Leahi Hospital

All Charges

Charge

Type

Setting

Price

PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC

Facility

$32,874.67

Service Code	MSDRG 542
Min. Negotiated Rate	$17,845.32
Max. Negotiated Rate	$32,874.67
Rate for Payer: AlohaCare Medicare	$17,845.32
Rate for Payer: Hawaii Medical Service Association Commercial	$32,874.67
Rate for Payer: Hawaii Medical Service Association Medicare	$17,845.32
Rate for Payer: Humana Medicare	$17,845.32
Rate for Payer: Kaiser Permanente Medicare	$17,845.32
Rate for Payer: Ohana Health Plan Medicare	$17,845.32
Rate for Payer: UnitedHealthcare Medicare	$17,845.32

PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC

Facility

$32,874.67

Service Code	MSDRG 544
Min. Negotiated Rate	$7,872.68
Max. Negotiated Rate	$32,874.67
Rate for Payer: AlohaCare Medicare	$7,872.68
Rate for Payer: Hawaii Medical Service Association Commercial	$32,874.67
Rate for Payer: Hawaii Medical Service Association Medicare	$7,872.68
Rate for Payer: Humana Medicare	$7,872.68
Rate for Payer: Kaiser Permanente Medicare	$7,872.68
Rate for Payer: Ohana Health Plan Medicare	$7,872.68
Rate for Payer: UnitedHealthcare Medicare	$7,872.68

PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC

Facility

$39,487.53

Service Code	MSDRG 734
Min. Negotiated Rate	$21,427.74
Max. Negotiated Rate	$39,487.53
Rate for Payer: AlohaCare Medicare	$21,427.74
Rate for Payer: Hawaii Medical Service Association Commercial	$39,487.53
Rate for Payer: Hawaii Medical Service Association Medicare	$21,427.74
Rate for Payer: Humana Medicare	$21,427.74
Rate for Payer: Kaiser Permanente Medicare	$21,427.74
Rate for Payer: Ohana Health Plan Medicare	$21,427.74
Rate for Payer: UnitedHealthcare Medicare	$21,427.74

PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC

Facility

$39,487.53

Service Code	MSDRG 735
Min. Negotiated Rate	$13,696.20
Max. Negotiated Rate	$39,487.53
Rate for Payer: AlohaCare Medicare	$13,696.20
Rate for Payer: Hawaii Medical Service Association Commercial	$39,487.53
Rate for Payer: Hawaii Medical Service Association Medicare	$13,696.20
Rate for Payer: Humana Medicare	$13,696.20
Rate for Payer: Kaiser Permanente Medicare	$13,696.20
Rate for Payer: Ohana Health Plan Medicare	$13,696.20
Rate for Payer: UnitedHealthcare Medicare	$13,696.20

PENIS PROCEDURES WITH CC/MCC

Facility

$24,958.21

Service Code	MSDRG 709
Min. Negotiated Rate	$23,370.24
Max. Negotiated Rate	$24,958.21
Rate for Payer: AlohaCare Medicare	$23,370.24
Rate for Payer: Hawaii Medical Service Association Commercial	$24,958.21
Rate for Payer: Hawaii Medical Service Association Medicare	$23,370.24
Rate for Payer: Humana Medicare	$23,370.24
Rate for Payer: Kaiser Permanente Medicare	$23,370.24
Rate for Payer: Ohana Health Plan Medicare	$23,370.24
Rate for Payer: UnitedHealthcare Medicare	$23,370.24

PENIS PROCEDURES WITHOUT CC/MCC

Facility

$24,958.21

Service Code	MSDRG 710
Min. Negotiated Rate	$14,245.16
Max. Negotiated Rate	$24,958.21
Rate for Payer: AlohaCare Medicare	$14,245.16
Rate for Payer: Hawaii Medical Service Association Commercial	$24,958.21
Rate for Payer: Hawaii Medical Service Association Medicare	$14,245.16
Rate for Payer: Humana Medicare	$14,245.16
Rate for Payer: Kaiser Permanente Medicare	$14,245.16
Rate for Payer: Ohana Health Plan Medicare	$14,245.16
Rate for Payer: UnitedHealthcare Medicare	$14,245.16

PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC

Facility

$53,400.61

Service Code	MSDRG 273
Min. Negotiated Rate	$41,094.11
Max. Negotiated Rate	$53,400.61
Rate for Payer: AlohaCare Medicare	$41,094.11
Rate for Payer: Hawaii Medical Service Association Commercial	$53,400.61
Rate for Payer: Hawaii Medical Service Association Medicare	$41,094.11
Rate for Payer: Humana Medicare	$41,094.11
Rate for Payer: Kaiser Permanente Medicare	$41,094.11
Rate for Payer: Ohana Health Plan Medicare	$41,094.11
Rate for Payer: UnitedHealthcare Medicare	$41,094.11

PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC

Facility

$37,591.37

Service Code	MSDRG 274
Min. Negotiated Rate	$32,876.70
Max. Negotiated Rate	$37,591.37
Rate for Payer: AlohaCare Medicare	$32,876.70
Rate for Payer: Hawaii Medical Service Association Commercial	$37,591.37
Rate for Payer: Hawaii Medical Service Association Medicare	$32,876.70
Rate for Payer: Humana Medicare	$32,876.70
Rate for Payer: Kaiser Permanente Medicare	$32,876.70
Rate for Payer: Ohana Health Plan Medicare	$32,876.70
Rate for Payer: UnitedHealthcare Medicare	$32,876.70

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES

Facility

$57,050.71

Service Code	MSDRG 321
Min. Negotiated Rate	$27,250.28
Max. Negotiated Rate	$57,050.71
Rate for Payer: AlohaCare Medicare	$27,250.28
Rate for Payer: Hawaii Medical Service Association Commercial	$57,050.71
Rate for Payer: Hawaii Medical Service Association Medicare	$27,250.28
Rate for Payer: Humana Medicare	$27,250.28
Rate for Payer: Kaiser Permanente Medicare	$27,250.28
Rate for Payer: Ohana Health Plan Medicare	$27,250.28
Rate for Payer: UnitedHealthcare Medicare	$27,250.28

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC

Facility

$40,483.02

Service Code	MSDRG 322
Min. Negotiated Rate	$17,810.82
Max. Negotiated Rate	$40,483.02
Rate for Payer: AlohaCare Medicare	$17,810.82
Rate for Payer: Hawaii Medical Service Association Commercial	$40,483.02
Rate for Payer: Hawaii Medical Service Association Medicare	$17,810.82
Rate for Payer: Humana Medicare	$17,810.82
Rate for Payer: Kaiser Permanente Medicare	$17,810.82
Rate for Payer: Ohana Health Plan Medicare	$17,810.82
Rate for Payer: UnitedHealthcare Medicare	$17,810.82

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC

Facility

$47,996.55

Service Code	MSDRG 250
Min. Negotiated Rate	$21,945.15
Max. Negotiated Rate	$47,996.55
Rate for Payer: AlohaCare Medicare	$21,945.15
Rate for Payer: Hawaii Medical Service Association Commercial	$47,996.55
Rate for Payer: Hawaii Medical Service Association Medicare	$21,945.15
Rate for Payer: Humana Medicare	$21,945.15
Rate for Payer: Kaiser Permanente Medicare	$21,945.15
Rate for Payer: Ohana Health Plan Medicare	$21,945.15
Rate for Payer: UnitedHealthcare Medicare	$21,945.15

PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC

Facility

$35,742.62

Service Code	MSDRG 251
Min. Negotiated Rate	$15,164.67
Max. Negotiated Rate	$35,742.62
Rate for Payer: AlohaCare Medicare	$15,164.67
Rate for Payer: Hawaii Medical Service Association Commercial	$35,742.62
Rate for Payer: Hawaii Medical Service Association Medicare	$15,164.67
Rate for Payer: Humana Medicare	$15,164.67
Rate for Payer: Kaiser Permanente Medicare	$15,164.67
Rate for Payer: Ohana Health Plan Medicare	$15,164.67
Rate for Payer: UnitedHealthcare Medicare	$15,164.67

PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC

Facility

$57,050.71

Service Code	MSDRG 359
Min. Negotiated Rate	$34,324.47
Max. Negotiated Rate	$57,050.71
Rate for Payer: AlohaCare Medicare	$34,324.47
Rate for Payer: Hawaii Medical Service Association Commercial	$57,050.71
Rate for Payer: Hawaii Medical Service Association Medicare	$34,324.47
Rate for Payer: Humana Medicare	$34,324.47
Rate for Payer: Kaiser Permanente Medicare	$34,324.47
Rate for Payer: Ohana Health Plan Medicare	$34,324.47
Rate for Payer: UnitedHealthcare Medicare	$34,324.47

PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC

Facility

$40,483.02

Service Code	MSDRG 360
Min. Negotiated Rate	$24,229.62
Max. Negotiated Rate	$40,483.02
Rate for Payer: AlohaCare Medicare	$24,229.62
Rate for Payer: Hawaii Medical Service Association Commercial	$40,483.02
Rate for Payer: Hawaii Medical Service Association Medicare	$24,229.62
Rate for Payer: Humana Medicare	$24,229.62
Rate for Payer: Kaiser Permanente Medicare	$24,229.62
Rate for Payer: Ohana Health Plan Medicare	$24,229.62
Rate for Payer: UnitedHealthcare Medicare	$24,229.62

PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE

Facility

$47,996.55

Service Code	MSDRG 318
Min. Negotiated Rate	$24,307.46
Max. Negotiated Rate	$47,996.55
Rate for Payer: AlohaCare Medicare	$24,307.46
Rate for Payer: Hawaii Medical Service Association Commercial	$47,996.55
Rate for Payer: Hawaii Medical Service Association Medicare	$24,307.46
Rate for Payer: Humana Medicare	$24,307.46
Rate for Payer: Kaiser Permanente Medicare	$24,307.46
Rate for Payer: Ohana Health Plan Medicare	$24,307.46
Rate for Payer: UnitedHealthcare Medicare	$24,307.46

PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR

Facility

$58,093.60

Service Code	MSDRG 041
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$58,093.60
Rate for Payer: AlohaCare Medicare	$22,104.81
Rate for Payer: Hawaii Medical Service Association Commercial	$58,093.60
Rate for Payer: Hawaii Medical Service Association Medicare	$22,104.81
Rate for Payer: Humana Medicare	$22,104.81
Rate for Payer: Kaiser Permanente Medicare	$22,104.81
Rate for Payer: Ohana Health Plan Medicare	$22,104.81
Rate for Payer: UnitedHealthcare Medicare	$22,104.81
Rate for Payer: University Health Alliance Commercial	$10,400.00

PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC

Facility

$66,057.47

Service Code	MSDRG 040
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$66,057.47
Rate for Payer: AlohaCare Medicare	$38,489.33
Rate for Payer: Hawaii Medical Service Association Commercial	$66,057.47
Rate for Payer: Hawaii Medical Service Association Medicare	$38,489.33
Rate for Payer: Humana Medicare	$38,489.33
Rate for Payer: Kaiser Permanente Medicare	$38,489.33
Rate for Payer: Ohana Health Plan Medicare	$38,489.33
Rate for Payer: UnitedHealthcare Medicare	$38,489.33
Rate for Payer: University Health Alliance Commercial	$10,400.00

PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC

Facility

$50,106.03

Service Code	MSDRG 042
Min. Negotiated Rate	$10,400.00
Max. Negotiated Rate	$50,106.03
Rate for Payer: AlohaCare Medicare	$17,462.92
Rate for Payer: Hawaii Medical Service Association Commercial	$50,106.03
Rate for Payer: Hawaii Medical Service Association Medicare	$17,462.92
Rate for Payer: Humana Medicare	$17,462.92
Rate for Payer: Kaiser Permanente Medicare	$17,462.92
Rate for Payer: Ohana Health Plan Medicare	$17,462.92
Rate for Payer: UnitedHealthcare Medicare	$17,462.92
Rate for Payer: University Health Alliance Commercial	$10,400.00

PERIPHERAL VASCULAR DISORDERS WITH CC

Facility

$24,531.57

Service Code	MSDRG 300
Min. Negotiated Rate	$10,956.43
Max. Negotiated Rate	$24,531.57
Rate for Payer: AlohaCare Medicare	$10,956.43
Rate for Payer: Hawaii Medical Service Association Commercial	$24,531.57
Rate for Payer: Hawaii Medical Service Association Medicare	$10,956.43
Rate for Payer: Humana Medicare	$10,956.43
Rate for Payer: Kaiser Permanente Medicare	$10,956.43
Rate for Payer: Ohana Health Plan Medicare	$10,956.43
Rate for Payer: UnitedHealthcare Medicare	$10,956.43

PERIPHERAL VASCULAR DISORDERS WITH MCC

Facility

$26,024.80

Service Code	MSDRG 299
Min. Negotiated Rate	$16,526.69
Max. Negotiated Rate	$26,024.80
Rate for Payer: AlohaCare Medicare	$16,526.69
Rate for Payer: Hawaii Medical Service Association Commercial	$26,024.80
Rate for Payer: Hawaii Medical Service Association Medicare	$16,526.69
Rate for Payer: Humana Medicare	$16,526.69
Rate for Payer: Kaiser Permanente Medicare	$16,526.69
Rate for Payer: Ohana Health Plan Medicare	$16,526.69
Rate for Payer: UnitedHealthcare Medicare	$16,526.69

PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC

Facility

$18,060.92

Service Code	MSDRG 301
Min. Negotiated Rate	$7,528.73
Max. Negotiated Rate	$18,060.92
Rate for Payer: AlohaCare Medicare	$7,528.73
Rate for Payer: Hawaii Medical Service Association Commercial	$18,060.92
Rate for Payer: Hawaii Medical Service Association Medicare	$7,528.73
Rate for Payer: Humana Medicare	$7,528.73
Rate for Payer: Kaiser Permanente Medicare	$7,528.73
Rate for Payer: Ohana Health Plan Medicare	$7,528.73
Rate for Payer: UnitedHealthcare Medicare	$7,528.73

PERITONEAL ADHESIOLYSIS WITH CC

Facility

$53,400.61

Service Code	MSDRG 336
Min. Negotiated Rate	$21,217.81
Max. Negotiated Rate	$53,400.61
Rate for Payer: AlohaCare Medicare	$21,217.81
Rate for Payer: Hawaii Medical Service Association Commercial	$53,400.61
Rate for Payer: Hawaii Medical Service Association Medicare	$21,217.81
Rate for Payer: Humana Medicare	$21,217.81
Rate for Payer: Kaiser Permanente Medicare	$21,217.81
Rate for Payer: Ohana Health Plan Medicare	$21,217.81
Rate for Payer: UnitedHealthcare Medicare	$21,217.81

PERITONEAL ADHESIOLYSIS WITH MCC

Facility

$60,416.40

Service Code	MSDRG 335
Min. Negotiated Rate	$35,628.32
Max. Negotiated Rate	$60,416.40
Rate for Payer: AlohaCare Medicare	$35,628.32
Rate for Payer: Hawaii Medical Service Association Commercial	$60,416.40
Rate for Payer: Hawaii Medical Service Association Medicare	$35,628.32
Rate for Payer: Humana Medicare	$35,628.32
Rate for Payer: Kaiser Permanente Medicare	$35,628.32
Rate for Payer: Ohana Health Plan Medicare	$35,628.32
Rate for Payer: UnitedHealthcare Medicare	$35,628.32

PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC

Facility

$32,779.87

Service Code	MSDRG 337
Min. Negotiated Rate	$15,563.80
Max. Negotiated Rate	$32,779.87
Rate for Payer: AlohaCare Medicare	$15,563.80
Rate for Payer: Hawaii Medical Service Association Commercial	$32,779.87
Rate for Payer: Hawaii Medical Service Association Medicare	$15,563.80
Rate for Payer: Humana Medicare	$15,563.80
Rate for Payer: Kaiser Permanente Medicare	$15,563.80
Rate for Payer: Ohana Health Plan Medicare	$15,563.80
Rate for Payer: UnitedHealthcare Medicare	$15,563.80

PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC

Facility

$53,519.12

Service Code	MSDRG 243
Min. Negotiated Rate	$21,436.61
Max. Negotiated Rate	$53,519.12
Rate for Payer: AlohaCare Medicare	$21,436.61
Rate for Payer: Hawaii Medical Service Association Commercial	$53,519.12
Rate for Payer: Hawaii Medical Service Association Medicare	$21,436.61
Rate for Payer: Humana Medicare	$21,436.61
Rate for Payer: Kaiser Permanente Medicare	$21,436.61
Rate for Payer: Ohana Health Plan Medicare	$21,436.61
Rate for Payer: UnitedHealthcare Medicare	$21,436.61

Know your out-of-pocket cost for care.

All Charges