Pali Momi Medical Center prices
Pali Momi Medical Center in Aiea, HI publishes its standard charges, as every US hospital must under the federal Hospital Price Transparency Rule. Below is what its own file lists for common services, next to what it has agreed to accept from insurers.
What Pali Momi Medical Center publishes for common services
ER visit, level 3 (moderate): listed at $1,715. Insurers pay a median of $282, across 5 insurers.
If you were billed the list price, you may have been charged far more than insurers typically pay. See how to use these numbers below.
| Service | List price | Cash price | Insurers pay (median) |
|---|---|---|---|
| ER visit, level 1 (minor)CPT 99281, listed as "ED FACILITY I" | $477 | $286 | $89.74$86.29 to $120, 5 insurers |
| ER visit, level 2 (low-moderate)CPT 99282, listed as "ED FACILITY II" | $791 | $475 | $161$155 to $216, 5 insurers |
| ER visit, level 3 (moderate)CPT 99283, listed as "ED FACILITY III" | $1,715 | $1,029 | $282$271 to $377, 5 insurers |
| ER visit, level 4 (high)CPT 99284, listed as "ED FACILITY IV" | $2,628 | $1,577 | $434$417 to $580, 5 insurers |
| ER visit, level 5 (critical)CPT 99285, listed as "ED FACILITY V" | $3,768 | $2,261 | $625$601 to $836, 5 insurers |
| Office visit, established patient, low complexityCPT 99213, listed as "INFUSION VISIT,LVL3?(20MINS/+)" | $120 to $432 | $72.00 to $259 | $68.56$36.31 to $70.55, 4 insurers |
| Office visit, established patient, moderate complexityCPT 99214, listed as "OFFICE/OP E&M ESTAB MODERATE LEVEL 30+MINS" | $161 | $96.60 | $101$56.46 to $104, 4 insurers |
| Routine venipuncture (blood draw)CPT 36415, listed as "VENIPUNCTURE" | $15.00 to $23.00 | $9.00 to $13.80 | $7.23$3.00 to $10.91, 12 insurers |
| Vitamin B12 injectionCPT J3420, listed as "Cyanocobalamin Inj 1000 MCG/ML" | $28.59 | $17.15 | - |
| Comprehensive metabolic panelCPT 80053, listed as "COMP METABOLIC PANEL" | $109 to $114 | $65.40 to $68.40 | $14.61$10.35 to $26.81, 12 insurers |
| Basic metabolic panelCPT 80048, listed as "BASIC METABOLIC PANEL" | $72.00 to $94.00 | $43.20 to $56.40 | $11.70$8.29 to $21.46, 12 insurers |
| CBC with differentialCPT 85025, listed as "CBC PLT W/AUTO DIFF" | $71.00 to $74.00 | $42.60 to $44.40 | $10.74$7.61 to $19.72, 12 insurers |
| Lipid panelCPT 80061, listed as "LIPID PROFILE PANEL" | $47.00 to $159 | $28.20 to $95.40 | $18.51$13.12 to $33.98, 12 insurers |
| Hepatic function panelCPT 80076, listed as "HEPATIC FUNCTION PANEL" | $90.00 | $54.00 | $11.29$8.01 to $20.74, 12 insurers |
| X-ray, ankle, 3 viewsCPT 73610, listed as "XR ANKLE, 3+ VIEWS -TECH" | $403 to $645 | $242 to $387 | $55.25$17.34 to $115, 12 insurers |
| CT abdomen, without contrastCPT 74176, listed as "CT ABDOMEN AND PELVIS;W/OUT CONTRAST-TECH" | $2,231 to $3,327 | $1,339 to $1,996 | $237$94.66 to $760, 10 insurers |
| CT abdomen and pelvis, with contrastCPT 74177, listed as "CT ABDOMEN AND PELVIS W/CONTRAST-TECH" | $3,275 to $3,981 | $1,965 to $2,389 | $350$181 to $901, 10 insurers |
| CT abdomen and pelvis, with and without contrastCPT 74178, listed as "CT ABD/PELVIS;W/O CON ONE/BOTH REGNS THEN W/CON ON" | $4,193 to $4,307 | $2,516 to $2,584 | $364$239 to $1,115, 10 insurers |
| MRI brain, without contrastCPT 70551, listed as "MR BRAIN WITHOUT CONTRAST-TECH" | $2,469 | $1,481 | $315$137 to $737, 12 insurers |
| MRI brain, with and without contrastCPT 70553, listed as "MR BRAIN WITHOUT & WITH CONTRAST-TECH" | $3,279 | $1,967 | $466$223 to $1,637, 12 insurers |
| MRI pelvis, without contrastCPT 72195, listed as "MR PELVIS (LOWER ABD.) WITHOUT CONTRAST-TECH" | $2,652 to $2,998 | $1,591 to $1,799 | $315$161 to $955, 12 insurers |
| MRI pelvis, with and without contrastCPT 72197, listed as "MR PELVIS W/O & W/CONTRAST - TECH" | $3,159 to $3,253 | $1,895 to $1,952 | $466$237 to $1,621, 12 insurers |
| Complete echocardiogram with DopplerCPT 93306, listed as "ECHO TTHRC COMP SPEC/COLR FLW DPLR W/CON-TC" | $2,015 to $2,217 | $1,209 to $1,330 | $537$133 to $715, 7 insurers |
| Echocardiogram, completeCPT 93307, listed as "TTE W/O DOPPLER COMPLETE" | - | - | $237$128 to $315, 7 insurers |
| Electrocardiogram, routine ECG with interpretationCPT 93000, listed as "ELECTROCARDIOGRAM COMPLETE" | - | - | $19.88$15.67 to $42.08, 5 insurers |
| Electrocardiogram, tracing only (technical component)CPT 93005, listed as "EKG ROUTNE 12 LEAD W/O INT/RPT" | $28.00 to $405 | $16.80 to $243 | $58.21$7.28 to $77.45, 7 insurers |
| Electrocardiogram, interpretation and report onlyCPT 93010, listed as "ELECTROCARDIOGRAM REPORT" | - | - | $8.47$8.38 to $8.63, 4 insurers |
| Laparoscopic cholecystectomyCPT 47562, listed as "LAPAROSCOPIC CHOLECYSTECTOMY" | - | - | $5,718$678 to $7,608, 5 insurers |
| Knee arthroscopy, meniscectomyCPT 29881, listed as "ARTHRS KNE SRG MNISECTMY M/L" | - | - | $3,307$3,180 to $4,231, 5 insurers |
Source: Pali Momi Medical Center's standard charges file, which the hospital dated February 12, 2026. Read on September 28, 2026. View the hospital's file (a large data file). Hospitals must publish this file under 45 CFR § 180.
List price
The hospital's full charge (its "gross charge") before any discount. Few people pay it, but it is often the starting point on a bill.
Cash price
What the hospital says it accepts from patients paying without insurance.
Insurers pay
The median of the per-service rates the hospital has negotiated with insurers, shown only when at least 3 insurers report one. Your plan's rate may differ.
How to use these numbers
Uninsured or paying yourself? You can ask Pali Momi Medical Center to bill you its published cash price, and ask about financial assistance, which nonprofit hospitals must offer.
Insured, and the hospital is in your network? Your share should be based on your plan's negotiated rate, not the list price. If your bill or explanation of benefits shows the list price, ask the billing office why.
These figures summarize what the hospital publishes. They are not a quote, and they don't include separate physician bills.
Check your Pali Momi Medical Center bill for errors
The free check looks for duplicate charges, unbundling, upcoding and surprise billing. Its price comparison uses national reference pricing, separate from the hospital's published prices above.
BillMender is a document-preparation tool, not a law firm, and does not provide legal advice. We don't guarantee any outcome or dollar amount. Estimates are based on public reference pricing, not your hospital's actual contract rates.