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 |
|---|---|---|---|---|
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | not published | 0 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | not published | 0 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | not published | 0 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | not published | 0 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | not published | 0 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | not published | 0 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | not published | 0 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | not published | 0 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | not published | 0 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | not published | 0 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | not published | 0 |
| Detect agent nos dna dir CPT 87797 | $148.50 | $198.00 | $30.00 – $30.00 | 1 |
| Detect agnt mult dna direc CPT 87800 | $243.75 | $325.00 | $44.00 – $44.00 | 1 |
| Device ablt adv novasure HCPCS C1886 | $675.00 | $900.00 | not published | 0 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $56.25 | $75.00 | not published | 0 |
| Device intraute mirena HCPCS J7298 | $2,845.99 | $3,794.65 | not published | 0 |
| Device sut capio slim opn HCPCS C2631 | $745.01 | $993.34 | not published | 0 |
| Device tiss remov myosure reach HCPCS C1782 | $744.98 | $993.30 | not published | 0 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $232.50 | $310.00 | $90.00 – $90.00 | 1 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $101.00 – $101.00 | 1 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $144.95 | $193.26 | $0.02 – $0.02 | 1 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $24.00 | $31.99 | $0.10 – $0.10 | 1 |
| Dexamethasone intra implant HCPCS J7312 | $3,216.57 | $4,288.76 | $205.00 – $205.00 | 1 |
| Dexamethasone panel CPT 80420 | $798.75 | $1,065.00 | $162.00 – $162.00 | 1 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | $247.20 | $329.60 | $0.60 – $0.60 | 1 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $1,287.27 | $1,716.35 | $32.00 – $32.00 | 1 |
| Dextran 40 infusion HCPCS J7100 | $214.13 | $285.50 | $87.00 – $87.00 | 1 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $0.37 – $0.37 | 1 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $29.10 | $38.80 | $1.35 – $1.35 | 1 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $44.10 | $58.80 | not published | 0 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $99.87 | $133.15 | $2.00 – $2.00 | 1 |
| Dextrose 5 % IV bolus HCPCS J7070 | not published | not published | $3.00 – $3.00 | 1 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $139.50 | $186.00 | $22.00 – $22.00 | 1 |
| Diabetes (HbA1c) Test CPT 83036 | $67.50 | $90.00 | $10.00 – $10.00 | 1 |
| Diag bronchoscope/catheter CPT 31643 | $4,758.00 | $6,344.00 | not published | 0 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | not published | 0 |
| Diagnostic anoscopy CPT 46601 | not published | not published | not published | 0 |
| Diagnostic anoscopy & biopsy CPT 46607 | $1,905.00 | $2,540.00 | not published | 0 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $206.25 | $275.00 | not published | 0 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $702.75 | $937.00 | $109.00 – $109.00 | 1 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $553.50 | $738.00 | $86.00 – $86.00 | 1 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $526.50 | $702.00 | not published | 0 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $370.50 | $494.00 | not published | 0 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $540.75 | $721.00 | $109.00 – $109.00 | 1 |
| Diagnostic Mammogram (one breast) CPT 77065 | $393.00 | $524.00 | $86.00 – $86.00 | 1 |
| Diagnostic radio unlisted proc CPT 76499 | $87.00 | $116.00 | not published | 0 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $5,770.50 | $7,694.00 | not published | 0 |
| Dialysis one evaluation CPT 90945 | $1,059.00 | $1,412.00 | not published | 0 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $152.93 | $203.90 | $0.07 – $0.07 | 1 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $106.76 | $142.34 | $6.00 – $6.00 | 1 |
| Dicyclomine injection HCPCS J0500 | $117.24 | $156.31 | $12.00 – $12.00 | 1 |
| Difelikefalin, esrd on dialy HCPCS J0879 | $354.75 | $473.00 | $0.08 – $0.08 | 1 |
| Diffusing capacity CPT 94729 | $264.00 | $352.00 | not published | 0 |
| Digital analysis of eeg CPT 95957 | $980.25 | $1,307.00 | not published | 0 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $326.04 | $434.72 | $4.00 – $4.00 | 1 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $11,642.91 | $15,523.88 | $4,966.00 – $4,966.00 | 1 |
| Digoxin total therapeutic drug level CPT 80162 | $129.75 | $173.00 | $13.00 – $13.00 | 1 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $249.45 | $332.60 | $97.00 – $97.00 | 1 |
| Dilate biliary duct/ampulla CPT 47542 | $1,334.25 | $1,779.00 | not published | 0 |
| Dilate esophagus CPT 43453 | not published | not published | not published | 0 |
| Dilate esophagus 1/mult pass CPT 43450 | $2,283.00 | $3,044.00 | not published | 0 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $1,102.50 | $1,470.00 | not published | 0 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $550.50 | $734.00 | not published | 0 |
| Dilate ic vasospasm init CPT 61640 | $1,566.00 | $2,088.00 | not published | 0 |
| Dilate tear duct opening CPT 68801 | not published | not published | not published | 0 |
| Dilate urethra stricture CPT 53600 | not published | not published | not published | 0 |
| Dilate urethra stricture CPT 53601 | not published | not published | not published | 0 |
| Dilate urethra stricture CPT 53605 | not published | not published | not published | 0 |
| Dilate urethra stricture CPT 53621 | not published | not published | not published | 0 |
| Dilation/female urethra/initial 53660 CPT 53660 | $268.50 | $358.00 | not published | 0 |
| Dilation of anal sphincter CPT 45905 | not published | not published | not published | 0 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | not published | 0 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | not published | 0 |
| Dilation of salivary duct CPT 42660 | not published | not published | not published | 0 |
| Dilation of urethra CPT 53661 | not published | not published | not published | 0 |
| Dilation of urethra CPT 53665 | not published | not published | not published | 0 |
| Dilation of vagina CPT 57400 | not published | not published | not published | 0 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | not published | 0 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | not published | 0 |
| Dilator fascial 10fx20cm HCPCS C2627 | $736.88 | $982.50 | not published | 0 |
| Dilat xst trc ndurlgc px CPT 50436 | $6,298.50 | $8,398.00 | not published | 0 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | not published | 0 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $73.73 | $98.30 | $0.04 – $0.04 | 1 |
| Dimecaprol injection HCPCS J0470 | $379.18 | $505.57 | not published | 0 |
| Dimenhydrinate injection HCPCS J1240 | $43.96 | $58.61 | $8.00 – $8.00 | 1 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $1,711.37 | $2,281.82 | $743.00 – $743.00 | 1 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $0.37 – $0.37 | 1 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $7.34 | $9.78 | $0.90 – $0.90 | 1 |
| Dipyridamole injection HCPCS J1245 | $64.34 | $85.78 | $3.86 – $3.86 | 1 |
| Disability dlco CPT 94727 | $279.75 | $373.00 | not published | 0 |
| Disaccharidases CPT 82657 | $113.25 | $151.00 | $22.00 – $22.00 | 1 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | not published | 0 |
| Discography cerv/thor spine CPT 72285 | $5,006.25 | $6,675.00 | $2,011.00 – $2,011.00 | 1 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | not published | 0 |
| Dist revas ligation hemo CPT 36838 | not published | not published | not published | 0 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | not published | 0 |
| #d/lmeth-l-methamphetamine CPT 80374 | $86.25 | $115.00 | $27.00 – $27.00 | 1 |
| Dmd dup/delet analysis CPT 81161 | $27.75 | $37.00 | $278.00 – $278.00 | 1 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $274.00 – $274.00 | 1 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $137.00 – $137.00 | 1 |
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.