rate for Payer: Kaiser Permanente Commercial	$25,457.55
Rate for Payer: Kaiser Permanente Medicare	$19,410.85
Rate for Payer: Ohana Health Plan Medicare	$19,410.85
Rate for Payer: UnitedHealthcare Medicare	$19,410.85

OTHER FEMALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES

Facility

$9,912.48

Service Code	APR-DRG 5183
Min. Negotiated Rate	$9,912.48
Max. Negotiated Rate	$9,912.48
Rate for Payer: AlohaCare Medicaid	$9,912.48
Rate for Payer: Hawaii Medical Service Association ABD	$9,912.48
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,912.48
Rate for Payer: Kaiser Permanente Medicaid	$9,912.48
Rate for Payer: Ohana Health Plan Medicaid	$9,912.48
Rate for Payer: UnitedHealthcare Medicaid	$9,912.48

OTHER FEMALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES

Facility

$5,778.35

Service Code	APR-DRG 5182
Min. Negotiated Rate	$5,778.35
Max. Negotiated Rate	$5,778.35
Rate for Payer: AlohaCare Medicaid	$5,778.35
Rate for Payer: Hawaii Medical Service Association ABD	$5,778.35
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,778.35
Rate for Payer: Kaiser Permanente Medicaid	$5,778.35
Rate for Payer: Ohana Health Plan Medicaid	$5,778.35
Rate for Payer: UnitedHealthcare Medicaid	$5,778.35

OTHER FEMALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES

Facility

$3,894.69

Service Code	APR-DRG 5181
Min. Negotiated Rate	$3,894.69
Max. Negotiated Rate	$3,894.69
Rate for Payer: AlohaCare Medicaid	$3,894.69
Rate for Payer: Hawaii Medical Service Association ABD	$3,894.69
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,894.69
Rate for Payer: Kaiser Permanente Medicaid	$3,894.69
Rate for Payer: Ohana Health Plan Medicaid	$3,894.69
Rate for Payer: UnitedHealthcare Medicaid	$3,894.69

OTHER FEMALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES

Facility

$19,216.80

Service Code	APR-DRG 5184
Min. Negotiated Rate	$19,216.80
Max. Negotiated Rate	$19,216.80
Rate for Payer: AlohaCare Medicaid	$19,216.80
Rate for Payer: Hawaii Medical Service Association ABD	$19,216.80
Rate for Payer: Hawaii Medical Service Association Non-ABD	$19,216.80
Rate for Payer: Kaiser Permanente Medicaid	$19,216.80
Rate for Payer: Ohana Health Plan Medicaid	$19,216.80
Rate for Payer: UnitedHealthcare Medicaid	$19,216.80

OTHER GASTROENTERITIS, NAUSEA & VOMITING

Facility

$2,860.52

Service Code	APR-DRG 2492
Min. Negotiated Rate	$2,860.52
Max. Negotiated Rate	$2,860.52
Rate for Payer: AlohaCare Medicaid	$2,860.52
Rate for Payer: Hawaii Medical Service Association ABD	$2,860.52
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,860.52
Rate for Payer: Kaiser Permanente Medicaid	$2,860.52
Rate for Payer: Ohana Health Plan Medicaid	$2,860.52
Rate for Payer: UnitedHealthcare Medicaid	$2,860.52

OTHER GASTROENTERITIS, NAUSEA & VOMITING

Facility

$4,113.75

Service Code	APR-DRG 2493
Min. Negotiated Rate	$4,113.75
Max. Negotiated Rate	$4,113.75
Rate for Payer: AlohaCare Medicaid	$4,113.75
Rate for Payer: Hawaii Medical Service Association ABD	$4,113.75
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,113.75
Rate for Payer: Kaiser Permanente Medicaid	$4,113.75
Rate for Payer: Ohana Health Plan Medicaid	$4,113.75
Rate for Payer: UnitedHealthcare Medicaid	$4,113.75

OTHER GASTROENTERITIS, NAUSEA & VOMITING

Facility

$7,814.21

Service Code	APR-DRG 2494
Min. Negotiated Rate	$7,814.21
Max. Negotiated Rate	$7,814.21
Rate for Payer: AlohaCare Medicaid	$7,814.21
Rate for Payer: Hawaii Medical Service Association ABD	$7,814.21
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,814.21
Rate for Payer: Kaiser Permanente Medicaid	$7,814.21
Rate for Payer: Ohana Health Plan Medicaid	$7,814.21
Rate for Payer: UnitedHealthcare Medicaid	$7,814.21

OTHER GASTROENTERITIS, NAUSEA & VOMITING

Facility

$2,300.77

Service Code	APR-DRG 2491
Min. Negotiated Rate	$2,300.77
Max. Negotiated Rate	$2,300.77
Rate for Payer: AlohaCare Medicaid	$2,300.77
Rate for Payer: Hawaii Medical Service Association ABD	$2,300.77
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,300.77
Rate for Payer: Kaiser Permanente Medicaid	$2,300.77
Rate for Payer: Ohana Health Plan Medicaid	$2,300.77
Rate for Payer: UnitedHealthcare Medicaid	$2,300.77

OTHER HEART ASSIST SYSTEM IMPLANT

Facility

$173,546.29

Service Code	MSDRG 215
Min. Negotiated Rate	$130,962.09
Max. Negotiated Rate	$173,546.29
Rate for Payer: AlohaCare Medicare	$130,962.09
Rate for Payer: Devoted Health Medicare	$144,058.30
Rate for Payer: Hawaii Medical Service Association Commercial	$173,546.29
Rate for Payer: Hawaii Medical Service Association Medicare	$130,962.09
Rate for Payer: Humana Medicare	$130,962.09
Rate for Payer: Kaiser Permanente Commercial	$171,758.25
Rate for Payer: Kaiser Permanente Medicare	$130,962.09
Rate for Payer: Ohana Health Plan Medicare	$130,962.09
Rate for Payer: UnitedHealthcare Medicare	$130,962.09

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC

Facility

$98,477.10

Service Code	MSDRG 424
Min. Negotiated Rate	$28,776.93
Max. Negotiated Rate	$98,477.10
Rate for Payer: AlohaCare Medicare	$28,776.93
Rate for Payer: Devoted Health Medicare	$31,654.62
Rate for Payer: Hawaii Medical Service Association Commercial	$98,477.10
Rate for Payer: Hawaii Medical Service Association Medicare	$28,776.93
Rate for Payer: Humana Medicare	$28,776.93
Rate for Payer: Kaiser Permanente Commercial	$37,741.28
Rate for Payer: Kaiser Permanente Medicare	$28,776.93
Rate for Payer: Ohana Health Plan Medicare	$28,776.93
Rate for Payer: UnitedHealthcare Medicare	$28,776.93

Know your out-of-pocket cost for care.

All Charges