Leahi Hospital

All Charges

Charge

Type

Setting

Price

ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility

$10,760.71

Service Code	MSDRG 770
Min. Negotiated Rate	$10,317.79
Max. Negotiated Rate	$10,760.71
Rate for Payer: AlohaCare Medicare	$10,317.79
Rate for Payer: Hawaii Medical Service Association Commercial	$10,760.71
Rate for Payer: Hawaii Medical Service Association Medicare	$10,317.79
Rate for Payer: Humana Medicare	$10,317.79
Rate for Payer: Kaiser Permanente Medicare	$10,317.79
Rate for Payer: Ohana Health Plan Medicare	$10,317.79
Rate for Payer: UnitedHealthcare Medicare	$10,317.79

ABORTION WITHOUT D&C

Facility

$8,727.14

Service Code	MSDRG 779
Min. Negotiated Rate	$7,347.62
Max. Negotiated Rate	$8,727.14
Rate for Payer: AlohaCare Medicare	$8,727.14
Rate for Payer: Hawaii Medical Service Association Commercial	$7,347.62
Rate for Payer: Hawaii Medical Service Association Medicare	$8,727.14
Rate for Payer: Humana Medicare	$8,727.14
Rate for Payer: Kaiser Permanente Medicare	$8,727.14
Rate for Payer: Ohana Health Plan Medicare	$8,727.14
Rate for Payer: UnitedHealthcare Medicare	$8,727.14

ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION

Facility

$11,661.38

Service Code	MSDRG 880
Min. Negotiated Rate	$9,898.95
Max. Negotiated Rate	$11,661.38
Rate for Payer: AlohaCare Medicare	$9,898.95
Rate for Payer: Hawaii Medical Service Association Commercial	$11,661.38
Rate for Payer: Hawaii Medical Service Association Medicare	$9,898.95
Rate for Payer: Humana Medicare	$9,898.95
Rate for Payer: Kaiser Permanente Medicare	$9,898.95
Rate for Payer: Ohana Health Plan Medicare	$9,898.95
Rate for Payer: UnitedHealthcare Medicare	$9,898.95

ACUTE AND SUBACUTE ENDOCARDITIS WITH CC

Facility

$47,996.55

Service Code	MSDRG 289
Min. Negotiated Rate	$17,257.94
Max. Negotiated Rate	$47,996.55
Rate for Payer: AlohaCare Medicare	$17,257.94
Rate for Payer: Hawaii Medical Service Association Commercial	$47,996.55
Rate for Payer: Hawaii Medical Service Association Medicare	$17,257.94
Rate for Payer: Humana Medicare	$17,257.94
Rate for Payer: Kaiser Permanente Medicare	$17,257.94
Rate for Payer: Ohana Health Plan Medicare	$17,257.94
Rate for Payer: UnitedHealthcare Medicare	$17,257.94

ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC

Facility

$47,996.55

Service Code	MSDRG 288
Min. Negotiated Rate	$27,106.40
Max. Negotiated Rate	$47,996.55
Rate for Payer: AlohaCare Medicare	$27,106.40
Rate for Payer: Hawaii Medical Service Association Commercial	$47,996.55
Rate for Payer: Hawaii Medical Service Association Medicare	$27,106.40
Rate for Payer: Humana Medicare	$27,106.40
Rate for Payer: Kaiser Permanente Medicare	$27,106.40
Rate for Payer: Ohana Health Plan Medicare	$27,106.40
Rate for Payer: UnitedHealthcare Medicare	$27,106.40

ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC

Facility

$47,996.55

Service Code	MSDRG 290
Min. Negotiated Rate	$9,598.35
Max. Negotiated Rate	$47,996.55
Rate for Payer: AlohaCare Medicare	$9,598.35
Rate for Payer: Hawaii Medical Service Association Commercial	$47,996.55
Rate for Payer: Hawaii Medical Service Association Medicare	$9,598.35
Rate for Payer: Humana Medicare	$9,598.35
Rate for Payer: Kaiser Permanente Medicare	$9,598.35
Rate for Payer: Ohana Health Plan Medicare	$9,598.35
Rate for Payer: UnitedHealthcare Medicare	$9,598.35

ACUTE LEUKEMIA WITH CC

Facility

$139,699.59

Service Code	MSDRG 835
Min. Negotiated Rate	$20,992.14
Max. Negotiated Rate	$139,699.59
Rate for Payer: AlohaCare Medicare	$20,992.14
Rate for Payer: Hawaii Medical Service Association Commercial	$139,699.59
Rate for Payer: Hawaii Medical Service Association Medicare	$20,992.14
Rate for Payer: Humana Medicare	$20,992.14
Rate for Payer: Kaiser Permanente Medicare	$20,992.14
Rate for Payer: Ohana Health Plan Medicare	$20,992.14
Rate for Payer: UnitedHealthcare Medicare	$20,992.14

ACUTE LEUKEMIA WITH MCC

Facility

$139,699.59

Service Code	MSDRG 834
Min. Negotiated Rate	$54,540.76
Max. Negotiated Rate	$139,699.59
Rate for Payer: AlohaCare Medicare	$54,540.76
Rate for Payer: Hawaii Medical Service Association Commercial	$139,699.59
Rate for Payer: Hawaii Medical Service Association Medicare	$54,540.76
Rate for Payer: Humana Medicare	$54,540.76
Rate for Payer: Kaiser Permanente Medicare	$54,540.76
Rate for Payer: Ohana Health Plan Medicare	$54,540.76
Rate for Payer: UnitedHealthcare Medicare	$54,540.76

ACUTE LEUKEMIA WITH OTHER PROCEDURES

Facility

$139,699.59

Service Code	MSDRG 850
Min. Negotiated Rate	$85,778.31
Max. Negotiated Rate	$139,699.59
Rate for Payer: AlohaCare Medicare	$85,778.31
Rate for Payer: Hawaii Medical Service Association Commercial	$139,699.59
Rate for Payer: Hawaii Medical Service Association Medicare	$85,778.31
Rate for Payer: Humana Medicare	$85,778.31
Rate for Payer: Kaiser Permanente Medicare	$85,778.31
Rate for Payer: Ohana Health Plan Medicare	$85,778.31
Rate for Payer: UnitedHealthcare Medicare	$85,778.31

ACUTE LEUKEMIA WITHOUT CC/MCC

Facility

$139,699.59

Service Code	MSDRG 836
Min. Negotiated Rate	$12,454.44
Max. Negotiated Rate	$139,699.59
Rate for Payer: AlohaCare Medicare	$12,454.44
Rate for Payer: Hawaii Medical Service Association Commercial	$139,699.59
Rate for Payer: Hawaii Medical Service Association Medicare	$12,454.44
Rate for Payer: Humana Medicare	$12,454.44
Rate for Payer: Kaiser Permanente Medicare	$12,454.44
Rate for Payer: Ohana Health Plan Medicare	$12,454.44
Rate for Payer: UnitedHealthcare Medicare	$12,454.44

ACUTE MAJOR EYE INFECTIONS WITH CC/MCC

Facility

$11,900.57

Service Code	MSDRG 121
Min. Negotiated Rate	$9,125.27
Max. Negotiated Rate	$11,900.57
Rate for Payer: AlohaCare Medicare	$11,900.57
Rate for Payer: Hawaii Medical Service Association Commercial	$9,125.27
Rate for Payer: Hawaii Medical Service Association Medicare	$11,900.57
Rate for Payer: Humana Medicare	$11,900.57
Rate for Payer: Kaiser Permanente Medicare	$11,900.57
Rate for Payer: Ohana Health Plan Medicare	$11,900.57
Rate for Payer: UnitedHealthcare Medicare	$11,900.57

ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC

Facility

$9,125.27

Service Code	MSDRG 122
Min. Negotiated Rate	$8,180.17
Max. Negotiated Rate	$9,125.27
Rate for Payer: AlohaCare Medicare	$8,180.17
Rate for Payer: Hawaii Medical Service Association Commercial	$9,125.27
Rate for Payer: Hawaii Medical Service Association Medicare	$8,180.17
Rate for Payer: Humana Medicare	$8,180.17
Rate for Payer: Kaiser Permanente Medicare	$8,180.17
Rate for Payer: Ohana Health Plan Medicare	$8,180.17
Rate for Payer: UnitedHealthcare Medicare	$8,180.17

ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC

Facility

$28,940.14

Service Code	MSDRG 281
Min. Negotiated Rate	$9,493.88
Max. Negotiated Rate	$28,940.14
Rate for Payer: AlohaCare Medicare	$9,493.88
Rate for Payer: Hawaii Medical Service Association Commercial	$28,940.14
Rate for Payer: Hawaii Medical Service Association Medicare	$9,493.88
Rate for Payer: Humana Medicare	$9,493.88
Rate for Payer: Kaiser Permanente Medicare	$9,493.88
Rate for Payer: Ohana Health Plan Medicare	$9,493.88
Rate for Payer: UnitedHealthcare Medicare	$9,493.88

ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC

Facility

$33,467.22

Service Code	MSDRG 280
Min. Negotiated Rate	$16,244.80
Max. Negotiated Rate	$33,467.22
Rate for Payer: AlohaCare Medicare	$16,244.80
Rate for Payer: Hawaii Medical Service Association Commercial	$33,467.22
Rate for Payer: Hawaii Medical Service Association Medicare	$16,244.80
Rate for Payer: Humana Medicare	$16,244.80
Rate for Payer: Kaiser Permanente Medicare	$16,244.80
Rate for Payer: Ohana Health Plan Medicare	$16,244.80
Rate for Payer: UnitedHealthcare Medicare	$16,244.80

ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC

Facility

$25,337.44

Service Code	MSDRG 282
Min. Negotiated Rate	$7,562.23
Max. Negotiated Rate	$25,337.44
Rate for Payer: AlohaCare Medicare	$7,562.23
Rate for Payer: Hawaii Medical Service Association Commercial	$25,337.44
Rate for Payer: Hawaii Medical Service Association Medicare	$7,562.23
Rate for Payer: Humana Medicare	$7,562.23
Rate for Payer: Kaiser Permanente Medicare	$7,562.23
Rate for Payer: Ohana Health Plan Medicare	$7,562.23
Rate for Payer: UnitedHealthcare Medicare	$7,562.23

ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC

Facility

$55,913.02

Service Code	MSDRG 284
Min. Negotiated Rate	$7,257.71
Max. Negotiated Rate	$55,913.02
Rate for Payer: AlohaCare Medicare	$7,257.71
Rate for Payer: Hawaii Medical Service Association Commercial	$55,913.02
Rate for Payer: Hawaii Medical Service Association Medicare	$7,257.71
Rate for Payer: Humana Medicare	$7,257.71
Rate for Payer: Kaiser Permanente Medicare	$7,257.71
Rate for Payer: Ohana Health Plan Medicare	$7,257.71
Rate for Payer: UnitedHealthcare Medicare	$7,257.71

ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC

Facility

$55,913.02

Service Code	MSDRG 283
Min. Negotiated Rate	$19,957.33
Max. Negotiated Rate	$55,913.02
Rate for Payer: AlohaCare Medicare	$19,957.33
Rate for Payer: Hawaii Medical Service Association Commercial	$55,913.02
Rate for Payer: Hawaii Medical Service Association Medicare	$19,957.33
Rate for Payer: Humana Medicare	$19,957.33
Rate for Payer: Kaiser Permanente Medicare	$19,957.33
Rate for Payer: Ohana Health Plan Medicare	$19,957.33
Rate for Payer: UnitedHealthcare Medicare	$19,957.33

ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC

Facility

$55,913.02

Service Code	MSDRG 285
Min. Negotiated Rate	$6,338.20
Max. Negotiated Rate	$55,913.02
Rate for Payer: AlohaCare Medicare	$6,338.20
Rate for Payer: Hawaii Medical Service Association Commercial	$55,913.02
Rate for Payer: Hawaii Medical Service Association Medicare	$6,338.20
Rate for Payer: Humana Medicare	$6,338.20
Rate for Payer: Kaiser Permanente Medicare	$6,338.20
Rate for Payer: Ohana Health Plan Medicare	$6,338.20
Rate for Payer: UnitedHealthcare Medicare	$6,338.20

ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC

Facility

$57,050.71

Service Code	MSDRG 614
Min. Negotiated Rate	$22,036.79
Max. Negotiated Rate	$57,050.71
Rate for Payer: AlohaCare Medicare	$22,036.79
Rate for Payer: Hawaii Medical Service Association Commercial	$57,050.71
Rate for Payer: Hawaii Medical Service Association Medicare	$22,036.79
Rate for Payer: Humana Medicare	$22,036.79
Rate for Payer: Kaiser Permanente Medicare	$22,036.79
Rate for Payer: Ohana Health Plan Medicare	$22,036.79
Rate for Payer: UnitedHealthcare Medicare	$22,036.79

ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC

Facility

$57,050.71

Service Code	MSDRG 615
Min. Negotiated Rate	$14,226.43
Max. Negotiated Rate	$57,050.71
Rate for Payer: AlohaCare Medicare	$14,226.43
Rate for Payer: Hawaii Medical Service Association Commercial	$57,050.71
Rate for Payer: Hawaii Medical Service Association Medicare	$14,226.43
Rate for Payer: Humana Medicare	$14,226.43
Rate for Payer: Kaiser Permanente Medicare	$14,226.43
Rate for Payer: Ohana Health Plan Medicare	$14,226.43
Rate for Payer: UnitedHealthcare Medicare	$14,226.43

AFB smear

Facility

$114.00

Service Code	HCPCS 87206
Hospital Charge Code	87206
Hospital Revenue Code	306
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$110.58
Rate for Payer: AlohaCare Medicaid	$57.00
Rate for Payer: Cash Price	$74.10
Rate for Payer: Cash Price	$74.10
Rate for Payer: Hawaii Medical Service Association ABD	$7.42
Rate for Payer: Hawaii Medical Service Association Commercial	$6.74
Rate for Payer: Hawaii Medical Service Association Non-ABD	$7.79
Rate for Payer: Hawaii Western Management Group Commercial	$5.39
Rate for Payer: Health Management Network Commercial	$96.90
Rate for Payer: Kaiser Permanente Commercial	$102.60
Rate for Payer: Kaiser Permanente Medicaid	$58.14
Rate for Payer: MDX Hawaii PPO	$110.58
Rate for Payer: UnitedHealthcare Medicaid	$7.42
Rate for Payer: University Health Alliance Commercial	$13.88

AFB smear

Facility

$114.00

Service Code	HCPCS 87206
Hospital Charge Code	87206
Hospital Revenue Code	306
Min. Negotiated Rate	$96.90
Max. Negotiated Rate	$110.58
Rate for Payer: Cash Price	$74.10
Rate for Payer: Health Management Network Commercial	$96.90
Rate for Payer: Kaiser Permanente Commercial	$102.60
Rate for Payer: MDX Hawaii PPO	$110.58

AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC

Facility

$16,567.70

Service Code	MSDRG 560
Min. Negotiated Rate	$11,533.95
Max. Negotiated Rate	$16,567.70
Rate for Payer: AlohaCare Medicare	$11,533.95
Rate for Payer: Hawaii Medical Service Association Commercial	$16,567.70
Rate for Payer: Hawaii Medical Service Association Medicare	$11,533.95
Rate for Payer: Humana Medicare	$11,533.95
Rate for Payer: Kaiser Permanente Medicare	$11,533.95
Rate for Payer: Ohana Health Plan Medicare	$11,533.95
Rate for Payer: UnitedHealthcare Medicare	$11,533.95

AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

Facility

$18,815.08

Service Code	MSDRG 559
Min. Negotiated Rate	$16,567.70
Max. Negotiated Rate	$18,815.08
Rate for Payer: AlohaCare Medicare	$18,815.08
Rate for Payer: Hawaii Medical Service Association Commercial	$16,567.70
Rate for Payer: Hawaii Medical Service Association Medicare	$18,815.08
Rate for Payer: Humana Medicare	$18,815.08
Rate for Payer: Kaiser Permanente Medicare	$18,815.08
Rate for Payer: Ohana Health Plan Medicare	$18,815.08
Rate for Payer: UnitedHealthcare Medicare	$18,815.08

AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC

Facility

$16,567.70

Service Code	MSDRG 561
Min. Negotiated Rate	$8,358.55
Max. Negotiated Rate	$16,567.70
Rate for Payer: AlohaCare Medicare	$8,358.55
Rate for Payer: Hawaii Medical Service Association Commercial	$16,567.70
Rate for Payer: Hawaii Medical Service Association Medicare	$8,358.55
Rate for Payer: Humana Medicare	$8,358.55
Rate for Payer: Kaiser Permanente Medicare	$8,358.55
Rate for Payer: Ohana Health Plan Medicare	$8,358.55
Rate for Payer: UnitedHealthcare Medicare	$8,358.55

Know your out-of-pocket cost for care.

All Charges