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 |
|---|---|---|---|---|
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $495.00 | $660.00 | not published | 0 |
| CT guid cryo ablat intramuscular CPT 20999 | not published | not published | not published | 0 |
| CT guid parench tis ablat CPT 77013 | $1,096.50 | $1,462.00 | not published | 0 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $292.50 | $390.00 | $109.00 – $109.00 | 1 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | $1,237.50 | $1,650.00 | $367.00 – $367.00 | 1 |
| CT hrt w/3d image CPT 75572 | $1,095.00 | $1,460.00 | $367.00 – $367.00 | 1 |
| CT limited or localized follow-up study CPT 76380 | $435.00 | $580.00 | $128.00 – $128.00 | 1 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $1,822.50 | $2,430.00 | $184.00 – $184.00 | 1 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,380.00 | $1,840.00 | $124.00 – $124.00 | 1 |
| CT lwr extremity w/o&w/dye CPT 73702 | $2,107.50 | $2,810.00 | $206.00 – $206.00 | 1 |
| CT neck soft tissue w/contrast CPT 70491 | $1,747.50 | $2,330.00 | $184.00 – $184.00 | 1 |
| CT neck soft tissue without contrast CPT 70490 | $1,552.50 | $2,070.00 | $134.00 – $134.00 | 1 |
| CT neck soft tissue without & w/contrast CPT 70492 | $1,965.00 | $2,620.00 | $216.00 – $216.00 | 1 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,747.50 | $2,330.00 | $224.00 – $224.00 | 1 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $1,597.50 | $2,130.00 | $190.00 – $190.00 | 1 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $1,455.00 | $1,940.00 | $147.00 – $147.00 | 1 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | not published | not published | not published | 0 |
| CT scan for localization CPT 77011 | $909.00 | $1,212.00 | not published | 0 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $3,472.50 | $4,630.00 | $367.00 – $367.00 | 1 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $2,692.50 | $3,590.00 | $367.00 – $367.00 | 1 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,400.00 | $3,200.00 | $249.00 – $249.00 | 1 |
| CT thoracic spine w/contrast CPT 72129 | $1,627.50 | $2,170.00 | $184.00 – $184.00 | 1 |
| CT thoracic spine without contrast CPT 72128 | $1,312.50 | $1,750.00 | $124.00 – $124.00 | 1 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $652.50 | $870.00 | $129.00 – $129.00 | 1 |
| CT t-spine w /wo contrast CPT 72130 | $1,747.50 | $2,330.00 | $207.00 – $207.00 | 1 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $1,597.50 | $2,130.00 | $367.00 – $367.00 | 1 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,380.00 | $1,840.00 | $160.00 – $160.00 | 1 |
| CT uppr extremity w/o&w/dye CPT 73202 | $1,777.50 | $2,370.00 | $268.00 – $268.00 | 1 |
| Cultr oocyte/embryo <4 days CPT 89250 | $3,815.25 | $5,087.00 | $1,243.00 – $1,243.00 | 1 |
| Cultr oocyte/embryo <4 days CPT 89251 | $3,637.50 | $4,850.00 | $1,293.00 – $1,293.00 | 1 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | not published | 0 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | not published | 0 |
| Culture aerobic additional method definitive id each CPT 87077 | $74.25 | $99.00 | $8.00 – $8.00 | 1 |
| Culture afb any source CPT 87116 | $78.75 | $105.00 | $11.00 – $11.00 | 1 |
| Culture anaerobic additional method definitive id each CPT 87076 | $118.50 | $158.00 | $8.00 – $8.00 | 1 |
| Culture anaerobic except blood CPT 87075 | $84.00 | $112.00 | $9.00 – $9.00 | 1 |
| Culture bacteria anaerobic CPT 87073 | $57.00 | $76.00 | $9.00 – $9.00 | 1 |
| Culture bacterial urine HCPCS P7001 | $72.00 | $96.00 | $20.00 – $20.00 | 1 |
| Culture bact stool aero addl path ea CPT 87046 | $52.50 | $70.00 | $9.00 – $9.00 | 1 |
| Culture body fluid CPT 87070 | $73.50 | $98.00 | $8.00 – $8.00 | 1 |
| Culture fungi definitive id mold CPT 87107 | $63.00 | $84.00 | $10.00 – $10.00 | 1 |
| Culture fungi definitive id yeast CPT 87106 | $79.50 | $106.00 | $10.00 – $10.00 | 1 |
| Culture fungi other (except blood) CPT 87102 | $77.25 | $103.00 | $8.00 – $8.00 | 1 |
| Culture fungi skin/hair/nail CPT 87101 | $51.00 | $68.00 | $8.00 – $8.00 | 1 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $72.00 | $96.00 | $15.00 – $15.00 | 1 |
| Culture mycoplasma any source CPT 87109 | $96.75 | $129.00 | $15.00 – $15.00 | 1 |
| Culture of specimen by kit CPT 87084 | $134.25 | $179.00 | $27.00 – $27.00 | 1 |
| Culture quantitative aerobic other source CPT 87071 | $84.00 | $112.00 | $10.00 – $10.00 | 1 |
| Culture screening strep group a CPT 87081 | $55.50 | $74.00 | $7.00 – $7.00 | 1 |
| Culture type pulse field gel CPT 87152 | $38.25 | $51.00 | $8.00 – $8.00 | 1 |
| Culture typing added method CPT 87158 | $38.25 | $51.00 | $8.00 – $8.00 | 1 |
| Culture typing glc/hplc CPT 87143 | $75.75 | $101.00 | $13.00 – $13.00 | 1 |
| Culture typing immunologic CPT 87147 | $31.50 | $42.00 | $5.00 – $5.00 | 1 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | not published | not published | $217.00 – $217.00 | 1 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $213.00 | $284.00 | $35.00 – $35.00 | 1 |
| Culture urine each isolate CPT 87088 | $71.25 | $95.00 | $8.00 – $8.00 | 1 |
| Culture virus isolation CPT 87250 | $118.50 | $158.00 | $20.00 – $20.00 | 1 |
| Curette/treat cornea CPT 65435 | not published | not published | not published | 0 |
| Curette/treat cornea CPT 65436 | not published | not published | not published | 0 |
| Cutter lead HCPCS C1773 | $675.00 | $900.00 | not published | 0 |
| Cv line/pic reposition CPT 36597 | $3,534.00 | $4,712.00 | not published | 0 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $87.00 | $116.00 | $14.00 – $14.00 | 1 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $14.16 | $18.87 | $0.95 – $0.95 | 1 |
| Cyclic citrullinated peptide antibody CPT 86200 | $102.00 | $136.00 | $13.00 – $13.00 | 1 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $1,747.80 | $2,330.40 | $0.60 – $0.60 | 1 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $1,180.97 | $1,574.62 | $1.98 – $1.98 | 1 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $195.93 | $261.23 | $72.00 – $72.00 | 1 |
| Cyclosporine 2 hour CPT 80158 | $113.25 | $151.00 | $18.00 – $18.00 | 1 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $15.51 | $20.67 | $0.77 – $0.77 | 1 |
| Cyclosporine oral 100 mg HCPCS J7502 | $1,956.57 | $2,608.76 | $2.07 – $2.07 | 1 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $727.50 | $970.00 | not published | 0 |
| Cymetra injectable HCPCS Q4112 | $417.00 | $556.00 | not published | 0 |
| Cyp2c19 gene com variants CPT 81225 | not published | not published | $291.00 – $291.00 | 1 |
| Cyp2c9 gene com variants CPT 81227 | not published | not published | $175.00 – $175.00 | 1 |
| Cyp2d6 gene com variants CPT 81226 | not published | not published | $450.00 – $450.00 | 1 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $175.00 – $175.00 | 1 |
| Cyp3a5 gene common variants CPT 81231 | not published | not published | $175.00 – $175.00 | 1 |
| Cystatin c CPT 82610 | $99.00 | $132.00 | $19.00 – $19.00 | 1 |
| Cystic fibrosis cftr CPT 81223 | $105.75 | $141.00 | $498.00 – $498.00 | 1 |
| Cystine urine quantitative CPT 82131 | $114.00 | $152.00 | $23.00 – $23.00 | 1 |
| Cysto cgen post urtl valves CPT 52400 | not published | not published | not published | 0 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $1,026.00 | $1,368.00 | $367.00 – $367.00 | 1 |
| Cysto impl 4 or more HCPCS C9740 | not published | not published | not published | 0 |
| Cysto insj dev ischmc rmdlg CPT 53865 | not published | not published | not published | 0 |
| Cysto, litho, vacuum kidney HCPCS C9761 | not published | not published | not published | 0 |
| Cystometrogram w/up 51727 CPT 51727 | $1,719.00 | $2,292.00 | not published | 0 |
| Cystorrhaphy wound simple 51860 CPT 51860 | not published | not published | not published | 0 |
| Cysto rx balo cath urtl strx CPT 52284 | not published | not published | not published | 0 |
| Cystoscopy and biopsy CPT 52007 | not published | not published | not published | 0 |
| Cystoscopy and radiotracer CPT 52250 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52214 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52224 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52234 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52235 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52240 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52260 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52265 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52276 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52277 | not published | not published | not published | 0 |
| Cystoscopy and treatment CPT 52283 | 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.