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(808) 293-9221

(808) 293-9221

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Package

Emergency room visit, moderate

Package

Emergency room visit, moderate

A moderate emergency room visit provides immediate care for urgent conditions requiring diagnostic testing, treatment, and monitoring but that are not immediately life-threatening, such as moderate injuries, infections, or worsening chronic symptoms. Upon arrival, a nurse will assess your condition through triage, and a care team will evaluate and treat you based on the severity of your presentation. Most moderate visits are resolved and discharged within several hours, though hospital admission may be recommended depending on findings. Costs for ER visits vary based on the complexity of care provided.
You'd pay up to
$1,385 / Case Rate

A single, all-inclusive pricing methodology for a procedure in healthcare contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

$1,385

Without insurance

What goes into a price?

Negotiated prices across insurers

Lowest
$453
Highest
$3,276
Cash price
up to $1,385

Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.

Procedures included in this package

This list includes the services and fees bundled into the Emergency room visit, moderate Standard Service Package (SSP EM000). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.

Code Code Type Description
HCPCS 99284 Facility Fee Emergency department visit for moderate complexity evaluation and management with counseling/coordination of care
HCPCS 96374 Facility Fee Therapeutic IV injection of single substance/drug
HCPCS 85025 Facility Fee Complete blood count (CBC) with differential WBC
HCPCS 80053 Facility Fee Comprehensive metabolic panel also includes albumin, total protein, ALP, ALT, AST and bilirubin
Revenue Code 270 Facility Fee Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - General
Revenue Code 636 Facility Fee Pharmacy - Extension of 025X - Drugs requiring detailed coding
Revenue Code 637 Facility Fee Pharmacy - Extension of 025X - Self-administered drugs
HCPCS 36415 Facility Fee Collection of blood from a vein via puncture

Disclaimer

Kahuku Medical Center is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

You'd pay up to
$1,385 / Case Rate

A single, all-inclusive pricing methodology for a procedure in healthcare contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

Disclaimer

Kahuku Medical Center is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

What’s the difference between an individual procedure and a Standard Service Package (SSP)?

Individual Procedure

Individual procedures, like blood tests, each have unique prices and billing codes (like a CPT or HCPCS code). While they can be billed alone, they're usually grouped with other procedures on a claim. This grouping is what determines the total cost of your care.

Standard Service Package (SSP)

A SSP combines all medical services, materials, and fees associated with a healthcare visit or procedure into a single bundle to offer a more comprehensive estimate.

Contact us to verify your estimate

Have your service name, codes, and payment preference ready. If you’re using insurance, you may be asked for insurance details like your Member or Group ID.

Service Emergency room visit, moderate
Service Codes HCPCS 99284, HCPCS 96374, HCPCS 85025, HCPCS 80053, Revenue Code 270
Insurance I'm not using insurance
Location Kahuku Medical Center
When you contact us, you can say:
"Hi, I'm calling to verify a price for Emergency room visit, moderate I found through Kahuku Medical Center's price estimate tool. Here are the codes I’m looking at: HCPCS 99284, HCPCS 96374, HCPCS 85025, HCPCS 80053, Revenue Code 270. I'm not using insurance, can you confirm the cash pay estimate and help me schedule if needed?"
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