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 |
|---|---|---|---|---|
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | $52.50 | $70.00 | $8.00 – $8.00 | 1 |
| Ghs mbp CPT 83873 | $108.00 | $144.00 | $17.00 – $17.00 | 1 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $181.50 | $242.00 | not published | 0 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $193.50 | $258.00 | not published | 0 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $34.50 | $46.00 | not published | 0 |
| Ghs musc test done w/n test comp CPT 95886 | $237.00 | $316.00 | not published | 0 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $172.50 | $230.00 | not published | 0 |
| Ghs musc tst done w/n tst non ext CPT 95887 | $255.00 | $340.00 | not published | 0 |
| Ghs myocardial strain img spckl track CPT 93356 | $119.25 | $159.00 | not published | 0 |
| Ghs nailbed repair/nail removal CPT 11760 | $922.50 | $1,230.00 | not published | 0 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $1,082.25 | $1,443.00 | not published | 0 |
| Ghs nerve blk intercostal, single level CPT 64420 | $819.00 | $1,092.00 | not published | 0 |
| Ghs nerve block axillary nerve CPT 64417 | $605.25 | $807.00 | not published | 0 |
| Ghs nerve block brachial plexus CPT 64415 | $1,082.25 | $1,443.00 | not published | 0 |
| Ghs nerve block celiac plexus CPT 64530 | $1,150.50 | $1,534.00 | not published | 0 |
| Ghs nerve block interscaline CPT 64510 | $2,506.50 | $3,342.00 | not published | 0 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $2,506.50 | $3,342.00 | not published | 0 |
| Ghs nerve block sciatic nerve CPT 64445 | $1,872.75 | $2,497.00 | not published | 0 |
| Ghs nerve block suprascapular CPT 64418 | not published | not published | not published | 0 |
| Ghs ng placement w fluoro guidance CPT 43752 | $1,141.50 | $1,522.00 | not published | 0 |
| Ghs o2 saturation CPT 82810 | $53.25 | $71.00 | $10.00 – $10.00 | 1 |
| Ghs o2 uptake rest & exercise CPT 94680 | $189.00 | $252.00 | not published | 0 |
| Ghs o2 uptake rest & indirect CPT 94690 | $183.00 | $244.00 | not published | 0 |
| Ghs opcc repair cvp without subq port CPT 36575 | $1,556.25 | $2,075.00 | not published | 0 |
| Ghs opcc repair cvp w subq port CPT 36576 | not published | not published | not published | 0 |
| Ghs optokenetic CPT 92544 | $417.00 | $556.00 | not published | 0 |
| Ghs oscillating trac CPT 92545 | $723.75 | $965.00 | not published | 0 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $169.50 | $226.00 | not published | 0 |
| Ghs pacing - transcutaneous CPT 92953 | $1,728.75 | $2,305.00 | not published | 0 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $181.50 | $242.00 | not published | 0 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $131.25 | $175.00 | not published | 0 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | $108.75 | $145.00 | $26.00 – $26.00 | 1 |
| Ghs peritonsillar abscess i andd CPT 42700 | $648.75 | $865.00 | not published | 0 |
| Ghs phenylketonurid CPT 84030 | $33.75 | $45.00 | $5.00 – $5.00 | 1 |
| Ghs picc line insert < 5 CPT 36568 | $2,458.50 | $3,278.00 | not published | 0 |
| Ghs plngl fx pm cl CPT 26725 | $772.50 | $1,030.00 | not published | 0 |
| Ghs plt ct-manual CPT 85032 | $27.00 | $36.00 | $4.00 – $4.00 | 1 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $3,343.50 | $4,458.00 | not published | 0 |
| Ghs pos nystagmus CPT 92542 | $86.25 | $115.00 | not published | 0 |
| Ghs ppd (tb intradermal) CPT 86580 | $29.25 | $39.00 | $11.00 – $11.00 | 1 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $58.50 | $78.00 | $9.00 – $9.00 | 1 |
| Ghs protein, misc fluid CPT 84160 | $25.50 | $34.00 | $6.00 – $6.00 | 1 |
| Ghs protoporphyrins fract CPT 84202 | $90.75 | $121.00 | $14.00 – $14.00 | 1 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $74.25 | $99.00 | $12.00 – $12.00 | 1 |
| Ghs quinidine CPT 80194 | $89.25 | $119.00 | $15.00 – $15.00 | 1 |
| Ghs removal intranasal foreign body CPT 30300 | $485.25 | $647.00 | not published | 0 |
| Ghs removal pharyngeal foreign body CPT 42809 | $1,188.00 | $1,584.00 | not published | 0 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $4,853.25 | $6,471.00 | not published | 0 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | not published | 0 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $78.75 | $105.00 | $16.00 – $16.00 | 1 |
| Ghs reticulocyte count CPT 85044 | $27.00 | $36.00 | $4.00 – $4.00 | 1 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $72.75 | $97.00 | $14.00 – $14.00 | 1 |
| Ghs sedimentation rate CPT 85651 | $30.00 | $40.00 | $4.00 – $4.00 | 1 |
| Ghs semen analysis fert CPT 89320 | $45.00 | $60.00 | $12.00 – $12.00 | 1 |
| Ghs semen analysis, post-vas CPT 89300 | $30.75 | $41.00 | $10.00 – $10.00 | 1 |
| Ghs sensitivity (per antimicro) CPT 87184 | $54.75 | $73.00 | $7.00 – $7.00 | 1 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $675.75 | $901.00 | not published | 0 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $531.00 | $708.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $743.25 | $991.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | not published | 0 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $390.00 | $520.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $399.75 | $533.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $424.50 | $566.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | not published | not published | not published | 0 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | not published | 0 |
| Ghs sleep study unattended CPT 95800 | $465.00 | $620.00 | not published | 0 |
| Ghs somatosensory testing lower extremit CPT 95926 | $830.25 | $1,107.00 | not published | 0 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $1,441.50 | $1,922.00 | not published | 0 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $144.75 | $193.00 | not published | 0 |
| Ghs sphenopalatine ganglion block CPT 64505 | $2,517.00 | $3,356.00 | not published | 0 |
| Ghs spont nystagmus CPT 92541 | $86.25 | $115.00 | not published | 0 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $305.25 | $407.00 | not published | 0 |
| Ghs st - eval for alt comm CPT 92567 | $84.75 | $113.00 | not published | 0 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | not published | 0 |
| Ghs st - re-eval for alt comm CPT 92597 | $238.50 | $318.00 | not published | 0 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,100.25 | $1,467.00 | not published | 0 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $1,118.25 | $1,491.00 | not published | 0 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | not published | 0 |
| Ghs trypsin (fecal) CPT 84488 | $45.00 | $60.00 | $7.00 – $7.00 | 1 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $772.50 | $1,030.00 | not published | 0 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | not published | 0 |
| Ghs urine, hydroxproline total CPT 83505 | $148.50 | $198.00 | $24.00 – $24.00 | 1 |
| Ghs urine, porphyrins quant CPT 84120 | $92.25 | $123.00 | $15.00 – $15.00 | 1 |
| Ghs vaginal delivery only CPT 59409 | $2,419.50 | $3,226.00 | not published | 0 |
| Ghs windowing of cast CPT 29730 | not published | not published | not published | 0 |
| Giardia ag if CPT 87269 | $72.75 | $97.00 | $14.00 – $14.00 | 1 |
| Giardia lamblia antibody CPT 86674 | $92.25 | $123.00 | $15.00 – $15.00 | 1 |
| Gi endoscopic ultrasound CPT 76975 | $740.25 | $987.00 | $249.00 – $249.00 | 1 |
| Gi inhouse confirmation CPT 87045 | $59.25 | $79.00 | $9.00 – $9.00 | 1 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | not published | 0 |
| Gi protein loss CPT 78282 | $997.50 | $1,330.00 | $414.00 – $414.00 | 1 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $3,174.75 | $4,233.00 | not published | 0 |
| Gi trc img intral esophagus CPT 91111 | $2,571.00 | $3,428.00 | not published | 0 |
| Gi wireless capsule measure CPT 91112 | $3,575.25 | $4,767.00 | not published | 0 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $101.00 – $101.00 | 1 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $61.00 – $61.00 | 1 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $35.00 – $35.00 | 1 |
| Glassia injection HCPCS J0257 | $27.21 | $36.28 | $5.70 – $5.70 | 1 |
| Glaucoma surgery CPT 66150 | not published | not published | not published | 0 |
| Glaucoma surgery CPT 66155 | 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.