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 |
|---|---|---|---|---|
| Rpr aa hrn rcr < 3 ncr/strn CPT 49614 | not published | not published | not published | 0 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | not published | not published | not published | 0 |
| Rpr blood ves w/vein graft/up ext 35236 CPT 35236 | not published | not published | not published | 0 |
| Rpr blood vsl grf oth vein lo ex CPT 35286 | not published | not published | not published | 0 |
| Rpr choanal atresia ntranasl CPT 30540 | not published | not published | not published | 0 |
| Rpr choanal atresia trsnpltn CPT 30545 | not published | not published | not published | 0 |
| Rpr fem hernia init blocked CPT 49553 | not published | not published | not published | 0 |
| Rpr hern preemie reduc CPT 49491 | not published | not published | not published | 0 |
| Rpr hypspad comp dsj & urtp CPT 54348 | not published | not published | not published | 0 |
| Rpr hypspad comp simple CPT 54340 | not published | not published | not published | 0 |
| Rpr ing hernia baby blocked CPT 49496 | not published | not published | not published | 0 |
| Rpr ing hernia baby reduc CPT 49495 | not published | not published | not published | 0 |
| Rpr ing hernia init blocked CPT 49501 | not published | not published | not published | 0 |
| Rpr ing hernia init reduce CPT 49500 | not published | not published | not published | 0 |
| Rpr ing hern premie blocked CPT 49492 | not published | not published | not published | 0 |
| Rpr intst excl anrect fist HCPCS C9796 | not published | not published | not published | 0 |
| Rpr nsl vlv collapse w/implt CPT 30468 | $14,958.75 | $19,945.00 | not published | 0 |
| Rpr nsl vlv collapse w/rmdlg CPT 30469 | not published | not published | not published | 0 |
| Rpr rem hernia init reduce CPT 49550 | not published | not published | not published | 0 |
| Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 | not published | not published | not published | 0 |
| Rrp hypspad comp moblj&urtp CPT 54344 | not published | not published | not published | 0 |
| Rsv assay w/optic CPT 87807 | $72.75 | $97.00 | $13.00 – $13.00 | 1 |
| Rsv vacc mrna lipid nano im CPT 90683 | $682.35 | $909.80 | not published | 0 |
| Rubella antibody igg CPT 86762 | $96.00 | $128.00 | $14.00 – $14.00 | 1 |
| Rubeola ag if CPT 87283 | $299.25 | $399.00 | $61.00 – $61.00 | 1 |
| Rubeola antibody igg CPT 86765 | $81.00 | $108.00 | $13.00 – $13.00 | 1 |
| Runx1 gene targeted seq alys CPT 81334 | not published | not published | $329.00 – $329.00 | 1 |
| Russell viper venom diluted CPT 85613 | $39.75 | $53.00 | $9.00 – $9.00 | 1 |
| Rx metab gen seq alys pnl 6 CPT 81418 | not published | not published | $915.00 – $915.00 | 1 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $6,032.34 | $8,043.12 | $36.00 – $36.00 | 1 |
| Salivary gland function exam CPT 78232 | $997.50 | $1,330.00 | $414.00 – $414.00 | 1 |
| Salivary gland imaging CPT 78230 | $997.50 | $1,330.00 | $414.00 – $414.00 | 1 |
| Salivary glnd img serial img CPT 78231 | $997.50 | $1,330.00 | $414.00 – $414.00 | 1 |
| Salmonella antibody CPT 86768 | $81.00 | $108.00 | $13.00 – $13.00 | 1 |
| Salpingostomy 58770 CPT 58770 | not published | not published | not published | 0 |
| Saquinavir, 200 mg HCPCS S0140 | not published | not published | $1.49 – $1.49 | 1 |
| Sargramostim injection HCPCS J2820 | $739.98 | $986.64 | $56.00 – $56.00 | 1 |
| Sars-cov-2 antb quantitative CPT 86413 | not published | not published | $51.00 – $51.00 | 1 |
| Sarscov2 vac 5mcg/0.5ml im CPT 91304 | $397.69 | $530.25 | not published | 0 |
| Sarscov coronavirus ag ia CPT 87426 | $94.50 | $126.00 | $35.00 – $35.00 | 1 |
| Sarscov & inf vir a&b ag ia CPT 87428 | not published | not published | $70.00 – $70.00 | 1 |
| S bowel endoscope w/stent CPT 44379 | $9,196.50 | $12,262.00 | not published | 0 |
| Sbrt management CPT 77435 | $1,779.75 | $2,373.00 | not published | 0 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $948.75 | $1,265.00 | not published | 0 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $768.00 | $1,024.00 | not published | 0 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $847.50 | $1,130.00 | not published | 0 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $394.50 | $526.00 | not published | 0 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $423.75 | $565.00 | not published | 0 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $600.00 | $800.00 | not published | 0 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $807.00 | $1,076.00 | not published | 0 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $638.25 | $851.00 | not published | 0 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $442.50 | $590.00 | not published | 0 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $3,077.25 | $4,103.00 | not published | 0 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | not published | 0 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $690.00 | $920.00 | not published | 0 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | $90.00 | $120.00 | not published | 0 |
| Screen cerv/vag thin layer HCPCS G0123 | $123.75 | $165.00 | not published | 0 |
| Screen c/v thin layer by md HCPCS G0124 | $108.75 | $145.00 | not published | 0 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $3,452.25 | $4,603.00 | not published | 0 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $4,625.25 | $6,167.00 | not published | 0 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $78.75 | $105.00 | $18.00 – $18.00 | 1 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | not published | not published | $28.00 – $28.00 | 1 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $150.00 | $200.00 | $46.00 – $46.00 | 1 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | $74.25 | $99.00 | $24.00 – $24.00 | 1 |
| Screening Mammogram CPT 77067 | $317.25 | $423.00 | $90.00 – $90.00 | 1 |
| Screening prostate cancer PSA HCPCS G0103 | $123.00 | $164.00 | $19.00 – $19.00 | 1 |
| Screen/visual acuity/bilat/quant 99173 CPT 99173 | $6.00 | $8.00 | not published | 0 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $749.69 | $999.58 | not published | 0 |
| Sc ther infusion reset pump CPT 96371 | $146.25 | $195.00 | not published | 0 |
| Sedimentation rate erythrocyte automated CPT 85652 | $25.50 | $34.00 | $3.00 – $3.00 | 1 |
| Semen analysis HCPCS G0027 | $19.50 | $26.00 | $6.00 – $6.00 | 1 |
| Semen analysis presence/motility CPT 89321 | $45.00 | $60.00 | $12.00 – $12.00 | 1 |
| Semen analysis w/count CPT 89310 | $25.50 | $34.00 | $8.00 – $8.00 | 1 |
| Sensorimotor examination CPT 92060 | $66.00 | $88.00 | not published | 0 |
| Separate eyelid adhesions CPT 68340 | not published | not published | not published | 0 |
| Sept9 promoter methylation analysis CPT 81327 | not published | not published | $191.00 – $191.00 | 1 |
| Sequestrectomy olecrn proces CPT 24138 | not published | not published | not published | 0 |
| Sequestrectomy radial h/n CPT 24136 | not published | not published | not published | 0 |
| Sequestrectomy shft/dstl hum CPT 24134 | not published | not published | not published | 0 |
| Sermorelin acetate injection HCPCS Q0515 | not published | not published | $1.49 – $1.49 | 1 |
| Serpina1 gene CPT 81332 | not published | not published | $44.00 – $44.00 | 1 |
| Sertraline (zoloft) - sendout CPT 80332 | $93.75 | $125.00 | $27.00 – $27.00 | 1 |
| Set radiation therapy field CPT 77280 | $983.25 | $1,311.00 | $224.00 – $224.00 | 1 |
| Set radiation therapy field CPT 77285 | $1,397.25 | $1,863.00 | $378.00 – $378.00 | 1 |
| Set radiation therapy field CPT 77290 | $1,620.00 | $2,160.00 | $377.00 – $377.00 | 1 |
| Set up port xray equipment HCPCS Q0092 | $72.00 | $96.00 | not published | 0 |
| Sever cranial nerve CPT 64771 | not published | not published | not published | 0 |
| Sex chromatin identification CPT 88130 | $56.25 | $75.00 | $18.00 – $18.00 | 1 |
| Sex chromatin identification CPT 88140 | $24.00 | $32.00 | $8.00 – $8.00 | 1 |
| Sex transformation f to m CPT 55980 | not published | not published | not published | 0 |
| Sex transformation m to f CPT 55970 | not published | not published | not published | 0 |
| Sf3b1 gene common variants CPT 81347 | not published | not published | $193.00 – $193.00 | 1 |
| Sgmdsc w/band ligation CPT 45350 | not published | not published | not published | 0 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | not published | not published | not published | 0 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | not published | not published | not published | 0 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | not published | not published | not published | 0 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | not published | not published | not published | 0 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $505.50 | $674.00 | not published | 0 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | not published | not published | not published | 0 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | 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.