Leahi Hospital

All Charges

Charge

Type

Setting

Price

LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC

Facility

$26,996.58

Service Code	MSDRG 418
Min. Negotiated Rate	$17,107.15
Max. Negotiated Rate	$26,996.58
Rate for Payer: AlohaCare Medicare	$17,107.15
Rate for Payer: Hawaii Medical Service Association Commercial	$26,996.58
Rate for Payer: Hawaii Medical Service Association Medicare	$17,107.15
Rate for Payer: Humana Medicare	$17,107.15
Rate for Payer: Kaiser Permanente Medicare	$17,107.15
Rate for Payer: Ohana Health Plan Medicare	$17,107.15
Rate for Payer: UnitedHealthcare Medicare	$17,107.15

LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC

Facility

$29,603.80

Service Code	MSDRG 417
Min. Negotiated Rate	$23,954.66
Max. Negotiated Rate	$29,603.80
Rate for Payer: AlohaCare Medicare	$23,954.66
Rate for Payer: Hawaii Medical Service Association Commercial	$29,603.80
Rate for Payer: Hawaii Medical Service Association Medicare	$23,954.66
Rate for Payer: Humana Medicare	$23,954.66
Rate for Payer: Kaiser Permanente Medicare	$23,954.66
Rate for Payer: Ohana Health Plan Medicare	$23,954.66
Rate for Payer: UnitedHealthcare Medicare	$23,954.66

LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$17,468.37

Service Code	MSDRG 419
Min. Negotiated Rate	$13,896.28
Max. Negotiated Rate	$17,468.37
Rate for Payer: AlohaCare Medicare	$13,896.28
Rate for Payer: Hawaii Medical Service Association Commercial	$17,468.37
Rate for Payer: Hawaii Medical Service Association Medicare	$13,896.28
Rate for Payer: Humana Medicare	$13,896.28
Rate for Payer: Kaiser Permanente Medicare	$13,896.28
Rate for Payer: Ohana Health Plan Medicare	$13,896.28
Rate for Payer: UnitedHealthcare Medicare	$13,896.28

LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$214,242.38

Service Code	MSDRG 956
Min. Negotiated Rate	$37,521.54
Max. Negotiated Rate	$214,242.38
Rate for Payer: AlohaCare Medicare	$37,521.54
Rate for Payer: Hawaii Medical Service Association Commercial	$214,242.38
Rate for Payer: Hawaii Medical Service Association Medicare	$37,521.54
Rate for Payer: Humana Medicare	$37,521.54
Rate for Payer: Kaiser Permanente Medicare	$37,521.54
Rate for Payer: Ohana Health Plan Medicare	$37,521.54
Rate for Payer: UnitedHealthcare Medicare	$37,521.54

Lipid panel

Facility

$239.00

Service Code	HCPCS 80061
Hospital Charge Code	80061
Hospital Revenue Code	301
Min. Negotiated Rate	$13.39
Max. Negotiated Rate	$231.83
Rate for Payer: AlohaCare Medicaid	$119.50
Rate for Payer: Cash Price	$155.35
Rate for Payer: Cash Price	$155.35
Rate for Payer: Hawaii Medical Service Association ABD	$18.51
Rate for Payer: Hawaii Medical Service Association Commercial	$16.74
Rate for Payer: Hawaii Medical Service Association Non-ABD	$19.44
Rate for Payer: Hawaii Western Management Group Commercial	$13.39
Rate for Payer: Health Management Network Commercial	$203.15
Rate for Payer: Kaiser Permanente Commercial	$215.10
Rate for Payer: Kaiser Permanente Medicaid	$121.89
Rate for Payer: MDX Hawaii PPO	$231.83
Rate for Payer: UnitedHealthcare Medicaid	$18.51
Rate for Payer: University Health Alliance Commercial	$34.63

Lipid panel

Facility

$239.00

Service Code	HCPCS 80061
Hospital Charge Code	80061
Hospital Revenue Code	301
Min. Negotiated Rate	$203.15
Max. Negotiated Rate	$231.83
Rate for Payer: Cash Price	$155.35
Rate for Payer: Health Management Network Commercial	$203.15
Rate for Payer: Kaiser Permanente Commercial	$215.10
Rate for Payer: MDX Hawaii PPO	$231.83

LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT

Facility

$358,611.26

Service Code	MSDRG 005
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$358,611.26
Rate for Payer: AlohaCare Medicare	$102,049.50
Rate for Payer: Hawaii Medical Service Association Commercial	$358,611.26
Rate for Payer: Hawaii Medical Service Association Medicare	$102,049.50
Rate for Payer: Kaiser Permanente Medicare	$102,049.50
Rate for Payer: Ohana Health Plan Medicare	$102,049.50
Rate for Payer: UnitedHealthcare Medicare	$102,049.50
Rate for Payer: University Health Alliance Commercial	$10,400.00

LIVER TRANSPLANT WITHOUT MCC

Facility

$358,611.26

Service Code	MSDRG 006
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$358,611.26
Rate for Payer: AlohaCare Medicare	$46,135.13
Rate for Payer: Hawaii Medical Service Association Commercial	$358,611.26
Rate for Payer: Hawaii Medical Service Association Medicare	$46,135.13
Rate for Payer: Kaiser Permanente Medicare	$46,135.13
Rate for Payer: Ohana Health Plan Medicare	$46,135.13
Rate for Payer: UnitedHealthcare Medicare	$46,135.13
Rate for Payer: University Health Alliance Commercial	$10,400.00

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC

Facility

$35,553.00

Service Code	MSDRG 496
Min. Negotiated Rate	$18,213.91
Max. Negotiated Rate	$35,553.00
Rate for Payer: AlohaCare Medicare	$18,213.91
Rate for Payer: Hawaii Medical Service Association Commercial	$35,553.00
Rate for Payer: Hawaii Medical Service Association Medicare	$18,213.91
Rate for Payer: Humana Medicare	$18,213.91
Rate for Payer: Kaiser Permanente Medicare	$18,213.91
Rate for Payer: Ohana Health Plan Medicare	$18,213.91
Rate for Payer: UnitedHealthcare Medicare	$18,213.91

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC

Facility

$38,278.73

Service Code	MSDRG 495
Min. Negotiated Rate	$36,168.39
Max. Negotiated Rate	$38,278.73
Rate for Payer: AlohaCare Medicare	$36,168.39
Rate for Payer: Hawaii Medical Service Association Commercial	$38,278.73
Rate for Payer: Hawaii Medical Service Association Medicare	$36,168.39
Rate for Payer: Humana Medicare	$36,168.39
Rate for Payer: Kaiser Permanente Medicare	$36,168.39
Rate for Payer: Ohana Health Plan Medicare	$36,168.39
Rate for Payer: UnitedHealthcare Medicare	$36,168.39

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC

Facility

$24,673.78

Service Code	MSDRG 497
Min. Negotiated Rate	$12,344.07
Max. Negotiated Rate	$24,673.78
Rate for Payer: AlohaCare Medicare	$12,344.07
Rate for Payer: Hawaii Medical Service Association Commercial	$24,673.78
Rate for Payer: Hawaii Medical Service Association Medicare	$12,344.07
Rate for Payer: Humana Medicare	$12,344.07
Rate for Payer: Kaiser Permanente Medicare	$12,344.07
Rate for Payer: Ohana Health Plan Medicare	$12,344.07
Rate for Payer: UnitedHealthcare Medicare	$12,344.07

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC

Facility

$42,971.73

Service Code	MSDRG 498
Min. Negotiated Rate	$30,167.47
Max. Negotiated Rate	$42,971.73
Rate for Payer: AlohaCare Medicare	$30,167.47
Rate for Payer: Hawaii Medical Service Association Commercial	$42,971.73
Rate for Payer: Hawaii Medical Service Association Medicare	$30,167.47
Rate for Payer: Humana Medicare	$30,167.47
Rate for Payer: Kaiser Permanente Medicare	$30,167.47
Rate for Payer: Ohana Health Plan Medicare	$30,167.47
Rate for Payer: UnitedHealthcare Medicare	$30,167.47

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC

Facility

$42,971.73

Service Code	MSDRG 499
Min. Negotiated Rate	$20,292.40
Max. Negotiated Rate	$42,971.73
Rate for Payer: AlohaCare Medicare	$20,292.40
Rate for Payer: Hawaii Medical Service Association Commercial	$42,971.73
Rate for Payer: Hawaii Medical Service Association Medicare	$20,292.40
Rate for Payer: Humana Medicare	$20,292.40
Rate for Payer: Kaiser Permanente Medicare	$20,292.40
Rate for Payer: Ohana Health Plan Medicare	$20,292.40
Rate for Payer: UnitedHealthcare Medicare	$20,292.40

LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC

Facility

$54,751.62

Service Code	MSDRG 493
Min. Negotiated Rate	$25,430.00
Max. Negotiated Rate	$54,751.62
Rate for Payer: AlohaCare Medicare	$25,430.00
Rate for Payer: Hawaii Medical Service Association Commercial	$54,751.62
Rate for Payer: Hawaii Medical Service Association Medicare	$25,430.00
Rate for Payer: Humana Medicare	$25,430.00
Rate for Payer: Kaiser Permanente Medicare	$25,430.00
Rate for Payer: Ohana Health Plan Medicare	$25,430.00
Rate for Payer: UnitedHealthcare Medicare	$25,430.00

LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC

Facility

$54,751.62

Service Code	MSDRG 492
Min. Negotiated Rate	$36,620.76
Max. Negotiated Rate	$54,751.62
Rate for Payer: AlohaCare Medicare	$36,620.76
Rate for Payer: Hawaii Medical Service Association Commercial	$54,751.62
Rate for Payer: Hawaii Medical Service Association Medicare	$36,620.76
Rate for Payer: Humana Medicare	$36,620.76
Rate for Payer: Kaiser Permanente Medicare	$36,620.76
Rate for Payer: Ohana Health Plan Medicare	$36,620.76
Rate for Payer: UnitedHealthcare Medicare	$36,620.76

LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC

Facility

$32,329.53

Service Code	MSDRG 494
Min. Negotiated Rate	$20,210.61
Max. Negotiated Rate	$32,329.53
Rate for Payer: AlohaCare Medicare	$20,210.61
Rate for Payer: Hawaii Medical Service Association Commercial	$32,329.53
Rate for Payer: Hawaii Medical Service Association Medicare	$20,210.61
Rate for Payer: Humana Medicare	$20,210.61
Rate for Payer: Kaiser Permanente Medicare	$20,210.61
Rate for Payer: Ohana Health Plan Medicare	$20,210.61
Rate for Payer: UnitedHealthcare Medicare	$20,210.61

LUNG TRANSPLANT

Facility

$128,064.68

Service Code	MSDRG 007
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$128,064.68
Rate for Payer: AlohaCare Medicare	$128,064.68
Rate for Payer: Hawaii Medical Service Association Medicare	$128,064.68
Rate for Payer: Kaiser Permanente Medicare	$128,064.68
Rate for Payer: Ohana Health Plan Medicare	$128,064.68
Rate for Payer: UnitedHealthcare Medicare	$128,064.68
Rate for Payer: University Health Alliance Commercial	$10,400.00

LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC

Facility

$76,510.06

Service Code	MSDRG 821
Min. Negotiated Rate	$22,498.04
Max. Negotiated Rate	$76,510.06
Rate for Payer: AlohaCare Medicare	$22,498.04
Rate for Payer: Hawaii Medical Service Association Commercial	$76,510.06
Rate for Payer: Hawaii Medical Service Association Medicare	$22,498.04
Rate for Payer: Humana Medicare	$22,498.04
Rate for Payer: Kaiser Permanente Medicare	$22,498.04
Rate for Payer: Ohana Health Plan Medicare	$22,498.04
Rate for Payer: UnitedHealthcare Medicare	$22,498.04

LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC

Facility

$76,510.06

Service Code	MSDRG 820
Min. Negotiated Rate	$58,235.53
Max. Negotiated Rate	$76,510.06
Rate for Payer: AlohaCare Medicare	$58,235.53
Rate for Payer: Hawaii Medical Service Association Commercial	$76,510.06
Rate for Payer: Hawaii Medical Service Association Medicare	$58,235.53
Rate for Payer: Humana Medicare	$58,235.53
Rate for Payer: Kaiser Permanente Medicare	$58,235.53
Rate for Payer: Ohana Health Plan Medicare	$58,235.53
Rate for Payer: UnitedHealthcare Medicare	$58,235.53

LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC

Facility

$30,646.69

Service Code	MSDRG 822
Min. Negotiated Rate	$12,301.68
Max. Negotiated Rate	$30,646.69
Rate for Payer: AlohaCare Medicare	$12,301.68
Rate for Payer: Hawaii Medical Service Association Commercial	$30,646.69
Rate for Payer: Hawaii Medical Service Association Medicare	$12,301.68
Rate for Payer: Humana Medicare	$12,301.68
Rate for Payer: Kaiser Permanente Medicare	$12,301.68
Rate for Payer: Ohana Health Plan Medicare	$12,301.68
Rate for Payer: UnitedHealthcare Medicare	$12,301.68

LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC

Facility

$77,718.86

Service Code	MSDRG 841
Min. Negotiated Rate	$16,513.85
Max. Negotiated Rate	$77,718.86
Rate for Payer: AlohaCare Medicare	$16,513.85
Rate for Payer: Hawaii Medical Service Association Commercial	$77,718.86
Rate for Payer: Hawaii Medical Service Association Medicare	$16,513.85
Rate for Payer: Humana Medicare	$16,513.85
Rate for Payer: Kaiser Permanente Medicare	$16,513.85
Rate for Payer: Ohana Health Plan Medicare	$16,513.85
Rate for Payer: UnitedHealthcare Medicare	$16,513.85

LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC

Facility

$82,293.34

Service Code	MSDRG 840
Min. Negotiated Rate	$32,316.93
Max. Negotiated Rate	$82,293.34
Rate for Payer: AlohaCare Medicare	$32,316.93
Rate for Payer: Hawaii Medical Service Association Commercial	$82,293.34
Rate for Payer: Hawaii Medical Service Association Medicare	$32,316.93
Rate for Payer: Humana Medicare	$32,316.93
Rate for Payer: Kaiser Permanente Medicare	$32,316.93
Rate for Payer: Ohana Health Plan Medicare	$32,316.93
Rate for Payer: UnitedHealthcare Medicare	$32,316.93

LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC

Facility

$92,532.61

Service Code	MSDRG 824
Min. Negotiated Rate	$22,764.12
Max. Negotiated Rate	$92,532.61
Rate for Payer: AlohaCare Medicare	$22,764.12
Rate for Payer: Hawaii Medical Service Association Commercial	$92,532.61
Rate for Payer: Hawaii Medical Service Association Medicare	$22,764.12
Rate for Payer: Humana Medicare	$22,764.12
Rate for Payer: Kaiser Permanente Medicare	$22,764.12
Rate for Payer: Ohana Health Plan Medicare	$22,764.12
Rate for Payer: UnitedHealthcare Medicare	$22,764.12

LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC

Facility

$92,532.61

Service Code	MSDRG 823
Min. Negotiated Rate	$45,620.68
Max. Negotiated Rate	$92,532.61
Rate for Payer: AlohaCare Medicare	$45,620.68
Rate for Payer: Hawaii Medical Service Association Commercial	$92,532.61
Rate for Payer: Hawaii Medical Service Association Medicare	$45,620.68
Rate for Payer: Humana Medicare	$45,620.68
Rate for Payer: Kaiser Permanente Medicare	$45,620.68
Rate for Payer: Ohana Health Plan Medicare	$45,620.68
Rate for Payer: UnitedHealthcare Medicare	$45,620.68

LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC

Facility

$25,053.01

Service Code	MSDRG 825
Min. Negotiated Rate	$13,734.66
Max. Negotiated Rate	$25,053.01
Rate for Payer: AlohaCare Medicare	$13,734.66
Rate for Payer: Hawaii Medical Service Association Commercial	$25,053.01
Rate for Payer: Hawaii Medical Service Association Medicare	$13,734.66
Rate for Payer: Humana Medicare	$13,734.66
Rate for Payer: Kaiser Permanente Medicare	$13,734.66
Rate for Payer: Ohana Health Plan Medicare	$13,734.66
Rate for Payer: UnitedHealthcare Medicare	$13,734.66

Know your out-of-pocket cost for care.

All Charges