Kona Community Hospital

All Charges

Charge

Type

Setting

Price

CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC

Facility

$31,700.71

Service Code	MSDRG 262
Min. Negotiated Rate	$21,437.70
Max. Negotiated Rate	$31,700.71
Rate for Payer: AlohaCare Medicare	$21,437.70
Rate for Payer: Devoted Health Medicare	$23,581.47
Rate for Payer: Hawaii Medical Service Association Commercial	$31,700.71
Rate for Payer: Hawaii Medical Service Association Medicare	$21,437.70
Rate for Payer: Humana Medicare	$21,437.70
Rate for Payer: Kaiser Permanente Commercial	$28,115.78
Rate for Payer: Kaiser Permanente Medicare	$21,437.70
Rate for Payer: Ohana Health Plan Medicare	$21,437.70
Rate for Payer: UnitedHealthcare Medicare	$21,437.70

CARDIAC STRUCTURAL & VALVULAR DISORDERS

Facility

$4,568.42

Service Code	APR-DRG 2003
Min. Negotiated Rate	$4,568.42
Max. Negotiated Rate	$4,568.42
Rate for Payer: AlohaCare Medicaid	$4,568.42
Rate for Payer: Hawaii Medical Service Association ABD	$4,568.42
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,568.42
Rate for Payer: Kaiser Permanente Medicaid	$4,568.42
Rate for Payer: Ohana Health Plan Medicaid	$4,568.42
Rate for Payer: UnitedHealthcare Medicaid	$4,568.42

CARDIAC STRUCTURAL & VALVULAR DISORDERS

Facility

$2,512.82

Service Code	APR-DRG 2001
Min. Negotiated Rate	$2,512.82
Max. Negotiated Rate	$2,512.82
Rate for Payer: AlohaCare Medicaid	$2,512.82
Rate for Payer: Hawaii Medical Service Association ABD	$2,512.82
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,512.82
Rate for Payer: Kaiser Permanente Medicaid	$2,512.82
Rate for Payer: Ohana Health Plan Medicaid	$2,512.82
Rate for Payer: UnitedHealthcare Medicaid	$2,512.82

CARDIAC STRUCTURAL & VALVULAR DISORDERS

Facility

$3,195.48

Service Code	APR-DRG 2002
Min. Negotiated Rate	$3,195.48
Max. Negotiated Rate	$3,195.48
Rate for Payer: AlohaCare Medicaid	$3,195.48
Rate for Payer: Hawaii Medical Service Association ABD	$3,195.48
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,195.48
Rate for Payer: Kaiser Permanente Medicaid	$3,195.48
Rate for Payer: Ohana Health Plan Medicaid	$3,195.48
Rate for Payer: UnitedHealthcare Medicaid	$3,195.48

CARDIAC STRUCTURAL & VALVULAR DISORDERS

Facility

$7,637.82

Service Code	APR-DRG 2004
Min. Negotiated Rate	$7,637.82
Max. Negotiated Rate	$7,637.82
Rate for Payer: AlohaCare Medicaid	$7,637.82
Rate for Payer: Hawaii Medical Service Association ABD	$7,637.82
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,637.82
Rate for Payer: Kaiser Permanente Medicaid	$7,637.82
Rate for Payer: Ohana Health Plan Medicaid	$7,637.82
Rate for Payer: UnitedHealthcare Medicaid	$7,637.82

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC

Facility

$196,664.91

Service Code	MSDRG 217
Min. Negotiated Rate	$86,483.38
Max. Negotiated Rate	$196,664.91
Rate for Payer: AlohaCare Medicare	$86,483.38
Rate for Payer: Devoted Health Medicare	$95,131.72
Rate for Payer: Hawaii Medical Service Association Commercial	$196,664.91
Rate for Payer: Hawaii Medical Service Association Medicare	$86,483.38
Rate for Payer: Humana Medicare	$86,483.38
Rate for Payer: Kaiser Permanente Commercial	$113,423.93
Rate for Payer: Kaiser Permanente Medicare	$86,483.38
Rate for Payer: Ohana Health Plan Medicare	$86,483.38
Rate for Payer: UnitedHealthcare Medicare	$86,483.38

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC

Facility

$196,664.91

Service Code	MSDRG 216
Min. Negotiated Rate	$128,670.88
Max. Negotiated Rate	$196,664.91
Rate for Payer: AlohaCare Medicare	$128,670.88
Rate for Payer: Devoted Health Medicare	$141,537.97
Rate for Payer: Hawaii Medical Service Association Commercial	$196,664.91
Rate for Payer: Hawaii Medical Service Association Medicare	$128,670.88
Rate for Payer: Humana Medicare	$128,670.88
Rate for Payer: Kaiser Permanente Commercial	$168,753.30
Rate for Payer: Kaiser Permanente Medicare	$128,670.88
Rate for Payer: Ohana Health Plan Medicare	$128,670.88
Rate for Payer: UnitedHealthcare Medicare	$128,670.88

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC

Facility

$196,664.91

Service Code	MSDRG 218
Min. Negotiated Rate	$86,483.38
Max. Negotiated Rate	$196,664.91
Rate for Payer: AlohaCare Medicare	$86,483.38
Rate for Payer: Devoted Health Medicare	$95,131.72
Rate for Payer: Hawaii Medical Service Association Commercial	$196,664.91
Rate for Payer: Hawaii Medical Service Association Medicare	$86,483.38
Rate for Payer: Humana Medicare	$86,483.38
Rate for Payer: Kaiser Permanente Commercial	$113,423.93
Rate for Payer: Kaiser Permanente Medicare	$86,483.38
Rate for Payer: Ohana Health Plan Medicare	$86,483.38
Rate for Payer: UnitedHealthcare Medicare	$86,483.38

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC

Facility

$127,911.74

Service Code	MSDRG 220
Min. Negotiated Rate	$70,141.06
Max. Negotiated Rate	$127,911.74
Rate for Payer: AlohaCare Medicare	$70,141.06
Rate for Payer: Devoted Health Medicare	$77,155.17
Rate for Payer: Hawaii Medical Service Association Commercial	$127,911.74
Rate for Payer: Hawaii Medical Service Association Medicare	$70,141.06
Rate for Payer: Humana Medicare	$70,141.06
Rate for Payer: Kaiser Permanente Commercial	$91,990.80
Rate for Payer: Kaiser Permanente Medicare	$70,141.06
Rate for Payer: Ohana Health Plan Medicare	$70,141.06
Rate for Payer: UnitedHealthcare Medicare	$70,141.06

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC

Facility

$132,450.67

Service Code	MSDRG 219
Min. Negotiated Rate	$100,990.89
Max. Negotiated Rate	$132,450.67
Rate for Payer: AlohaCare Medicare	$100,990.89
Rate for Payer: Devoted Health Medicare	$111,089.98
Rate for Payer: Hawaii Medical Service Association Commercial	$127,911.74
Rate for Payer: Hawaii Medical Service Association Medicare	$100,990.89
Rate for Payer: Humana Medicare	$100,990.89
Rate for Payer: Kaiser Permanente Commercial	$132,450.67
Rate for Payer: Kaiser Permanente Medicare	$100,990.89
Rate for Payer: Ohana Health Plan Medicare	$100,990.89
Rate for Payer: UnitedHealthcare Medicare	$100,990.89

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC

Facility

$127,911.74

Service Code	MSDRG 221
Min. Negotiated Rate	$66,292.58
Max. Negotiated Rate	$127,911.74
Rate for Payer: AlohaCare Medicare	$66,292.58
Rate for Payer: Devoted Health Medicare	$72,921.84
Rate for Payer: Hawaii Medical Service Association Commercial	$127,911.74
Rate for Payer: Hawaii Medical Service Association Medicare	$66,292.58
Rate for Payer: Humana Medicare	$66,292.58
Rate for Payer: Kaiser Permanente Commercial	$86,943.45
Rate for Payer: Kaiser Permanente Medicare	$66,292.58
Rate for Payer: Ohana Health Plan Medicare	$66,292.58
Rate for Payer: UnitedHealthcare Medicare	$66,292.58

CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX

Facility

$26,575.06

Service Code	APR-DRG 1622
Min. Negotiated Rate	$26,575.06
Max. Negotiated Rate	$26,575.06
Rate for Payer: AlohaCare Medicaid	$26,575.06
Rate for Payer: Hawaii Medical Service Association ABD	$26,575.06
Rate for Payer: Hawaii Medical Service Association Non-ABD	$26,575.06
Rate for Payer: Kaiser Permanente Medicaid	$26,575.06
Rate for Payer: Ohana Health Plan Medicaid	$26,575.06
Rate for Payer: UnitedHealthcare Medicaid	$26,575.06

CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX

Facility

$34,061.96

Service Code	APR-DRG 1623
Min. Negotiated Rate	$34,061.96
Max. Negotiated Rate	$34,061.96
Rate for Payer: AlohaCare Medicaid	$34,061.96
Rate for Payer: Hawaii Medical Service Association ABD	$34,061.96
Rate for Payer: Hawaii Medical Service Association Non-ABD	$34,061.96
Rate for Payer: Kaiser Permanente Medicaid	$34,061.96
Rate for Payer: Ohana Health Plan Medicaid	$34,061.96
Rate for Payer: UnitedHealthcare Medicaid	$34,061.96

CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX

Facility

$48,316.79

Service Code	APR-DRG 1624
Min. Negotiated Rate	$48,316.79
Max. Negotiated Rate	$48,316.79
Rate for Payer: AlohaCare Medicaid	$48,316.79
Rate for Payer: Hawaii Medical Service Association ABD	$48,316.79
Rate for Payer: Hawaii Medical Service Association Non-ABD	$48,316.79
Rate for Payer: Kaiser Permanente Medicaid	$48,316.79
Rate for Payer: Ohana Health Plan Medicaid	$48,316.79
Rate for Payer: UnitedHealthcare Medicaid	$48,316.79

CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX

Facility

$23,610.11

Service Code	APR-DRG 1621
Min. Negotiated Rate	$23,610.11
Max. Negotiated Rate	$23,610.11
Rate for Payer: AlohaCare Medicaid	$23,610.11
Rate for Payer: Hawaii Medical Service Association ABD	$23,610.11
Rate for Payer: Hawaii Medical Service Association Non-ABD	$23,610.11
Rate for Payer: Kaiser Permanente Medicaid	$23,610.11
Rate for Payer: Ohana Health Plan Medicaid	$23,610.11
Rate for Payer: UnitedHealthcare Medicaid	$23,610.11

CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX

Facility

$19,983.51

Service Code	APR-DRG 1631
Min. Negotiated Rate	$19,983.51
Max. Negotiated Rate	$19,983.51
Rate for Payer: AlohaCare Medicaid	$19,983.51
Rate for Payer: Hawaii Medical Service Association ABD	$19,983.51
Rate for Payer: Hawaii Medical Service Association Non-ABD	$19,983.51
Rate for Payer: Kaiser Permanente Medicaid	$19,983.51
Rate for Payer: Ohana Health Plan Medicaid	$19,983.51
Rate for Payer: UnitedHealthcare Medicaid	$19,983.51

CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX

Facility

$40,959.81

Service Code	APR-DRG 1634
Min. Negotiated Rate	$40,959.81
Max. Negotiated Rate	$40,959.81
Rate for Payer: AlohaCare Medicaid	$40,959.81
Rate for Payer: Hawaii Medical Service Association ABD	$40,959.81
Rate for Payer: Hawaii Medical Service Association Non-ABD	$40,959.81
Rate for Payer: Kaiser Permanente Medicaid	$40,959.81
Rate for Payer: Ohana Health Plan Medicaid	$40,959.81
Rate for Payer: UnitedHealthcare Medicaid	$40,959.81

CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX

Facility

$27,502.25

Service Code	APR-DRG 1633
Min. Negotiated Rate	$27,502.25
Max. Negotiated Rate	$27,502.25
Rate for Payer: AlohaCare Medicaid	$27,502.25
Rate for Payer: Hawaii Medical Service Association ABD	$27,502.25
Rate for Payer: Hawaii Medical Service Association Non-ABD	$27,502.25
Rate for Payer: Kaiser Permanente Medicaid	$27,502.25
Rate for Payer: Ohana Health Plan Medicaid	$27,502.25
Rate for Payer: UnitedHealthcare Medicaid	$27,502.25

CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX

Facility

$22,177.30

Service Code	APR-DRG 1632
Min. Negotiated Rate	$22,177.30
Max. Negotiated Rate	$22,177.30
Rate for Payer: AlohaCare Medicaid	$22,177.30
Rate for Payer: Hawaii Medical Service Association ABD	$22,177.30
Rate for Payer: Hawaii Medical Service Association Non-ABD	$22,177.30
Rate for Payer: Kaiser Permanente Medicaid	$22,177.30
Rate for Payer: Ohana Health Plan Medicaid	$22,177.30
Rate for Payer: UnitedHealthcare Medicaid	$22,177.30

CARDIOMYOPATHY

Facility

$2,721.06

Service Code	APR-DRG 2051
Min. Negotiated Rate	$2,721.06
Max. Negotiated Rate	$2,721.06
Rate for Payer: AlohaCare Medicaid	$2,721.06
Rate for Payer: Hawaii Medical Service Association ABD	$2,721.06
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,721.06
Rate for Payer: Kaiser Permanente Medicaid	$2,721.06
Rate for Payer: Ohana Health Plan Medicaid	$2,721.06
Rate for Payer: UnitedHealthcare Medicaid	$2,721.06

CARDIOMYOPATHY

Facility

$3,283.99

Service Code	APR-DRG 2052
Min. Negotiated Rate	$3,283.99
Max. Negotiated Rate	$3,283.99
Rate for Payer: AlohaCare Medicaid	$3,283.99
Rate for Payer: Hawaii Medical Service Association ABD	$3,283.99
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,283.99
Rate for Payer: Kaiser Permanente Medicaid	$3,283.99
Rate for Payer: Ohana Health Plan Medicaid	$3,283.99
Rate for Payer: UnitedHealthcare Medicaid	$3,283.99

CARDIOMYOPATHY

Facility

$10,332.13

Service Code	APR-DRG 2054
Min. Negotiated Rate	$10,332.13
Max. Negotiated Rate	$10,332.13
Rate for Payer: AlohaCare Medicaid	$10,332.13
Rate for Payer: Hawaii Medical Service Association ABD	$10,332.13
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10,332.13
Rate for Payer: Kaiser Permanente Medicaid	$10,332.13
Rate for Payer: Ohana Health Plan Medicaid	$10,332.13
Rate for Payer: UnitedHealthcare Medicaid	$10,332.13

CARDIOMYOPATHY

Facility

$4,886.19

Service Code	APR-DRG 2053
Min. Negotiated Rate	$4,886.19
Max. Negotiated Rate	$4,886.19
Rate for Payer: AlohaCare Medicaid	$4,886.19
Rate for Payer: Hawaii Medical Service Association ABD	$4,886.19
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,886.19
Rate for Payer: Kaiser Permanente Medicaid	$4,886.19
Rate for Payer: Ohana Health Plan Medicaid	$4,886.19
Rate for Payer: UnitedHealthcare Medicaid	$4,886.19

CARDIOVERSION, ELECTIVE, ELECTRICAL CONVERSION OF ARRHYTHMIA; EXTERNAL

Facility

$6,183.00

Service Code	CPT 92960
Hospital Revenue Code	360
Min. Negotiated Rate	$340.18
Max. Negotiated Rate	$6,183.00
Rate for Payer: AlohaCare Medicaid	$780.80
Rate for Payer: AlohaCare Medicare	$780.80
Rate for Payer: Devoted Health Medicare	$858.88
Rate for Payer: Hawaii Medical Service Association ABD	$695.00
Rate for Payer: Hawaii Medical Service Association Commercial	$6,183.00
Rate for Payer: Hawaii Medical Service Association Medicare	$780.80
Rate for Payer: Hawaii Medical Service Association Non-ABD	$700.72
Rate for Payer: Humana Medicare	$780.80
Rate for Payer: Kaiser Permanente Medicaid	$2,837.00
Rate for Payer: Kaiser Permanente Medicare	$780.80
Rate for Payer: Ohana Health Plan Medicaid	$858.88
Rate for Payer: Ohana Health Plan Medicare	$780.80
Rate for Payer: UnitedHealthcare Medicaid	$340.18
Rate for Payer: UnitedHealthcare Medicare	$780.80
Rate for Payer: University Health Alliance Commercial	$4,035.20

CARFILZOMIB 60 MG IV RECON.SOLN.

Facility

$5,363.03

Service Code	HCPCS J9047
Hospital Revenue Code	250
Min. Negotiated Rate	$4,558.58
Max. Negotiated Rate	$5,202.14
Rate for Payer: Cash Price	$3,485.97
Rate for Payer: Health Management Network Commercial	$4,558.58
Rate for Payer: MDX Hawaii PPO	$5,202.14

Know your out-of-pocket cost for care.

All Charges