Leahi Hospital

All Charges

Charge

Type

Setting

Price

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC

Facility

$26,380.33

Service Code	MSDRG 717
Min. Negotiated Rate	$19,067.39
Max. Negotiated Rate	$26,380.33
Rate for Payer: AlohaCare Medicare	$19,067.39
Rate for Payer: Hawaii Medical Service Association Commercial	$26,380.33
Rate for Payer: Hawaii Medical Service Association Medicare	$19,067.39
Rate for Payer: Humana Medicare	$19,067.39
Rate for Payer: Kaiser Permanente Medicare	$19,067.39
Rate for Payer: Ohana Health Plan Medicare	$19,067.39
Rate for Payer: UnitedHealthcare Medicare	$19,067.39

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC

Facility

$26,380.33

Service Code	MSDRG 718
Min. Negotiated Rate	$13,672.55
Max. Negotiated Rate	$26,380.33
Rate for Payer: AlohaCare Medicare	$13,672.55
Rate for Payer: Hawaii Medical Service Association Commercial	$26,380.33
Rate for Payer: Hawaii Medical Service Association Medicare	$13,672.55
Rate for Payer: Humana Medicare	$13,672.55
Rate for Payer: Kaiser Permanente Medicare	$13,672.55
Rate for Payer: Ohana Health Plan Medicare	$13,672.55
Rate for Payer: UnitedHealthcare Medicare	$13,672.55

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC

Facility

$41,597.01

Service Code	MSDRG 715
Min. Negotiated Rate	$22,485.22
Max. Negotiated Rate	$41,597.01
Rate for Payer: AlohaCare Medicare	$22,485.22
Rate for Payer: Hawaii Medical Service Association Commercial	$41,597.01
Rate for Payer: Hawaii Medical Service Association Medicare	$22,485.22
Rate for Payer: Humana Medicare	$22,485.22
Rate for Payer: Kaiser Permanente Medicare	$22,485.22
Rate for Payer: Ohana Health Plan Medicare	$22,485.22
Rate for Payer: UnitedHealthcare Medicare	$22,485.22

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC

Facility

$41,597.01

Service Code	MSDRG 716
Min. Negotiated Rate	$14,933.06
Max. Negotiated Rate	$41,597.01
Rate for Payer: AlohaCare Medicare	$14,933.06
Rate for Payer: Hawaii Medical Service Association Commercial	$41,597.01
Rate for Payer: Hawaii Medical Service Association Medicare	$14,933.06
Rate for Payer: Humana Medicare	$14,933.06
Rate for Payer: Kaiser Permanente Medicare	$14,933.06
Rate for Payer: Ohana Health Plan Medicare	$14,933.06
Rate for Payer: UnitedHealthcare Medicare	$14,933.06

OTHER MENTAL DISORDER DIAGNOSES

Facility

$36,477.38

Service Code	MSDRG 887
Min. Negotiated Rate	$10,989.93
Max. Negotiated Rate	$36,477.38
Rate for Payer: AlohaCare Medicare	$10,989.93
Rate for Payer: Hawaii Medical Service Association Commercial	$36,477.38
Rate for Payer: Hawaii Medical Service Association Medicare	$10,989.93
Rate for Payer: Humana Medicare	$10,989.93
Rate for Payer: Kaiser Permanente Medicare	$10,989.93
Rate for Payer: Ohana Health Plan Medicare	$10,989.93
Rate for Payer: UnitedHealthcare Medicare	$10,989.93

OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC

Facility

$41,928.84

Service Code	MSDRG 964
Min. Negotiated Rate	$15,540.15
Max. Negotiated Rate	$41,928.84
Rate for Payer: AlohaCare Medicare	$15,540.15
Rate for Payer: Hawaii Medical Service Association Commercial	$41,928.84
Rate for Payer: Hawaii Medical Service Association Medicare	$15,540.15
Rate for Payer: Humana Medicare	$15,540.15
Rate for Payer: Kaiser Permanente Medicare	$15,540.15
Rate for Payer: Ohana Health Plan Medicare	$15,540.15
Rate for Payer: UnitedHealthcare Medicare	$15,540.15

OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC

Facility

$41,928.84

Service Code	MSDRG 963
Min. Negotiated Rate	$27,378.41
Max. Negotiated Rate	$41,928.84
Rate for Payer: AlohaCare Medicare	$27,378.41
Rate for Payer: Hawaii Medical Service Association Commercial	$41,928.84
Rate for Payer: Hawaii Medical Service Association Medicare	$27,378.41
Rate for Payer: Humana Medicare	$27,378.41
Rate for Payer: Kaiser Permanente Medicare	$27,378.41
Rate for Payer: Ohana Health Plan Medicare	$27,378.41
Rate for Payer: UnitedHealthcare Medicare	$27,378.41

OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC

Facility

$41,928.84

Service Code	MSDRG 965
Min. Negotiated Rate	$9,704.79
Max. Negotiated Rate	$41,928.84
Rate for Payer: AlohaCare Medicare	$9,704.79
Rate for Payer: Hawaii Medical Service Association Commercial	$41,928.84
Rate for Payer: Hawaii Medical Service Association Medicare	$9,704.79
Rate for Payer: Humana Medicare	$9,704.79
Rate for Payer: Kaiser Permanente Medicare	$9,704.79
Rate for Payer: Ohana Health Plan Medicare	$9,704.79
Rate for Payer: UnitedHealthcare Medicare	$9,704.79

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC

Facility

$16,686.21

Service Code	MSDRG 565
Min. Negotiated Rate	$10,038.90
Max. Negotiated Rate	$16,686.21
Rate for Payer: AlohaCare Medicare	$10,038.90
Rate for Payer: Hawaii Medical Service Association Commercial	$16,686.21
Rate for Payer: Hawaii Medical Service Association Medicare	$10,038.90
Rate for Payer: Humana Medicare	$10,038.90
Rate for Payer: Kaiser Permanente Medicare	$10,038.90
Rate for Payer: Ohana Health Plan Medicare	$10,038.90
Rate for Payer: UnitedHealthcare Medicare	$10,038.90

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC

Facility

$16,686.21

Service Code	MSDRG 564
Min. Negotiated Rate	$15,648.56
Max. Negotiated Rate	$16,686.21
Rate for Payer: AlohaCare Medicare	$15,648.56
Rate for Payer: Hawaii Medical Service Association Commercial	$16,686.21
Rate for Payer: Hawaii Medical Service Association Medicare	$15,648.56
Rate for Payer: Humana Medicare	$15,648.56
Rate for Payer: Kaiser Permanente Medicare	$15,648.56
Rate for Payer: Ohana Health Plan Medicare	$15,648.56
Rate for Payer: UnitedHealthcare Medicare	$15,648.56

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC

Facility

$16,686.21

Service Code	MSDRG 566
Min. Negotiated Rate	$7,820.45
Max. Negotiated Rate	$16,686.21
Rate for Payer: AlohaCare Medicare	$7,820.45
Rate for Payer: Hawaii Medical Service Association Commercial	$16,686.21
Rate for Payer: Hawaii Medical Service Association Medicare	$7,820.45
Rate for Payer: Humana Medicare	$7,820.45
Rate for Payer: Kaiser Permanente Medicare	$7,820.45
Rate for Payer: Ohana Health Plan Medicare	$7,820.45
Rate for Payer: UnitedHealthcare Medicare	$7,820.45

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC

Facility

$61,435.58

Service Code	MSDRG 516
Min. Negotiated Rate	$20,916.24
Max. Negotiated Rate	$61,435.58
Rate for Payer: AlohaCare Medicare	$20,916.24
Rate for Payer: Hawaii Medical Service Association Commercial	$61,435.58
Rate for Payer: Hawaii Medical Service Association Medicare	$20,916.24
Rate for Payer: Humana Medicare	$20,916.24
Rate for Payer: Kaiser Permanente Medicare	$20,916.24
Rate for Payer: Ohana Health Plan Medicare	$20,916.24
Rate for Payer: UnitedHealthcare Medicare	$20,916.24

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC

Facility

$61,435.58

Service Code	MSDRG 515
Min. Negotiated Rate	$31,843.87
Max. Negotiated Rate	$61,435.58
Rate for Payer: AlohaCare Medicare	$31,843.87
Rate for Payer: Hawaii Medical Service Association Commercial	$61,435.58
Rate for Payer: Hawaii Medical Service Association Medicare	$31,843.87
Rate for Payer: Humana Medicare	$31,843.87
Rate for Payer: Kaiser Permanente Medicare	$31,843.87
Rate for Payer: Ohana Health Plan Medicare	$31,843.87
Rate for Payer: UnitedHealthcare Medicare	$31,843.87

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC

Facility

$34,083.48

Service Code	MSDRG 517
Min. Negotiated Rate	$15,580.54
Max. Negotiated Rate	$34,083.48
Rate for Payer: AlohaCare Medicare	$15,580.54
Rate for Payer: Hawaii Medical Service Association Commercial	$34,083.48
Rate for Payer: Hawaii Medical Service Association Medicare	$15,580.54
Rate for Payer: Humana Medicare	$15,580.54
Rate for Payer: Kaiser Permanente Medicare	$15,580.54
Rate for Payer: Ohana Health Plan Medicare	$15,580.54
Rate for Payer: UnitedHealthcare Medicare	$15,580.54

OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC

Facility

$41,620.71

Service Code	MSDRG 844
Min. Negotiated Rate	$12,433.73
Max. Negotiated Rate	$41,620.71
Rate for Payer: AlohaCare Medicare	$12,433.73
Rate for Payer: Hawaii Medical Service Association Commercial	$41,620.71
Rate for Payer: Hawaii Medical Service Association Medicare	$12,433.73
Rate for Payer: Humana Medicare	$12,433.73
Rate for Payer: Kaiser Permanente Medicare	$12,433.73
Rate for Payer: Ohana Health Plan Medicare	$12,433.73
Rate for Payer: UnitedHealthcare Medicare	$12,433.73

OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC

Facility

$46,052.99

Service Code	MSDRG 843
Min. Negotiated Rate	$20,095.30
Max. Negotiated Rate	$46,052.99
Rate for Payer: AlohaCare Medicare	$20,095.30
Rate for Payer: Hawaii Medical Service Association Commercial	$46,052.99
Rate for Payer: Hawaii Medical Service Association Medicare	$20,095.30
Rate for Payer: Humana Medicare	$20,095.30
Rate for Payer: Kaiser Permanente Medicare	$20,095.30
Rate for Payer: Ohana Health Plan Medicare	$20,095.30
Rate for Payer: UnitedHealthcare Medicare	$20,095.30

OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC

Facility

$41,620.71

Service Code	MSDRG 845
Min. Negotiated Rate	$8,828.64
Max. Negotiated Rate	$41,620.71
Rate for Payer: AlohaCare Medicare	$8,828.64
Rate for Payer: Hawaii Medical Service Association Commercial	$41,620.71
Rate for Payer: Hawaii Medical Service Association Medicare	$8,828.64
Rate for Payer: Humana Medicare	$8,828.64
Rate for Payer: Kaiser Permanente Medicare	$8,828.64
Rate for Payer: Ohana Health Plan Medicare	$8,828.64
Rate for Payer: UnitedHealthcare Medicare	$8,828.64

OTHER O.R. PROCEDURES FOR INJURIES WITH CC

Facility

$44,370.14

Service Code	MSDRG 908
Min. Negotiated Rate	$20,099.25
Max. Negotiated Rate	$44,370.14
Rate for Payer: AlohaCare Medicare	$20,099.25
Rate for Payer: Hawaii Medical Service Association Commercial	$44,370.14
Rate for Payer: Hawaii Medical Service Association Medicare	$20,099.25
Rate for Payer: Humana Medicare	$20,099.25
Rate for Payer: Kaiser Permanente Medicare	$20,099.25
Rate for Payer: Ohana Health Plan Medicare	$20,099.25
Rate for Payer: UnitedHealthcare Medicare	$20,099.25

OTHER O.R. PROCEDURES FOR INJURIES WITH MCC

Facility

$47,475.11

Service Code	MSDRG 907
Min. Negotiated Rate	$38,273.51
Max. Negotiated Rate	$47,475.11
Rate for Payer: AlohaCare Medicare	$38,273.51
Rate for Payer: Hawaii Medical Service Association Commercial	$47,475.11
Rate for Payer: Hawaii Medical Service Association Medicare	$38,273.51
Rate for Payer: Humana Medicare	$38,273.51
Rate for Payer: Kaiser Permanente Medicare	$38,273.51
Rate for Payer: Ohana Health Plan Medicare	$38,273.51
Rate for Payer: UnitedHealthcare Medicare	$38,273.51

OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC

Facility

$22,990.94

Service Code	MSDRG 909
Min. Negotiated Rate	$13,372.96
Max. Negotiated Rate	$22,990.94
Rate for Payer: AlohaCare Medicare	$13,372.96
Rate for Payer: Hawaii Medical Service Association Commercial	$22,990.94
Rate for Payer: Hawaii Medical Service Association Medicare	$13,372.96
Rate for Payer: Humana Medicare	$13,372.96
Rate for Payer: Kaiser Permanente Medicare	$13,372.96
Rate for Payer: Ohana Health Plan Medicare	$13,372.96
Rate for Payer: UnitedHealthcare Medicare	$13,372.96

OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC

Facility

$152,759.39

Service Code	MSDRG 958
Min. Negotiated Rate	$41,965.32
Max. Negotiated Rate	$152,759.39
Rate for Payer: AlohaCare Medicare	$41,965.32
Rate for Payer: Hawaii Medical Service Association Commercial	$152,759.39
Rate for Payer: Hawaii Medical Service Association Medicare	$41,965.32
Rate for Payer: Humana Medicare	$41,965.32
Rate for Payer: Kaiser Permanente Medicare	$41,965.32
Rate for Payer: Ohana Health Plan Medicare	$41,965.32
Rate for Payer: UnitedHealthcare Medicare	$41,965.32

OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC

Facility

$152,759.39

Service Code	MSDRG 957
Min. Negotiated Rate	$75,532.66
Max. Negotiated Rate	$152,759.39
Rate for Payer: AlohaCare Medicare	$75,532.66
Rate for Payer: Hawaii Medical Service Association Commercial	$152,759.39
Rate for Payer: Hawaii Medical Service Association Medicare	$75,532.66
Rate for Payer: Humana Medicare	$75,532.66
Rate for Payer: Kaiser Permanente Medicare	$75,532.66
Rate for Payer: Ohana Health Plan Medicare	$75,532.66
Rate for Payer: UnitedHealthcare Medicare	$75,532.66

OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC

Facility

$152,759.39

Service Code	MSDRG 959
Min. Negotiated Rate	$29,450.99
Max. Negotiated Rate	$152,759.39
Rate for Payer: AlohaCare Medicare	$29,450.99
Rate for Payer: Hawaii Medical Service Association Commercial	$152,759.39
Rate for Payer: Hawaii Medical Service Association Medicare	$29,450.99
Rate for Payer: Humana Medicare	$29,450.99
Rate for Payer: Kaiser Permanente Medicare	$29,450.99
Rate for Payer: Ohana Health Plan Medicare	$29,450.99
Rate for Payer: UnitedHealthcare Medicare	$29,450.99

OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC

Facility

$42,260.67

Service Code	MSDRG 803
Min. Negotiated Rate	$18,755.95
Max. Negotiated Rate	$42,260.67
Rate for Payer: AlohaCare Medicare	$18,755.95
Rate for Payer: Hawaii Medical Service Association Commercial	$42,260.67
Rate for Payer: Hawaii Medical Service Association Medicare	$18,755.95
Rate for Payer: Humana Medicare	$18,755.95
Rate for Payer: Kaiser Permanente Medicare	$18,755.95
Rate for Payer: Ohana Health Plan Medicare	$18,755.95
Rate for Payer: UnitedHealthcare Medicare	$18,755.95

OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC

Facility

$42,260.67

Service Code	MSDRG 802
Min. Negotiated Rate	$39,700.56
Max. Negotiated Rate	$42,260.67
Rate for Payer: AlohaCare Medicare	$39,700.56
Rate for Payer: Hawaii Medical Service Association Commercial	$42,260.67
Rate for Payer: Hawaii Medical Service Association Medicare	$39,700.56
Rate for Payer: Humana Medicare	$39,700.56
Rate for Payer: Kaiser Permanente Medicare	$39,700.56
Rate for Payer: Ohana Health Plan Medicare	$39,700.56
Rate for Payer: UnitedHealthcare Medicare	$39,700.56

Know your out-of-pocket cost for care.

All Charges