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 |
|---|---|---|---|---|
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $240.00 | $320.00 | $90.00 – $90.00 | 1 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $616.50 | $822.00 | $109.00 – $109.00 | 1 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $242.25 | $323.00 | $90.00 – $90.00 | 1 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $232.50 | $310.00 | $90.00 – $90.00 | 1 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $458.25 | $611.00 | $184.00 – $184.00 | 1 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $509.25 | $679.00 | $184.00 – $184.00 | 1 |
| X-ray wrist 2 views (both sides) CPT 73100 | $240.00 | $320.00 | $90.00 – $90.00 | 1 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | $504.00 | $672.00 | $184.00 – $184.00 | 1 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | $450.75 | $601.00 | not published | 0 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | $296.25 | $395.00 | not published | 0 |
| Xylose absorption test blood &/or urine CPT 84620 | $72.00 | $96.00 | $13.00 – $13.00 | 1 |
| Xyntha inj HCPCS J7185 | $9.60 | $12.79 | $1.50 – $1.50 | 1 |
| Yersinia antibody CPT 86793 | $81.00 | $108.00 | $13.00 – $13.00 | 1 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | $146,496.24 | $195,328.32 | $82,357.00 – $82,357.00 | 1 |
| Ziconotide injection HCPCS J2278 | $13,947.93 | $18,597.24 | $10.00 – $10.00 | 1 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $93.06 | $124.07 | $1.50 – $1.50 | 1 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $1.49 – $1.49 | 1 |
| Zika virus dna/rna amp probe CPT 87662 | $330.75 | $441.00 | $51.00 – $51.00 | 1 |
| Zika virus igm antibody CPT 86794 | $108.75 | $145.00 | $17.00 – $17.00 | 1 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $177.72 | $236.95 | $3.10 – $3.10 | 1 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | $7,521.75 | $10,029.00 | $8.00 – $8.00 | 1 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | $11,265.75 | $15,021.00 | $34.00 – $34.00 | 1 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $3,067.01 | $4,089.34 | $5.20 – $5.20 | 1 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $193.00 – $193.00 | 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.