Supplies, drugs & other prices at The Queen's Medical Center

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

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

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ProcedureCash priceGross charge× Medicare
2019-ncov diagnostic p (U0001) $122.50 $175 3.4×
2d tee w or w/o fol w/con,in (C8925) $1,975.40 $2,822 2.1×
2d tte w or w/o fol w/con,co (C8923) $1,505 $2,150 1.6×
2d tte w or w/o fol w/con,fu (C8924) $783.30 $1,119 1.9×
Admin hepatitis b vaccine (G0010) $136.15 $194.50 2.5×
Admin influenza virus vac (G0008) $112.70 $161 2.0×
Admin pneumococcal vaccine (G0009) $132.30 $189 2.4×
Alcohol/subs interv 15-30mn (G0396) $99.40 $142 2.2×
Alcohol/subs interv >30 min (G0397) $177.80 $254 0.8×
Ca screen;pelvic/breast exam (G0101) $158.90 $227 1.3×
Chemo extend iv infus w/pump (G0498) $1,190 $1,700 3.0×
Colon ca scrn not hi rsk ind (G0121) $3,802.40 $5,432 3.5×
Colorectal scrn; hi risk ind (G0105) $3,709.30 $5,299 3.4×
Covid-19 lab test non-cdc (U0002) $122.50 $175 2.4×
Cysto impl 4 or more (C9740)
unusually low: confirm this is the full procedure
$5,373.20 $7,676 0.5×
Cystoscopy prostatic imp 1-3 (C9739) $5,271 $7,530 0.8×
Depression screen annual (G0444) $56 $80 1.3×
Diab manage trn per indiv (G0108) $86.10 $123 1.5×
Diab manage trn ind/group (G0109) $113.40 $162 7.1×
Drug test def 1-7 classes (G0480) $790.30 $1,129 6.9×
Elec stim other than wound (G0283) $90.30 $129 7.1×
Elec stim unattend for press (G0281) $41.30 $59 3.5×
Electrophysiological eval icds w/ss electrode (0577T) $2,434.60 $3,478 1.7×
Ephys eval ccm-d ld 1st impl (0930T) $250.60 $358 0.2×
Ephys eval ccm-d ld separate (0931T) $2,518.60 $3,598 1.8×
Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) $13,476.40 $19,252 1.0×
Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis propria (ie,… (0184T) $28,098.71 $40,141.01 3.9×
Fern test (Q0114) $43.40 $62 4.5×
Hbot, full body chamber, 30m (G0277) $1,081.50 $1,545 6.7×
Home sleep test/type 3 porta (G0399) $926.80 $1,324 3.6×
Hospital outpt clinic visit (G0463) $225.40 $322 1.4×
Iliac Atherectomy (0238T) $41,395.90 $59,137 1.9×
Inj for sacroiliac jt anesth (G0260) $1,059.10 $1,513 1.3×
Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that… (0216T) $1,787.80 $2,554 1.7×
Insertion of substernal implantable defibrillator electrode (0572T) $17,377.50 $24,825 1.8×
Insertion perm ccm-d system pulse generator only (0916T) $46,563.30 $66,519 1.8×
Insj Perm Ccm-D Sys 1 Transvns Lead Only (0917T) $17,168.20 $24,526 1.8×
Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) $17,168.20 $24,526 1.8×
Insj perm ccm-d sys pg&eltrd (0915T) $66,510.50 $95,015 1.8×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) $67,293.10 $96,133 1.8×
Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) $17,168.20 $24,526 1.8×
Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) $17,168.20 $24,526 1.8×
Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) $46,563.30 $66,519 1.8×
Insj/Rplcmt Icds W/Substernal Electrode (0571T) $67,293.10 $96,133 1.8×
Interro Device Evaluation Cardiac Modulj System (0418T) $77.70 $111 1.8×
Interrog dev eval impl ccm-d system in person (0927T) $77.70 $111 1.8×
Interrogation device evaluation(s) (remote), up to 90 days, substernal lead implantable cardioverter-defibrillator… (0579T) $105.70 $151 2.4×
Mra w/cont, abd (C8900) $2,988.30 $4,269 7.3×
Mra w/cont, chest (C8909) $2,988.30 $4,269 7.3×
Mra w/cont, lwr ext (C8912) $4,326 $6,180 10.5×
Mra w/o cont, abd (C8901) $2,988.30 $4,269 10.6×
Mra w/o cont, chest (C8910) $2,988.30 $4,269 10.6×
Mra w/o cont, pelvis (C8919) $2,979.20 $4,256 10.6×
Mra w/o fol w/cont, abd (C8902) $3,062.85 $4,375.50 7.4×
Mra w/o fol w/cont, chest (C8911) $2,988.30 $4,269 7.3×
Mra w/o fol w/cont, lwr ext (C8914) $4,326 $6,180 10.5×
Mra w/o fol w/cont, pelvis (C8920) $2,837.10 $4,053 6.9×
Mri w/o fol w/cont, breast, (C8908) $2,289.70 $3,271 5.6×
Mri w/o fol w/cont, brst, un (C8905) $2,387 $3,410 5.8×
Neuro csf prion prtn qual (0035U) $1,264.20 $1,806 2.3×
Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) $1,787.80 $2,554 1.7×
Njx pltlt plasma w/img harvest/preparation (0232T) $677.60 $968 1.3×
Oth resp proc, indiv (G0238) $172.20 $246 5.0×
Pathogen test for platelets (P9100) $125.30 $179 1.8×
Perc d-e cor revasc chro sin (C9607) $21,357 $30,510 1.0×
Perc d-e cor revasc t cabg s (C9604) $21,357 $30,510 1.6×
Perc d-e cor stent ather s (C9602) $23,934.40 $34,192 1.1×
Perc drug-el cor stent sing (C9600) $29,058.75 $41,512.50 2.1×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) $11,827.20 $16,896 0.9×
Ppps, subseq visit (G0439) $210.70 $301 1.5×
Prgrmg Device Evaluation Cardiac Modulj System (0417T) $77.70 $111 1.8×
Programming device eval impl ccm-d sys in person (0926T) $77.70 $111 1.8×
Prolonged iv inf, req pump (C8957) $638.40 $912 2.5×
Prostate biopsy, any mthd (G0416) $2,025.80 $2,894 4.8×
Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) $3,794.70 $5,421 1.6×
Relocation skin pocket implanted ccm-d pg (0925T) $3,794.70 $5,421 1.6×
Remote interrog dev eval ccm-d sys <90d tech (0929T) $77.70 $111 1.8×
Removal Cardiac Modulj Sys Pls Generator Only (0412T) $7,549.50 $10,785 1.7×
Removal Cardiac Modulj Sys Transvenous Electrode (0413T) $7,549.50 $10,785 1.7×
Removal of substernal implantable defibrillator electrode (0573T) $8,032.50 $11,475 1.8×
Removal perm ccm-d system pulse generator only (0919T) $7,549.50 $10,785 1.7×
Repos Cardiac Modulj Transvenous Electrode (0415T) $1,282.40 $1,832 1.7×
Repos prev impl ss impltbl dfb pacing eltrd (0574T) $8,032.50 $11,475 1.8×
Repositioning prev impl ccm-d transvns eltrd/ld (0924T) $1,282.40 $1,832 1.7×
Revasc intra lithotrip-ather (C9766) $35,867.30 $51,239 1.7×
Revasc intra lithotrip-stent (C9765) $22,389.50 $31,985 1.0×
Revasc intravasc lithotripsy (C9764) $12,972.40 $18,532 1.0×
Revasc lithotr-ather tib/per (C9774) $37,250.50 $53,215 1.7×
Revasc lithotrip tibi/perone (C9772) $22,502.20 $32,146 1.7×
Revasc lithotrip-stent-ather (C9767) $37,250.50 $53,215 1.7×
Rmvl & Rpl Cardiac Modulj Sys Pls Generator Only (0414T) $46,563.30 $66,519 1.8×
Rmvl Perm Ccm-D Sys 1 Transvns Dfb Lead Only (0921T) $7,549.50 $10,785 1.7×
Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) $7,549.50 $10,785 1.7×
Rmvl Perm Ccm-D Sys Dual Transvns Leads Only (0922T) $7,549.50 $10,785 1.7×
Rmvl Substernal Impltbl Dfb Pulse Generator Only (0580T) $8,032.50 $11,475 1.8×
Rmvl&rplcmt permanent ccm-d pulse generator only (0923T) $46,563.30 $66,519 1.8×
Rmvl&rplcmt substernal impltbl defibrillator pg (0614T) $48,213.90 $68,877 1.8×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $39,561.90 $56,517 1.7×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $11,766.30 $16,809 1.7×
Tomosynthesis, mammo (G0279) $107.10 $153 8.4×
Tpmt nudt15 gene analysis common variants (0034U) $1,388.80 $1,984 3.0×
Trauma respons w/hosp criti (G0390) $26,082 $37,260 16.6×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $16,114.70 $23,021 1.2×
Tte w or w/o contr, cont ecg (C8930) $1,551.20 $2,216 1.7×
Tte w or w/o fol w/con,stres (C8928) $1,840.30 $2,629 2.0×
Tte w or wo fol wcon,doppler (C8929) $1,210.30 $1,729 1.3×
Unsched dialysis esrd pt hos (G0257) $2,186.10 $3,123 2.7×