Kona Community Hospital

All Charges

Charge

Type

Setting

Price

OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$8,347.21

Service Code	APR-DRG 4684
Min. Negotiated Rate	$8,347.21
Max. Negotiated Rate	$8,347.21
Rate for Payer: AlohaCare Medicaid	$8,347.21
Rate for Payer: Hawaii Medical Service Association ABD	$8,347.21
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,347.21
Rate for Payer: Kaiser Permanente Medicaid	$8,347.21
Rate for Payer: Ohana Health Plan Medicaid	$8,347.21
Rate for Payer: UnitedHealthcare Medicaid	$8,347.21

OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$3,247.70

Service Code	APR-DRG 4682
Min. Negotiated Rate	$3,247.70
Max. Negotiated Rate	$3,247.70
Rate for Payer: AlohaCare Medicaid	$3,247.70
Rate for Payer: Hawaii Medical Service Association ABD	$3,247.70
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,247.70
Rate for Payer: Kaiser Permanente Medicaid	$3,247.70
Rate for Payer: Ohana Health Plan Medicaid	$3,247.70
Rate for Payer: UnitedHealthcare Medicaid	$3,247.70

OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$2,428.77

Service Code	APR-DRG 4681
Min. Negotiated Rate	$2,428.77
Max. Negotiated Rate	$2,428.77
Rate for Payer: AlohaCare Medicaid	$2,428.77
Rate for Payer: Hawaii Medical Service Association ABD	$2,428.77
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,428.77
Rate for Payer: Kaiser Permanente Medicaid	$2,428.77
Rate for Payer: Ohana Health Plan Medicaid	$2,428.77
Rate for Payer: UnitedHealthcare Medicaid	$2,428.77

OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$4,672.22

Service Code	APR-DRG 4683
Min. Negotiated Rate	$4,672.22
Max. Negotiated Rate	$4,672.22
Rate for Payer: AlohaCare Medicaid	$4,672.22
Rate for Payer: Hawaii Medical Service Association ABD	$4,672.22
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,672.22
Rate for Payer: Kaiser Permanente Medicaid	$4,672.22
Rate for Payer: Ohana Health Plan Medicaid	$4,672.22
Rate for Payer: UnitedHealthcare Medicaid	$4,672.22

OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES

Facility

$22,308.48

Service Code	APR-DRG 4474
Min. Negotiated Rate	$22,308.48
Max. Negotiated Rate	$22,308.48
Rate for Payer: AlohaCare Medicaid	$22,308.48
Rate for Payer: Hawaii Medical Service Association ABD	$22,308.48
Rate for Payer: Hawaii Medical Service Association Non-ABD	$22,308.48
Rate for Payer: Kaiser Permanente Medicaid	$22,308.48
Rate for Payer: Ohana Health Plan Medicaid	$22,308.48
Rate for Payer: UnitedHealthcare Medicaid	$22,308.48

OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES

Facility

$6,536.15

Service Code	APR-DRG 4471
Min. Negotiated Rate	$6,536.15
Max. Negotiated Rate	$6,536.15
Rate for Payer: AlohaCare Medicaid	$6,536.15
Rate for Payer: Hawaii Medical Service Association ABD	$6,536.15
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6,536.15
Rate for Payer: Kaiser Permanente Medicaid	$6,536.15
Rate for Payer: Ohana Health Plan Medicaid	$6,536.15
Rate for Payer: UnitedHealthcare Medicaid	$6,536.15

OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES

Facility

$10,453.12

Service Code	APR-DRG 4473
Min. Negotiated Rate	$10,453.12
Max. Negotiated Rate	$10,453.12
Rate for Payer: AlohaCare Medicaid	$10,453.12
Rate for Payer: Hawaii Medical Service Association ABD	$10,453.12
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10,453.12
Rate for Payer: Kaiser Permanente Medicaid	$10,453.12
Rate for Payer: Ohana Health Plan Medicaid	$10,453.12
Rate for Payer: UnitedHealthcare Medicaid	$10,453.12

OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES

Facility

$7,704.04

Service Code	APR-DRG 4472
Min. Negotiated Rate	$7,704.04
Max. Negotiated Rate	$7,704.04
Rate for Payer: AlohaCare Medicaid	$7,704.04
Rate for Payer: Hawaii Medical Service Association ABD	$7,704.04
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,704.04
Rate for Payer: Kaiser Permanente Medicaid	$7,704.04
Rate for Payer: Ohana Health Plan Medicaid	$7,704.04
Rate for Payer: UnitedHealthcare Medicaid	$7,704.04

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC

Facility

$97,681.56

Service Code	MSDRG 271
Min. Negotiated Rate	$46,775.17
Max. Negotiated Rate	$97,681.56
Rate for Payer: AlohaCare Medicare	$46,775.17
Rate for Payer: Devoted Health Medicare	$51,452.69
Rate for Payer: Hawaii Medical Service Association Commercial	$97,681.56
Rate for Payer: Hawaii Medical Service Association Medicare	$46,775.17
Rate for Payer: Humana Medicare	$46,775.17
Rate for Payer: Kaiser Permanente Commercial	$61,346.18
Rate for Payer: Kaiser Permanente Medicare	$46,775.17
Rate for Payer: Ohana Health Plan Medicare	$46,775.17
Rate for Payer: UnitedHealthcare Medicare	$46,775.17

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC

Facility

$113,182.37

Service Code	MSDRG 270
Min. Negotiated Rate	$69,397.93
Max. Negotiated Rate	$113,182.37
Rate for Payer: AlohaCare Medicare	$69,397.93
Rate for Payer: Devoted Health Medicare	$76,337.72
Rate for Payer: Hawaii Medical Service Association Commercial	$113,182.37
Rate for Payer: Hawaii Medical Service Association Medicare	$69,397.93
Rate for Payer: Humana Medicare	$69,397.93
Rate for Payer: Kaiser Permanente Commercial	$91,016.18
Rate for Payer: Kaiser Permanente Medicare	$69,397.93
Rate for Payer: Ohana Health Plan Medicare	$69,397.93
Rate for Payer: UnitedHealthcare Medicare	$69,397.93

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC

Facility

$97,681.56

Service Code	MSDRG 272
Min. Negotiated Rate	$33,579.01
Max. Negotiated Rate	$97,681.56
Rate for Payer: AlohaCare Medicare	$33,579.01
Rate for Payer: Devoted Health Medicare	$36,936.91
Rate for Payer: Hawaii Medical Service Association Commercial	$97,681.56
Rate for Payer: Hawaii Medical Service Association Medicare	$33,579.01
Rate for Payer: Humana Medicare	$33,579.01
Rate for Payer: Kaiser Permanente Commercial	$44,039.25
Rate for Payer: Kaiser Permanente Medicare	$33,579.01
Rate for Payer: Ohana Health Plan Medicare	$33,579.01
Rate for Payer: UnitedHealthcare Medicare	$33,579.01

OTHER MAJOR HEAD & NECK PROCEDURES

Facility

$6,230.48

Service Code	APR-DRG 0911
Min. Negotiated Rate	$6,230.48
Max. Negotiated Rate	$6,230.48
Rate for Payer: AlohaCare Medicaid	$6,230.48
Rate for Payer: Hawaii Medical Service Association ABD	$6,230.48
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6,230.48
Rate for Payer: Kaiser Permanente Medicaid	$6,230.48
Rate for Payer: Ohana Health Plan Medicaid	$6,230.48
Rate for Payer: UnitedHealthcare Medicaid	$6,230.48

OTHER MAJOR HEAD & NECK PROCEDURES

Facility

$17,531.82

Service Code	APR-DRG 0913
Min. Negotiated Rate	$17,531.82
Max. Negotiated Rate	$17,531.82
Rate for Payer: AlohaCare Medicaid	$17,531.82
Rate for Payer: Hawaii Medical Service Association ABD	$17,531.82
Rate for Payer: Hawaii Medical Service Association Non-ABD	$17,531.82
Rate for Payer: Kaiser Permanente Medicaid	$17,531.82
Rate for Payer: Ohana Health Plan Medicaid	$17,531.82
Rate for Payer: UnitedHealthcare Medicaid	$17,531.82

OTHER MAJOR HEAD & NECK PROCEDURES

Facility

$33,192.72

Service Code	APR-DRG 0914
Min. Negotiated Rate	$33,192.72
Max. Negotiated Rate	$33,192.72
Rate for Payer: AlohaCare Medicaid	$33,192.72
Rate for Payer: Hawaii Medical Service Association ABD	$33,192.72
Rate for Payer: Hawaii Medical Service Association Non-ABD	$33,192.72
Rate for Payer: Kaiser Permanente Medicaid	$33,192.72
Rate for Payer: Ohana Health Plan Medicaid	$33,192.72
Rate for Payer: UnitedHealthcare Medicaid	$33,192.72

OTHER MAJOR HEAD & NECK PROCEDURES

Facility

$9,939.86

Service Code	APR-DRG 0912
Min. Negotiated Rate	$9,939.86
Max. Negotiated Rate	$9,939.86
Rate for Payer: AlohaCare Medicaid	$9,939.86
Rate for Payer: Hawaii Medical Service Association ABD	$9,939.86
Rate for Payer: Hawaii Medical Service Association Non-ABD	$9,939.86
Rate for Payer: Kaiser Permanente Medicaid	$9,939.86
Rate for Payer: Ohana Health Plan Medicaid	$9,939.86
Rate for Payer: UnitedHealthcare Medicaid	$9,939.86

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC

Facility

$18,262.58

Service Code	MSDRG 729
Min. Negotiated Rate	$13,572.24
Max. Negotiated Rate	$18,262.58
Rate for Payer: AlohaCare Medicare	$13,924.84
Rate for Payer: Devoted Health Medicare	$15,317.32
Rate for Payer: Hawaii Medical Service Association Commercial	$13,572.24
Rate for Payer: Hawaii Medical Service Association Medicare	$13,924.84
Rate for Payer: Humana Medicare	$13,924.84
Rate for Payer: Kaiser Permanente Commercial	$18,262.58
Rate for Payer: Kaiser Permanente Medicare	$13,924.84
Rate for Payer: Ohana Health Plan Medicare	$13,924.84
Rate for Payer: UnitedHealthcare Medicare	$13,924.84

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$13,572.24

Service Code	MSDRG 730
Min. Negotiated Rate	$8,838.65
Max. Negotiated Rate	$13,572.24
Rate for Payer: AlohaCare Medicare	$8,838.65
Rate for Payer: Devoted Health Medicare	$9,722.51
Rate for Payer: Hawaii Medical Service Association Commercial	$13,572.24
Rate for Payer: Hawaii Medical Service Association Medicare	$8,838.65
Rate for Payer: Humana Medicare	$8,838.65
Rate for Payer: Kaiser Permanente Commercial	$11,592.00
Rate for Payer: Kaiser Permanente Medicare	$8,838.65
Rate for Payer: Ohana Health Plan Medicare	$8,838.65
Rate for Payer: UnitedHealthcare Medicare	$8,838.65

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC

Facility

$32,611.12

Service Code	MSDRG 717
Min. Negotiated Rate	$24,865.31
Max. Negotiated Rate	$32,611.12
Rate for Payer: AlohaCare Medicare	$24,865.31
Rate for Payer: Devoted Health Medicare	$27,351.84
Rate for Payer: Hawaii Medical Service Association Commercial	$26,831.09
Rate for Payer: Hawaii Medical Service Association Medicare	$24,865.31
Rate for Payer: Humana Medicare	$24,865.31
Rate for Payer: Kaiser Permanente Commercial	$32,611.12
Rate for Payer: Kaiser Permanente Medicare	$24,865.31
Rate for Payer: Ohana Health Plan Medicare	$24,865.31
Rate for Payer: UnitedHealthcare Medicare	$24,865.31

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC

Facility

$26,831.09

Service Code	MSDRG 718
Min. Negotiated Rate	$17,665.47
Max. Negotiated Rate	$26,831.09
Rate for Payer: AlohaCare Medicare	$17,665.47
Rate for Payer: Devoted Health Medicare	$19,432.02
Rate for Payer: Hawaii Medical Service Association Commercial	$26,831.09
Rate for Payer: Hawaii Medical Service Association Medicare	$17,665.47
Rate for Payer: Humana Medicare	$17,665.47
Rate for Payer: Kaiser Permanente Commercial	$23,168.47
Rate for Payer: Kaiser Permanente Medicare	$17,665.47
Rate for Payer: Ohana Health Plan Medicare	$17,665.47
Rate for Payer: UnitedHealthcare Medicare	$17,665.47

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC

Facility

$42,307.79

Service Code	MSDRG 715
Min. Negotiated Rate	$29,426.69
Max. Negotiated Rate	$42,307.79
Rate for Payer: AlohaCare Medicare	$29,426.69
Rate for Payer: Devoted Health Medicare	$32,369.36
Rate for Payer: Hawaii Medical Service Association Commercial	$42,307.79
Rate for Payer: Hawaii Medical Service Association Medicare	$29,426.69
Rate for Payer: Humana Medicare	$29,426.69
Rate for Payer: Kaiser Permanente Commercial	$38,593.43
Rate for Payer: Kaiser Permanente Medicare	$29,426.69
Rate for Payer: Ohana Health Plan Medicare	$29,426.69
Rate for Payer: UnitedHealthcare Medicare	$29,426.69

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC

Facility

$42,307.79

Service Code	MSDRG 716
Min. Negotiated Rate	$19,347.72
Max. Negotiated Rate	$42,307.79
Rate for Payer: AlohaCare Medicare	$19,347.72
Rate for Payer: Devoted Health Medicare	$21,282.49
Rate for Payer: Hawaii Medical Service Association Commercial	$42,307.79
Rate for Payer: Hawaii Medical Service Association Medicare	$19,347.72
Rate for Payer: Humana Medicare	$19,347.72
Rate for Payer: Kaiser Permanente Commercial	$25,374.75
Rate for Payer: Kaiser Permanente Medicare	$19,347.72
Rate for Payer: Ohana Health Plan Medicare	$19,347.72
Rate for Payer: UnitedHealthcare Medicare	$19,347.72

OTHER MALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES

Facility

$5,632.52

Service Code	APR-DRG 4841
Min. Negotiated Rate	$5,632.52
Max. Negotiated Rate	$5,632.52
Rate for Payer: AlohaCare Medicaid	$5,632.52
Rate for Payer: Hawaii Medical Service Association ABD	$5,632.52
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,632.52
Rate for Payer: Kaiser Permanente Medicaid	$5,632.52
Rate for Payer: Ohana Health Plan Medicaid	$5,632.52
Rate for Payer: UnitedHealthcare Medicaid	$5,632.52

OTHER MALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES

Facility

$19,304.05

Service Code	APR-DRG 4844
Min. Negotiated Rate	$19,304.05
Max. Negotiated Rate	$19,304.05
Rate for Payer: AlohaCare Medicaid	$19,304.05
Rate for Payer: Hawaii Medical Service Association ABD	$19,304.05
Rate for Payer: Hawaii Medical Service Association Non-ABD	$19,304.05
Rate for Payer: Kaiser Permanente Medicaid	$19,304.05
Rate for Payer: Ohana Health Plan Medicaid	$19,304.05
Rate for Payer: UnitedHealthcare Medicaid	$19,304.05

OTHER MALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES

Facility

$7,038.58

Service Code	APR-DRG 4842
Min. Negotiated Rate	$7,038.58
Max. Negotiated Rate	$7,038.58
Rate for Payer: AlohaCare Medicaid	$7,038.58
Rate for Payer: Hawaii Medical Service Association ABD	$7,038.58
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,038.58
Rate for Payer: Kaiser Permanente Medicaid	$7,038.58
Rate for Payer: Ohana Health Plan Medicaid	$7,038.58
Rate for Payer: UnitedHealthcare Medicaid	$7,038.58

OTHER MALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES

Facility

$8,295.00

Service Code	APR-DRG 4843
Min. Negotiated Rate	$8,295.00
Max. Negotiated Rate	$8,295.00
Rate for Payer: AlohaCare Medicaid	$8,295.00
Rate for Payer: Hawaii Medical Service Association ABD	$8,295.00
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,295.00
Rate for Payer: Kaiser Permanente Medicaid	$8,295.00
Rate for Payer: Ohana Health Plan Medicaid	$8,295.00
Rate for Payer: UnitedHealthcare Medicaid	$8,295.00

Know your out-of-pocket cost for care.

All Charges