Kona Community Hospital

All Charges

Charge

Type

Setting

Price

OTHER MENTAL DISORDER DIAGNOSES

Facility

$37,100.67

Service Code	MSDRG 887
Min. Negotiated Rate	$14,085.30
Max. Negotiated Rate	$37,100.67
Rate for Payer: AlohaCare Medicare	$14,085.30
Rate for Payer: Devoted Health Medicare	$15,493.83
Rate for Payer: Hawaii Medical Service Association Commercial	$37,100.67
Rate for Payer: Hawaii Medical Service Association Medicare	$14,085.30
Rate for Payer: Humana Medicare	$14,085.30
Rate for Payer: Kaiser Permanente Commercial	$18,473.03
Rate for Payer: Kaiser Permanente Medicare	$14,085.30
Rate for Payer: Ohana Health Plan Medicare	$14,085.30
Rate for Payer: UnitedHealthcare Medicare	$14,085.30

OTHER MENTAL HEALTH DISORDERS

Facility

$2,887.55

Service Code	APR-DRG 7601
Min. Negotiated Rate	$2,887.55
Max. Negotiated Rate	$2,887.55
Rate for Payer: AlohaCare Medicaid	$2,887.55
Rate for Payer: Hawaii Medical Service Association ABD	$2,887.55
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,887.55
Rate for Payer: Kaiser Permanente Medicaid	$2,887.55
Rate for Payer: Ohana Health Plan Medicaid	$2,887.55
Rate for Payer: UnitedHealthcare Medicaid	$2,887.55

OTHER MENTAL HEALTH DISORDERS

Facility

$10,215.91

Service Code	APR-DRG 7604
Min. Negotiated Rate	$10,215.91
Max. Negotiated Rate	$10,215.91
Rate for Payer: AlohaCare Medicaid	$10,215.91
Rate for Payer: Hawaii Medical Service Association ABD	$10,215.91
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10,215.91
Rate for Payer: Kaiser Permanente Medicaid	$10,215.91
Rate for Payer: Ohana Health Plan Medicaid	$10,215.91
Rate for Payer: UnitedHealthcare Medicaid	$10,215.91

OTHER MENTAL HEALTH DISORDERS

Facility

$5,988.94

Service Code	APR-DRG 7603
Min. Negotiated Rate	$5,988.94
Max. Negotiated Rate	$5,988.94
Rate for Payer: AlohaCare Medicaid	$5,988.94
Rate for Payer: Hawaii Medical Service Association ABD	$5,988.94
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,988.94
Rate for Payer: Kaiser Permanente Medicaid	$5,988.94
Rate for Payer: Ohana Health Plan Medicaid	$5,988.94
Rate for Payer: UnitedHealthcare Medicaid	$5,988.94

OTHER MENTAL HEALTH DISORDERS

Facility

$3,997.75

Service Code	APR-DRG 7602
Min. Negotiated Rate	$3,997.75
Max. Negotiated Rate	$3,997.75
Rate for Payer: AlohaCare Medicaid	$3,997.75
Rate for Payer: Hawaii Medical Service Association ABD	$3,997.75
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,997.75
Rate for Payer: Kaiser Permanente Medicaid	$3,997.75
Rate for Payer: Ohana Health Plan Medicaid	$3,997.75
Rate for Payer: UnitedHealthcare Medicaid	$3,997.75

OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC

Facility

$42,645.28

Service Code	MSDRG 964
Min. Negotiated Rate	$20,157.91
Max. Negotiated Rate	$42,645.28
Rate for Payer: AlohaCare Medicare	$20,157.91
Rate for Payer: Devoted Health Medicare	$22,173.70
Rate for Payer: Hawaii Medical Service Association Commercial	$42,645.28
Rate for Payer: Hawaii Medical Service Association Medicare	$20,157.91
Rate for Payer: Humana Medicare	$20,157.91
Rate for Payer: Kaiser Permanente Commercial	$26,437.35
Rate for Payer: Kaiser Permanente Medicare	$20,157.91
Rate for Payer: Ohana Health Plan Medicare	$20,157.91
Rate for Payer: UnitedHealthcare Medicare	$20,157.91

OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC

Facility

$47,158.05

Service Code	MSDRG 963
Min. Negotiated Rate	$35,957.04
Max. Negotiated Rate	$47,158.05
Rate for Payer: AlohaCare Medicare	$35,957.04
Rate for Payer: Devoted Health Medicare	$39,552.74
Rate for Payer: Hawaii Medical Service Association Commercial	$42,645.28
Rate for Payer: Hawaii Medical Service Association Medicare	$35,957.04
Rate for Payer: Humana Medicare	$35,957.04
Rate for Payer: Kaiser Permanente Commercial	$47,158.05
Rate for Payer: Kaiser Permanente Medicare	$35,957.04
Rate for Payer: Ohana Health Plan Medicare	$35,957.04
Rate for Payer: UnitedHealthcare Medicare	$35,957.04

OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC

Facility

$42,645.28

Service Code	MSDRG 965
Min. Negotiated Rate	$12,370.17
Max. Negotiated Rate	$42,645.28
Rate for Payer: AlohaCare Medicare	$12,370.17
Rate for Payer: Devoted Health Medicare	$13,607.19
Rate for Payer: Hawaii Medical Service Association Commercial	$42,645.28
Rate for Payer: Hawaii Medical Service Association Medicare	$12,370.17
Rate for Payer: Humana Medicare	$12,370.17
Rate for Payer: Kaiser Permanente Commercial	$16,223.62
Rate for Payer: Kaiser Permanente Medicare	$12,370.17
Rate for Payer: Ohana Health Plan Medicare	$12,370.17
Rate for Payer: UnitedHealthcare Medicare	$12,370.17

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC

Facility

$16,971.33

Service Code	MSDRG 565
Min. Negotiated Rate	$12,816.05
Max. Negotiated Rate	$16,971.33
Rate for Payer: AlohaCare Medicare	$12,816.05
Rate for Payer: Devoted Health Medicare	$14,097.66
Rate for Payer: Hawaii Medical Service Association Commercial	$16,971.33
Rate for Payer: Hawaii Medical Service Association Medicare	$12,816.05
Rate for Payer: Humana Medicare	$12,816.05
Rate for Payer: Kaiser Permanente Commercial	$16,808.40
Rate for Payer: Kaiser Permanente Medicare	$12,816.05
Rate for Payer: Ohana Health Plan Medicare	$12,816.05
Rate for Payer: UnitedHealthcare Medicare	$12,816.05

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC

Facility

$26,627.10

Service Code	MSDRG 564
Min. Negotiated Rate	$16,971.33
Max. Negotiated Rate	$26,627.10
Rate for Payer: AlohaCare Medicare	$20,302.60
Rate for Payer: Devoted Health Medicare	$22,332.86
Rate for Payer: Hawaii Medical Service Association Commercial	$16,971.33
Rate for Payer: Hawaii Medical Service Association Medicare	$20,302.60
Rate for Payer: Humana Medicare	$20,302.60
Rate for Payer: Kaiser Permanente Commercial	$26,627.10
Rate for Payer: Kaiser Permanente Medicare	$20,302.60
Rate for Payer: Ohana Health Plan Medicare	$20,302.60
Rate for Payer: UnitedHealthcare Medicare	$20,302.60

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC

Facility

$16,971.33

Service Code	MSDRG 566
Min. Negotiated Rate	$9,855.37
Max. Negotiated Rate	$16,971.33
Rate for Payer: AlohaCare Medicare	$9,855.37
Rate for Payer: Devoted Health Medicare	$10,840.91
Rate for Payer: Hawaii Medical Service Association Commercial	$16,971.33
Rate for Payer: Hawaii Medical Service Association Medicare	$9,855.37
Rate for Payer: Humana Medicare	$9,855.37
Rate for Payer: Kaiser Permanente Commercial	$12,925.42
Rate for Payer: Kaiser Permanente Medicare	$9,855.37
Rate for Payer: Ohana Health Plan Medicare	$9,855.37
Rate for Payer: UnitedHealthcare Medicare	$9,855.37

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC

Facility

$62,485.34

Service Code	MSDRG 516
Min. Negotiated Rate	$27,332.77
Max. Negotiated Rate	$62,485.34
Rate for Payer: AlohaCare Medicare	$27,332.77
Rate for Payer: Devoted Health Medicare	$30,066.05
Rate for Payer: Hawaii Medical Service Association Commercial	$62,485.34
Rate for Payer: Hawaii Medical Service Association Medicare	$27,332.77
Rate for Payer: Humana Medicare	$27,332.77
Rate for Payer: Kaiser Permanente Commercial	$35,847.22
Rate for Payer: Kaiser Permanente Medicare	$27,332.77
Rate for Payer: Ohana Health Plan Medicare	$27,332.77
Rate for Payer: UnitedHealthcare Medicare	$27,332.77

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC

Facility

$62,485.34

Service Code	MSDRG 515
Min. Negotiated Rate	$41,916.56
Max. Negotiated Rate	$62,485.34
Rate for Payer: AlohaCare Medicare	$41,916.56
Rate for Payer: Devoted Health Medicare	$46,108.22
Rate for Payer: Hawaii Medical Service Association Commercial	$62,485.34
Rate for Payer: Hawaii Medical Service Association Medicare	$41,916.56
Rate for Payer: Humana Medicare	$41,916.56
Rate for Payer: Kaiser Permanente Commercial	$54,974.03
Rate for Payer: Kaiser Permanente Medicare	$41,916.56
Rate for Payer: Ohana Health Plan Medicare	$41,916.56
Rate for Payer: UnitedHealthcare Medicare	$41,916.56

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC

Facility

$34,665.87

Service Code	MSDRG 517
Min. Negotiated Rate	$20,211.86
Max. Negotiated Rate	$34,665.87
Rate for Payer: AlohaCare Medicare	$20,211.86
Rate for Payer: Devoted Health Medicare	$22,233.05
Rate for Payer: Hawaii Medical Service Association Commercial	$34,665.87
Rate for Payer: Hawaii Medical Service Association Medicare	$20,211.86
Rate for Payer: Humana Medicare	$20,211.86
Rate for Payer: Kaiser Permanente Commercial	$26,508.08
Rate for Payer: Kaiser Permanente Medicare	$20,211.86
Rate for Payer: Ohana Health Plan Medicare	$20,211.86
Rate for Payer: UnitedHealthcare Medicare	$20,211.86

OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES

Facility

$3,218.40

Service Code	APR-DRG 3512
Min. Negotiated Rate	$3,218.40
Max. Negotiated Rate	$3,218.40
Rate for Payer: AlohaCare Medicaid	$3,218.40
Rate for Payer: Hawaii Medical Service Association ABD	$3,218.40
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,218.40
Rate for Payer: Kaiser Permanente Medicaid	$3,218.40
Rate for Payer: Ohana Health Plan Medicaid	$3,218.40
Rate for Payer: UnitedHealthcare Medicaid	$3,218.40

OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES

Facility

$8,872.58

Service Code	APR-DRG 3514
Min. Negotiated Rate	$8,872.58
Max. Negotiated Rate	$8,872.58
Rate for Payer: AlohaCare Medicaid	$8,872.58
Rate for Payer: Hawaii Medical Service Association ABD	$8,872.58
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,872.58
Rate for Payer: Kaiser Permanente Medicaid	$8,872.58
Rate for Payer: Ohana Health Plan Medicaid	$8,872.58
Rate for Payer: UnitedHealthcare Medicaid	$8,872.58

OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES

Facility

$4,881.09

Service Code	APR-DRG 3513
Min. Negotiated Rate	$4,881.09
Max. Negotiated Rate	$4,881.09
Rate for Payer: AlohaCare Medicaid	$4,881.09
Rate for Payer: Hawaii Medical Service Association ABD	$4,881.09
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,881.09
Rate for Payer: Kaiser Permanente Medicaid	$4,881.09
Rate for Payer: Ohana Health Plan Medicaid	$4,881.09
Rate for Payer: UnitedHealthcare Medicaid	$4,881.09

OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES

Facility

$2,500.73

Service Code	APR-DRG 3511
Min. Negotiated Rate	$2,500.73
Max. Negotiated Rate	$2,500.73
Rate for Payer: AlohaCare Medicaid	$2,500.73
Rate for Payer: Hawaii Medical Service Association ABD	$2,500.73
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,500.73
Rate for Payer: Kaiser Permanente Medicaid	$2,500.73
Rate for Payer: Ohana Health Plan Medicaid	$2,500.73
Rate for Payer: UnitedHealthcare Medicaid	$2,500.73

OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE PROCEDURES

Facility

$10,615.51

Service Code	APR-DRG 3203
Min. Negotiated Rate	$10,615.51
Max. Negotiated Rate	$10,615.51
Rate for Payer: AlohaCare Medicaid	$10,615.51
Rate for Payer: Hawaii Medical Service Association ABD	$10,615.51
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10,615.51
Rate for Payer: Kaiser Permanente Medicaid	$10,615.51
Rate for Payer: Ohana Health Plan Medicaid	$10,615.51
Rate for Payer: UnitedHealthcare Medicaid	$10,615.51

OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE PROCEDURES

Facility

$5,398.18

Service Code	APR-DRG 3201
Min. Negotiated Rate	$5,398.18
Max. Negotiated Rate	$5,398.18
Rate for Payer: AlohaCare Medicaid	$5,398.18
Rate for Payer: Hawaii Medical Service Association ABD	$5,398.18
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,398.18
Rate for Payer: Kaiser Permanente Medicaid	$5,398.18
Rate for Payer: Ohana Health Plan Medicaid	$5,398.18
Rate for Payer: UnitedHealthcare Medicaid	$5,398.18

OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE PROCEDURES

Facility

$7,372.27

Service Code	APR-DRG 3202
Min. Negotiated Rate	$7,372.27
Max. Negotiated Rate	$7,372.27
Rate for Payer: AlohaCare Medicaid	$7,372.27
Rate for Payer: Hawaii Medical Service Association ABD	$7,372.27
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,372.27
Rate for Payer: Kaiser Permanente Medicaid	$7,372.27
Rate for Payer: Ohana Health Plan Medicaid	$7,372.27
Rate for Payer: UnitedHealthcare Medicaid	$7,372.27

OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE PROCEDURES

Facility

$18,087.12

Service Code	APR-DRG 3204
Min. Negotiated Rate	$18,087.12
Max. Negotiated Rate	$18,087.12
Rate for Payer: AlohaCare Medicaid	$18,087.12
Rate for Payer: Hawaii Medical Service Association ABD	$18,087.12
Rate for Payer: Hawaii Medical Service Association Non-ABD	$18,087.12
Rate for Payer: Kaiser Permanente Medicaid	$18,087.12
Rate for Payer: Ohana Health Plan Medicaid	$18,087.12
Rate for Payer: UnitedHealthcare Medicaid	$18,087.12

OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC

Facility

$42,331.89

Service Code	MSDRG 844
Min. Negotiated Rate	$16,012.17
Max. Negotiated Rate	$42,331.89
Rate for Payer: AlohaCare Medicare	$16,012.17
Rate for Payer: Devoted Health Medicare	$17,613.39
Rate for Payer: Hawaii Medical Service Association Commercial	$42,331.89
Rate for Payer: Hawaii Medical Service Association Medicare	$16,012.17
Rate for Payer: Humana Medicare	$16,012.17
Rate for Payer: Kaiser Permanente Commercial	$21,000.15
Rate for Payer: Kaiser Permanente Medicare	$16,012.17
Rate for Payer: Ohana Health Plan Medicare	$16,012.17
Rate for Payer: UnitedHealthcare Medicare	$16,012.17

OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC

Facility

$46,839.90

Service Code	MSDRG 843
Min. Negotiated Rate	$26,237.16
Max. Negotiated Rate	$46,839.90
Rate for Payer: AlohaCare Medicare	$26,237.16
Rate for Payer: Devoted Health Medicare	$28,860.88
Rate for Payer: Hawaii Medical Service Association Commercial	$46,839.90
Rate for Payer: Hawaii Medical Service Association Medicare	$26,237.16
Rate for Payer: Humana Medicare	$26,237.16
Rate for Payer: Kaiser Permanente Commercial	$34,410.30
Rate for Payer: Kaiser Permanente Medicare	$26,237.16
Rate for Payer: Ohana Health Plan Medicare	$26,237.16
Rate for Payer: UnitedHealthcare Medicare	$26,237.16

OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC

Facility

$42,331.89

Service Code	MSDRG 845
Min. Negotiated Rate	$11,200.90
Max. Negotiated Rate	$42,331.89
Rate for Payer: AlohaCare Medicare	$11,200.90
Rate for Payer: Devoted Health Medicare	$12,320.99
Rate for Payer: Hawaii Medical Service Association Commercial	$42,331.89
Rate for Payer: Hawaii Medical Service Association Medicare	$11,200.90
Rate for Payer: Humana Medicare	$11,200.90
Rate for Payer: Kaiser Permanente Commercial	$14,690.10
Rate for Payer: Kaiser Permanente Medicare	$11,200.90
Rate for Payer: Ohana Health Plan Medicare	$11,200.90
Rate for Payer: UnitedHealthcare Medicare	$11,200.90

Know your out-of-pocket cost for care.

All Charges