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 |
|---|---|---|---|---|
| Smear nasal eosinophil CPT 89190 | $21.75 | $29.00 | $6.00 – $6.00 | 1 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $90.00 | $120.00 | $6.00 – $6.00 | 1 |
| Smear wet mount CPT 87210 | $33.00 | $44.00 | $6.00 – $6.00 | 1 |
| Smn1 gene full gene sequence CPT 81336 | not published | not published | $301.00 – $301.00 | 1 |
| Smn1 gen nown famil seq vrnt CPT 81337 | not published | not published | $185.00 – $185.00 | 1 |
| Smpd1 gene common variants CPT 81330 | $9.75 | $13.00 | $47.00 – $47.00 | 1 |
| Snrpn/ube3a gene CPT 81331 | not published | not published | $51.00 – $51.00 | 1 |
| Sodium 24 hour urine CPT 84300 | $39.00 | $52.00 | $5.00 – $5.00 | 1 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $96.68 | $128.90 | $2.28 – $2.28 | 1 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $24.00 | $32.00 | $1.38 – $1.38 | 1 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $27.32 | $36.42 | $0.70 – $0.70 | 1 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $33.08 | $44.10 | not published | 0 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $101.06 | $134.74 | $2.18 – $2.18 | 1 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $559.50 | $746.00 | $74.00 – $74.00 | 1 |
| Sodium serum/plasma/whole blood CPT 84295 | $48.75 | $65.00 | $5.00 – $5.00 | 1 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $237.75 | $317.00 | not published | 0 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | not published | not published | $1,342.00 – $1,342.00 | 1 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $1,193.00 – $1,193.00 | 1 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $3,281.00 – $3,281.00 | 1 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $1,044.00 – $1,044.00 | 1 |
| Somatosensory testing CPT 95927 | $830.25 | $1,107.00 | not published | 0 |
| Somatropin injection HCPCS J2941 | $11,877.38 | $15,836.50 | $49.00 – $49.00 | 1 |
| So neo gsap dna/dna&rna CPT 81459 | not published | not published | $2,983.00 – $2,983.00 | 1 |
| So neo gsap dna mcrstl ins CPT 81457 | not published | not published | $895.00 – $895.00 | 1 |
| Sotalol hydrochloride IV HCPCS C9482 | $7,716.39 | $10,288.52 | not published | 0 |
| Spacer bag/reservoir HCPCS A4627 | $15.75 | $21.00 | not published | 0 |
| Sp bone algrft morsel add-on CPT 20930 | $331.50 | $442.00 | not published | 0 |
| Special physics consult CPT 77370 | $483.75 | $645.00 | $143.00 – $143.00 | 1 |
| Special radiation dosimetry CPT 77331 | $384.00 | $512.00 | $137.00 – $137.00 | 1 |
| Special radiation treatment CPT 77470 | $1,641.75 | $2,189.00 | $596.00 – $596.00 | 1 |
| Special supplies phys/qhp CPT 99070 | $20.18 | $26.90 | not published | 0 |
| Special teletx port plan CPT 77321 | $1,031.25 | $1,375.00 | $377.00 – $377.00 | 1 |
| Specific gravity body fluid CPT 84315 | $17.25 | $23.00 | $3.00 – $3.00 | 1 |
| Specimen fat stain CPT 89125 | $29.25 | $39.00 | $6.00 – $6.00 | 1 |
| Speech evaluation complex CPT 70371 | $652.50 | $870.00 | $249.00 – $249.00 | 1 |
| Sperm antibody test CPT 89325 | $33.75 | $45.00 | $10.00 – $10.00 | 1 |
| Sperm evaluation test CPT 89329 | $60.00 | $80.00 | $20.00 – $20.00 | 1 |
| Sperm isolation complex CPT 89261 | $141.00 | $188.00 | not published | 0 |
| Sperm washing 58323 CPT 58323 | not published | not published | not published | 0 |
| Sphenoid sinus surgery CPT 31051 | not published | not published | not published | 0 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | not published | not published | not published | 0 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,787.25 | $2,383.00 | not published | 0 |
| Spine device implant surgery HCPCS C9757 | not published | not published | not published | 0 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $830.25 | $1,107.00 | not published | 0 |
| Spleen imaging CPT 78185 | $997.50 | $1,330.00 | $414.00 – $414.00 | 1 |
| Splint finger 4 prong foam sm HCPCS A4570 | $16.50 | $22.00 | not published | 0 |
| Splint finger fold over sm HCPCS L3924 | $106.50 | $142.00 | not published | 0 |
| Splint fing stax assort 1-7in HCPCS Q4049 | $3.30 | $4.39 | not published | 0 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $25.50 | $34.00 | not published | 0 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | not published | not published | not published | 0 |
| Split blood or products CPT 86985 | $159.00 | $212.00 | $21.00 – $21.00 | 1 |
| Sprchoroidal spc njx rx agt CPT 67516 | not published | not published | not published | 0 |
| Sputum specimen collection CPT 89220 | $159.75 | $213.00 | $21.00 – $21.00 | 1 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | not published | not published | $439.00 – $439.00 | 1 |
| Srsf2 gene common variants CPT 81348 | not published | not published | $175.00 – $175.00 | 1 |
| Srs linear based CPT 77372 | $22,077.00 | $29,436.00 | $7,869.00 – $7,869.00 | 1 |
| Srs multisource CPT 77371 | $22,077.00 | $29,436.00 | $7,869.00 – $7,869.00 | 1 |
| Staggered spondaic word test CPT 92572 | $450.00 | $600.00 | not published | 0 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $304.50 | $406.00 | not published | 0 |
| Staph a dna amp probe CPT 87640 | $213.00 | $284.00 | $35.00 – $35.00 | 1 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $305.25 | $407.00 | not published | 0 |
| Stem cells total count CPT 86367 | $383.25 | $511.00 | $77.00 – $77.00 | 1 |
| Stenger test speech CPT 92577 | $1,466.25 | $1,955.00 | not published | 0 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $715.50 | $954.00 | not published | 0 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $697.50 | $930.00 | not published | 0 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $748.50 | $998.00 | not published | 0 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $323.73 | $431.64 | not published | 0 |
| Stereotactic radiation trmt CPT 77432 | $1,177.50 | $1,570.00 | $375.00 – $375.00 | 1 |
| Sterile gauze <= 16 sq in HCPCS A6402 | $0.75 | $1.00 | not published | 0 |
| Sterile needle HCPCS A4215 | $0.75 | $1.00 | not published | 0 |
| St evaluate speech sound production CPT 92522 | $280.50 | $374.00 | not published | 0 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $534.00 | $712.00 | not published | 0 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $224.25 | $299.00 | not published | 0 |
| St evaluation swallow function CPT 92610 | $310.50 | $414.00 | not published | 0 |
| Stimulants synthetic CPT 80371 | $86.25 | $115.00 | $27.00 – $27.00 | 1 |
| Stimulation of spinal cord CPT 63610 | not published | not published | not published | 0 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $185.25 | $247.00 | not published | 0 |
| Strapping of chest CPT 29200 | not published | not published | not published | 0 |
| Strapping of elbow or wrist 29260 CPT 29260 | $75.00 | $100.00 | not published | 0 |
| Strapping of hand or finger CPT 29280 | not published | not published | not published | 0 |
| Strapping of hip CPT 29520 | not published | not published | not published | 0 |
| Strapping of knee CPT 29530 | not published | not published | not published | 0 |
| Strapping of toes 29550 CPT 29550 | $60.00 | $80.00 | not published | 0 |
| Strep a ag ia CPT 87430 | $82.50 | $110.00 | $17.00 – $17.00 | 1 |
| Strep a dna dir probe CPT 87650 | $122.25 | $163.00 | $20.00 – $20.00 | 1 |
| Strep a dna quant CPT 87652 | $255.00 | $340.00 | $42.00 – $42.00 | 1 |
| Strep b assay w/optic CPT 87802 | $72.75 | $97.00 | $13.00 – $13.00 | 1 |
| Strep b dna amp probe CPT 87653 | $219.75 | $293.00 | $35.00 – $35.00 | 1 |
| Streptokinase antibody CPT 86590 | $67.50 | $90.00 | $13.00 – $13.00 | 1 |
| Streptomycin injection HCPCS J3000 | $206.25 | $275.00 | $31.00 – $31.00 | 1 |
| Streptozocin injection HCPCS J9320 | $850.94 | $1,134.58 | $195.00 – $195.00 | 1 |
| Stress test pulmonary CPT 94618 | $138.00 | $184.00 | not published | 0 |
| Stress tte complete CPT 93351 | $1,462.50 | $1,950.00 | not published | 0 |
| Str markers spec anal addl CPT 81266 | not published | not published | $304.00 – $304.00 | 1 |
| Str markers specimen anal CPT 81265 | not published | not published | $233.00 – $233.00 | 1 |
| St treatment speech individual CPT 92507 | $192.00 | $256.00 | not published | 0 |
| St treatment swallow dysfunction/oral CPT 92526 | $288.00 | $384.00 | not published | 0 |
| Subdural tap fontanelle/sutur infant init 61000 CPT 61000 | not published | not published | not published | 0 |
| Subq njx filling matrl 1cc/< CPT 11950 | not published | not published | not published | 0 |
| Subq njx fil matrl 5.1-10cc CPT 11952 | 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.