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 |
|---|---|---|---|---|
| Incision secondary cataract CPT 66820 | not published | not published | not published | 0 |
| Incision tendon sheath CPT 26055 | $4,028.25 | $5,371.00 | not published | 0 |
| Incisn of toe tndn CPT 28010 | not published | not published | not published | 0 |
| Incisn windpipe CPT 31600 | $5,590.50 | $7,454.00 | not published | 0 |
| Incobotulinumtoxin a HCPCS J0588 | $2,395.23 | $3,193.64 | $5.30 – $5.30 | 1 |
| Indigotindisulfonate 8 mg/ml soln 5 ml ampule HCPCS J9220 | $939.75 | $1,253.00 | $10.00 – $10.00 | 1 |
| Induced ab 1+ vag sup w/dlv fetus CPT 59855 | $1,119.00 | $1,492.00 | not published | 0 |
| Induced abortion d&c CPT 59840 | not published | not published | not published | 0 |
| Induced abortion dilat&evac CPT 59841 | $2,076.00 | $2,768.00 | not published | 0 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | $176.25 | $235.00 | $70.00 – $70.00 | 1 |
| Infect ag drug suscept pheno predict CPT 87900 | $817.50 | $1,090.00 | $130.00 – $130.00 | 1 |
| Infect ag eia chlamydia trachomatis CPT 87320 | $74.25 | $99.00 | $15.00 – $15.00 | 1 |
| Infect ag eia influenza a or b ea CPT 87400 | $72.75 | $97.00 | $14.00 – $14.00 | 1 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $1,566.75 | $2,089.00 | $257.00 – $257.00 | 1 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $1,613.25 | $2,151.00 | $257.00 – $257.00 | 1 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $807.00 | $1,076.00 | $129.00 – $129.00 | 1 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $1,613.25 | $2,151.00 | $257.00 – $257.00 | 1 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | $166.50 | $222.00 | $33.00 – $33.00 | 1 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | $173.25 | $231.00 | $35.00 – $35.00 | 1 |
| Infect ag ia optc obs influenza CPT 87804 | $105.00 | $140.00 | $17.00 – $17.00 | 1 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | $72.75 | $97.00 | $12.00 – $12.00 | 1 |
| Infect ag if hep delta agent CPT 87380 | $99.75 | $133.00 | $18.00 – $18.00 | 1 |
| Infect ag if influenza a CPT 87276 | $81.00 | $108.00 | $16.00 – $16.00 | 1 |
| Infect ag if influenza b CPT 87275 | $75.00 | $100.00 | $12.00 – $12.00 | 1 |
| Infect ag if legionella pneumophila CPT 87278 | $100.50 | $134.00 | $16.00 – $16.00 | 1 |
| Infect ag if nos ea CPT 87299 | $81.00 | $108.00 | $16.00 – $16.00 | 1 |
| Infect ag if pneumocystis carinii CPT 87281 | $75.00 | $100.00 | $12.00 – $12.00 | 1 |
| Infect ag if varicella zoster CPT 87290 | $75.00 | $100.00 | $14.00 – $14.00 | 1 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | $263.25 | $351.00 | $53.00 – $53.00 | 1 |
| Infect ag na hep b amp CPT 87516 | $213.00 | $284.00 | $35.00 – $35.00 | 1 |
| Infect ag na herpes simplex quant CPT 87530 | $261.00 | $348.00 | $43.00 – $43.00 | 1 |
| Infect ag na hpv high-risk types CPT 87624 | $197.25 | $263.00 | $35.00 – $35.00 | 1 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $705.00 | $940.00 | $96.00 – $96.00 | 1 |
| Infect ag na influenza revr/amp ea type CPT 87501 | $312.75 | $417.00 | $51.00 – $51.00 | 1 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $157.50 | $210.00 | $51.00 – $51.00 | 1 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $2,595.75 | $3,461.00 | $416.00 – $416.00 | 1 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $2,974.50 | $3,966.00 | $488.00 – $488.00 | 1 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $158.25 | $211.00 | $26.00 – $26.00 | 1 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $41.00 – $41.00 | 1 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $116.25 | $155.00 | $12.00 – $12.00 | 1 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $75.00 | $100.00 | $14.00 – $14.00 | 1 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $75.00 | $100.00 | $14.00 – $14.00 | 1 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $81.75 | $109.00 | $12.00 – $12.00 | 1 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $101.25 | $135.00 | $14.00 – $14.00 | 1 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $130.50 | $174.00 | $10.00 – $10.00 | 1 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $64.50 | $86.00 | $10.00 – $10.00 | 1 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $229.50 | $306.00 | $24.00 – $24.00 | 1 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $133.50 | $178.00 | $12.00 – $12.00 | 1 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $75.00 | $100.00 | $12.00 – $12.00 | 1 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $72.75 | $97.00 | $12.00 – $12.00 | 1 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $575.25 | $767.00 | $35.00 – $35.00 | 1 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $260.25 | $347.00 | $35.00 – $35.00 | 1 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $225.75 | $301.00 | $37.00 – $37.00 | 1 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $2,759.25 | $3,679.00 | $416.00 – $416.00 | 1 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $261.00 | $348.00 | $35.00 – $35.00 | 1 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $286.50 | $382.00 | $35.00 – $35.00 | 1 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $333.00 | $444.00 | $42.00 – $42.00 | 1 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $337.50 | $450.00 | $35.00 – $35.00 | 1 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $127.50 | $170.00 | $51.00 – $51.00 | 1 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $384.75 | $513.00 | $142.00 – $142.00 | 1 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $359.25 | $479.00 | $142.00 – $142.00 | 1 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $377.25 | $503.00 | $35.00 – $35.00 | 1 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $153.00 | $204.00 | $35.00 – $35.00 | 1 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $378.75 | $505.00 | $70.00 – $70.00 | 1 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | not published | not published | $76.00 – $76.00 | 1 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | $3,670.50 | $4,894.00 | $678.00 – $678.00 | 1 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $2,537.25 | $3,383.00 | $416.00 – $416.00 | 1 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $848.25 | $1,131.00 | $128.00 – $128.00 | 1 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $1,299.00 | $1,732.00 | $262.00 – $262.00 | 1 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $310.50 | $414.00 | $43.00 – $43.00 | 1 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $189.00 | $252.00 | $43.00 – $43.00 | 1 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $345.00 | $460.00 | $43.00 – $43.00 | 1 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $562.50 | $750.00 | $85.00 – $85.00 | 1 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $441.00 | $588.00 | $142.00 – $142.00 | 1 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $2,736.45 | $3,648.60 | $117.00 – $117.00 | 1 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $50.00 – $50.00 | 1 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $2,218.05 | $2,957.39 | $19.00 – $19.00 | 1 |
| Influenza dna amp prob addl CPT 87503 | $144.00 | $192.00 | $29.00 – $29.00 | 1 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | $203.78 | $271.70 | not published | 0 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | $81.60 | $108.80 | not published | 0 |
| Infuse radioactive materials CPT 77750 | $1,506.75 | $2,009.00 | $271.00 – $271.00 | 1 |
| Ingest challenge ini 120 min CPT 95076 | $1,163.25 | $1,551.00 | not published | 0 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $596.25 | $795.00 | not published | 0 |
| Initiation & management bipap/cpap initial day CPT 94660 | $565.50 | $754.00 | not published | 0 |
| Init/sub psych care m 1st 30 HCPCS G2214 | $246.75 | $329.00 | not published | 0 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | $13,596.51 | $18,128.67 | $6.00 – $6.00 | 1 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $6,800.14 | $9,066.85 | $7.00 – $7.00 | 1 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.20 – $0.20 | 1 |
| Inj, acetaminophen (b braun) HCPCS J0136 | $22.50 | $29.99 | $0.05 – $0.05 | 1 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.05 – $0.05 | 1 |
| Inj, acetaminophen (hikma) HCPCS J0137 | not published | not published | $0.05 – $0.05 | 1 |
| Inj. acthar gel to 40 units HCPCS J0801 | $10,604.89 | $14,139.85 | $4,186.00 – $4,186.00 | 1 |
| Inj, adalimumab, 1 mg HCPCS J0139 | $16,202.75 | $21,603.66 | $92.00 – $92.00 | 1 |
| Inj adalimumab-ryvk, 1 mg HCPCS Q5142 | not published | not published | $13.00 – $13.00 | 1 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | $32,889.75 | $43,853.00 | $63,402.00 – $63,402.00 | 1 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $36.00 – $36.00 | 1 |
| Inj, aflibercept-ayyh, 1 mg HCPCS Q5147 | $3,997.27 | $5,329.69 | $507.00 – $507.00 | 1 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | $6,394.41 | $8,525.88 | $320.00 – $320.00 | 1 |
| Inj, afstyla, 1 i.u HCPCS J7210 | $9.75 | $13.00 | $1.58 – $1.58 | 1 |
| Inj, alfentanil hcl, 500mcg HCPCS J0216 | $51.84 | $69.12 | 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.