Kona Community Hospital

All Charges

Charge

Type

Setting

Price

VECURONIUM BROMIDE 10 MG IV RECON.SOLN.

Facility

$24.29

Service Code	NDC 25021068510
Hospital Revenue Code	250
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$23.56
Rate for Payer: Cash Price	$15.79
Rate for Payer: Hawaii Western Management Group Commercial	$23.08
Rate for Payer: Health Management Network Commercial	$20.65
Rate for Payer: Kaiser Permanente Commercial	$15.30
Rate for Payer: Kaiser Permanente Medicaid	$12.39
Rate for Payer: MDX Hawaii PPO	$23.56
Rate for Payer: UnitedHealthcare Medicaid	$14.57
Rate for Payer: University Health Alliance Commercial	$17.70

VECURONIUM BROMIDE 10 MG IV RECON.SOLN.

Facility

$24.29

Service Code	NDC 25021068510
Hospital Revenue Code	250
Min. Negotiated Rate	$20.65
Max. Negotiated Rate	$23.56
Rate for Payer: Cash Price	$15.79
Rate for Payer: Health Management Network Commercial	$20.65
Rate for Payer: MDX Hawaii PPO	$23.56

VECURONIUM BROMIDE 10 MG IV RECON.SOLN.

Facility

$31.47

Service Code	NDC 67457043810
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$30.53
Rate for Payer: Cash Price	$20.46
Rate for Payer: Hawaii Western Management Group Commercial	$29.90
Rate for Payer: Health Management Network Commercial	$26.75
Rate for Payer: Kaiser Permanente Commercial	$19.83
Rate for Payer: Kaiser Permanente Medicaid	$16.05
Rate for Payer: MDX Hawaii PPO	$30.53
Rate for Payer: UnitedHealthcare Medicaid	$18.88
Rate for Payer: University Health Alliance Commercial	$22.94

VEDOLIZUMAB 300 MG IV RECON.SOLN.

Facility

$12,350.30

Service Code	HCPCS J3380
Hospital Revenue Code	250
Min. Negotiated Rate	$10,497.75
Max. Negotiated Rate	$11,979.79
Rate for Payer: Cash Price	$8,027.70
Rate for Payer: Health Management Network Commercial	$10,497.75
Rate for Payer: MDX Hawaii PPO	$11,979.79

VEDOLIZUMAB 300 MG IV RECON.SOLN.

Facility

$12,350.30

Service Code	HCPCS J3380
Hospital Revenue Code	636
Min. Negotiated Rate	$20.98
Max. Negotiated Rate	$11,979.79
Rate for Payer: AlohaCare Medicaid	$20.98
Rate for Payer: AlohaCare Medicare	$20.98
Rate for Payer: Cash Price	$8,027.70
Rate for Payer: Cash Price	$8,027.70
Rate for Payer: Devoted Health Medicare	$23.08
Rate for Payer: Hawaii Medical Service Association ABD	$22.06
Rate for Payer: Hawaii Medical Service Association Commercial	$26.23
Rate for Payer: Hawaii Medical Service Association Medicare	$20.98
Rate for Payer: Hawaii Medical Service Association Non-ABD	$22.06
Rate for Payer: Hawaii Western Management Group Commercial	$11,732.78
Rate for Payer: Health Management Network Commercial	$10,497.75
Rate for Payer: Humana Medicare	$20.98
Rate for Payer: Kaiser Permanente Commercial	$7,780.69
Rate for Payer: Kaiser Permanente Medicaid	$6,298.65
Rate for Payer: Kaiser Permanente Medicare	$20.98
Rate for Payer: MDX Hawaii PPO	$11,979.79
Rate for Payer: Ohana Health Plan Medicaid	$23.08
Rate for Payer: Ohana Health Plan Medicare	$20.98
Rate for Payer: UnitedHealthcare Medicaid	$7,410.18
Rate for Payer: UnitedHealthcare Medicare	$20.98
Rate for Payer: University Health Alliance Commercial	$9,002.13

VEIN LIGATION AND STRIPPING

Facility

$52,740.15

Service Code	MSDRG 263
Min. Negotiated Rate	$33,460.52
Max. Negotiated Rate	$52,740.15
Rate for Payer: AlohaCare Medicare	$40,213.28
Rate for Payer: Devoted Health Medicare	$44,234.61
Rate for Payer: Hawaii Medical Service Association Commercial	$33,460.52
Rate for Payer: Hawaii Medical Service Association Medicare	$40,213.28
Rate for Payer: Humana Medicare	$40,213.28
Rate for Payer: Kaiser Permanente Commercial	$52,740.15
Rate for Payer: Kaiser Permanente Medicare	$40,213.28
Rate for Payer: Ohana Health Plan Medicare	$40,213.28
Rate for Payer: UnitedHealthcare Medicare	$40,213.28

VENLAFAXINE 25 MG PO TABLET

Facility

$11.41

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$9.70
Max. Negotiated Rate	$11.07
Rate for Payer: Cash Price	$7.42
Rate for Payer: Health Management Network Commercial	$9.70
Rate for Payer: MDX Hawaii PPO	$11.07

VENLAFAXINE 25 MG PO TABLET

Facility

$11.41

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$5.82
Max. Negotiated Rate	$11.07
Rate for Payer: Cash Price	$7.42
Rate for Payer: Hawaii Western Management Group Commercial	$10.84
Rate for Payer: Health Management Network Commercial	$9.70
Rate for Payer: Kaiser Permanente Commercial	$7.19
Rate for Payer: Kaiser Permanente Medicaid	$5.82
Rate for Payer: MDX Hawaii PPO	$11.07
Rate for Payer: UnitedHealthcare Medicaid	$6.85
Rate for Payer: University Health Alliance Commercial	$8.32

VENLAFAXINE 37.5 MG PO CAP SR 24HR

Facility

$22.99

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$11.72
Max. Negotiated Rate	$22.30
Rate for Payer: Cash Price	$14.94
Rate for Payer: Cash Price	$13.43
Rate for Payer: Hawaii Western Management Group Commercial	$19.63
Rate for Payer: Hawaii Western Management Group Commercial	$21.84
Rate for Payer: Health Management Network Commercial	$17.56
Rate for Payer: Health Management Network Commercial	$19.54
Rate for Payer: Kaiser Permanente Commercial	$13.02
Rate for Payer: Kaiser Permanente Commercial	$14.48
Rate for Payer: Kaiser Permanente Medicaid	$11.72
Rate for Payer: Kaiser Permanente Medicaid	$10.54
Rate for Payer: MDX Hawaii PPO	$20.04
Rate for Payer: MDX Hawaii PPO	$22.30
Rate for Payer: UnitedHealthcare Medicaid	$12.40
Rate for Payer: UnitedHealthcare Medicaid	$13.79
Rate for Payer: University Health Alliance Commercial	$15.06
Rate for Payer: University Health Alliance Commercial	$16.76

VENLAFAXINE 37.5 MG PO CAP SR 24HR

Facility

$20.66

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$17.56
Max. Negotiated Rate	$20.04
Rate for Payer: Cash Price	$13.43
Rate for Payer: Cash Price	$14.94
Rate for Payer: Health Management Network Commercial	$17.56
Rate for Payer: Health Management Network Commercial	$19.54
Rate for Payer: MDX Hawaii PPO	$22.30
Rate for Payer: MDX Hawaii PPO	$20.04

VENLAFAXINE 75 MG PO CAP SR 24HR

Facility

$23.17

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$22.47
Rate for Payer: Cash Price	$15.06
Rate for Payer: Health Management Network Commercial	$19.69
Rate for Payer: MDX Hawaii PPO	$22.47

VENLAFAXINE 75 MG PO CAP SR 24HR

Facility

$23.17

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$22.47
Rate for Payer: Cash Price	$15.06
Rate for Payer: Hawaii Western Management Group Commercial	$22.01
Rate for Payer: Health Management Network Commercial	$19.69
Rate for Payer: Kaiser Permanente Commercial	$14.60
Rate for Payer: Kaiser Permanente Medicaid	$11.82
Rate for Payer: MDX Hawaii PPO	$22.47
Rate for Payer: UnitedHealthcare Medicaid	$13.90
Rate for Payer: University Health Alliance Commercial	$16.89

VENTRICULAR SHUNT PROCEDURES

Facility

$7,622.53

Service Code	APR-DRG 0222
Min. Negotiated Rate	$7,622.53
Max. Negotiated Rate	$7,622.53
Rate for Payer: AlohaCare Medicaid	$7,622.53
Rate for Payer: Hawaii Medical Service Association ABD	$7,622.53
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7,622.53
Rate for Payer: Kaiser Permanente Medicaid	$7,622.53
Rate for Payer: Ohana Health Plan Medicaid	$7,622.53
Rate for Payer: UnitedHealthcare Medicaid	$7,622.53

VENTRICULAR SHUNT PROCEDURES

Facility

$6,591.55

Service Code	APR-DRG 0221
Min. Negotiated Rate	$6,591.55
Max. Negotiated Rate	$6,591.55
Rate for Payer: AlohaCare Medicaid	$6,591.55
Rate for Payer: Hawaii Medical Service Association ABD	$6,591.55
Rate for Payer: Hawaii Medical Service Association Non-ABD	$6,591.55
Rate for Payer: Kaiser Permanente Medicaid	$6,591.55
Rate for Payer: Ohana Health Plan Medicaid	$6,591.55
Rate for Payer: UnitedHealthcare Medicaid	$6,591.55

VENTRICULAR SHUNT PROCEDURES

Facility

$10,705.30

Service Code	APR-DRG 0223
Min. Negotiated Rate	$10,705.30
Max. Negotiated Rate	$10,705.30
Rate for Payer: AlohaCare Medicaid	$10,705.30
Rate for Payer: Hawaii Medical Service Association ABD	$10,705.30
Rate for Payer: Hawaii Medical Service Association Non-ABD	$10,705.30
Rate for Payer: Kaiser Permanente Medicaid	$10,705.30
Rate for Payer: Ohana Health Plan Medicaid	$10,705.30
Rate for Payer: UnitedHealthcare Medicaid	$10,705.30

VENTRICULAR SHUNT PROCEDURES

Facility

$23,376.40

Service Code	APR-DRG 0224
Min. Negotiated Rate	$23,376.40
Max. Negotiated Rate	$23,376.40
Rate for Payer: AlohaCare Medicaid	$23,376.40
Rate for Payer: Hawaii Medical Service Association ABD	$23,376.40
Rate for Payer: Hawaii Medical Service Association Non-ABD	$23,376.40
Rate for Payer: Kaiser Permanente Medicaid	$23,376.40
Rate for Payer: Ohana Health Plan Medicaid	$23,376.40
Rate for Payer: UnitedHealthcare Medicaid	$23,376.40

VENTRICULAR SHUNT PROCEDURES WITH CC

Facility

$54,747.00

Service Code	MSDRG 032
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$54,747.00
Rate for Payer: AlohaCare Medicare	$28,028.55
Rate for Payer: Devoted Health Medicare	$30,831.40
Rate for Payer: Hawaii Medical Service Association Commercial	$54,747.00
Rate for Payer: Hawaii Medical Service Association Medicare	$28,028.55
Rate for Payer: Humana Medicare	$28,028.55
Rate for Payer: Kaiser Permanente Commercial	$36,759.75
Rate for Payer: Kaiser Permanente Medicare	$28,028.55
Rate for Payer: Ohana Health Plan Medicare	$28,028.55
Rate for Payer: UnitedHealthcare Medicare	$28,028.55
Rate for Payer: University Health Alliance Commercial	$10,400.00

VENTRICULAR SHUNT PROCEDURES WITH MCC

Facility

$77,288.62

Service Code	MSDRG 031
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$77,288.62
Rate for Payer: AlohaCare Medicare	$58,930.98
Rate for Payer: Devoted Health Medicare	$64,824.08
Rate for Payer: Hawaii Medical Service Association Commercial	$54,747.00
Rate for Payer: Hawaii Medical Service Association Medicare	$58,930.98
Rate for Payer: Humana Medicare	$58,930.98
Rate for Payer: Kaiser Permanente Commercial	$77,288.62
Rate for Payer: Kaiser Permanente Medicare	$58,930.98
Rate for Payer: Ohana Health Plan Medicare	$58,930.98
Rate for Payer: UnitedHealthcare Medicare	$58,930.98
Rate for Payer: University Health Alliance Commercial	$10,400.00

VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC

Facility

$38,040.85

Service Code	MSDRG 033
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$38,040.85
Rate for Payer: AlohaCare Medicare	$21,871.73
Rate for Payer: Devoted Health Medicare	$24,058.90
Rate for Payer: Hawaii Medical Service Association Commercial	$38,040.85
Rate for Payer: Hawaii Medical Service Association Medicare	$21,871.73
Rate for Payer: Humana Medicare	$21,871.73
Rate for Payer: Kaiser Permanente Commercial	$28,685.03
Rate for Payer: Kaiser Permanente Medicare	$21,871.73
Rate for Payer: Ohana Health Plan Medicare	$21,871.73
Rate for Payer: UnitedHealthcare Medicare	$21,871.73
Rate for Payer: University Health Alliance Commercial	$10,400.00

VERAPAMIL 120 MG PO TABLET

Facility

$3.78

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$3.67
Rate for Payer: Cash Price	$2.46
Rate for Payer: Cash Price	$2.98
Rate for Payer: Hawaii Western Management Group Commercial	$4.36
Rate for Payer: Hawaii Western Management Group Commercial	$3.59
Rate for Payer: Health Management Network Commercial	$3.90
Rate for Payer: Health Management Network Commercial	$3.21
Rate for Payer: Kaiser Permanente Commercial	$2.38
Rate for Payer: Kaiser Permanente Commercial	$2.89
Rate for Payer: Kaiser Permanente Medicaid	$1.93
Rate for Payer: Kaiser Permanente Medicaid	$2.34
Rate for Payer: MDX Hawaii PPO	$4.45
Rate for Payer: MDX Hawaii PPO	$3.67
Rate for Payer: UnitedHealthcare Medicaid	$2.27
Rate for Payer: UnitedHealthcare Medicaid	$2.75
Rate for Payer: University Health Alliance Commercial	$2.76
Rate for Payer: University Health Alliance Commercial	$3.35

VERAPAMIL 120 MG PO TABLET

Facility

$4.59

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$4.45
Rate for Payer: Cash Price	$2.98
Rate for Payer: Cash Price	$2.46
Rate for Payer: Health Management Network Commercial	$3.21
Rate for Payer: Health Management Network Commercial	$3.90
Rate for Payer: MDX Hawaii PPO	$4.45
Rate for Payer: MDX Hawaii PPO	$3.67

VERAPAMIL 180 MG PO TAB SR

Facility

$7.95

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$6.76
Max. Negotiated Rate	$7.71
Rate for Payer: Cash Price	$5.17
Rate for Payer: Health Management Network Commercial	$6.76
Rate for Payer: MDX Hawaii PPO	$7.71

VERAPAMIL 180 MG PO TAB SR

Facility

$7.95

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$7.71
Rate for Payer: Cash Price	$5.17
Rate for Payer: Hawaii Western Management Group Commercial	$7.55
Rate for Payer: Health Management Network Commercial	$6.76
Rate for Payer: Kaiser Permanente Commercial	$5.01
Rate for Payer: Kaiser Permanente Medicaid	$4.05
Rate for Payer: MDX Hawaii PPO	$7.71
Rate for Payer: UnitedHealthcare Medicaid	$4.77
Rate for Payer: University Health Alliance Commercial	$5.79

VERAPAMIL 240 MG PO TAB SR

Facility

$9.04

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$7.68
Max. Negotiated Rate	$8.77
Rate for Payer: Cash Price	$5.88
Rate for Payer: Health Management Network Commercial	$7.68
Rate for Payer: MDX Hawaii PPO	$8.77

VERAPAMIL 240 MG PO TAB SR

Facility

$9.04

Service Code	HCPCS A9270
Hospital Revenue Code	250
Min. Negotiated Rate	$4.61
Max. Negotiated Rate	$8.77
Rate for Payer: Cash Price	$5.88
Rate for Payer: Hawaii Western Management Group Commercial	$8.59
Rate for Payer: Health Management Network Commercial	$7.68
Rate for Payer: Kaiser Permanente Commercial	$5.70
Rate for Payer: Kaiser Permanente Medicaid	$4.61
Rate for Payer: MDX Hawaii PPO	$8.77
Rate for Payer: UnitedHealthcare Medicaid	$5.42
Rate for Payer: University Health Alliance Commercial	$6.59

Know your out-of-pocket cost for care.

All Charges