Kona Community Hospital

All Charges

Charge

Type

Setting

Price

PRALIDOXIME 1 GRAM INJ RECON.SOLN.

Facility

$399.24

Service Code	HCPCS J2730
Hospital Revenue Code	636
Min. Negotiated Rate	$203.61
Max. Negotiated Rate	$387.26
Rate for Payer: Cash Price	$259.51
Rate for Payer: Hawaii Western Management Group Commercial	$379.28
Rate for Payer: Health Management Network Commercial	$339.35
Rate for Payer: Kaiser Permanente Commercial	$251.52
Rate for Payer: Kaiser Permanente Medicaid	$203.61
Rate for Payer: MDX Hawaii PPO	$387.26
Rate for Payer: UnitedHealthcare Medicaid	$239.54
Rate for Payer: University Health Alliance Commercial	$291.01

PRAMIPEXOLE 0.25 MG PO TABLET

Facility

$1.99

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.93
Rate for Payer: Cash Price	$1.29
Rate for Payer: Health Management Network Commercial	$1.69
Rate for Payer: MDX Hawaii PPO	$1.93

PRAMIPEXOLE 0.25 MG PO TABLET

Facility

$1.99

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$1.93
Rate for Payer: Cash Price	$1.29
Rate for Payer: Hawaii Western Management Group Commercial	$1.89
Rate for Payer: Health Management Network Commercial	$1.69
Rate for Payer: Kaiser Permanente Commercial	$1.25
Rate for Payer: Kaiser Permanente Medicaid	$1.01
Rate for Payer: MDX Hawaii PPO	$1.93
Rate for Payer: UnitedHealthcare Medicaid	$1.19
Rate for Payer: University Health Alliance Commercial	$1.45

PRAZIQUANTEL 600 MG PO TABLET

Facility

$409.53

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$208.86
Max. Negotiated Rate	$397.24
Rate for Payer: Cash Price	$266.19
Rate for Payer: Hawaii Western Management Group Commercial	$389.05
Rate for Payer: Health Management Network Commercial	$348.10
Rate for Payer: Kaiser Permanente Commercial	$258.00
Rate for Payer: Kaiser Permanente Medicaid	$208.86
Rate for Payer: MDX Hawaii PPO	$397.24
Rate for Payer: UnitedHealthcare Medicaid	$245.72
Rate for Payer: University Health Alliance Commercial	$298.51

PRAZIQUANTEL 600 MG PO TABLET

Facility

$409.53

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$348.10
Max. Negotiated Rate	$397.24
Rate for Payer: Cash Price	$266.19
Rate for Payer: Health Management Network Commercial	$348.10
Rate for Payer: MDX Hawaii PPO	$397.24

PRAZOSIN 1 MG PO CAP

Facility

$10.01

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$5.11
Max. Negotiated Rate	$9.71
Rate for Payer: Cash Price	$6.51
Rate for Payer: Hawaii Western Management Group Commercial	$9.51
Rate for Payer: Health Management Network Commercial	$8.51
Rate for Payer: Kaiser Permanente Commercial	$6.31
Rate for Payer: Kaiser Permanente Medicaid	$5.11
Rate for Payer: MDX Hawaii PPO	$9.71
Rate for Payer: UnitedHealthcare Medicaid	$6.01
Rate for Payer: University Health Alliance Commercial	$7.30

PRAZOSIN 1 MG PO CAP

Facility

$10.01

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$8.51
Max. Negotiated Rate	$9.71
Rate for Payer: Cash Price	$6.51
Rate for Payer: Health Management Network Commercial	$8.51
Rate for Payer: MDX Hawaii PPO	$9.71

PRAZOSIN 5 MG PO CAP

Facility

$12.06

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$11.70
Rate for Payer: Cash Price	$7.84
Rate for Payer: Hawaii Western Management Group Commercial	$11.46
Rate for Payer: Health Management Network Commercial	$10.25
Rate for Payer: Kaiser Permanente Commercial	$7.60
Rate for Payer: Kaiser Permanente Medicaid	$6.15
Rate for Payer: MDX Hawaii PPO	$11.70
Rate for Payer: UnitedHealthcare Medicaid	$7.24
Rate for Payer: University Health Alliance Commercial	$8.79

PRAZOSIN 5 MG PO CAP

Facility

$12.06

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$10.25
Max. Negotiated Rate	$11.70
Rate for Payer: Cash Price	$7.84
Rate for Payer: Health Management Network Commercial	$10.25
Rate for Payer: MDX Hawaii PPO	$11.70

PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC

Facility

$25,335.08

Service Code	MSDRG 067
Min. Negotiated Rate	$19,317.47
Max. Negotiated Rate	$25,335.08
Rate for Payer: AlohaCare Medicare	$19,317.47
Rate for Payer: Devoted Health Medicare	$21,249.22
Rate for Payer: Hawaii Medical Service Association Commercial	$20,756.13
Rate for Payer: Hawaii Medical Service Association Medicare	$19,317.47
Rate for Payer: Humana Medicare	$19,317.47
Rate for Payer: Kaiser Permanente Commercial	$25,335.08
Rate for Payer: Kaiser Permanente Medicare	$19,317.47
Rate for Payer: Ohana Health Plan Medicare	$19,317.47
Rate for Payer: UnitedHealthcare Medicare	$19,317.47

PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC

Facility

$20,756.13

Service Code	MSDRG 068
Min. Negotiated Rate	$11,369.25
Max. Negotiated Rate	$20,756.13
Rate for Payer: AlohaCare Medicare	$11,369.25
Rate for Payer: Devoted Health Medicare	$12,506.17
Rate for Payer: Hawaii Medical Service Association Commercial	$20,756.13
Rate for Payer: Hawaii Medical Service Association Medicare	$11,369.25
Rate for Payer: Humana Medicare	$11,369.25
Rate for Payer: Kaiser Permanente Commercial	$14,910.90
Rate for Payer: Kaiser Permanente Medicare	$11,369.25
Rate for Payer: Ohana Health Plan Medicare	$11,369.25
Rate for Payer: UnitedHealthcare Medicare	$11,369.25

PREDNISOLONE ACETATE 1 % OPHT DRPS

Facility

$282.08

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$239.77
Max. Negotiated Rate	$273.62
Rate for Payer: Cash Price	$183.35
Rate for Payer: Cash Price	$189.01
Rate for Payer: Health Management Network Commercial	$239.77
Rate for Payer: Health Management Network Commercial	$247.17
Rate for Payer: MDX Hawaii PPO	$273.62
Rate for Payer: MDX Hawaii PPO	$282.07

PREDNISOLONE ACETATE 1 % OPHT DRPS

Facility

$290.79

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$148.30
Max. Negotiated Rate	$282.07
Rate for Payer: Cash Price	$189.01
Rate for Payer: Cash Price	$183.35
Rate for Payer: Hawaii Western Management Group Commercial	$267.98
Rate for Payer: Hawaii Western Management Group Commercial	$276.25
Rate for Payer: Health Management Network Commercial	$239.77
Rate for Payer: Health Management Network Commercial	$247.17
Rate for Payer: Kaiser Permanente Commercial	$183.20
Rate for Payer: Kaiser Permanente Commercial	$177.71
Rate for Payer: Kaiser Permanente Medicaid	$148.30
Rate for Payer: Kaiser Permanente Medicaid	$143.86
Rate for Payer: MDX Hawaii PPO	$273.62
Rate for Payer: MDX Hawaii PPO	$282.07
Rate for Payer: UnitedHealthcare Medicaid	$169.25
Rate for Payer: UnitedHealthcare Medicaid	$174.47
Rate for Payer: University Health Alliance Commercial	$211.96
Rate for Payer: University Health Alliance Commercial	$205.61

PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) PO SOLN

Facility

$41.84

Service Code	HCPCS J7510
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$40.58
Rate for Payer: Cash Price	$27.20
Rate for Payer: Cash Price	$25.45
Rate for Payer: Cash Price	$27.20
Rate for Payer: Cash Price	$25.45
Rate for Payer: Hawaii Medical Service Association ABD	$0.27
Rate for Payer: Hawaii Medical Service Association ABD	$0.27
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.27
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.27
Rate for Payer: Hawaii Western Management Group Commercial	$37.19
Rate for Payer: Hawaii Western Management Group Commercial	$39.75
Rate for Payer: Health Management Network Commercial	$35.56
Rate for Payer: Health Management Network Commercial	$33.28
Rate for Payer: Kaiser Permanente Commercial	$26.36
Rate for Payer: Kaiser Permanente Commercial	$24.66
Rate for Payer: Kaiser Permanente Medicaid	$19.97
Rate for Payer: Kaiser Permanente Medicaid	$21.34
Rate for Payer: MDX Hawaii PPO	$40.58
Rate for Payer: MDX Hawaii PPO	$37.98
Rate for Payer: UnitedHealthcare Medicaid	$23.49
Rate for Payer: UnitedHealthcare Medicaid	$25.10
Rate for Payer: University Health Alliance Commercial	$30.50
Rate for Payer: University Health Alliance Commercial	$28.54

PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) PO SOLN

Facility

$41.84

Service Code	HCPCS J7510
Hospital Revenue Code	250
Min. Negotiated Rate	$35.56
Max. Negotiated Rate	$40.58
Rate for Payer: Cash Price	$27.20
Rate for Payer: Cash Price	$25.45
Rate for Payer: Health Management Network Commercial	$33.28
Rate for Payer: Health Management Network Commercial	$35.56
Rate for Payer: MDX Hawaii PPO	$37.98
Rate for Payer: MDX Hawaii PPO	$40.58

PREDNISONE 10 MG PO TABLET

Facility

$1.20

Service Code	HCPCS J7512
Hospital Revenue Code	250
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.16
Rate for Payer: Cash Price	$0.78
Rate for Payer: Health Management Network Commercial	$1.02
Rate for Payer: MDX Hawaii PPO	$1.16

PREDNISONE 10 MG PO TABLET

Facility

$1.20

Service Code	HCPCS J7512
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$1.16
Rate for Payer: Cash Price	$0.78
Rate for Payer: Cash Price	$0.78
Rate for Payer: Hawaii Medical Service Association ABD	$0.01
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.01
Rate for Payer: Hawaii Western Management Group Commercial	$1.14
Rate for Payer: Health Management Network Commercial	$1.02
Rate for Payer: Kaiser Permanente Commercial	$0.76
Rate for Payer: Kaiser Permanente Medicaid	$0.61
Rate for Payer: MDX Hawaii PPO	$1.16
Rate for Payer: UnitedHealthcare Medicaid	$0.72
Rate for Payer: University Health Alliance Commercial	$0.87

PREDNISONE 1 MG PO TABLET

Facility

$1.40

Service Code	HCPCS J7512
Hospital Revenue Code	250
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.36
Rate for Payer: Cash Price	$0.91
Rate for Payer: Health Management Network Commercial	$1.19
Rate for Payer: MDX Hawaii PPO	$1.36

PREDNISONE 1 MG PO TABLET

Facility

$1.40

Service Code	HCPCS J7512
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$1.36
Rate for Payer: Cash Price	$0.91
Rate for Payer: Cash Price	$0.91
Rate for Payer: Hawaii Medical Service Association ABD	$0.01
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.01
Rate for Payer: Hawaii Western Management Group Commercial	$1.33
Rate for Payer: Health Management Network Commercial	$1.19
Rate for Payer: Kaiser Permanente Commercial	$0.88
Rate for Payer: Kaiser Permanente Medicaid	$0.71
Rate for Payer: MDX Hawaii PPO	$1.36
Rate for Payer: UnitedHealthcare Medicaid	$0.84
Rate for Payer: University Health Alliance Commercial	$1.02

PREDNISONE 20 MG PO TABLET

Facility

$1.43

Service Code	HCPCS J7512
Hospital Revenue Code	250
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.39
Rate for Payer: Cash Price	$0.93
Rate for Payer: Health Management Network Commercial	$1.22
Rate for Payer: MDX Hawaii PPO	$1.39

PREDNISONE 20 MG PO TABLET

Facility

$1.43

Service Code	HCPCS J7512
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$1.39
Rate for Payer: Cash Price	$0.93
Rate for Payer: Cash Price	$0.93
Rate for Payer: Hawaii Medical Service Association ABD	$0.01
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.01
Rate for Payer: Hawaii Western Management Group Commercial	$1.36
Rate for Payer: Health Management Network Commercial	$1.22
Rate for Payer: Kaiser Permanente Commercial	$0.90
Rate for Payer: Kaiser Permanente Medicaid	$0.73
Rate for Payer: MDX Hawaii PPO	$1.39
Rate for Payer: UnitedHealthcare Medicaid	$0.86
Rate for Payer: University Health Alliance Commercial	$1.04

PREDNISONE 50 MG PO TABLET

Facility

$2.25

Service Code	HCPCS J7512
Hospital Revenue Code	250
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$2.18
Rate for Payer: Cash Price	$1.46
Rate for Payer: Cash Price	$1.93
Rate for Payer: Health Management Network Commercial	$1.91
Rate for Payer: Health Management Network Commercial	$2.52
Rate for Payer: MDX Hawaii PPO	$2.18
Rate for Payer: MDX Hawaii PPO	$2.88

PREDNISONE 50 MG PO TABLET

Facility

$2.97

Service Code	HCPCS J7512
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$2.88
Rate for Payer: Cash Price	$1.93
Rate for Payer: Cash Price	$1.46
Rate for Payer: Cash Price	$1.46
Rate for Payer: Cash Price	$1.93
Rate for Payer: Hawaii Medical Service Association ABD	$0.01
Rate for Payer: Hawaii Medical Service Association ABD	$0.01
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.01
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.01
Rate for Payer: Hawaii Western Management Group Commercial	$2.14
Rate for Payer: Hawaii Western Management Group Commercial	$2.82
Rate for Payer: Health Management Network Commercial	$2.52
Rate for Payer: Health Management Network Commercial	$1.91
Rate for Payer: Kaiser Permanente Commercial	$1.87
Rate for Payer: Kaiser Permanente Commercial	$1.42
Rate for Payer: Kaiser Permanente Medicaid	$1.15
Rate for Payer: Kaiser Permanente Medicaid	$1.51
Rate for Payer: MDX Hawaii PPO	$2.88
Rate for Payer: MDX Hawaii PPO	$2.18
Rate for Payer: UnitedHealthcare Medicaid	$1.35
Rate for Payer: UnitedHealthcare Medicaid	$1.78
Rate for Payer: University Health Alliance Commercial	$1.64
Rate for Payer: University Health Alliance Commercial	$2.16

PREDNISONE 5 MG PO TABLET

Facility

$1.20

Service Code	HCPCS J7512
Hospital Revenue Code	250
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.16
Rate for Payer: Cash Price	$0.78
Rate for Payer: Cash Price	$0.90
Rate for Payer: Health Management Network Commercial	$1.02
Rate for Payer: Health Management Network Commercial	$1.17
Rate for Payer: MDX Hawaii PPO	$1.16
Rate for Payer: MDX Hawaii PPO	$1.34

PREDNISONE 5 MG PO TABLET

Facility

$1.20

Service Code	HCPCS J7512
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$1.16
Rate for Payer: Cash Price	$0.78
Rate for Payer: Cash Price	$0.78
Rate for Payer: Cash Price	$0.90
Rate for Payer: Cash Price	$0.90
Rate for Payer: Hawaii Medical Service Association ABD	$0.01
Rate for Payer: Hawaii Medical Service Association ABD	$0.01
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.01
Rate for Payer: Hawaii Medical Service Association Non-ABD	$0.01
Rate for Payer: Hawaii Western Management Group Commercial	$1.14
Rate for Payer: Hawaii Western Management Group Commercial	$1.31
Rate for Payer: Health Management Network Commercial	$1.17
Rate for Payer: Health Management Network Commercial	$1.02
Rate for Payer: Kaiser Permanente Commercial	$0.87
Rate for Payer: Kaiser Permanente Commercial	$0.76
Rate for Payer: Kaiser Permanente Medicaid	$0.61
Rate for Payer: Kaiser Permanente Medicaid	$0.70
Rate for Payer: MDX Hawaii PPO	$1.34
Rate for Payer: MDX Hawaii PPO	$1.16
Rate for Payer: UnitedHealthcare Medicaid	$0.72
Rate for Payer: UnitedHealthcare Medicaid	$0.83
Rate for Payer: University Health Alliance Commercial	$1.01
Rate for Payer: University Health Alliance Commercial	$0.87

Know your out-of-pocket cost for care.

All Charges