Leahi Hospital

All Charges

Charge

Type

Setting

Price

OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC

Facility

$16,235.87

Service Code	MSDRG 072
Min. Negotiated Rate	$7,888.45
Max. Negotiated Rate	$16,235.87
Rate for Payer: AlohaCare Medicare	$7,888.45
Rate for Payer: Hawaii Medical Service Association Commercial	$16,235.87
Rate for Payer: Hawaii Medical Service Association Medicare	$7,888.45
Rate for Payer: Humana Medicare	$7,888.45
Rate for Payer: Kaiser Permanente Medicare	$7,888.45
Rate for Payer: Ohana Health Plan Medicare	$7,888.45
Rate for Payer: UnitedHealthcare Medicare	$7,888.45

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC

Facility

$26,641.05

Service Code	MSDRG 315
Min. Negotiated Rate	$9,929.49
Max. Negotiated Rate	$26,641.05
Rate for Payer: AlohaCare Medicare	$9,929.49
Rate for Payer: Hawaii Medical Service Association Commercial	$26,641.05
Rate for Payer: Hawaii Medical Service Association Medicare	$9,929.49
Rate for Payer: Humana Medicare	$9,929.49
Rate for Payer: Kaiser Permanente Medicare	$9,929.49
Rate for Payer: Ohana Health Plan Medicare	$9,929.49
Rate for Payer: UnitedHealthcare Medicare	$9,929.49

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC

Facility

$39,724.55

Service Code	MSDRG 314
Min. Negotiated Rate	$20,986.23
Max. Negotiated Rate	$39,724.55
Rate for Payer: AlohaCare Medicare	$20,986.23
Rate for Payer: Hawaii Medical Service Association Commercial	$39,724.55
Rate for Payer: Hawaii Medical Service Association Medicare	$20,986.23
Rate for Payer: Humana Medicare	$20,986.23
Rate for Payer: Kaiser Permanente Medicare	$20,986.23
Rate for Payer: Ohana Health Plan Medicare	$20,986.23
Rate for Payer: UnitedHealthcare Medicare	$20,986.23

OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$16,994.33

Service Code	MSDRG 316
Min. Negotiated Rate	$7,158.15
Max. Negotiated Rate	$16,994.33
Rate for Payer: AlohaCare Medicare	$7,158.15
Rate for Payer: Hawaii Medical Service Association Commercial	$16,994.33
Rate for Payer: Hawaii Medical Service Association Medicare	$7,158.15
Rate for Payer: Humana Medicare	$7,158.15
Rate for Payer: Kaiser Permanente Medicare	$7,158.15
Rate for Payer: Ohana Health Plan Medicare	$7,158.15
Rate for Payer: UnitedHealthcare Medicare	$7,158.15

OTHER CIRCULATORY SYSTEM O.R. PROCEDURES

Facility

$161,742.45

Service Code	MSDRG 264
Min. Negotiated Rate	$33,358.64
Max. Negotiated Rate	$161,742.45
Rate for Payer: AlohaCare Medicare	$33,358.64
Rate for Payer: Hawaii Medical Service Association Commercial	$161,742.45
Rate for Payer: Hawaii Medical Service Association Medicare	$33,358.64
Rate for Payer: Humana Medicare	$33,358.64
Rate for Payer: Kaiser Permanente Medicare	$33,358.64
Rate for Payer: Ohana Health Plan Medicare	$33,358.64
Rate for Payer: UnitedHealthcare Medicare	$33,358.64

OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC

Facility

$18,321.65

Service Code	MSDRG 394
Min. Negotiated Rate	$9,657.49
Max. Negotiated Rate	$18,321.65
Rate for Payer: AlohaCare Medicare	$9,657.49
Rate for Payer: Hawaii Medical Service Association Commercial	$18,321.65
Rate for Payer: Hawaii Medical Service Association Medicare	$9,657.49
Rate for Payer: Humana Medicare	$9,657.49
Rate for Payer: Kaiser Permanente Medicare	$9,657.49
Rate for Payer: Ohana Health Plan Medicare	$9,657.49
Rate for Payer: UnitedHealthcare Medicare	$9,657.49

OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC

Facility

$25,266.33

Service Code	MSDRG 393
Min. Negotiated Rate	$16,197.50
Max. Negotiated Rate	$25,266.33
Rate for Payer: AlohaCare Medicare	$16,197.50
Rate for Payer: Hawaii Medical Service Association Commercial	$25,266.33
Rate for Payer: Hawaii Medical Service Association Medicare	$16,197.50
Rate for Payer: Humana Medicare	$16,197.50
Rate for Payer: Kaiser Permanente Medicare	$16,197.50
Rate for Payer: Ohana Health Plan Medicare	$16,197.50
Rate for Payer: UnitedHealthcare Medicare	$16,197.50

OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$16,686.21

Service Code	MSDRG 395
Min. Negotiated Rate	$6,831.96
Max. Negotiated Rate	$16,686.21
Rate for Payer: AlohaCare Medicare	$6,831.96
Rate for Payer: Hawaii Medical Service Association Commercial	$16,686.21
Rate for Payer: Hawaii Medical Service Association Medicare	$6,831.96
Rate for Payer: Humana Medicare	$6,831.96
Rate for Payer: Kaiser Permanente Medicare	$6,831.96
Rate for Payer: Ohana Health Plan Medicare	$6,831.96
Rate for Payer: UnitedHealthcare Medicare	$6,831.96

OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC

Facility

$58,022.50

Service Code	MSDRG 357
Min. Negotiated Rate	$23,354.46
Max. Negotiated Rate	$58,022.50
Rate for Payer: AlohaCare Medicare	$23,354.46
Rate for Payer: Hawaii Medical Service Association Commercial	$58,022.50
Rate for Payer: Hawaii Medical Service Association Medicare	$23,354.46
Rate for Payer: Humana Medicare	$23,354.46
Rate for Payer: Kaiser Permanente Medicare	$23,354.46
Rate for Payer: Ohana Health Plan Medicare	$23,354.46
Rate for Payer: UnitedHealthcare Medicare	$23,354.46

OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC

Facility

$63,023.62

Service Code	MSDRG 356
Min. Negotiated Rate	$43,728.45
Max. Negotiated Rate	$63,023.62
Rate for Payer: AlohaCare Medicare	$43,728.45
Rate for Payer: Hawaii Medical Service Association Commercial	$63,023.62
Rate for Payer: Hawaii Medical Service Association Medicare	$43,728.45
Rate for Payer: Humana Medicare	$43,728.45
Rate for Payer: Kaiser Permanente Medicare	$43,728.45
Rate for Payer: Ohana Health Plan Medicare	$43,728.45
Rate for Payer: UnitedHealthcare Medicare	$43,728.45

OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$32,448.04

Service Code	MSDRG 358
Min. Negotiated Rate	$14,212.64
Max. Negotiated Rate	$32,448.04
Rate for Payer: AlohaCare Medicare	$14,212.64
Rate for Payer: Hawaii Medical Service Association Commercial	$32,448.04
Rate for Payer: Hawaii Medical Service Association Medicare	$14,212.64
Rate for Payer: Humana Medicare	$14,212.64
Rate for Payer: Kaiser Permanente Medicare	$14,212.64
Rate for Payer: Ohana Health Plan Medicare	$14,212.64
Rate for Payer: UnitedHealthcare Medicare	$14,212.64

OTHER DISORDERS OF NERVOUS SYSTEM WITH CC

Facility

$20,881.46

Service Code	MSDRG 092
Min. Negotiated Rate	$10,517.85
Max. Negotiated Rate	$20,881.46
Rate for Payer: AlohaCare Medicare	$10,517.85
Rate for Payer: Hawaii Medical Service Association Commercial	$20,881.46
Rate for Payer: Hawaii Medical Service Association Medicare	$10,517.85
Rate for Payer: Humana Medicare	$10,517.85
Rate for Payer: Kaiser Permanente Medicare	$10,517.85
Rate for Payer: Ohana Health Plan Medicare	$10,517.85
Rate for Payer: UnitedHealthcare Medicare	$10,517.85

OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC

Facility

$24,958.21

Service Code	MSDRG 091
Min. Negotiated Rate	$17,743.80
Max. Negotiated Rate	$24,958.21
Rate for Payer: AlohaCare Medicare	$17,743.80
Rate for Payer: Hawaii Medical Service Association Commercial	$24,958.21
Rate for Payer: Hawaii Medical Service Association Medicare	$17,743.80
Rate for Payer: Humana Medicare	$17,743.80
Rate for Payer: Kaiser Permanente Medicare	$17,743.80
Rate for Payer: Ohana Health Plan Medicare	$17,743.80
Rate for Payer: UnitedHealthcare Medicare	$17,743.80

OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC

Facility

$17,302.46

Service Code	MSDRG 093
Min. Negotiated Rate	$8,283.65
Max. Negotiated Rate	$17,302.46
Rate for Payer: AlohaCare Medicare	$8,283.65
Rate for Payer: Hawaii Medical Service Association Commercial	$17,302.46
Rate for Payer: Hawaii Medical Service Association Medicare	$8,283.65
Rate for Payer: Humana Medicare	$8,283.65
Rate for Payer: Kaiser Permanente Medicare	$8,283.65
Rate for Payer: Ohana Health Plan Medicare	$8,283.65
Rate for Payer: UnitedHealthcare Medicare	$8,283.65

OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT

Facility

$15,904.04

Service Code	MSDRG 124
Min. Negotiated Rate	$13,475.47
Max. Negotiated Rate	$15,904.04
Rate for Payer: AlohaCare Medicare	$13,475.47
Rate for Payer: Hawaii Medical Service Association Commercial	$15,904.04
Rate for Payer: Hawaii Medical Service Association Medicare	$13,475.47
Rate for Payer: Humana Medicare	$13,475.47
Rate for Payer: Kaiser Permanente Medicare	$13,475.47
Rate for Payer: Ohana Health Plan Medicare	$13,475.47
Rate for Payer: UnitedHealthcare Medicare	$13,475.47

OTHER DISORDERS OF THE EYE WITHOUT MCC

Facility

$8,034.98

Service Code	MSDRG 125
Min. Negotiated Rate	$8,002.78
Max. Negotiated Rate	$8,034.98
Rate for Payer: AlohaCare Medicare	$8,002.78
Rate for Payer: Hawaii Medical Service Association Commercial	$8,034.98
Rate for Payer: Hawaii Medical Service Association Medicare	$8,002.78
Rate for Payer: Humana Medicare	$8,002.78
Rate for Payer: Kaiser Permanente Medicare	$8,002.78
Rate for Payer: Ohana Health Plan Medicare	$8,002.78
Rate for Payer: UnitedHealthcare Medicare	$8,002.78

OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC

Facility

$14,813.75

Service Code	MSDRG 155
Min. Negotiated Rate	$9,468.26
Max. Negotiated Rate	$14,813.75
Rate for Payer: AlohaCare Medicare	$9,468.26
Rate for Payer: Hawaii Medical Service Association Commercial	$14,813.75
Rate for Payer: Hawaii Medical Service Association Medicare	$9,468.26
Rate for Payer: Humana Medicare	$9,468.26
Rate for Payer: Kaiser Permanente Medicare	$9,468.26
Rate for Payer: Ohana Health Plan Medicare	$9,468.26
Rate for Payer: UnitedHealthcare Medicare	$9,468.26

OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC

Facility

$15,844.69

Service Code	MSDRG 154
Min. Negotiated Rate	$14,813.75
Max. Negotiated Rate	$15,844.69
Rate for Payer: AlohaCare Medicare	$15,844.69
Rate for Payer: Hawaii Medical Service Association Commercial	$14,813.75
Rate for Payer: Hawaii Medical Service Association Medicare	$15,844.69
Rate for Payer: Humana Medicare	$15,844.69
Rate for Payer: Kaiser Permanente Medicare	$15,844.69
Rate for Payer: Ohana Health Plan Medicare	$15,844.69
Rate for Payer: UnitedHealthcare Medicare	$15,844.69

OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC

Facility

$14,813.75

Service Code	MSDRG 156
Min. Negotiated Rate	$7,246.87
Max. Negotiated Rate	$14,813.75
Rate for Payer: AlohaCare Medicare	$7,246.87
Rate for Payer: Hawaii Medical Service Association Commercial	$14,813.75
Rate for Payer: Hawaii Medical Service Association Medicare	$7,246.87
Rate for Payer: Humana Medicare	$7,246.87
Rate for Payer: Kaiser Permanente Medicare	$7,246.87
Rate for Payer: Ohana Health Plan Medicare	$7,246.87
Rate for Payer: UnitedHealthcare Medicare	$7,246.87

OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC

Facility

$34,533.81

Service Code	MSDRG 144
Min. Negotiated Rate	$17,514.18
Max. Negotiated Rate	$34,533.81
Rate for Payer: AlohaCare Medicare	$17,514.18
Rate for Payer: Hawaii Medical Service Association Commercial	$34,533.81
Rate for Payer: Hawaii Medical Service Association Medicare	$17,514.18
Rate for Payer: Humana Medicare	$17,514.18
Rate for Payer: Kaiser Permanente Medicare	$17,514.18
Rate for Payer: Ohana Health Plan Medicare	$17,514.18
Rate for Payer: UnitedHealthcare Medicare	$17,514.18

OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC

Facility

$100,780.90

Service Code	MSDRG 143
Min. Negotiated Rate	$37,359.91
Max. Negotiated Rate	$100,780.90
Rate for Payer: AlohaCare Medicare	$37,359.91
Rate for Payer: Hawaii Medical Service Association Commercial	$100,780.90
Rate for Payer: Hawaii Medical Service Association Medicare	$37,359.91
Rate for Payer: Humana Medicare	$37,359.91
Rate for Payer: Kaiser Permanente Medicare	$37,359.91
Rate for Payer: Ohana Health Plan Medicare	$37,359.91
Rate for Payer: UnitedHealthcare Medicare	$37,359.91

OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC

Facility

$22,256.18

Service Code	MSDRG 145
Min. Negotiated Rate	$12,284.92
Max. Negotiated Rate	$22,256.18
Rate for Payer: AlohaCare Medicare	$12,284.92
Rate for Payer: Hawaii Medical Service Association Commercial	$22,256.18
Rate for Payer: Hawaii Medical Service Association Medicare	$12,284.92
Rate for Payer: Humana Medicare	$12,284.92
Rate for Payer: Kaiser Permanente Medicare	$12,284.92
Rate for Payer: Ohana Health Plan Medicare	$12,284.92
Rate for Payer: UnitedHealthcare Medicare	$12,284.92

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC

Facility

$27,849.85

Service Code	MSDRG 629
Min. Negotiated Rate	$21,908.68
Max. Negotiated Rate	$27,849.85
Rate for Payer: AlohaCare Medicare	$21,908.68
Rate for Payer: Hawaii Medical Service Association Commercial	$27,849.85
Rate for Payer: Hawaii Medical Service Association Medicare	$21,908.68
Rate for Payer: Humana Medicare	$21,908.68
Rate for Payer: Kaiser Permanente Medicare	$21,908.68
Rate for Payer: Ohana Health Plan Medicare	$21,908.68
Rate for Payer: UnitedHealthcare Medicare	$21,908.68

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC

Facility

$39,203.11

Service Code	MSDRG 628
Min. Negotiated Rate	$37,164.77
Max. Negotiated Rate	$39,203.11
Rate for Payer: AlohaCare Medicare	$37,164.77
Rate for Payer: Hawaii Medical Service Association Commercial	$39,203.11
Rate for Payer: Hawaii Medical Service Association Medicare	$37,164.77
Rate for Payer: Humana Medicare	$37,164.77
Rate for Payer: Kaiser Permanente Medicare	$37,164.77
Rate for Payer: Ohana Health Plan Medicare	$37,164.77
Rate for Payer: UnitedHealthcare Medicare	$37,164.77

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC

Facility

$26,498.84

Service Code	MSDRG 630
Min. Negotiated Rate	$14,819.72
Max. Negotiated Rate	$26,498.84
Rate for Payer: AlohaCare Medicare	$14,819.72
Rate for Payer: Hawaii Medical Service Association Commercial	$26,498.84
Rate for Payer: Hawaii Medical Service Association Medicare	$14,819.72
Rate for Payer: Humana Medicare	$14,819.72
Rate for Payer: Kaiser Permanente Medicare	$14,819.72
Rate for Payer: Ohana Health Plan Medicare	$14,819.72
Rate for Payer: UnitedHealthcare Medicare	$14,819.72

Know your out-of-pocket cost for care.

All Charges