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 |
|---|---|---|---|---|
| Proton treatment complex CPT 77525 | $3,799.50 | $5,066.00 | $1,313.00 – $1,313.00 | 1 |
| Proton trmt intermediate CPT 77523 | $3,799.50 | $5,066.00 | $1,313.00 – $1,313.00 | 1 |
| Proton trmt simple w/comp CPT 77522 | $3,799.50 | $5,066.00 | $1,313.00 – $1,313.00 | 1 |
| Proton trmt simple without comp CPT 77520 | $2,715.75 | $3,621.00 | $900.00 – $900.00 | 1 |
| Protoporphyrin rbc screen CPT 84203 | $52.50 | $70.00 | $10.00 – $10.00 | 1 |
| Prp i/hern init block >5 yr CPT 49507 | $2,519.25 | $3,359.00 | not published | 0 |
| Pr planning advance care 1st 30 minutes CPT 99497 | $232.50 | $310.00 | not published | 0 |
| Prq av fstl crtj uxtr 1 acs CPT 36836 | not published | not published | not published | 0 |
| Prq av fstl crt uxtr sep acs CPT 36837 | not published | not published | not published | 0 |
| Prq card revasc mi 1 vsl CPT 92941 | $2,100.00 | $2,800.00 | not published | 0 |
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | $19,196.25 | $25,595.00 | not published | 0 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $7,350.00 | $9,800.00 | not published | 0 |
| Prq skel fix clcnl fx w/mnpj CPT 28406 | not published | not published | not published | 0 |
| Prq skel fix epcndylr hum fx CPT 24566 | not published | not published | not published | 0 |
| Prq skel fix sprcndlr hum fx CPT 24538 | not published | not published | not published | 0 |
| Prq skel fix talus fx w/mnpj CPT 28436 | not published | not published | not published | 0 |
| Prq skel fix tarsl fx w/mnpj CPT 28456 | not published | not published | not published | 0 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $18,000.00 | $24,000.00 | not published | 0 |
| Prq tcat plmt ntrac st 2+les CPT 92930 | $33,711.75 | $44,949.00 | not published | 0 |
| Prq trlml c athrc st angiop1 CPT 92933 | $11,700.00 | $15,600.00 | not published | 0 |
| Prq trl rvs ch occ ant&rtrgr CPT 92945 | $21,229.50 | $28,306.00 | not published | 0 |
| Prq trluml c angiop 1art&/br CPT 92920 | $9,375.00 | $12,500.00 | not published | 0 |
| Prq trluml c athrc 1 art&/br CPT 92924 | $7,350.00 | $9,800.00 | not published | 0 |
| Prq trluml revsc ch occ ant CPT 92943 | $7,350.00 | $9,800.00 | not published | 0 |
| Pr removal drug delivery implant CPT 11982 | $315.75 | $421.00 | not published | 0 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $238.50 | $318.00 | not published | 0 |
| Pr removal intrauterine device CPT 58301 | $318.00 | $424.00 | not published | 0 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $917.25 | $1,223.00 | not published | 0 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $359.25 | $479.00 | not published | 0 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $405.75 | $541.00 | not published | 0 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $263.25 | $351.00 | not published | 0 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $367.50 | $490.00 | not published | 0 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | not published | not published | not published | 0 |
| Prtl exc bone olecrn process CPT 24147 | not published | not published | not published | 0 |
| Prtl exc bone radial h/n CPT 24145 | not published | not published | not published | 0 |
| Prtl exchange transfuse nb CPT 36456 | not published | not published | not published | 0 |
| Prtl excision bone clavicle CPT 23180 | not published | not published | not published | 0 |
| Prtl excision bone scapula CPT 23182 | not published | not published | not published | 0 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $3,534.00 | $4,712.00 | not published | 0 |
| PSA (Prostate) Test CPT 84153 | $85.50 | $114.00 | $18.00 – $18.00 | 1 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $37.50 | $50.00 | not published | 0 |
| Pten gene dup/delet variant CPT 81323 | not published | not published | $299.00 – $299.00 | 1 |
| Pten gene full sequence CPT 81321 | not published | not published | $599.00 – $599.00 | 1 |
| Pten gene known fam variant CPT 81322 | not published | not published | $46.00 – $46.00 | 1 |
| Pterygomaxillary fossa surg any appr 31040 CPT 31040 | not published | not published | not published | 0 |
| Pt evaluation high complexity patient/family CPT 97163 | $318.75 | $425.00 | not published | 0 |
| Pt evaluation low complexity patient/family CPT 97161 | $236.25 | $315.00 | not published | 0 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $322.50 | $430.00 | not published | 0 |
| Pt prgrm for implt neurostim HCPCS L8681 | $2.25 | $3.00 | not published | 0 |
| Pt re-evaluation patient/family CPT 97164 | $175.50 | $234.00 | not published | 0 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $97.50 | $130.00 | not published | 0 |
| Pt wheelchair management each 15 minutes CPT 97542 | $90.00 | $120.00 | not published | 0 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $5,433.00 – $5,433.00 | 1 |
| Pulmonary vent imaging CPT 78579 | $997.50 | $1,330.00 | $414.00 – $414.00 | 1 |
| Pulse ox continuous overnight monitoring CPT 94762 | $417.00 | $556.00 | not published | 0 |
| Pulse ox multiple CPT 94761 | $39.00 | $52.00 | not published | 0 |
| Pump on-q 100mlx2ml/hr 2 day delivery HCPCS C9804 | $637.50 | $850.00 | not published | 0 |
| Punc of shunt for asp or inj CPT 61070 | not published | not published | not published | 0 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $265.50 | $354.00 | not published | 0 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $917.25 | $1,223.00 | not published | 0 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | not published | 0 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,928.25 | $2,571.00 | not published | 0 |
| Pvb thoracic 2nd+ inj site CPT 64462 | $621.75 | $829.00 | not published | 0 |
| Pvb thoracic cont infusion CPT 64463 | not published | not published | not published | 0 |
| Pvb thoracic single inj site CPT 64461 | $1,846.50 | $2,462.00 | not published | 0 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $70.25 | $93.66 | $13.00 – $13.00 | 1 |
| Pyruvate CPT 84210 | $73.50 | $98.00 | $15.00 – $15.00 | 1 |
| Pyruvate kinase CPT 84220 | $57.00 | $76.00 | $9.00 – $9.00 | 1 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $1,335.00 | $1,780.00 | $554.00 – $554.00 | 1 |
| Quant diff pulm perf w/imaging CPT 78597 | $997.50 | $1,330.00 | $414.00 – $414.00 | 1 |
| Quest t3 uptake CPT 84479 | $40.50 | $54.00 | $6.00 – $6.00 | 1 |
| Quinupristin/dalfopristin HCPCS J2770 | not published | not published | $4.26 – $4.26 | 1 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | $7,967.34 | $10,623.11 | not published | 0 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $8,124.84 | $10,833.12 | not published | 0 |
| Radiation handling CPT 77790 | $46.50 | $62.00 | not published | 0 |
| Radiation physics consult CPT 77336 | $727.50 | $970.00 | $137.00 – $137.00 | 1 |
| Radiation therapy dose plan CPT 77300 | $649.50 | $866.00 | $137.00 – $137.00 | 1 |
| Radiation therapy management CPT 77431 | $294.75 | $393.00 | $96.00 – $96.00 | 1 |
| Radiation treatment aid(s) CPT 77332 | $597.75 | $797.00 | $137.00 – $137.00 | 1 |
| Radiation treatment aid(s) CPT 77333 | $384.00 | $512.00 | $137.00 – $137.00 | 1 |
| Radiation treatment aid(s) CPT 77334 | $1,743.00 | $2,324.00 | $377.00 – $377.00 | 1 |
| Radiation treatment delivery CPT 77402 | $556.50 | $742.00 | $119.00 – $119.00 | 1 |
| Radiation treatment delivery CPT 77412 | $1,072.50 | $1,430.00 | $271.00 – $271.00 | 1 |
| Radiation tx management x5 CPT 77427 | $528.75 | $705.00 | $170.00 – $170.00 | 1 |
| Radical resection of elbow CPT 24149 | not published | not published | not published | 0 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | not published | 0 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | not published | 0 |
| Radiesse injection HCPCS Q2026 | $726.00 | $968.00 | not published | 0 |
| Radiology port images(s) CPT 77417 | $61.50 | $82.00 | not published | 0 |
| Radiotherapy dose plan imrt CPT 77301 | $6,261.00 | $8,348.00 | $1,408.00 – $1,408.00 | 1 |
| Radium ra223 dichl ther/uci HCPCS A9606 | $64,988.57 | $86,651.42 | $186.00 – $186.00 | 1 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $3,396.00 | $4,528.00 | $1,343.00 – $1,343.00 | 1 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $3,396.00 | $4,528.00 | $1,343.00 – $1,343.00 | 1 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $3,396.00 | $4,528.00 | $1,343.00 – $1,343.00 | 1 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $3,311.25 | $4,415.00 | $1,343.00 – $1,343.00 | 1 |
| Radphm lcl tumor plr sgl day CPT 78800 | $997.50 | $1,330.00 | $414.00 – $414.00 | 1 |
| Radphm quant measure sgl area add-on CPT 78835 | $557.25 | $743.00 | not published | 0 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | not published | 0 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | not published | 0 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | 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.