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 |
|---|---|---|---|---|
| Opn tx orbit fx without impl 21406 CPT 21406 | not published | not published | not published | 0 |
| Opn tx orbit periorbtl implt CPT 21390 | not published | not published | not published | 0 |
| Opn tx orbit periorbt w/grft CPT 21395 | not published | not published | not published | 0 |
| Oprelvekin injection HCPCS J2355 | not published | not published | $275.00 – $275.00 | 1 |
| Optical endomicroscpy interp CPT 88375 | $164.25 | $219.00 | $46.00 – $46.00 | 1 |
| Optx acrclv dslc aq/chrn grf CPT 23552 | not published | not published | not published | 0 |
| Optx acromclv dislc aqt/chrn CPT 23550 | not published | not published | not published | 0 |
| Optx acute shoulder dislc CPT 23660 | not published | not published | not published | 0 |
| Optx carpl scphd fx int fixj CPT 25628 | not published | not published | not published | 0 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | not published | 0 |
| Optx complicated mndblr fx CPT 21470 | not published | not published | not published | 0 |
| Optx crpl fx oth/thn scph ea CPT 25645 | not published | not published | not published | 0 |
| Optx gr hmrl tbrs fx int fix CPT 23630 | not published | not published | not published | 0 |
| Optx lunate dislocation CPT 25695 | not published | not published | not published | 0 |
| Optx medial ankle fx CPT 27766 | not published | not published | not published | 0 |
| Optx mndblr cndylr fx CPT 21465 | not published | not published | not published | 0 |
| Optx mndblr fx wo ntrdntl CPT 21461 | not published | not published | not published | 0 |
| Optx mndblr fx xtrnl fixj CPT 21454 | not published | not published | not published | 0 |
| Optx mndblr/max alv ridge fx CPT 21445 | not published | not published | not published | 0 |
| Optx palatal/max fracture CPT 21422 | not published | not published | not published | 0 |
| Optx partclr fx&/dslc elbw w CPT 24587 | not published | not published | not published | 0 |
| Optx post ankle fx CPT 27769 | not published | not published | not published | 0 |
| Optx prox humrl fx w/int fix CPT 23615 | not published | not published | not published | 0 |
| Optx prx hmrl fx fix rpr rpl CPT 23616 | not published | not published | not published | 0 |
| Optx radial shaft fracture CPT 25515 | not published | not published | not published | 0 |
| Optx rad/uln dislc aqt/chrnc CPT 25676 | not published | not published | not published | 0 |
| Optx rdcrpl/ntrcrpl dislc 1+ CPT 25670 | not published | not published | not published | 0 |
| Optx rdl shft fx&cltx rad/ul CPT 25525 | not published | not published | not published | 0 |
| Optx rdl shft fx&dstl rad/ul CPT 25526 | not published | not published | not published | 0 |
| Optx rdl&uln shft fx rds&uln CPT 25575 | not published | not published | not published | 0 |
| Optx rdl&uln shft fx rds/uln CPT 25574 | not published | not published | not published | 0 |
| Optx scapular fx w/int fixj CPT 23585 | not published | not published | not published | 0 |
| Optx sho dislc fx CPT 23670 | not published | not published | not published | 0 |
| Optx sho dislc neck fx fixj CPT 23680 | not published | not published | not published | 0 |
| Optx strclv dslc aq/chrn grf CPT 23532 | not published | not published | not published | 0 |
| Optx strnclav dislc aqt/chrn CPT 23530 | not published | not published | not published | 0 |
| Optx tmprmand dislocation CPT 21490 | not published | not published | not published | 0 |
| Optx trns-scphprlnr fx dislc CPT 25685 | not published | not published | not published | 0 |
| Optx ulnar shft fx int fixj CPT 25545 | not published | not published | not published | 0 |
| Optx ulnar styloid fracture CPT 25652 | not published | not published | not published | 0 |
| Oral aprepitant HCPCS J8501 | $801.39 | $1,068.51 | $2.70 – $2.70 | 1 |
| Oral busulfan HCPCS J8510 | $706.59 | $942.12 | $84.00 – $84.00 | 1 |
| Oral everolimus HCPCS J7527 | $1,602.93 | $2,137.24 | $1.99 – $1.99 | 1 |
| Oral hiv-1/hiv-2 screen HCPCS G0435 | $36.75 | $49.00 | $12.00 – $12.00 | 1 |
| Oral methotrexate (jylamvo) HCPCS J8611 | not published | not published | $18.00 – $18.00 | 1 |
| Oral methotrexate (xatmep) HCPCS J8612 | $5,854.69 | $7,806.25 | $23.00 – $23.00 | 1 |
| Oral netupitant, palonosetro HCPCS J8655 | $1,616.34 | $2,155.11 | $409.00 – $409.00 | 1 |
| Orchiectomy partial CPT 54522 | not published | not published | not published | 0 |
| Orchiopexy (fowler-stephens) CPT 54650 | not published | not published | not published | 0 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | not published | 0 |
| Organic acids total quant ea spec CPT 83918 | $120.00 | $160.00 | $24.00 – $24.00 | 1 |
| Oritavancin 1,200 mg intravenous solution HCPCS J2406 | $12,492.06 | $16,656.07 | $42.00 – $42.00 | 1 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | $2,720.05 | $3,626.73 | $28.00 – $28.00 | 1 |
| Oropharyngeal biopsy 42800 CPT 42800 | not published | not published | not published | 0 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $32.07 | $42.75 | $9.00 – $9.00 | 1 |
| Ortho elbow w/lock w/ft&adj HCPCS L3760 | $23.99 | $31.98 | not published | 0 |
| Ortho ewh rgd without jnt cstm w/fit&adj HCPCS L3763 | $1,083.75 | $1,445.00 | not published | 0 |
| Orthopantogram CPT 70355 | $240.00 | $320.00 | $90.00 – $90.00 | 1 |
| Orthop traing pfrmd phys/qhp CPT 92065 | $72.75 | $97.00 | not published | 0 |
| Orthovisc inj per dose HCPCS J7324 | $1,122.27 | $1,496.36 | $98.00 – $98.00 | 1 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $708.83 | $945.10 | not published | 0 |
| Oscillation chest wall mechanical per session CPT 94669 | $497.25 | $663.00 | not published | 0 |
| Osmolality blood CPT 83930 | $53.25 | $71.00 | $6.00 – $6.00 | 1 |
| Osmolality urine CPT 83935 | $55.50 | $74.00 | $7.00 – $7.00 | 1 |
| Ostectomy complete 1st metatarsal head 28111 CPT 28111 | not published | not published | not published | 0 |
| Ostectomy scapula partial CPT 23190 | not published | not published | not published | 0 |
| Osteochondral knee allograft CPT 27415 | not published | not published | not published | 0 |
| Osteochondral knee autograft CPT 27416 | not published | not published | not published | 0 |
| Osteochondral talus autogrft CPT 28446 | not published | not published | not published | 0 |
| Osteoplasty humerus CPT 24420 | not published | not published | not published | 0 |
| Osteot humerus w/wo int fixj CPT 24400 | not published | not published | not published | 0 |
| Osteotomy/graft tarsal/calcaneus/talus 28305 CPT 28305 | not published | not published | not published | 0 |
| Ot evaluation high complexity patient/family CPT 97167 | $486.00 | $648.00 | not published | 0 |
| Ot evaluation low complexity patient/family CPT 97165 | $241.50 | $322.00 | not published | 0 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $253.50 | $338.00 | not published | 0 |
| Other immunoelectrophoresis CPT 86325 | $144.00 | $192.00 | $23.00 – $23.00 | 1 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $140.25 | $187.00 | not published | 0 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $126.00 | $168.00 | not published | 0 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $156.00 | $208.00 | not published | 0 |
| Otolaryngo binocular microscopy 92504 CPT 92504 | $66.00 | $88.00 | not published | 0 |
| Otoplasty 69300 CPT 69300 | not published | not published | not published | 0 |
| Ot re-evaluation patient/family CPT 97168 | $175.50 | $234.00 | not published | 0 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $110.25 | $147.00 | not published | 0 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $77.25 | $103.00 | not published | 0 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $81.75 | $109.00 | not published | 0 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $114.75 | $153.00 | not published | 0 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $110.25 | $147.00 | not published | 0 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $102.00 | $136.00 | not published | 0 |
| Ovarian cystectomy 58925 CPT 58925 | not published | not published | not published | 0 |
| Ovine, 1000 usp units HCPCS J3472 | not published | not published | $122.00 – $122.00 | 1 |
| Ovulation tests CPT 84830 | $47.25 | $63.00 | $13.00 – $13.00 | 1 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | $272.85 | $363.80 | $0.80 – $0.80 | 1 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $2,927.40 | $3,903.19 | $0.09 – $0.09 | 1 |
| Oxymorphone hcl injection HCPCS J2410 | not published | not published | $2.60 – $2.60 | 1 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $96.68 | $128.90 | $4.09 – $4.09 | 1 |
| P-32 chromic phos ther per mci HCPCS A9564 | not published | not published | $174.00 – $174.00 | 1 |
| P-32 sod phosphate ther per mci HCPCS A9563 | not published | not published | $481.00 – $481.00 | 1 |
| Pabpn1 gene detc abnor allel CPT 81312 | not published | not published | $137.00 – $137.00 | 1 |
| Packing strips, non-impreg HCPCS A6407 | $8.05 | $10.73 | not published | 0 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $226.24 | $301.65 | $0.10 – $0.10 | 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.