Moanalua Medical Center
3288 MOANALUA ROAD, HONOLULU, HI · Kaiserpermanente · · NPI 1396813861
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Ciliary transsleral therapy CPT 66710 | not published | not published | not published | 0 |
| Ciltacabtagene car-pos t HCPCS Q2056 | not published | not published | $605,288.00 – $605,288.00 | 1 |
| Cine/video x-rays CPT 76120 | $327.75 | $437.00 | $109.00 – $109.00 | 1 |
| Cine/video x-rays add-on CPT 76125 | $129.00 | $172.00 | not published | 0 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $25.17 | $33.56 | $2.30 – $2.30 | 1 |
| Ciprofloxacin otic susp 6 mg HCPCS J7342 | $63.31 | $84.41 | not published | 0 |
| Circum 28 days or older CPT 54161 | $1,353.00 | $1,804.00 | not published | 0 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | $4,726.50 | $6,302.00 | not published | 0 |
| Circumcision (newborn) CPT 54150 | $4,726.50 | $6,302.00 | not published | 0 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $1,203.75 | $1,605.00 | $1.95 – $1.95 | 1 |
| C-kit mutation liquid tumor - sendout CPT 81272 | not published | not published | $329.00 – $329.00 | 1 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $1,051.65 | $1,402.20 | $9.00 – $9.00 | 1 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $712.50 | $950.00 | not published | 0 |
| Claviculectomy partial CPT 23120 | not published | not published | not published | 0 |
| Claviculectomy total CPT 23125 | not published | not published | not published | 0 |
| Clean out mastoid cavity CPT 69222 | not published | not published | not published | 0 |
| Clearance of airways CPT 31720 | not published | not published | not published | 0 |
| Clearance of tear duct CPT 68530 | not published | not published | not published | 0 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $54.90 | $73.20 | $1.67 – $1.67 | 1 |
| Clip ligating vesolock lg HCPCS C1760 | $748.11 | $997.48 | not published | 0 |
| Clip phn wireless f/baha4 proc HCPCS L9900 | $253.13 | $337.50 | not published | 0 |
| Clitoroplasty intersex state CPT 56805 | not published | not published | not published | 0 |
| Clofarabine 1 mg/ml intravenous solution HCPCS J9027 | $6,901.03 | $9,201.37 | $15.00 – $15.00 | 1 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $413.25 | $551.00 | $18.00 – $18.00 | 1 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | $862.50 | $1,150.00 | not published | 0 |
| Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 | $4,853.25 | $6,471.00 | not published | 0 |
| Closed tx/acetabululm without manip 27220 CPT 27220 | not published | not published | not published | 0 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $4,853.25 | $6,471.00 | not published | 0 |
| Closed tx humerus fx without manip 23600 CPT 23600 | not published | not published | not published | 0 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $4,028.25 | $5,371.00 | not published | 0 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $772.50 | $1,030.00 | not published | 0 |
| Closed tx nose/jaw fx CPT 21345 | $4,092.00 | $5,456.00 | not published | 0 |
| Closed tx orbit without manipulj CPT 21400 | not published | not published | not published | 0 |
| Closed tx orbit w/manipulj CPT 21401 | $3,906.00 | $5,208.00 | not published | 0 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | $4,853.25 | $6,471.00 | not published | 0 |
| Closed tx septal&nose fx CPT 21337 | $5,270.25 | $7,027.00 | not published | 0 |
| Closed tx sesamoid fx 28530 CPT 28530 | not published | not published | not published | 0 |
| Closed tx/talus fracture without manip 28430 CPT 28430 | not published | not published | not published | 0 |
| Closed tx vert fx w/manj CPT 22315 | not published | not published | not published | 0 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | $653.25 | $871.00 | not published | 0 |
| Close mastoid fistula CPT 69700 | not published | not published | not published | 0 |
| Close tear duct opening CPT 68760 | not published | not published | not published | 0 |
| Close tear duct opening CPT 68761 | not published | not published | not published | 0 |
| Close tear system fistula CPT 68770 | not published | not published | not published | 0 |
| Clostridium toxin a w/optic CPT 87803 | $79.50 | $106.00 | $16.00 – $16.00 | 1 |
| Clos txnose fx without stablz 21315 CPT 21315 | $3,637.50 | $4,850.00 | not published | 0 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | $1,654.50 | $2,206.00 | not published | 0 |
| Closure of eyelid by suture CPT 67875 | $980.25 | $1,307.00 | not published | 0 |
| Closure of salivary fistula CPT 42600 | not published | not published | not published | 0 |
| Closure of windpipe lesion 31820 CPT 31820 | not published | not published | not published | 0 |
| Closure paravalvlr leak pq CPT 33999 | $4,634.25 | $6,179.00 | not published | 0 |
| Clot factor fletcher fact CPT 85292 | $118.50 | $158.00 | $19.00 – $19.00 | 1 |
| Clot factor viii reltd antgn CPT 85244 | $124.50 | $166.00 | $20.00 – $20.00 | 1 |
| Clot factor wght kininogen CPT 85293 | $118.50 | $158.00 | $19.00 – $19.00 | 1 |
| Clot factor xii hageman CPT 85280 | $121.50 | $162.00 | $19.00 – $19.00 | 1 |
| Clot factor xiii fibrin scrn CPT 85291 | $54.00 | $72.00 | $9.00 – $9.00 | 1 |
| Clot factor xiii fibrin stab CPT 85290 | $102.00 | $136.00 | $16.00 – $16.00 | 1 |
| Clotting assay whole blood CPT 85396 | $108.75 | $145.00 | $19.00 – $19.00 | 1 |
| Clozapine, 25 mg HCPCS S0136 | not published | not published | $1.10 – $1.10 | 1 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $772.50 | $1,030.00 | not published | 0 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $834.75 | $1,113.00 | not published | 0 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $847.50 | $1,130.00 | not published | 0 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | not published | not published | not published | 0 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | not published | not published | not published | 0 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | not published | not published | not published | 0 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | not published | not published | not published | 0 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | not published | not published | not published | 0 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | not published | not published | not published | 0 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $1,050.00 | $1,400.00 | not published | 0 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | not published | not published | not published | 0 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $383.25 | $511.00 | not published | 0 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $4,853.25 | $6,471.00 | not published | 0 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | not published | not published | not published | 0 |
| Clsd tx fracture of radius 25500 CPT 25500 | not published | not published | not published | 0 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | not published | not published | not published | 0 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $772.50 | $1,030.00 | not published | 0 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | not published | not published | not published | 0 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $2,058.00 | $2,744.00 | not published | 0 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | not published | not published | not published | 0 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $1,571.25 | $2,095.00 | not published | 0 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | not published | not published | not published | 0 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $862.50 | $1,150.00 | not published | 0 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | not published | not published | not published | 0 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | not published | not published | not published | 0 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | $957.75 | $1,277.00 | not published | 0 |
| Clsd tx mandibular fx without manip 21450 CPT 21450 | $1,461.00 | $1,948.00 | not published | 0 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | not published | not published | not published | 0 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | not published | not published | not published | 0 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $812.25 | $1,083.00 | not published | 0 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | not published | not published | not published | 0 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | not published | not published | not published | 0 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | not published | not published | not published | 0 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $5,270.25 | $7,027.00 | not published | 0 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | not published | not published | not published | 0 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $829.50 | $1,106.00 | not published | 0 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | not published | not published | not published | 0 |
| Clsd tx pelvic ring fx CPT 27197 | not published | not published | not published | 0 |
| Clsd tx pelvic ring fx CPT 27198 | not published | not published | not published | 0 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | not published | not published | not published | 0 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | not published | not published | not published | 0 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.