Lab & pathology prices at Molokai General Hospital

Kaunakakai, HI · every code in this section with a posted price and a Medicare benchmark.

251 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Acetaminophen level (80143) $103.60 $148 5.6×
Acute hepatitis panel (80074) $590.10 $843 12.4×
Afp maternal serum (82105) $63.70 $91 3.8×
Albumin body fluid (82042) $51.80 $74 6.7×
Albumin serum (82040) $63 $90 12.7×
Allergen peanut (86003) $146.30 $209 28.0×
Allergen specific igg (86001) $88.20 $126 11.3×
Alpha-1-antitrypsin, total (82103) $185.50 $265 13.8×
Alt (sgpt) (84460) $85.40 $122 16.1×
Amikacin trough (80150) $149.80 $214 9.9×
Amylase urine (82150) $86.80 $124 13.4×
Antibody helicobacter pylori (86677) $133 $190 7.9×
Antibody Hiv-1&Hiv-2 Single Result (86703) $83.30 $119 6.1×
Antibody HIV-2 (86702) $49 $70 3.6×
Antibody identification (86870) $476 $680 1.1×
Antibody identification leukocyte antibodies (86021) $437.50 $625 29.1×
Antibody mumps (86735) $172.20 $246 13.2×
Antibody screen (86850) $142.10 $203 14.5×
Antibody treponema pallidum (86780) $132.30 $189 10.0×
Antigen typing (86905) $298.20 $426 77.9×
Antineutrophil Cytoplasmic Antb Screen Ea Antb (86036) $228.90 $327 19.0×
Antinuclear antibodies (86038) $254.80 $364 21.1×
Antistreptolysin o titer (86060) $56.70 $81 7.8×
Assay of ammonia (82140) $70.70 $101 4.9×
Assay of c-peptide (84681) $167.30 $239 8.0×
Assay of citrate (82507) $516.60 $738 18.6×
Assay of creatine (82540) $88.20 $126 19.0×
Assay of erythropoietin (82668) $123.90 $177 6.6×
Assay of ferritin (82728) $86.80 $124 6.4×
Assay of g6pd enzyme (82955) $52.50 $75 5.4×
Assay of gentamicin (80170) $217.70 $311 13.3×
Assay of homocystine (83090) $149.80 $214 8.4×
Assay of lactic acid (83605) $88.90 $127 7.7×
Assay of prealbumin (84134) $111.30 $159 7.6×
Assay of prolactin (84146) $240.10 $343 12.4×
Assay of tacrolimus (80197) $204.40 $292 14.9×
Assay of topiramate (80201) $113.40 $162 9.5×
Assay spec xcp ur&breath ia (82077) $490 $700 28.4×
Ast (sgot) (84450) $85.40 $122 16.5×
Beta hydroxybutyrate (82010) $120.40 $172 14.7×
Bilirubin direct (82248) $107.80 $154 21.5×
Bilirubin total (82247) $74.20 $106 14.8×
Bld Bank Phys Svcs Invstgj Tfuj Rxn Reprt (86078) $142.10 $203 0.7×
Bleeding time (85002) $73.50 $105 15.2×
Blood Count Automated Differential Wbc Count (85004) $98.70 $141 15.3×
Blood gas (82803) $330.75 $472.50 12.7×
Blood Occult Fecal Hgb Deter Ia Qual Feces 1-3 (82274) $102.90 $147 6.5×
Blood Occult Peroxidase Actv Qual Feces 1 Deter (82270) $53.90 $77 12.3×
Blood Ph (82800) $77.70 $111 7.1×
Blood Type Antigen Donor Reagent Serum Each - Blood Typing, Antigen (86902) $298.20 $426 47.0×
Blood typing abo (86900) $197.40 $282 66.0×
Blood typing serologic rh (d) (86901) $98.70 $141 33.0×
Body fluid cell count (89051) $100.80 $144 18.0×
Body fluid cell count (89050) $77 $110 16.3×
C diff amplified probe (87493) $472.50 $675 12.7×
C-reactive protein (86140) $55.30 $79 10.7×
C-Reactive Protein,High Sensitivity - High Sensitivity Crp (86141) $52.50 $75 4.1×
C1q binding assay (86332) $223.30 $319 9.2×
Ca 125 (86304) $144.90 $207 7.0×
Calcium ionized (82330) $106.40 $152 7.8×
Calcium total (82310) $74.20 $106 14.4×
Carbon dioxide (82374) $58.10 $83 11.9×
Carcinoembryonic antigen (82378) $190.40 $272 10.0×
Chloride blood (82435) $77.70 $111 16.9×
Chloride urine (82436) $53.20 $76 9.3×
Cholesterol HDL (83718) $82.60 $118 10.1×
Cholesterol total (82465) $58.10 $83 13.4×
Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) $335.30 $479 9.6×
Ckmb (82553) $241.50 $345 20.9×
Cmv ab igm (86645) $92.40 $132 5.5×
Compatibility test antiglob (86922) $392 $560 1.9×
Compatibility Test Incubate (86921) $368.20 $526 1.8×
Complement c3 (86160) $367.85 $525.50 30.7×
Complement/Function Activity - C1 Esterase Inhibitor, Functional (86161) $106.40 $152 8.9×
Concentration Infectious Agent (87015) $221.90 $317 33.2×
Coombs direct (86880) $147 $210 27.3×
Cortisol total (82533) $93.10 $133 5.7×
Creatine kinase total (82550) $103.60 $148 15.9×
Creatinine blood (82565) $74.20 $106 14.5×
Creatinine clearance (82575) $97.30 $139 10.3×
Creatinine other source (82570) $66.15 $94.50 12.8×
Crossmatch immediate spin (86920) $669.20 $956 3.3×
Crystals body fluid (89060) $118.30 $169 16.1×
Culture Aerobic Identify (87077) $159.60 $228 19.8×
Culture aerobic quant other (87071) $130.20 $186 13.2×
Culture afb (87116) $168.70 $241 15.6×
Culture anaerobic (87075) $174.30 $249 18.4×
Culture Bacteria Anaerobic (87073) $135.10 $193 14.0×
Culture blood (87040) $151.20 $216 14.7×
Culture chlamydia (87110) $114.80 $164 5.9×
Culture genital (87070) $99.05 $141.50 11.5×
Culture screen only (87081) $108.50 $155 16.4×
Culture stool (87045) $116.20 $166 12.3×
Culture Typing Immunologic Oth/Thn Immunofluores (87147) $94.50 $135 18.2×
Culture Typing, Nucleic Acid Amp Probe, Cult/Isolate, Each (87150) $165.90 $237 4.7×
Culture urine (87086) $358.40 $512 44.4×
Culture virus (87252) $56.70 $81 2.2×
Cytopath cell enhance tech (88112) $271.60 $388 4.4×
D-Dimer (85378) $65.10 $93 6.7×
Digoxin (80162) $170.10 $243 12.8×
Dilantin (80185) $144.90 $207 10.9×
Dna Antibody, Natv/2 Strand - Anti Dna, Double Stranded (86225) $92.40 $132 6.7×
Drug assay methotrexate (80204) $191.80 $274 5.0×
Drug quant nes (80299) $571.90 $817 30.7×
Drug Screen Quantitative Oxcarbazepine (80183) $289.10 $413 21.8×
Drug Scrn Quan Levetiracetam (80177) $103.60 $148 7.8×
Drug test prsmv chem anlyzr (80307) $591.50 $845 9.5×
Drug Test Prsmv Dir Opt Obs (80305) $503.30 $719 39.9×
E test (87181) $78.40 $112 16.5×
Electrolyte panel (80051) $95.90 $137 13.7×
Eosinophil count (85048) $30.10 $43 11.9×
Fibrin Degradation Quant (85379) $65.10 $93 6.4×
Fibrinogen activity (85384) $67.20 $96 6.9×
Fluorescent Nonnfct Agt Antb Titer Ea Antibody (86256) $161.70 $231 13.4×
Folate serum (82746) $137.20 $196 9.3×
Folic acid rbc (82747) $144.90 $207 8.2×
Follicle Stimulating Hormone (83001) $107.10 $153 5.8×
Gammaglobulin ige (82785) $184.10 $263 11.2×
Gardner vag DNA dir probe (87510) $137.20 $196 6.8×
Ggt (82977) $74.20 $106 10.3×
Glucose (82947) $79.10 $113 20.1×
Glucose Blood Test (82962) $171.50 $245 52.3×
Glucose body fluid (82945) $56.70 $81 14.4×
Glucose post dose (82950) $94.50 $135 19.9×
Glucose tolerance ea addl beyond 3 specimens (82952) $180.60 $258 46.1×
Glucose Tolerance Test (Gtt) - Bundled Charge (82951) $177.80 $254 13.8×
Haptoglobin (83010) $85.40 $122 6.8×
Hcg qualitative (84703) $138.60 $198 18.4×
Hcg quant (84702) $197.75 $282.50 13.1×
Hematocrit (85014) $30.10 $43 12.7×
Hemoglobin (85018) $36.40 $52 15.4×
Hemoglobin (Hgb), quantitative, transcutaneous Facility (88738) $28 $40 5.6×
Hemoglobin a1c (83036) $119 $170 12.3×
Hemoglobin Fetal,Diff Lysis - Kleihauer-Betke Stain (85460) $34.30 $49 4.4×
Hemoglobin quan tc per day carboxyhemoglobin (88740) $72.80 $104 7.8×
Hepatitis a antibody total (86708) $83.30 $119 6.7×
Hepatitis b core antibody total (86704) $83.30 $119 6.9×
Hepatitis B Surface Ab (86706) $129.15 $184.50 12.0×
Hepatitis B Surface Antigen (87340) $63 $90 6.1×
Hepatitis c antibody (86803) $83.30 $119 5.8×
Heterophile Antibodies,Screen - Mononucleosis Screen (86308) $74.90 $107 14.5×
Histamine plasma (83088) $280 $400 9.5×
HIV-1 antibody (86701) $49 $70 5.5×
HIV-1 p24 antigen (87390) $49 $70 2.0×
Hla-b27 (86812) $242.20 $346 9.4×
Hsv, Dna, Amp Probe - Hsv Pcr (87529) $264.60 $378 7.5×
Iaad ia clostridium difficile toxin (87324) $92.40 $132 7.7×
Iaad Ia Cryptococcus Neoformans (87327) $156.80 $224 11.7×
Iaad Ia Hiv-1 Ag W/Hiv-1 & Hiv-2 Antbdy Single (87389) $193.20 $276 8.0×
Iaad ia shiga-like toxin (87427) $25.20 $36 2.1×
Iaadi respiratory synctial virus (87280) $94.50 $135 7.0×
Iadna Candida Species Direct Probe Tq (87480) $137.20 $196 6.8×
Iadna Dna/Rna Rsv Amplified Probe Technique (87634) $51.80 $74 0.7×
Iadna HIV-1 amplified probe & reverse transcrpj (87535) $1,007.30 $1,439 28.7×
Iadna neisseria gonorrhoeae amplified probe tq (87591) $335.30 $479 9.6×
Iadna nos amplified probe tq each organism (87798) $473.90 $677 13.5×
Iadna-DNA/RNA probe tq 12-25 (87507) $553.70 $791 1.3×
Immunofixation urine (86335) $211.40 $302 7.2×
Indirect coombs (86885) $161 $230 28.1×
Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B… (87802) $79.80 $114 6.3×
Influenza a/b ag eia (87400) $197.40 $282 14.0×
Influenza DNA amp probe (87502) $424.20 $606 4.4×
Inhibin b (83520) $261.10 $373 15.1×
Iron (83540) $67.55 $96.50 10.4×
Iron binding capacity (83550) $198.80 $284 22.7×
Ldh body fluid (83615) $67.55 $96.50 11.2×
LDL cholesterol direct (83721) $81.90 $117 7.8×
Lead (83655) $151.90 $217 12.5×
Legionella antigen urine (87449) $219.10 $313 18.3×
Leukocyte Assmt Fecal Qual/Semiquantitative (89055) $100.10 $143 23.4×
Lipase (83690) $99.75 $142.50 14.5×
Lithium (80178) $78.40 $112 11.9×
Magnesium (83735) $74.20 $106 11.1×
Manual reticulocyte count (85044) $71.40 $102 16.6×
Metabolic Panel Ionized Ca (80047) $114.80 $164 8.4×
Methylmalonic acid serum (83921) $194.60 $278 9.2×
Microalbumin urine (82043) $212.45 $303.50 36.8×
Mtb PCR (87556) $168.70 $241 4.0×
Myoglobin urine (83874) $104.30 $149 8.1×
Natriuretic peptide (83880) $252.70 $361 6.4×
Occult blood stool (82272) $35 $50 8.3×
Osmolality serum (83930) $68.25 $97.50 10.3×
Osmolality urine (83935) $68.25 $97.50 10.0×
Ova and parasite direct-id lca (87177) $111.30 $159 12.5×
Ph urine (81003) $65.80 $94 29.2×
Phenytoin free (80186) $107.10 $153 7.8×
Phosphatase alkaline (84075) $74.20 $106 14.3×
Phosphorus blood (84100) $58.10 $83 12.3×
Platelet count automated (85049) $49 $70 10.9×
Potassium (84132) $77.70 $111 16.3×
Potassium urine (84133) $58.10 $83 12.3×
Procalcitonin (pct) (84145) $242.90 $347 8.9×
Protein body fluid (84157) $65.80 $94 16.5×
Protein electrophoresis serum (84165) $46.20 $66 4.3×
Protein Electrophoresis Urine (84166) $199.50 $285 11.2×
Protein total serum (84155) $60.20 $86 16.4×
Protein urine (84156) $65.80 $94 17.9×
Pth intact (83970) $452.90 $647 11.0×
Rbc antibody elution (86860) $309.40 $442 1.5×
Rbc pretreatment serum (86978) $269.50 $385 3.9×
Reagent strip/blood glucose (82948) $40.60 $58 8.1×
Resp virus 12-25 targets (87633) $4,874.80 $6,964 11.7×
Resp virus 3-5 targets (87631) $105 $150 0.7×
Reticulocyte count auto (85045) $18.90 $27 4.7×
Rheumatoid factor quant (86431) $76.65 $109.50 13.5×
Rickettsia antibody (86757) $831.25 $1,187.50 43.0×
Rsv (87807) $67.90 $97 5.2×
Rubella antibody (86762) $98 $140 6.8×
Salicylate Level (80179) $48.30 $69 2.6×
Sars-Cov-2 Covid-19 Amp Prb (87635) $90.30 $129 1.8×
Sarscov2 & inf a&b amp prb (87636) $497 $710 3.5×
Sarscov2&inf a&b&rsv amp prb (87637) $105 $150 0.7×
Sedimentation rate (85651) $47.60 $68 11.1×
Sedimentation rate auto (85652) $55.30 $79 20.5×
Semen analysis; sperm presence and motility of sperm, if performed Facility (89321) $148.40 $212 12.3×
Sensitivity kb (87184) $179.20 $256 24.0×
Sensitivity mic (87186) $239.40 $342 27.7×
Smear acid fast (87206) $158.90 $227 29.5×
Smear complex stain (87209) $201.60 $288 11.2×
Smear gram stain (87205) $176.40 $252 41.3×
Smr Prim Src Wet Mount Nfct Agt (87210) $91 $130 15.6×
Sodium (84295) $74.20 $106 15.4×
Sodium urine (84300) $50.40 $72 10.0×
Specific gravity body fluid (84315) $14 $20 4.3×
Spectrophotometry (84311) $208.60 $298 25.8×
Stool Culture, Addl Pathogens (87046) $116.20 $166 12.3×
Strep a assay w/optic (87880) $158.90 $227 9.6×
Strep b DNA amp probe (87653) $462.70 $661 13.2×
T Cells Absolute Cd4&Cd8 Count Ratio (86360) $187.60 $268 4.0×
T3 total (84480) $131.60 $188 9.3×
T4 free (84439) $131.60 $188 14.6×
T4 total (84436) $137.20 $196 20.0×
Tb intradermal test (86580) $97.30 $139 2.8×
Theophylline (80198) $206.50 $295 14.6×
Thyroglobulin antibody (86800) $137.90 $197 8.7×
Tiss Koh Slide Samps Skn/Hr/Nls Fngi/Ectoparasit (87220) $52.50 $75 12.3×
Transferrin (84466) $50.40 $72 3.9×
Trichomonas vagin dir probe (87660) $137.20 $196 6.8×
Triglycerides (84478) $62.65 $89.50 10.9×
Troponin (84484) $158.20 $226 12.7×
Urea nitrogen (84520) $74.20 $106 18.8×
Uric acid blood (84550) $88.20 $126 19.5×
Urinalysis auto w/scope (81001) $52.50 $75 16.6×
Urinalysis Microscopic Only (81015) $45.50 $65 14.9×
Urine Bacteria Culture (87088) $123.90 $177 15.3×
Urine pregnancy test (81025) $63.70 $91 7.4×
Valproic acid (80164) $385 $550 28.4×
Vancomycin trough (80202) $195.30 $279 14.4×
Vdrl csf (86592) $49.70 $71 11.6×
Vitamin b-12 (82607) $185.50 $265 12.3×
Vitamin D 25-Hydroxy (82306) $326.90 $467 11.0×