Pali Momi Medical Center
Aiea, HI
Posts prices for 38 of the 66 common shoppable procedures we track. Price file retrieved 2026-08-28.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Epidural injection, lumbar/sacral (with imaging) (62322) range across 2 matching MRF lines |
$176.40–$913.80 | $294–$1,523 | varies |
| Transforaminal epidural injection, lumbar/sacral (64483) | $1,187.40 | $1,979 | 1.1× |
| CT head/brain without contrast (70450) | $1,059 | $1,765 | 8.6× |
| MRI brain without contrast (70551) | $1,481.40 | $2,469 | 5.3× |
| MRI brain with contrast (70552) | $1,696.20 | $2,827 | 4.1× |
| MRI brain without and with contrast (70553) | $1,967.40 | $3,279 | 4.8× |
| X-ray lower spine, 4+ views (72110) | $316.80 | $528 | 2.6× |
| MRI lumbar spine without contrast (72148) | $1,510.20 | $2,517 | 5.4× |
| CT pelvis with contrast (72193) | $1,291.80 | $2,153 | 6.2× |
| MRI lower-extremity joint without contrast (73721) | $1,479 | $2,465 | 5.2× |
| CT abdomen and pelvis with contrast (74177) range across 3 matching MRF lines |
$1,965–$2,388.60 | $3,275–$3,981 | varies |
| Ultrasound, abdomen complete (76700) | $501 | $835 | 4.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) | $551.40 | $919 | 4.5× |
| Ultrasound, transvaginal (76830) range across 2 matching MRF lines |
$229.80–$420 | $383–$700 | varies |
| Mammography, one breast (diagnostic) (77065) | $299.40 | $499 | 3.5× |
| Mammography, both breasts (diagnostic) (77066) | $417 | $695 | 3.8× |
| Mammography, screening (bilateral) (77067) range across 4 matching MRF lines |
$226.80–$249.60 | $378–$416 | varies |
| Basic metabolic panel (80048) range across 3 matching MRF lines |
$43.20–$56.40 | $72–$94 | varies |
| Comprehensive metabolic panel (80053) range across 2 matching MRF lines |
$65.40–$68.40 | $109–$114 | varies |
| Obstetric panel (80055) | $393 | $655 | 8.2× |
| Lipid panel (80061) range across 4 matching MRF lines |
$28.20–$95.40 | $47–$159 | varies |
| Renal function panel (80069) range across 3 matching MRF lines |
$53.40–$56.40 | $89–$94 | varies |
| Hepatic function panel (80076) | $54 | $90 | 6.6× |
| Urinalysis, non-automated, with microscopy (81000) | $19.20 | $32 | 4.8× |
| Urinalysis, non-automated, without microscopy (81002) range across 8 matching MRF lines |
$16.20–$43.80 | $27–$73 | varies |
| PSA, total (84153) range across 6 matching MRF lines |
$51–$66.60 | $85–$111 | varies |
| Thyroid stimulating hormone (TSH) (84443) range across 4 matching MRF lines |
$63.60–$82.80 | $106–$138 | varies |
| CBC with automated differential (85025) range across 4 matching MRF lines |
$42.60–$44.40 | $71–$74 | varies |
| CBC, automated (85027) range across 4 matching MRF lines |
$31.20–$38.40 | $52–$64 | varies |
| Prothrombin time (PT) (85610) range across 4 matching MRF lines |
$11.40–$32.40 | $19–$54 | varies |
| Partial thromboplastin time (PTT) (85730) range across 8 matching MRF lines |
$15.60–$39.60 | $26–$66 | varies |
| Left heart catheterization (93452) | $4,191 | $6,985 | 1.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) | $93.60 | $156 | 3.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) range across 2 matching MRF lines |
$75–$87.60 | $125–$146 | varies |
| Office visit, new patient (moderate complexity, ~45 min) (99204) range across 2 matching MRF lines |
$101.40–$115.20 | $169–$192 | varies |
| Office visit, new patient (high complexity, ~60 min) (99205) range across 3 matching MRF lines |
$117–$144.60 | $195–$241 | varies |
| Office consultation (low complexity, ~30 min) (99243) | $75 | $125 | 0.5× |
| Office consultation (moderate complexity, ~40 min) (99244) | $101.40 | $169 | 0.6× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.
More prices at this hospital
- Imaging: 354 codes with posted prices and Medicare benchmarks
- Lab & pathology: 739 codes with posted prices and Medicare benchmarks
- Visits & medical services: 219 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 360 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 72 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (CSV, 333.2 MB) ↓ — captured 2026-08-28
File links point at the hospital's own hosting and sometimes rotate — if the download fails, use the hospital's transparency page.