Leahi Hospital

All Charges

Charge

Type

Setting

Price

HEART FAILURE AND SHOCK WITHOUT CC/MCC

Facility

$28,513.51

Service Code	MSDRG 293
Min. Negotiated Rate	$6,013.96
Max. Negotiated Rate	$28,513.51
Rate for Payer: AlohaCare Medicare	$6,013.96
Rate for Payer: Hawaii Medical Service Association Commercial	$28,513.51
Rate for Payer: Hawaii Medical Service Association Medicare	$6,013.96
Rate for Payer: Humana Medicare	$6,013.96
Rate for Payer: Kaiser Permanente Medicare	$6,013.96
Rate for Payer: Ohana Health Plan Medicare	$6,013.96
Rate for Payer: UnitedHealthcare Medicare	$6,013.96

HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC

Facility

$276,621.41

Service Code	MSDRG 001
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$276,621.41
Rate for Payer: AlohaCare Medicare	$276,621.41
Rate for Payer: Hawaii Medical Service Association Commercial	$270,036.89
Rate for Payer: Hawaii Medical Service Association Medicare	$276,621.41
Rate for Payer: Kaiser Permanente Medicare	$276,621.41
Rate for Payer: Ohana Health Plan Medicare	$276,621.41
Rate for Payer: UnitedHealthcare Medicare	$276,621.41
Rate for Payer: University Health Alliance Commercial	$10,400.00

HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC

Facility

$270,036.89

Service Code	MSDRG 002
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$270,036.89
Rate for Payer: AlohaCare Medicare	$112,114.78
Rate for Payer: Hawaii Medical Service Association Commercial	$270,036.89
Rate for Payer: Hawaii Medical Service Association Medicare	$112,114.78
Rate for Payer: Kaiser Permanente Medicare	$112,114.78
Rate for Payer: Ohana Health Plan Medicare	$112,114.78
Rate for Payer: UnitedHealthcare Medicare	$112,114.78
Rate for Payer: University Health Alliance Commercial	$10,400.00

Hematocrit

Facility

$41.00

Service Code	HCPCS 85014
Hospital Charge Code	85014
Hospital Revenue Code	305
Min. Negotiated Rate	$34.85
Max. Negotiated Rate	$39.77
Rate for Payer: Cash Price	$26.65
Rate for Payer: Health Management Network Commercial	$34.85
Rate for Payer: Kaiser Permanente Commercial	$36.90
Rate for Payer: MDX Hawaii PPO	$39.77

Hematocrit

Facility

$41.00

Service Code	HCPCS 85014
Hospital Charge Code	85014
Hospital Revenue Code	305
Min. Negotiated Rate	$2.37
Max. Negotiated Rate	$39.77
Rate for Payer: AlohaCare Medicaid	$20.50
Rate for Payer: Cash Price	$26.65
Rate for Payer: Cash Price	$26.65
Rate for Payer: Hawaii Medical Service Association ABD	$3.27
Rate for Payer: Hawaii Medical Service Association Commercial	$2.96
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3.43
Rate for Payer: Hawaii Western Management Group Commercial	$2.37
Rate for Payer: Health Management Network Commercial	$34.85
Rate for Payer: Kaiser Permanente Commercial	$36.90
Rate for Payer: Kaiser Permanente Medicaid	$20.91
Rate for Payer: MDX Hawaii PPO	$39.77
Rate for Payer: UnitedHealthcare Medicaid	$3.27
Rate for Payer: University Health Alliance Commercial	$6.12

Hemoglobin

Facility

$52.00

Service Code	HCPCS 85018
Hospital Charge Code	85018
Hospital Revenue Code	305
Min. Negotiated Rate	$2.37
Max. Negotiated Rate	$50.44
Rate for Payer: AlohaCare Medicaid	$26.00
Rate for Payer: Cash Price	$33.80
Rate for Payer: Cash Price	$33.80
Rate for Payer: Hawaii Medical Service Association ABD	$3.27
Rate for Payer: Hawaii Medical Service Association Commercial	$2.96
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3.43
Rate for Payer: Hawaii Western Management Group Commercial	$2.37
Rate for Payer: Health Management Network Commercial	$44.20
Rate for Payer: Kaiser Permanente Commercial	$46.80
Rate for Payer: Kaiser Permanente Medicaid	$26.52
Rate for Payer: MDX Hawaii PPO	$50.44
Rate for Payer: UnitedHealthcare Medicaid	$3.27
Rate for Payer: University Health Alliance Commercial	$6.12

Hemoglobin

Facility

$52.00

Service Code	HCPCS 85018
Hospital Charge Code	85018
Hospital Revenue Code	305
Min. Negotiated Rate	$44.20
Max. Negotiated Rate	$50.44
Rate for Payer: Cash Price	$33.80
Rate for Payer: Health Management Network Commercial	$44.20
Rate for Payer: Kaiser Permanente Commercial	$46.80
Rate for Payer: MDX Hawaii PPO	$50.44

Hemoglobin A1C

Facility

$185.00

Service Code	HCPCS 83036
Hospital Charge Code	83036
Hospital Revenue Code	301
Min. Negotiated Rate	$157.25
Max. Negotiated Rate	$179.45
Rate for Payer: Cash Price	$120.25
Rate for Payer: Health Management Network Commercial	$157.25
Rate for Payer: Kaiser Permanente Commercial	$166.50
Rate for Payer: MDX Hawaii PPO	$179.45

Hemoglobin A1C

Facility

$185.00

Service Code	HCPCS 83036
Hospital Charge Code	83036
Hospital Revenue Code	301
Min. Negotiated Rate	$9.71
Max. Negotiated Rate	$179.45
Rate for Payer: AlohaCare Medicaid	$92.50
Rate for Payer: Cash Price	$120.25
Rate for Payer: Cash Price	$120.25
Rate for Payer: Hawaii Medical Service Association ABD	$13.42
Rate for Payer: Hawaii Medical Service Association Commercial	$12.14
Rate for Payer: Hawaii Medical Service Association Non-ABD	$14.09
Rate for Payer: Hawaii Western Management Group Commercial	$9.71
Rate for Payer: Health Management Network Commercial	$157.25
Rate for Payer: Kaiser Permanente Commercial	$166.50
Rate for Payer: Kaiser Permanente Medicaid	$94.35
Rate for Payer: MDX Hawaii PPO	$179.45
Rate for Payer: UnitedHealthcare Medicaid	$13.42
Rate for Payer: University Health Alliance Commercial	$25.09

Hepatic function panel

Facility

$176.00

Service Code	HCPCS 80076
Hospital Charge Code	80076
Hospital Revenue Code	301
Min. Negotiated Rate	$149.60
Max. Negotiated Rate	$170.72
Rate for Payer: Cash Price	$114.40
Rate for Payer: Health Management Network Commercial	$149.60
Rate for Payer: Kaiser Permanente Commercial	$158.40
Rate for Payer: MDX Hawaii PPO	$170.72

Hepatic function panel

Facility

$176.00

Service Code	HCPCS 80076
Hospital Charge Code	80076
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$170.72
Rate for Payer: AlohaCare Medicaid	$88.00
Rate for Payer: Cash Price	$114.40
Rate for Payer: Cash Price	$114.40
Rate for Payer: Hawaii Medical Service Association ABD	$11.29
Rate for Payer: Hawaii Medical Service Association Commercial	$10.21
Rate for Payer: Hawaii Medical Service Association Non-ABD	$11.85
Rate for Payer: Hawaii Western Management Group Commercial	$8.17
Rate for Payer: Health Management Network Commercial	$149.60
Rate for Payer: Kaiser Permanente Commercial	$158.40
Rate for Payer: Kaiser Permanente Medicaid	$89.76
Rate for Payer: MDX Hawaii PPO	$170.72
Rate for Payer: UnitedHealthcare Medicaid	$11.29
Rate for Payer: University Health Alliance Commercial	$21.13

HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC

Facility

$65,464.92

Service Code	MSDRG 421
Min. Negotiated Rate	$17,559.51
Max. Negotiated Rate	$65,464.92
Rate for Payer: AlohaCare Medicare	$17,559.51
Rate for Payer: Hawaii Medical Service Association Commercial	$65,464.92
Rate for Payer: Hawaii Medical Service Association Medicare	$17,559.51
Rate for Payer: Humana Medicare	$17,559.51
Rate for Payer: Kaiser Permanente Medicare	$17,559.51
Rate for Payer: Ohana Health Plan Medicare	$17,559.51
Rate for Payer: UnitedHealthcare Medicare	$17,559.51

HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC

Facility

$65,464.92

Service Code	MSDRG 420
Min. Negotiated Rate	$34,014.02
Max. Negotiated Rate	$65,464.92
Rate for Payer: AlohaCare Medicare	$34,014.02
Rate for Payer: Hawaii Medical Service Association Commercial	$65,464.92
Rate for Payer: Hawaii Medical Service Association Medicare	$34,014.02
Rate for Payer: Humana Medicare	$34,014.02
Rate for Payer: Kaiser Permanente Medicare	$34,014.02
Rate for Payer: Ohana Health Plan Medicare	$34,014.02
Rate for Payer: UnitedHealthcare Medicare	$34,014.02

HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC

Facility

$58,093.60

Service Code	MSDRG 422
Min. Negotiated Rate	$14,228.40
Max. Negotiated Rate	$58,093.60
Rate for Payer: AlohaCare Medicare	$14,228.40
Rate for Payer: Hawaii Medical Service Association Commercial	$58,093.60
Rate for Payer: Hawaii Medical Service Association Medicare	$14,228.40
Rate for Payer: Humana Medicare	$14,228.40
Rate for Payer: Kaiser Permanente Medicare	$14,228.40
Rate for Payer: Ohana Health Plan Medicare	$14,228.40
Rate for Payer: UnitedHealthcare Medicare	$14,228.40

HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC

Facility

$31,950.30

Service Code	MSDRG 354
Min. Negotiated Rate	$17,016.48
Max. Negotiated Rate	$31,950.30
Rate for Payer: AlohaCare Medicare	$17,016.48
Rate for Payer: Hawaii Medical Service Association Commercial	$31,950.30
Rate for Payer: Hawaii Medical Service Association Medicare	$17,016.48
Rate for Payer: Humana Medicare	$17,016.48
Rate for Payer: Kaiser Permanente Medicare	$17,016.48
Rate for Payer: Ohana Health Plan Medicare	$17,016.48
Rate for Payer: UnitedHealthcare Medicare	$17,016.48

HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC

Facility

$41,407.39

Service Code	MSDRG 353
Min. Negotiated Rate	$29,036.07
Max. Negotiated Rate	$41,407.39
Rate for Payer: AlohaCare Medicare	$29,036.07
Rate for Payer: Hawaii Medical Service Association Commercial	$41,407.39
Rate for Payer: Hawaii Medical Service Association Medicare	$29,036.07
Rate for Payer: Humana Medicare	$29,036.07
Rate for Payer: Kaiser Permanente Medicare	$29,036.07
Rate for Payer: Ohana Health Plan Medicare	$29,036.07
Rate for Payer: UnitedHealthcare Medicare	$29,036.07

HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC

Facility

$23,607.19

Service Code	MSDRG 355
Min. Negotiated Rate	$13,691.28
Max. Negotiated Rate	$23,607.19
Rate for Payer: AlohaCare Medicare	$13,691.28
Rate for Payer: Hawaii Medical Service Association Commercial	$23,607.19
Rate for Payer: Hawaii Medical Service Association Medicare	$13,691.28
Rate for Payer: Humana Medicare	$13,691.28
Rate for Payer: Kaiser Permanente Medicare	$13,691.28
Rate for Payer: Ohana Health Plan Medicare	$13,691.28
Rate for Payer: UnitedHealthcare Medicare	$13,691.28

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC

Facility

$48,517.99

Service Code	MSDRG 481
Min. Negotiated Rate	$21,077.88
Max. Negotiated Rate	$48,517.99
Rate for Payer: AlohaCare Medicare	$21,077.88
Rate for Payer: Hawaii Medical Service Association Commercial	$48,517.99
Rate for Payer: Hawaii Medical Service Association Medicare	$21,077.88
Rate for Payer: Humana Medicare	$21,077.88
Rate for Payer: Kaiser Permanente Medicare	$21,077.88
Rate for Payer: Ohana Health Plan Medicare	$21,077.88
Rate for Payer: UnitedHealthcare Medicare	$21,077.88

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC

Facility

$49,750.50

Service Code	MSDRG 480
Min. Negotiated Rate	$29,137.59
Max. Negotiated Rate	$49,750.50
Rate for Payer: AlohaCare Medicare	$29,137.59
Rate for Payer: Hawaii Medical Service Association Commercial	$49,750.50
Rate for Payer: Hawaii Medical Service Association Medicare	$29,137.59
Rate for Payer: Humana Medicare	$29,137.59
Rate for Payer: Kaiser Permanente Medicare	$29,137.59
Rate for Payer: Ohana Health Plan Medicare	$29,137.59
Rate for Payer: UnitedHealthcare Medicare	$29,137.59

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC

Facility

$34,960.45

Service Code	MSDRG 482
Min. Negotiated Rate	$16,509.92
Max. Negotiated Rate	$34,960.45
Rate for Payer: AlohaCare Medicare	$16,509.92
Rate for Payer: Hawaii Medical Service Association Commercial	$34,960.45
Rate for Payer: Hawaii Medical Service Association Medicare	$16,509.92
Rate for Payer: Humana Medicare	$16,509.92
Rate for Payer: Kaiser Permanente Medicare	$16,509.92
Rate for Payer: Ohana Health Plan Medicare	$16,509.92
Rate for Payer: UnitedHealthcare Medicare	$16,509.92

HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC

Facility

$50,580.07

Service Code	MSDRG 521
Min. Negotiated Rate	$28,722.68
Max. Negotiated Rate	$50,580.07
Rate for Payer: AlohaCare Medicare	$28,722.68
Rate for Payer: Hawaii Medical Service Association Commercial	$50,580.07
Rate for Payer: Hawaii Medical Service Association Medicare	$28,722.68
Rate for Payer: Humana Medicare	$28,722.68
Rate for Payer: Kaiser Permanente Medicare	$28,722.68
Rate for Payer: Ohana Health Plan Medicare	$28,722.68
Rate for Payer: UnitedHealthcare Medicare	$28,722.68

HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC

Facility

$36,880.31

Service Code	MSDRG 522
Min. Negotiated Rate	$21,306.52
Max. Negotiated Rate	$36,880.31
Rate for Payer: AlohaCare Medicare	$21,306.52
Rate for Payer: Hawaii Medical Service Association Commercial	$36,880.31
Rate for Payer: Hawaii Medical Service Association Medicare	$21,306.52
Rate for Payer: Humana Medicare	$21,306.52
Rate for Payer: Kaiser Permanente Medicare	$21,306.52
Rate for Payer: Ohana Health Plan Medicare	$21,306.52
Rate for Payer: UnitedHealthcare Medicare	$21,306.52

HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC

Facility

$99,074.36

Service Code	MSDRG 969
Min. Negotiated Rate	$60,763.44
Max. Negotiated Rate	$99,074.36
Rate for Payer: AlohaCare Medicare	$60,763.44
Rate for Payer: Hawaii Medical Service Association Commercial	$99,074.36
Rate for Payer: Hawaii Medical Service Association Medicare	$60,763.44
Rate for Payer: Humana Medicare	$60,763.44
Rate for Payer: Kaiser Permanente Medicare	$60,763.44
Rate for Payer: Ohana Health Plan Medicare	$60,763.44
Rate for Payer: UnitedHealthcare Medicare	$60,763.44

HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC

Facility

$99,074.36

Service Code	MSDRG 970
Min. Negotiated Rate	$26,428.35
Max. Negotiated Rate	$99,074.36
Rate for Payer: AlohaCare Medicare	$26,428.35
Rate for Payer: Hawaii Medical Service Association Commercial	$99,074.36
Rate for Payer: Hawaii Medical Service Association Medicare	$26,428.35
Rate for Payer: Humana Medicare	$26,428.35
Rate for Payer: Kaiser Permanente Medicare	$26,428.35
Rate for Payer: Ohana Health Plan Medicare	$26,428.35
Rate for Payer: UnitedHealthcare Medicare	$26,428.35

HIV WITH MAJOR RELATED CONDITION WITH CC

Facility

$57,643.26

Service Code	MSDRG 975
Min. Negotiated Rate	$13,198.51
Max. Negotiated Rate	$57,643.26
Rate for Payer: AlohaCare Medicare	$13,198.51
Rate for Payer: Hawaii Medical Service Association Commercial	$57,643.26
Rate for Payer: Hawaii Medical Service Association Medicare	$13,198.51
Rate for Payer: Humana Medicare	$13,198.51
Rate for Payer: Kaiser Permanente Medicare	$13,198.51
Rate for Payer: Ohana Health Plan Medicare	$13,198.51
Rate for Payer: UnitedHealthcare Medicare	$13,198.51

Know your out-of-pocket cost for care.

All Charges