Leahi Hospital

All Charges

Charge

Type

Setting

Price

Iron binding capacity

Facility

$18.00

Service Code	HCPCS 83550
Hospital Charge Code	83550
Hospital Revenue Code	301
Min. Negotiated Rate	$15.30
Max. Negotiated Rate	$17.46
Rate for Payer: Cash Price	$11.70
Rate for Payer: Health Management Network Commercial	$15.30
Rate for Payer: Kaiser Permanente Commercial	$16.20
Rate for Payer: MDX Hawaii PPO	$17.46

ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC

Facility

$50,817.09

Service Code	MSDRG 062
Min. Negotiated Rate	$17,753.66
Max. Negotiated Rate	$50,817.09
Rate for Payer: AlohaCare Medicare	$17,753.66
Rate for Payer: Hawaii Medical Service Association Commercial	$50,817.09
Rate for Payer: Hawaii Medical Service Association Medicare	$17,753.66
Rate for Payer: Humana Medicare	$17,753.66
Rate for Payer: Kaiser Permanente Medicare	$17,753.66
Rate for Payer: Ohana Health Plan Medicare	$17,753.66
Rate for Payer: UnitedHealthcare Medicare	$17,753.66

ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC

Facility

$50,817.09

Service Code	MSDRG 061
Min. Negotiated Rate	$27,608.04
Max. Negotiated Rate	$50,817.09
Rate for Payer: AlohaCare Medicare	$27,608.04
Rate for Payer: Hawaii Medical Service Association Commercial	$50,817.09
Rate for Payer: Hawaii Medical Service Association Medicare	$27,608.04
Rate for Payer: Humana Medicare	$27,608.04
Rate for Payer: Kaiser Permanente Medicare	$27,608.04
Rate for Payer: Ohana Health Plan Medicare	$27,608.04
Rate for Payer: UnitedHealthcare Medicare	$27,608.04

ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC

Facility

$50,817.09

Service Code	MSDRG 063
Min. Negotiated Rate	$14,270.78
Max. Negotiated Rate	$50,817.09
Rate for Payer: AlohaCare Medicare	$14,270.78
Rate for Payer: Hawaii Medical Service Association Commercial	$50,817.09
Rate for Payer: Hawaii Medical Service Association Medicare	$14,270.78
Rate for Payer: Humana Medicare	$14,270.78
Rate for Payer: Kaiser Permanente Medicare	$14,270.78
Rate for Payer: Ohana Health Plan Medicare	$14,270.78
Rate for Payer: UnitedHealthcare Medicare	$14,270.78

KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC

Facility

$43,279.85

Service Code	MSDRG 657
Min. Negotiated Rate	$18,471.13
Max. Negotiated Rate	$43,279.85
Rate for Payer: AlohaCare Medicare	$18,471.13
Rate for Payer: Hawaii Medical Service Association Commercial	$43,279.85
Rate for Payer: Hawaii Medical Service Association Medicare	$18,471.13
Rate for Payer: Humana Medicare	$18,471.13
Rate for Payer: Kaiser Permanente Medicare	$18,471.13
Rate for Payer: Ohana Health Plan Medicare	$18,471.13
Rate for Payer: UnitedHealthcare Medicare	$18,471.13

KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC

Facility

$43,279.85

Service Code	MSDRG 656
Min. Negotiated Rate	$31,813.32
Max. Negotiated Rate	$43,279.85
Rate for Payer: AlohaCare Medicare	$31,813.32
Rate for Payer: Hawaii Medical Service Association Commercial	$43,279.85
Rate for Payer: Hawaii Medical Service Association Medicare	$31,813.32
Rate for Payer: Humana Medicare	$31,813.32
Rate for Payer: Kaiser Permanente Medicare	$31,813.32
Rate for Payer: Ohana Health Plan Medicare	$31,813.32
Rate for Payer: UnitedHealthcare Medicare	$31,813.32

KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC

Facility

$43,279.85

Service Code	MSDRG 658
Min. Negotiated Rate	$15,729.37
Max. Negotiated Rate	$43,279.85
Rate for Payer: AlohaCare Medicare	$15,729.37
Rate for Payer: Hawaii Medical Service Association Commercial	$43,279.85
Rate for Payer: Hawaii Medical Service Association Medicare	$15,729.37
Rate for Payer: Humana Medicare	$15,729.37
Rate for Payer: Kaiser Permanente Medicare	$15,729.37
Rate for Payer: Ohana Health Plan Medicare	$15,729.37
Rate for Payer: UnitedHealthcare Medicare	$15,729.37

KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC

Facility

$46,052.99

Service Code	MSDRG 660
Min. Negotiated Rate	$13,461.66
Max. Negotiated Rate	$46,052.99
Rate for Payer: AlohaCare Medicare	$13,461.66
Rate for Payer: Hawaii Medical Service Association Commercial	$46,052.99
Rate for Payer: Hawaii Medical Service Association Medicare	$13,461.66
Rate for Payer: Humana Medicare	$13,461.66
Rate for Payer: Kaiser Permanente Medicare	$13,461.66
Rate for Payer: Ohana Health Plan Medicare	$13,461.66
Rate for Payer: UnitedHealthcare Medicare	$13,461.66

KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC

Facility

$47,759.53

Service Code	MSDRG 659
Min. Negotiated Rate	$25,477.31
Max. Negotiated Rate	$47,759.53
Rate for Payer: AlohaCare Medicare	$25,477.31
Rate for Payer: Hawaii Medical Service Association Commercial	$47,759.53
Rate for Payer: Hawaii Medical Service Association Medicare	$25,477.31
Rate for Payer: Humana Medicare	$25,477.31
Rate for Payer: Kaiser Permanente Medicare	$25,477.31
Rate for Payer: Ohana Health Plan Medicare	$25,477.31
Rate for Payer: UnitedHealthcare Medicare	$25,477.31

KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC

Facility

$31,144.43

Service Code	MSDRG 661
Min. Negotiated Rate	$10,640.06
Max. Negotiated Rate	$31,144.43
Rate for Payer: AlohaCare Medicare	$10,640.06
Rate for Payer: Hawaii Medical Service Association Commercial	$31,144.43
Rate for Payer: Hawaii Medical Service Association Medicare	$10,640.06
Rate for Payer: Humana Medicare	$10,640.06
Rate for Payer: Kaiser Permanente Medicare	$10,640.06
Rate for Payer: Ohana Health Plan Medicare	$10,640.06
Rate for Payer: UnitedHealthcare Medicare	$10,640.06

KIDNEY AND URINARY TRACT INFECTIONS WITH MCC

Facility

$17,539.48

Service Code	MSDRG 689
Min. Negotiated Rate	$11,871.00
Max. Negotiated Rate	$17,539.48
Rate for Payer: AlohaCare Medicare	$11,871.00
Rate for Payer: Hawaii Medical Service Association Commercial	$17,539.48
Rate for Payer: Hawaii Medical Service Association Medicare	$11,871.00
Rate for Payer: Humana Medicare	$11,871.00
Rate for Payer: Kaiser Permanente Medicare	$11,871.00
Rate for Payer: Ohana Health Plan Medicare	$11,871.00
Rate for Payer: UnitedHealthcare Medicare	$11,871.00

KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC

Facility

$14,979.66

Service Code	MSDRG 690
Min. Negotiated Rate	$8,413.74
Max. Negotiated Rate	$14,979.66
Rate for Payer: AlohaCare Medicare	$8,413.74
Rate for Payer: Hawaii Medical Service Association Commercial	$14,979.66
Rate for Payer: Hawaii Medical Service Association Medicare	$8,413.74
Rate for Payer: Humana Medicare	$8,413.74
Rate for Payer: Kaiser Permanente Medicare	$8,413.74
Rate for Payer: Ohana Health Plan Medicare	$8,413.74
Rate for Payer: UnitedHealthcare Medicare	$8,413.74

KIDNEY AND URINARY TRACT NEOPLASMS WITH CC

Facility

$30,931.11

Service Code	MSDRG 687
Min. Negotiated Rate	$10,762.27
Max. Negotiated Rate	$30,931.11
Rate for Payer: AlohaCare Medicare	$10,762.27
Rate for Payer: Hawaii Medical Service Association Commercial	$30,931.11
Rate for Payer: Hawaii Medical Service Association Medicare	$10,762.27
Rate for Payer: Humana Medicare	$10,762.27
Rate for Payer: Kaiser Permanente Medicare	$10,762.27
Rate for Payer: Ohana Health Plan Medicare	$10,762.27
Rate for Payer: UnitedHealthcare Medicare	$10,762.27

KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC

Facility

$30,931.11

Service Code	MSDRG 686
Min. Negotiated Rate	$18,211.94
Max. Negotiated Rate	$30,931.11
Rate for Payer: AlohaCare Medicare	$18,211.94
Rate for Payer: Hawaii Medical Service Association Commercial	$30,931.11
Rate for Payer: Hawaii Medical Service Association Medicare	$18,211.94
Rate for Payer: Humana Medicare	$18,211.94
Rate for Payer: Kaiser Permanente Medicare	$18,211.94
Rate for Payer: Ohana Health Plan Medicare	$18,211.94
Rate for Payer: UnitedHealthcare Medicare	$18,211.94

KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC

Facility

$30,931.11

Service Code	MSDRG 688
Min. Negotiated Rate	$8,224.52
Max. Negotiated Rate	$30,931.11
Rate for Payer: AlohaCare Medicare	$8,224.52
Rate for Payer: Hawaii Medical Service Association Commercial	$30,931.11
Rate for Payer: Hawaii Medical Service Association Medicare	$8,224.52
Rate for Payer: Humana Medicare	$8,224.52
Rate for Payer: Kaiser Permanente Medicare	$8,224.52
Rate for Payer: Ohana Health Plan Medicare	$8,224.52
Rate for Payer: UnitedHealthcare Medicare	$8,224.52

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC

Facility

$20,525.93

Service Code	MSDRG 695
Min. Negotiated Rate	$11,708.39
Max. Negotiated Rate	$20,525.93
Rate for Payer: AlohaCare Medicare	$11,708.39
Rate for Payer: Hawaii Medical Service Association Commercial	$20,525.93
Rate for Payer: Hawaii Medical Service Association Medicare	$11,708.39
Rate for Payer: Humana Medicare	$11,708.39
Rate for Payer: Kaiser Permanente Medicare	$11,708.39
Rate for Payer: Ohana Health Plan Medicare	$11,708.39
Rate for Payer: UnitedHealthcare Medicare	$11,708.39

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC

Facility

$20,525.93

Service Code	MSDRG 696
Min. Negotiated Rate	$7,226.18
Max. Negotiated Rate	$20,525.93
Rate for Payer: AlohaCare Medicare	$7,226.18
Rate for Payer: Hawaii Medical Service Association Commercial	$20,525.93
Rate for Payer: Hawaii Medical Service Association Medicare	$7,226.18
Rate for Payer: Humana Medicare	$7,226.18
Rate for Payer: Kaiser Permanente Medicare	$7,226.18
Rate for Payer: Ohana Health Plan Medicare	$7,226.18
Rate for Payer: UnitedHealthcare Medicare	$7,226.18

KIDNEY TRANSPLANT

Facility

$154,726.66

Service Code	MSDRG 652
Min. Negotiated Rate	$32,263.71
Max. Negotiated Rate	$154,726.66
Rate for Payer: AlohaCare Medicare	$32,263.71
Rate for Payer: Hawaii Medical Service Association Commercial	$154,726.66
Rate for Payer: Hawaii Medical Service Association Medicare	$32,263.71
Rate for Payer: Kaiser Permanente Medicare	$32,263.71
Rate for Payer: Ohana Health Plan Medicare	$32,263.71
Rate for Payer: UnitedHealthcare Medicare	$32,263.71

KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC

Facility

$154,726.66

Service Code	MSDRG 650
Min. Negotiated Rate	$46,769.81
Max. Negotiated Rate	$154,726.66
Rate for Payer: AlohaCare Medicare	$46,769.81
Rate for Payer: Hawaii Medical Service Association Commercial	$154,726.66
Rate for Payer: Hawaii Medical Service Association Medicare	$46,769.81
Rate for Payer: Humana Medicare	$46,769.81
Rate for Payer: Kaiser Permanente Medicare	$46,769.81
Rate for Payer: Ohana Health Plan Medicare	$46,769.81
Rate for Payer: UnitedHealthcare Medicare	$46,769.81

KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC

Facility

$154,726.66

Service Code	MSDRG 651
Min. Negotiated Rate	$36,957.80
Max. Negotiated Rate	$154,726.66
Rate for Payer: AlohaCare Medicare	$36,957.80
Rate for Payer: Hawaii Medical Service Association Commercial	$154,726.66
Rate for Payer: Hawaii Medical Service Association Medicare	$36,957.80
Rate for Payer: Humana Medicare	$36,957.80
Rate for Payer: Kaiser Permanente Medicare	$36,957.80
Rate for Payer: Ohana Health Plan Medicare	$36,957.80
Rate for Payer: UnitedHealthcare Medicare	$36,957.80

KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC

Facility

$24,934.50

Service Code	MSDRG 488
Min. Negotiated Rate	$17,868.97
Max. Negotiated Rate	$24,934.50
Rate for Payer: AlohaCare Medicare	$17,868.97
Rate for Payer: Hawaii Medical Service Association Commercial	$24,934.50
Rate for Payer: Hawaii Medical Service Association Medicare	$17,868.97
Rate for Payer: Humana Medicare	$17,868.97
Rate for Payer: Kaiser Permanente Medicare	$17,868.97
Rate for Payer: Ohana Health Plan Medicare	$17,868.97
Rate for Payer: UnitedHealthcare Medicare	$17,868.97

KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC

Facility

$24,934.50

Service Code	MSDRG 489
Min. Negotiated Rate	$11,442.29
Max. Negotiated Rate	$24,934.50
Rate for Payer: AlohaCare Medicare	$11,442.29
Rate for Payer: Hawaii Medical Service Association Commercial	$24,934.50
Rate for Payer: Hawaii Medical Service Association Medicare	$11,442.29
Rate for Payer: Humana Medicare	$11,442.29
Rate for Payer: Kaiser Permanente Medicare	$11,442.29
Rate for Payer: Ohana Health Plan Medicare	$11,442.29
Rate for Payer: UnitedHealthcare Medicare	$11,442.29

KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC

Facility

$44,156.83

Service Code	MSDRG 486
Min. Negotiated Rate	$21,044.37
Max. Negotiated Rate	$44,156.83
Rate for Payer: AlohaCare Medicare	$21,044.37
Rate for Payer: Hawaii Medical Service Association Commercial	$44,156.83
Rate for Payer: Hawaii Medical Service Association Medicare	$21,044.37
Rate for Payer: Humana Medicare	$21,044.37
Rate for Payer: Kaiser Permanente Medicare	$21,044.37
Rate for Payer: Ohana Health Plan Medicare	$21,044.37
Rate for Payer: UnitedHealthcare Medicare	$21,044.37

KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC

Facility

$44,156.83

Service Code	MSDRG 485
Min. Negotiated Rate	$32,240.06
Max. Negotiated Rate	$44,156.83
Rate for Payer: AlohaCare Medicare	$32,240.06
Rate for Payer: Hawaii Medical Service Association Commercial	$44,156.83
Rate for Payer: Hawaii Medical Service Association Medicare	$32,240.06
Rate for Payer: Humana Medicare	$32,240.06
Rate for Payer: Kaiser Permanente Medicare	$32,240.06
Rate for Payer: Ohana Health Plan Medicare	$32,240.06
Rate for Payer: UnitedHealthcare Medicare	$32,240.06

KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC

Facility

$31,547.36

Service Code	MSDRG 487
Min. Negotiated Rate	$15,871.28
Max. Negotiated Rate	$31,547.36
Rate for Payer: AlohaCare Medicare	$15,871.28
Rate for Payer: Hawaii Medical Service Association Commercial	$31,547.36
Rate for Payer: Hawaii Medical Service Association Medicare	$15,871.28
Rate for Payer: Humana Medicare	$15,871.28
Rate for Payer: Kaiser Permanente Medicare	$15,871.28
Rate for Payer: Ohana Health Plan Medicare	$15,871.28
Rate for Payer: UnitedHealthcare Medicare	$15,871.28

Know your out-of-pocket cost for care.

All Charges