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 |
|---|---|---|---|---|
| Subtalar arthro w/deb CPT 29906 | not published | not published | not published | 0 |
| Subtalar arthro w/exc CPT 29905 | not published | not published | not published | 0 |
| Subtalar arthro w/fb rmvl CPT 29904 | not published | not published | not published | 0 |
| Subtalar arthro w/fusion CPT 29907 | not published | not published | not published | 0 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $97.36 | $129.81 | $0.70 – $0.70 | 1 |
| Suction lipectomy head&neck CPT 15876 | not published | not published | not published | 0 |
| Suction lipectomy lwr extrem CPT 15879 | not published | not published | not published | 0 |
| Suction lipectomy trunk CPT 15877 | not published | not published | not published | 0 |
| Suction lipectomy upr extrem CPT 15878 | not published | not published | not published | 0 |
| Sugars multiple quant CPT 84379 | $70.50 | $94.00 | $11.00 – $11.00 | 1 |
| Sugars single quant CPT 84378 | $70.50 | $94.00 | $11.00 – $11.00 | 1 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $21,424.80 | $28,566.39 | not published | 0 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $118.89 | $158.51 | $0.05 – $0.05 | 1 |
| Sulfonylurea screen qn-sendout CPT 80377 | $330.75 | $441.00 | $27.00 – $27.00 | 1 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $568.29 | $757.72 | $59.00 – $59.00 | 1 |
| Support clav 29.6-40.5in med HCPCS L3650 | $9.32 | $12.42 | not published | 0 |
| Supprelin la implant HCPCS J9226 | $108,396.06 | $144,528.07 | $45,540.00 – $45,540.00 | 1 |
| Surg dx exam anorectal CPT 45990 | not published | not published | not published | 0 |
| Surgery for urethra pouch CPT 53240 | not published | not published | not published | 0 |
| Surgery to stop leg growth CPT 27475 | not published | not published | not published | 0 |
| Surgery to stop leg growth CPT 27477 | not published | not published | not published | 0 |
| Surgery to stop leg growth CPT 27479 | not published | not published | not published | 0 |
| Surgery to stop leg growth CPT 27485 | not published | not published | not published | 0 |
| Surgical exposure prostate 55860 CPT 55860 | not published | not published | not published | 0 |
| Surgical opening of stomach CPT 43510 | not published | not published | not published | 0 |
| Surgical opening of throat CPT 42955 | not published | not published | not published | 0 |
| Surgical pathology level 1 gross examination only CPT 88300 | $39.75 | $53.00 | $14.00 – $14.00 | 1 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $144.00 | $192.00 | $29.00 – $29.00 | 1 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $286.50 | $382.00 | $35.00 – $35.00 | 1 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $328.50 | $438.00 | $40.00 – $40.00 | 1 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $690.75 | $921.00 | $230.00 – $230.00 | 1 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $1,027.50 | $1,370.00 | $320.00 – $320.00 | 1 |
| Surgical trays HCPCS A4550 | $74.82 | $99.75 | not published | 0 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | not published | 0 |
| Susceptibility agar dilution per agent CPT 87181 | $29.25 | $39.00 | $5.00 – $5.00 | 1 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $29.25 | $39.00 | $5.00 – $5.00 | 1 |
| Susceptibility mic per plate CPT 87186 | $183.75 | $245.00 | $9.00 – $9.00 | 1 |
| Suscept studies macrobroth dilution ea CPT 87188 | $40.50 | $54.00 | $7.00 – $7.00 | 1 |
| Suspension of testis CPT 54620 | not published | not published | not published | 0 |
| Svc venogram s&i CPT 75827 | $4,141.50 | $5,522.00 | $1,598.00 – $1,598.00 | 1 |
| Sweat collection by iontophoresis CPT 89230 | $53.25 | $71.00 | $3.00 – $3.00 | 1 |
| Sympathectomy cervical CPT 64802 | not published | not published | not published | 0 |
| Sympathectomy digital artery CPT 64820 | not published | not published | not published | 0 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | not published | 0 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $5.60 – $5.60 | 1 |
| Synvisc or synvisc-one HCPCS J7325 | $3,208.66 | $4,278.21 | $9.00 – $9.00 | 1 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $27.00 | $36.00 | $4.00 – $4.00 | 1 |
| System cardiomems hosp electronics HCPCS C2624 | $38.25 | $51.00 | not published | 0 |
| System pacing micra av HCPCS C1786 | $656.93 | $875.90 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $656.93 | $875.90 | not published | 0 |
| System recell skin grafting/harvesting HCPCS C1832 | $8.25 | $11.00 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $146.25 | $195.00 | $17.00 – $17.00 | 1 |
| T3 (triiodothyronine) total CPT 84480 | $94.50 | $126.00 | $14.00 – $14.00 | 1 |
| T4 (thyroxine) free CPT 84439 | $60.75 | $81.00 | $9.00 – $9.00 | 1 |
| T4 (thyroxine) total CPT 84436 | $42.75 | $57.00 | $7.00 – $7.00 | 1 |
| Tacrol astagraf ex rel oral HCPCS J7508 | $89.89 | $119.85 | $0.59 – $0.59 | 1 |
| Tacrol envarsus ex rel oral HCPCS J7503 | $88.08 | $117.44 | $1.80 – $1.80 | 1 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $6,904.89 | $9,206.52 | $0.15 – $0.15 | 1 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $600.52 | $800.69 | $262.00 – $262.00 | 1 |
| Tacrolimus therapeutic drug level CPT 80197 | $94.50 | $126.00 | $14.00 – $14.00 | 1 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $3,300.09 | $4,400.11 | $14.00 – $14.00 | 1 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | $1,638.43 | $2,184.57 | $74.00 – $74.00 | 1 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | $24,988.30 | $33,317.73 | $72.00 – $72.00 | 1 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | not published | not published | $1.86 – $1.86 | 1 |
| Target gsa panel hmtlmph neop CPT 81450 | $2,025.00 | $2,700.00 | $758.00 – $758.00 | 1 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | not published | not published | $2,913.00 – $2,913.00 | 1 |
| Target gsa panel organ neop CPT 81445 | not published | not published | $597.00 – $597.00 | 1 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | $32,433.75 | $43,245.00 | $1,567.00 – $1,567.00 | 1 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | not published | 0 |
| Tavr perq femoral CPT 33361 | $4,634.25 | $6,179.00 | not published | 0 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $939.48 | $1,252.64 | $0.10 – $0.10 | 1 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $137.00 – $137.00 | 1 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $38.00 – $38.00 | 1 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $8.00 – $8.00 | 1 |
| Tbs techl calculation only CPT 77091 | not published | not published | $90.00 – $90.00 | 1 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $90.00 – $90.00 | 1 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $492.75 | $657.00 | $100.00 – $100.00 | 1 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $422.25 | $563.00 | $62.00 – $62.00 | 1 |
| Tc-99m apcitide diag HCPCS A9504 | not published | not published | $585.00 – $585.00 | 1 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $1,442.00 – $1,442.00 | 1 |
| Tc-99m bicisate HCPCS A9557 | $129.38 | $172.50 | $3,157.00 – $3,157.00 | 1 |
| Tc-99m depreotide HCPCS A9536 | not published | not published | $890.00 – $890.00 | 1 |
| Tc-99m disofenin HCPCS A9510 | $131.37 | $175.15 | $69.00 – $69.00 | 1 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | not published | not published | $2,111.00 – $2,111.00 | 1 |
| Tc-99m exametazime diag HCPCS A9521 | $4,214.97 | $5,619.96 | $1,783.00 – $1,783.00 | 1 |
| Tc-99m gluceptate HCPCS A9550 | $41.99 | $55.98 | not published | 0 |
| Tc-99m labeled rbc HCPCS A9560 | $1,852.52 | $2,470.02 | $121.00 – $121.00 | 1 |
| Tc-99m maa HCPCS A9540 | $1,788.75 | $2,385.00 | $34.00 – $34.00 | 1 |
| Tc-99m mebrofenin HCPCS A9537 | $911.25 | $1,215.00 | $58.00 – $58.00 | 1 |
| Tc-99m medronate HCPCS A9503 | $794.25 | $1,059.00 | $68.00 – $68.00 | 1 |
| Tc-99m mertiatide HCPCS A9562 | $42.01 | $56.01 | $882.00 – $882.00 | 1 |
| Tc-99m oxidronate HCPCS A9561 | $876.03 | $1,168.04 | $58.00 – $58.00 | 1 |
| Tc-99m pentetate dtpa HCPCS A9539 | $302.04 | $402.71 | $32.00 – $32.00 | 1 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | not published | not published | $23.00 – $23.00 | 1 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $14,398.71 | $19,198.27 | $12.00 – $12.00 | 1 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $735.61 | $980.81 | $47.00 – $47.00 | 1 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $1,457.39 | $1,943.18 | $148.00 – $148.00 | 1 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $1,436.40 | $1,915.19 | $562.00 – $562.00 | 1 |
| Tc-99m sulfur colloid HCPCS A9541 | $5,006.25 | $6,675.00 | $231.00 – $231.00 | 1 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $5,735.16 | $7,646.88 | $130.00 – $130.00 | 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.