Leahi Hospital

All Charges

Charge

Type

Setting

Price

MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC

Facility

$27,802.45

Service Code	MSDRG 470
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$27,802.45
Rate for Payer: AlohaCare Medicare	$19,445.83
Rate for Payer: Hawaii Medical Service Association Commercial	$27,802.45
Rate for Payer: Hawaii Medical Service Association Medicare	$19,445.83
Rate for Payer: Humana Medicare	$19,445.83
Rate for Payer: Kaiser Permanente Medicare	$19,445.83
Rate for Payer: Ohana Health Plan Medicare	$19,445.83
Rate for Payer: UnitedHealthcare Medicare	$19,445.83
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES

Facility

$36,880.31

Service Code	MSDRG 483
Min. Negotiated Rate	$27,753.89
Max. Negotiated Rate	$36,880.31
Rate for Payer: AlohaCare Medicare	$27,753.89
Rate for Payer: Hawaii Medical Service Association Commercial	$36,880.31
Rate for Payer: Hawaii Medical Service Association Medicare	$27,753.89
Rate for Payer: Humana Medicare	$27,753.89
Rate for Payer: Kaiser Permanente Medicare	$27,753.89
Rate for Payer: Ohana Health Plan Medicare	$27,753.89
Rate for Payer: UnitedHealthcare Medicare	$27,753.89

MAJOR MALE PELVIC PROCEDURES WITH CC/MCC

Facility

$30,954.81

Service Code	MSDRG 707
Min. Negotiated Rate	$20,149.49
Max. Negotiated Rate	$30,954.81
Rate for Payer: AlohaCare Medicare	$20,149.49
Rate for Payer: Hawaii Medical Service Association Commercial	$30,954.81
Rate for Payer: Hawaii Medical Service Association Medicare	$20,149.49
Rate for Payer: Humana Medicare	$20,149.49
Rate for Payer: Kaiser Permanente Medicare	$20,149.49
Rate for Payer: Ohana Health Plan Medicare	$20,149.49
Rate for Payer: UnitedHealthcare Medicare	$20,149.49

MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC

Facility

$28,134.27

Service Code	MSDRG 708
Min. Negotiated Rate	$15,555.92
Max. Negotiated Rate	$28,134.27
Rate for Payer: AlohaCare Medicare	$15,555.92
Rate for Payer: Hawaii Medical Service Association Commercial	$28,134.27
Rate for Payer: Hawaii Medical Service Association Medicare	$15,555.92
Rate for Payer: Humana Medicare	$15,555.92
Rate for Payer: Kaiser Permanente Medicare	$15,555.92
Rate for Payer: Ohana Health Plan Medicare	$15,555.92
Rate for Payer: UnitedHealthcare Medicare	$15,555.92

MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC

Facility

$23,180.56

Service Code	MSDRG 507
Min. Negotiated Rate	$18,238.54
Max. Negotiated Rate	$23,180.56
Rate for Payer: AlohaCare Medicare	$18,238.54
Rate for Payer: Hawaii Medical Service Association Commercial	$23,180.56
Rate for Payer: Hawaii Medical Service Association Medicare	$18,238.54
Rate for Payer: Humana Medicare	$18,238.54
Rate for Payer: Kaiser Permanente Medicare	$18,238.54
Rate for Payer: Ohana Health Plan Medicare	$18,238.54
Rate for Payer: UnitedHealthcare Medicare	$18,238.54

MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC

Facility

$23,180.56

Service Code	MSDRG 508
Min. Negotiated Rate	$15,360.79
Max. Negotiated Rate	$23,180.56
Rate for Payer: AlohaCare Medicare	$15,360.79
Rate for Payer: Hawaii Medical Service Association Commercial	$23,180.56
Rate for Payer: Hawaii Medical Service Association Medicare	$15,360.79
Rate for Payer: Humana Medicare	$15,360.79
Rate for Payer: Kaiser Permanente Medicare	$15,360.79
Rate for Payer: Ohana Health Plan Medicare	$15,360.79
Rate for Payer: UnitedHealthcare Medicare	$15,360.79

MAJOR SKIN DISORDERS WITH MCC

Facility

$40,506.72

Service Code	MSDRG 595
Min. Negotiated Rate	$21,336.07
Max. Negotiated Rate	$40,506.72
Rate for Payer: AlohaCare Medicare	$21,336.07
Rate for Payer: Hawaii Medical Service Association Commercial	$40,506.72
Rate for Payer: Hawaii Medical Service Association Medicare	$21,336.07
Rate for Payer: Humana Medicare	$21,336.07
Rate for Payer: Kaiser Permanente Medicare	$21,336.07
Rate for Payer: Ohana Health Plan Medicare	$21,336.07
Rate for Payer: UnitedHealthcare Medicare	$21,336.07

MAJOR SKIN DISORDERS WITHOUT MCC

Facility

$32,495.44

Service Code	MSDRG 596
Min. Negotiated Rate	$11,104.25
Max. Negotiated Rate	$32,495.44
Rate for Payer: AlohaCare Medicare	$11,104.25
Rate for Payer: Hawaii Medical Service Association Commercial	$32,495.44
Rate for Payer: Hawaii Medical Service Association Medicare	$11,104.25
Rate for Payer: Humana Medicare	$11,104.25
Rate for Payer: Kaiser Permanente Medicare	$11,104.25
Rate for Payer: Ohana Health Plan Medicare	$11,104.25
Rate for Payer: UnitedHealthcare Medicare	$11,104.25

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$65,227.90

Service Code	MSDRG 330
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$65,227.90
Rate for Payer: AlohaCare Medicare	$24,061.09
Rate for Payer: Hawaii Medical Service Association Commercial	$65,227.90
Rate for Payer: Hawaii Medical Service Association Medicare	$24,061.09
Rate for Payer: Humana Medicare	$24,061.09
Rate for Payer: Kaiser Permanente Medicare	$24,061.09
Rate for Payer: Ohana Health Plan Medicare	$24,061.09
Rate for Payer: UnitedHealthcare Medicare	$24,061.09
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$80,563.10

Service Code	MSDRG 329
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$80,563.10
Rate for Payer: AlohaCare Medicare	$45,735.98
Rate for Payer: Hawaii Medical Service Association Commercial	$80,563.10
Rate for Payer: Hawaii Medical Service Association Medicare	$45,735.98
Rate for Payer: Humana Medicare	$45,735.98
Rate for Payer: Kaiser Permanente Medicare	$45,735.98
Rate for Payer: Ohana Health Plan Medicare	$45,735.98
Rate for Payer: UnitedHealthcare Medicare	$45,735.98
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$36,524.78

Service Code	MSDRG 331
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$36,524.78
Rate for Payer: AlohaCare Medicare	$17,021.41
Rate for Payer: Hawaii Medical Service Association Commercial	$36,524.78
Rate for Payer: Hawaii Medical Service Association Medicare	$17,021.41
Rate for Payer: Humana Medicare	$17,021.41
Rate for Payer: Kaiser Permanente Medicare	$17,021.41
Rate for Payer: Ohana Health Plan Medicare	$17,021.41
Rate for Payer: UnitedHealthcare Medicare	$17,021.41
Rate for Payer: University Health Alliance Commercial	$10,400.00

MAJOR THUMB OR JOINT PROCEDURES

Facility

$34,865.64

Service Code	MSDRG 506
Min. Negotiated Rate	$13,732.66
Max. Negotiated Rate	$34,865.64
Rate for Payer: AlohaCare Medicare	$13,732.66
Rate for Payer: Hawaii Medical Service Association Commercial	$34,865.64
Rate for Payer: Hawaii Medical Service Association Medicare	$13,732.66
Rate for Payer: Humana Medicare	$13,732.66
Rate for Payer: Kaiser Permanente Medicare	$13,732.66
Rate for Payer: Ohana Health Plan Medicare	$13,732.66
Rate for Payer: UnitedHealthcare Medicare	$13,732.66

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC

Facility

$57,382.54

Service Code	MSDRG 755
Min. Negotiated Rate	$11,156.49
Max. Negotiated Rate	$57,382.54
Rate for Payer: AlohaCare Medicare	$11,156.49
Rate for Payer: Hawaii Medical Service Association Commercial	$57,382.54
Rate for Payer: Hawaii Medical Service Association Medicare	$11,156.49
Rate for Payer: Humana Medicare	$11,156.49
Rate for Payer: Kaiser Permanente Medicare	$11,156.49
Rate for Payer: Ohana Health Plan Medicare	$11,156.49
Rate for Payer: UnitedHealthcare Medicare	$11,156.49

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$57,382.54

Service Code	MSDRG 754
Min. Negotiated Rate	$18,586.44
Max. Negotiated Rate	$57,382.54
Rate for Payer: AlohaCare Medicare	$18,586.44
Rate for Payer: Hawaii Medical Service Association Commercial	$57,382.54
Rate for Payer: Hawaii Medical Service Association Medicare	$18,586.44
Rate for Payer: Humana Medicare	$18,586.44
Rate for Payer: Kaiser Permanente Medicare	$18,586.44
Rate for Payer: Ohana Health Plan Medicare	$18,586.44
Rate for Payer: UnitedHealthcare Medicare	$18,586.44

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$21,545.12

Service Code	MSDRG 756
Min. Negotiated Rate	$9,901.89
Max. Negotiated Rate	$21,545.12
Rate for Payer: AlohaCare Medicare	$9,901.89
Rate for Payer: Hawaii Medical Service Association Commercial	$21,545.12
Rate for Payer: Hawaii Medical Service Association Medicare	$9,901.89
Rate for Payer: Humana Medicare	$9,901.89
Rate for Payer: Kaiser Permanente Medicare	$9,901.89
Rate for Payer: Ohana Health Plan Medicare	$9,901.89
Rate for Payer: UnitedHealthcare Medicare	$9,901.89

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC

Facility

$43,350.96

Service Code	MSDRG 723
Min. Negotiated Rate	$11,697.53
Max. Negotiated Rate	$43,350.96
Rate for Payer: AlohaCare Medicare	$11,697.53
Rate for Payer: Hawaii Medical Service Association Commercial	$43,350.96
Rate for Payer: Hawaii Medical Service Association Medicare	$11,697.53
Rate for Payer: Humana Medicare	$11,697.53
Rate for Payer: Kaiser Permanente Medicare	$11,697.53
Rate for Payer: Ohana Health Plan Medicare	$11,697.53
Rate for Payer: UnitedHealthcare Medicare	$11,697.53

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$43,350.96

Service Code	MSDRG 722
Min. Negotiated Rate	$18,271.07
Max. Negotiated Rate	$43,350.96
Rate for Payer: AlohaCare Medicare	$18,271.07
Rate for Payer: Hawaii Medical Service Association Commercial	$43,350.96
Rate for Payer: Hawaii Medical Service Association Medicare	$18,271.07
Rate for Payer: Humana Medicare	$18,271.07
Rate for Payer: Kaiser Permanente Medicare	$18,271.07
Rate for Payer: Ohana Health Plan Medicare	$18,271.07
Rate for Payer: UnitedHealthcare Medicare	$18,271.07

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$30,148.94

Service Code	MSDRG 724
Min. Negotiated Rate	$6,897.99
Max. Negotiated Rate	$30,148.94
Rate for Payer: AlohaCare Medicare	$6,897.99
Rate for Payer: Hawaii Medical Service Association Commercial	$30,148.94
Rate for Payer: Hawaii Medical Service Association Medicare	$6,897.99
Rate for Payer: Humana Medicare	$6,897.99
Rate for Payer: Kaiser Permanente Medicare	$6,897.99
Rate for Payer: Ohana Health Plan Medicare	$6,897.99
Rate for Payer: UnitedHealthcare Medicare	$6,897.99

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC

Facility

$38,634.26

Service Code	MSDRG 436
Min. Negotiated Rate	$11,583.22
Max. Negotiated Rate	$38,634.26
Rate for Payer: AlohaCare Medicare	$11,583.22
Rate for Payer: Hawaii Medical Service Association Commercial	$38,634.26
Rate for Payer: Hawaii Medical Service Association Medicare	$11,583.22
Rate for Payer: Humana Medicare	$11,583.22
Rate for Payer: Kaiser Permanente Medicare	$11,583.22
Rate for Payer: Ohana Health Plan Medicare	$11,583.22
Rate for Payer: UnitedHealthcare Medicare	$11,583.22

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC

Facility

$38,634.26

Service Code	MSDRG 435
Min. Negotiated Rate	$18,537.17
Max. Negotiated Rate	$38,634.26
Rate for Payer: AlohaCare Medicare	$18,537.17
Rate for Payer: Hawaii Medical Service Association Commercial	$38,634.26
Rate for Payer: Hawaii Medical Service Association Medicare	$18,537.17
Rate for Payer: Humana Medicare	$18,537.17
Rate for Payer: Kaiser Permanente Medicare	$18,537.17
Rate for Payer: Ohana Health Plan Medicare	$18,537.17
Rate for Payer: UnitedHealthcare Medicare	$18,537.17

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC

Facility

$38,634.26

Service Code	MSDRG 437
Min. Negotiated Rate	$8,845.40
Max. Negotiated Rate	$38,634.26
Rate for Payer: AlohaCare Medicare	$8,845.40
Rate for Payer: Hawaii Medical Service Association Commercial	$38,634.26
Rate for Payer: Hawaii Medical Service Association Medicare	$8,845.40
Rate for Payer: Humana Medicare	$8,845.40
Rate for Payer: Kaiser Permanente Medicare	$8,845.40
Rate for Payer: Ohana Health Plan Medicare	$8,845.40
Rate for Payer: UnitedHealthcare Medicare	$8,845.40

MALIGNANT BREAST DISORDERS WITH CC

Facility

$51,978.49

Service Code	MSDRG 598
Min. Negotiated Rate	$11,585.19
Max. Negotiated Rate	$51,978.49
Rate for Payer: AlohaCare Medicare	$11,585.19
Rate for Payer: Hawaii Medical Service Association Commercial	$51,978.49
Rate for Payer: Hawaii Medical Service Association Medicare	$11,585.19
Rate for Payer: Humana Medicare	$11,585.19
Rate for Payer: Kaiser Permanente Medicare	$11,585.19
Rate for Payer: Ohana Health Plan Medicare	$11,585.19
Rate for Payer: UnitedHealthcare Medicare	$11,585.19

MALIGNANT BREAST DISORDERS WITH MCC

Facility

$51,978.49

Service Code	MSDRG 597
Min. Negotiated Rate	$16,865.69
Max. Negotiated Rate	$51,978.49
Rate for Payer: AlohaCare Medicare	$16,865.69
Rate for Payer: Hawaii Medical Service Association Commercial	$51,978.49
Rate for Payer: Hawaii Medical Service Association Medicare	$16,865.69
Rate for Payer: Humana Medicare	$16,865.69
Rate for Payer: Kaiser Permanente Medicare	$16,865.69
Rate for Payer: Ohana Health Plan Medicare	$16,865.69
Rate for Payer: UnitedHealthcare Medicare	$16,865.69

MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility

$8,018.54

Service Code	MSDRG 599
Min. Negotiated Rate	$1,753.95
Max. Negotiated Rate	$8,018.54
Rate for Payer: AlohaCare Medicare	$8,018.54
Rate for Payer: Hawaii Medical Service Association Commercial	$1,753.95
Rate for Payer: Hawaii Medical Service Association Medicare	$8,018.54
Rate for Payer: Humana Medicare	$8,018.54
Rate for Payer: Kaiser Permanente Medicare	$8,018.54
Rate for Payer: Ohana Health Plan Medicare	$8,018.54
Rate for Payer: UnitedHealthcare Medicare	$8,018.54

Manual Therapy Technique

Facility

$192.00

Service Code	HCPCS 97140 GP
Hospital Charge Code	PT97140
Hospital Revenue Code	420
Min. Negotiated Rate	$20.55
Max. Negotiated Rate	$186.24
Rate for Payer: AlohaCare Medicaid	$96.00
Rate for Payer: Cash Price	$124.80
Rate for Payer: Cash Price	$124.80
Rate for Payer: Hawaii Western Management Group Commercial	$182.40
Rate for Payer: Health Management Network Commercial	$163.20
Rate for Payer: Kaiser Permanente Commercial	$172.80
Rate for Payer: Kaiser Permanente Medicaid	$97.92
Rate for Payer: MDX Hawaii PPO	$186.24
Rate for Payer: UnitedHealthcare Medicaid	$20.55
Rate for Payer: University Health Alliance Commercial	$139.95

Know your out-of-pocket cost for care.

All Charges