Kona Community Hospital

All Charges

Charge

Type

Setting

Price

PACLITAXEL PROTEIN-BOUND 100 MG IV SUSR

Facility

$3,014.48

Service Code	HCPCS J9264
Hospital Revenue Code	250
Min. Negotiated Rate	$2,562.31
Max. Negotiated Rate	$2,924.05
Rate for Payer: Cash Price	$1,959.41
Rate for Payer: Health Management Network Commercial	$2,562.31
Rate for Payer: MDX Hawaii PPO	$2,924.05

Palabowl Heraeus Cement Mixing Bowl 5050166 [3645414]

Facility

$388.00

Hospital Charge Code	3645414
Hospital Revenue Code	272
Min. Negotiated Rate	$197.88
Max. Negotiated Rate	$376.36
Rate for Payer: Cash Price	$252.20
Rate for Payer: Hawaii Western Management Group Commercial	$368.60
Rate for Payer: Health Management Network Commercial	$329.80
Rate for Payer: Kaiser Permanente Commercial	$244.44
Rate for Payer: Kaiser Permanente Medicaid	$197.88
Rate for Payer: MDX Hawaii PPO	$376.36
Rate for Payer: University Health Alliance Commercial	$282.81

Palabowl Heraeus Cement Mixing Bowl 5050166 [3645414]

Facility

$388.00

Hospital Charge Code	3645414
Hospital Revenue Code	272
Min. Negotiated Rate	$329.80
Max. Negotiated Rate	$376.36
Rate for Payer: Cash Price	$252.20
Rate for Payer: Health Management Network Commercial	$329.80
Rate for Payer: MDX Hawaii PPO	$376.36

Palajet Heraeus Disp Lavage System 5156831 [3645415]

Facility

$363.00

Hospital Charge Code	3645415
Hospital Revenue Code	272
Min. Negotiated Rate	$185.13
Max. Negotiated Rate	$352.11
Rate for Payer: Cash Price	$235.95
Rate for Payer: Hawaii Western Management Group Commercial	$344.85
Rate for Payer: Health Management Network Commercial	$308.55
Rate for Payer: Kaiser Permanente Commercial	$228.69
Rate for Payer: Kaiser Permanente Medicaid	$185.13
Rate for Payer: MDX Hawaii PPO	$352.11
Rate for Payer: University Health Alliance Commercial	$264.59

Palajet Heraeus Disp Lavage System 5156831 [3645415]

Facility

$363.00

Hospital Charge Code	3645415
Hospital Revenue Code	272
Min. Negotiated Rate	$308.55
Max. Negotiated Rate	$352.11
Rate for Payer: Cash Price	$235.95
Rate for Payer: Health Management Network Commercial	$308.55
Rate for Payer: MDX Hawaii PPO	$352.11

PALIPERIDONE 3 MG PO TO24

Facility

$144.67

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$73.78
Max. Negotiated Rate	$140.33
Rate for Payer: Cash Price	$94.04
Rate for Payer: Cash Price	$93.94
Rate for Payer: Hawaii Western Management Group Commercial	$137.30
Rate for Payer: Hawaii Western Management Group Commercial	$137.44
Rate for Payer: Health Management Network Commercial	$122.85
Rate for Payer: Health Management Network Commercial	$122.97
Rate for Payer: Kaiser Permanente Commercial	$91.14
Rate for Payer: Kaiser Permanente Commercial	$91.05
Rate for Payer: Kaiser Permanente Medicaid	$73.78
Rate for Payer: Kaiser Permanente Medicaid	$73.71
Rate for Payer: MDX Hawaii PPO	$140.19
Rate for Payer: MDX Hawaii PPO	$140.33
Rate for Payer: UnitedHealthcare Medicaid	$86.72
Rate for Payer: UnitedHealthcare Medicaid	$86.80
Rate for Payer: University Health Alliance Commercial	$105.45
Rate for Payer: University Health Alliance Commercial	$105.35

PALIPERIDONE 3 MG PO TO24

Facility

$144.53

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$122.85
Max. Negotiated Rate	$140.19
Rate for Payer: Cash Price	$93.94
Rate for Payer: Cash Price	$94.04
Rate for Payer: Health Management Network Commercial	$122.85
Rate for Payer: Health Management Network Commercial	$122.97
Rate for Payer: MDX Hawaii PPO	$140.19
Rate for Payer: MDX Hawaii PPO	$140.33

PALIPERIDONE 6 MG PO TR24

Facility

$144.67

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$122.97
Max. Negotiated Rate	$140.33
Rate for Payer: Cash Price	$94.04
Rate for Payer: Cash Price	$58.38
Rate for Payer: Health Management Network Commercial	$122.97
Rate for Payer: Health Management Network Commercial	$76.35
Rate for Payer: MDX Hawaii PPO	$140.33
Rate for Payer: MDX Hawaii PPO	$87.13

PALIPERIDONE 6 MG PO TR24

Facility

$89.82

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$45.81
Max. Negotiated Rate	$87.13
Rate for Payer: Cash Price	$58.38
Rate for Payer: Cash Price	$94.04
Rate for Payer: Hawaii Western Management Group Commercial	$137.44
Rate for Payer: Hawaii Western Management Group Commercial	$85.33
Rate for Payer: Health Management Network Commercial	$122.97
Rate for Payer: Health Management Network Commercial	$76.35
Rate for Payer: Kaiser Permanente Commercial	$56.59
Rate for Payer: Kaiser Permanente Commercial	$91.14
Rate for Payer: Kaiser Permanente Medicaid	$45.81
Rate for Payer: Kaiser Permanente Medicaid	$73.78
Rate for Payer: MDX Hawaii PPO	$140.33
Rate for Payer: MDX Hawaii PPO	$87.13
Rate for Payer: UnitedHealthcare Medicaid	$86.80
Rate for Payer: UnitedHealthcare Medicaid	$53.89
Rate for Payer: University Health Alliance Commercial	$65.47
Rate for Payer: University Health Alliance Commercial	$105.45

PALIPERIDONE PALMITATE 156 MG/ML (1 ML) IM SYR

Facility

$3,973.79

Service Code	HCPCS J2426
Hospital Revenue Code	250
Min. Negotiated Rate	$3,377.72
Max. Negotiated Rate	$3,854.58
Rate for Payer: Cash Price	$2,582.96
Rate for Payer: Health Management Network Commercial	$3,377.72
Rate for Payer: MDX Hawaii PPO	$3,854.58

PALIPERIDONE PALMITATE 156 MG/ML (1 ML) IM SYR

Facility

$3,973.79

Service Code	HCPCS J2426
Hospital Revenue Code	636
Min. Negotiated Rate	$15.08
Max. Negotiated Rate	$3,854.58
Rate for Payer: AlohaCare Medicaid	$15.08
Rate for Payer: AlohaCare Medicare	$15.08
Rate for Payer: Cash Price	$2,582.96
Rate for Payer: Cash Price	$2,582.96
Rate for Payer: Devoted Health Medicare	$16.59
Rate for Payer: Hawaii Medical Service Association ABD	$15.08
Rate for Payer: Hawaii Medical Service Association Commercial	$18.85
Rate for Payer: Hawaii Medical Service Association Medicare	$15.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$15.08
Rate for Payer: Hawaii Western Management Group Commercial	$3,775.10
Rate for Payer: Health Management Network Commercial	$3,377.72
Rate for Payer: Humana Medicare	$15.08
Rate for Payer: Kaiser Permanente Commercial	$2,503.49
Rate for Payer: Kaiser Permanente Medicaid	$2,026.63
Rate for Payer: Kaiser Permanente Medicare	$15.08
Rate for Payer: MDX Hawaii PPO	$3,854.58
Rate for Payer: Ohana Health Plan Medicaid	$16.59
Rate for Payer: Ohana Health Plan Medicare	$15.08
Rate for Payer: UnitedHealthcare Medicaid	$2,384.27
Rate for Payer: UnitedHealthcare Medicare	$15.08
Rate for Payer: University Health Alliance Commercial	$2,896.50

PALIPERIDONE PALMITATE 234 MG/1.5 ML IM SYR

Facility

$5,401.38

Service Code	HCPCS J2426
Hospital Revenue Code	250
Min. Negotiated Rate	$4,591.17
Max. Negotiated Rate	$5,239.34
Rate for Payer: Cash Price	$3,510.90
Rate for Payer: Health Management Network Commercial	$4,591.17
Rate for Payer: MDX Hawaii PPO	$5,239.34

PALIPERIDONE PALMITATE 234 MG/1.5 ML IM SYR

Facility

$5,401.38

Service Code	HCPCS J2426
Hospital Revenue Code	636
Min. Negotiated Rate	$15.08
Max. Negotiated Rate	$5,239.34
Rate for Payer: AlohaCare Medicaid	$15.08
Rate for Payer: AlohaCare Medicare	$15.08
Rate for Payer: Cash Price	$3,510.90
Rate for Payer: Cash Price	$3,510.90
Rate for Payer: Devoted Health Medicare	$16.59
Rate for Payer: Hawaii Medical Service Association ABD	$15.08
Rate for Payer: Hawaii Medical Service Association Commercial	$18.85
Rate for Payer: Hawaii Medical Service Association Medicare	$15.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$15.08
Rate for Payer: Hawaii Western Management Group Commercial	$5,131.31
Rate for Payer: Health Management Network Commercial	$4,591.17
Rate for Payer: Humana Medicare	$15.08
Rate for Payer: Kaiser Permanente Commercial	$3,402.87
Rate for Payer: Kaiser Permanente Medicaid	$2,754.70
Rate for Payer: Kaiser Permanente Medicare	$15.08
Rate for Payer: MDX Hawaii PPO	$5,239.34
Rate for Payer: Ohana Health Plan Medicaid	$16.59
Rate for Payer: Ohana Health Plan Medicare	$15.08
Rate for Payer: UnitedHealthcare Medicaid	$3,240.83
Rate for Payer: UnitedHealthcare Medicare	$15.08
Rate for Payer: University Health Alliance Commercial	$3,937.07

PALIPERIDONE PALMITATE 78 MG/0.5 ML IM SYR

Facility

$2,546.02

Service Code	HCPCS J2426
Hospital Revenue Code	636
Min. Negotiated Rate	$15.08
Max. Negotiated Rate	$2,469.64
Rate for Payer: AlohaCare Medicaid	$15.08
Rate for Payer: AlohaCare Medicare	$15.08
Rate for Payer: Cash Price	$1,654.91
Rate for Payer: Cash Price	$1,654.91
Rate for Payer: Devoted Health Medicare	$16.59
Rate for Payer: Hawaii Medical Service Association ABD	$15.08
Rate for Payer: Hawaii Medical Service Association Commercial	$18.85
Rate for Payer: Hawaii Medical Service Association Medicare	$15.08
Rate for Payer: Hawaii Medical Service Association Non-ABD	$15.08
Rate for Payer: Hawaii Western Management Group Commercial	$2,418.72
Rate for Payer: Health Management Network Commercial	$2,164.12
Rate for Payer: Humana Medicare	$15.08
Rate for Payer: Kaiser Permanente Commercial	$1,603.99
Rate for Payer: Kaiser Permanente Medicaid	$1,298.47
Rate for Payer: Kaiser Permanente Medicare	$15.08
Rate for Payer: MDX Hawaii PPO	$2,469.64
Rate for Payer: Ohana Health Plan Medicaid	$16.59
Rate for Payer: Ohana Health Plan Medicare	$15.08
Rate for Payer: UnitedHealthcare Medicaid	$1,527.61
Rate for Payer: UnitedHealthcare Medicare	$15.08
Rate for Payer: University Health Alliance Commercial	$1,855.79

PALIPERIDONE PALMITATE 78 MG/0.5 ML IM SYR

Facility

$2,546.02

Service Code	HCPCS J2426
Hospital Revenue Code	250
Min. Negotiated Rate	$2,164.12
Max. Negotiated Rate	$2,469.64
Rate for Payer: Cash Price	$1,654.91
Rate for Payer: Health Management Network Commercial	$2,164.12
Rate for Payer: MDX Hawaii PPO	$2,469.64

PALONOSETRON 0.25 MG/5 ML IV SOLN

Facility

$588.77

Service Code	HCPCS J2469
Hospital Revenue Code	250
Min. Negotiated Rate	$500.45
Max. Negotiated Rate	$571.11
Rate for Payer: Cash Price	$382.70
Rate for Payer: Cash Price	$60.14
Rate for Payer: Health Management Network Commercial	$500.45
Rate for Payer: Health Management Network Commercial	$78.64
Rate for Payer: MDX Hawaii PPO	$571.11
Rate for Payer: MDX Hawaii PPO	$89.74

PALONOSETRON 0.25 MG/5 ML IV SOLN

Facility

$92.52

Service Code	HCPCS J2469
Hospital Revenue Code	636
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$89.74
Rate for Payer: Cash Price	$60.14
Rate for Payer: Cash Price	$382.70
Rate for Payer: Cash Price	$382.70
Rate for Payer: Cash Price	$60.14
Rate for Payer: Hawaii Medical Service Association ABD	$0.45
Rate for Payer: Hawaii Medical Service Association ABD	$0.45
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.45
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.45
Rate for Payer: Hawaii Western Management Group Commercial	$559.33
Rate for Payer: Hawaii Western Management Group Commercial	$87.89
Rate for Payer: Health Management Network Commercial	$78.64
Rate for Payer: Health Management Network Commercial	$500.45
Rate for Payer: Kaiser Permanente Commercial	$58.29
Rate for Payer: Kaiser Permanente Commercial	$370.93
Rate for Payer: Kaiser Permanente Medicaid	$300.27
Rate for Payer: Kaiser Permanente Medicaid	$47.19
Rate for Payer: MDX Hawaii PPO	$89.74
Rate for Payer: MDX Hawaii PPO	$571.11
Rate for Payer: UnitedHealthcare Medicaid	$353.26
Rate for Payer: UnitedHealthcare Medicaid	$55.51
Rate for Payer: University Health Alliance Commercial	$429.15
Rate for Payer: University Health Alliance Commercial	$67.44

PAMIDRONATE 30 MG/10 ML (3 MG/ML) IV SOLN

Facility

$152.14

Service Code	HCPCS J2430
Hospital Revenue Code	250
Min. Negotiated Rate	$129.32
Max. Negotiated Rate	$147.58
Rate for Payer: Cash Price	$98.89
Rate for Payer: Cash Price	$50.56
Rate for Payer: Health Management Network Commercial	$129.32
Rate for Payer: Health Management Network Commercial	$66.12
Rate for Payer: MDX Hawaii PPO	$147.58
Rate for Payer: MDX Hawaii PPO	$75.46

PAMIDRONATE 30 MG/10 ML (3 MG/ML) IV SOLN

Facility

$77.79

Service Code	HCPCS J2430
Hospital Revenue Code	636
Min. Negotiated Rate	$11.16
Max. Negotiated Rate	$75.46
Rate for Payer: Cash Price	$50.56
Rate for Payer: Cash Price	$50.56
Rate for Payer: Cash Price	$98.89
Rate for Payer: Cash Price	$98.89
Rate for Payer: Hawaii Medical Service Association ABD	$11.16
Rate for Payer: Hawaii Medical Service Association ABD	$11.16
Rate for Payer: Hawaii Medical Service Association Non-ABD	$11.16
Rate for Payer: Hawaii Medical Service Association Non-ABD	$11.16
Rate for Payer: Hawaii Western Management Group Commercial	$73.90
Rate for Payer: Hawaii Western Management Group Commercial	$144.53
Rate for Payer: Health Management Network Commercial	$66.12
Rate for Payer: Health Management Network Commercial	$129.32
Rate for Payer: Kaiser Permanente Commercial	$49.01
Rate for Payer: Kaiser Permanente Commercial	$95.85
Rate for Payer: Kaiser Permanente Medicaid	$77.59
Rate for Payer: Kaiser Permanente Medicaid	$39.67
Rate for Payer: MDX Hawaii PPO	$147.58
Rate for Payer: MDX Hawaii PPO	$75.46
Rate for Payer: UnitedHealthcare Medicaid	$46.67
Rate for Payer: UnitedHealthcare Medicaid	$91.28
Rate for Payer: University Health Alliance Commercial	$56.70
Rate for Payer: University Health Alliance Commercial	$110.89

PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC

Facility

$52,529.15

Service Code	MSDRG 406
Min. Negotiated Rate	$38,145.65
Max. Negotiated Rate	$52,529.15
Rate for Payer: AlohaCare Medicare	$38,145.65
Rate for Payer: Devoted Health Medicare	$41,960.21
Rate for Payer: Hawaii Medical Service Association Commercial	$52,529.15
Rate for Payer: Hawaii Medical Service Association Medicare	$38,145.65
Rate for Payer: Humana Medicare	$38,145.65
Rate for Payer: Kaiser Permanente Commercial	$50,028.45
Rate for Payer: Kaiser Permanente Medicare	$38,145.65
Rate for Payer: Ohana Health Plan Medicare	$38,145.65
Rate for Payer: UnitedHealthcare Medicare	$38,145.65

PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC

Facility

$95,029.79

Service Code	MSDRG 405
Min. Negotiated Rate	$71,952.21
Max. Negotiated Rate	$95,029.79
Rate for Payer: AlohaCare Medicare	$71,952.21
Rate for Payer: Devoted Health Medicare	$79,147.43
Rate for Payer: Hawaii Medical Service Association Commercial	$95,029.79
Rate for Payer: Hawaii Medical Service Association Medicare	$71,952.21
Rate for Payer: Humana Medicare	$71,952.21
Rate for Payer: Kaiser Permanente Commercial	$94,366.12
Rate for Payer: Kaiser Permanente Medicare	$71,952.21
Rate for Payer: Ohana Health Plan Medicare	$71,952.21
Rate for Payer: UnitedHealthcare Medicare	$71,952.21

PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC

Facility

$38,288.10

Service Code	MSDRG 407
Min. Negotiated Rate	$29,193.87
Max. Negotiated Rate	$38,288.10
Rate for Payer: AlohaCare Medicare	$29,193.87
Rate for Payer: Devoted Health Medicare	$32,113.26
Rate for Payer: Hawaii Medical Service Association Commercial	$37,655.13
Rate for Payer: Hawaii Medical Service Association Medicare	$29,193.87
Rate for Payer: Humana Medicare	$29,193.87
Rate for Payer: Kaiser Permanente Commercial	$38,288.10
Rate for Payer: Kaiser Permanente Medicare	$29,193.87
Rate for Payer: Ohana Health Plan Medicare	$29,193.87
Rate for Payer: UnitedHealthcare Medicare	$29,193.87

PANCREAS TRANSPLANT

Facility

$50,895.84

Service Code	APR-DRG 0063
Min. Negotiated Rate	$50,895.84
Max. Negotiated Rate	$50,895.84
Rate for Payer: AlohaCare Medicaid	$50,895.84
Rate for Payer: Hawaii Medical Service Association ABD	$50,895.84
Rate for Payer: Hawaii Medical Service Association Non-ABD	$50,895.84
Rate for Payer: Kaiser Permanente Medicaid	$50,895.84
Rate for Payer: Ohana Health Plan Medicaid	$50,895.84
Rate for Payer: UnitedHealthcare Medicaid	$50,895.84

PANCREAS TRANSPLANT

Facility

$103,818.33

Service Code	MSDRG 010
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$103,818.33
Rate for Payer: AlohaCare Medicare	$94,380.30
Rate for Payer: Devoted Health Medicare	$103,818.33
Rate for Payer: Hawaii Medical Service Association Medicare	$94,380.30
Rate for Payer: Kaiser Permanente Commercial	$52,955.78
Rate for Payer: Kaiser Permanente Medicare	$94,380.30
Rate for Payer: Ohana Health Plan Medicare	$94,380.30
Rate for Payer: UnitedHealthcare Medicare	$94,380.30
Rate for Payer: University Health Alliance Commercial	$10,400.00

PANCREAS TRANSPLANT

Facility

$42,958.09

Service Code	APR-DRG 0062
Min. Negotiated Rate	$42,958.09
Max. Negotiated Rate	$42,958.09
Rate for Payer: AlohaCare Medicaid	$42,958.09
Rate for Payer: Hawaii Medical Service Association ABD	$42,958.09
Rate for Payer: Hawaii Medical Service Association Non-ABD	$42,958.09
Rate for Payer: Kaiser Permanente Medicaid	$42,958.09
Rate for Payer: Ohana Health Plan Medicaid	$42,958.09
Rate for Payer: UnitedHealthcare Medicaid	$42,958.09

Know your out-of-pocket cost for care.

All Charges