Culture, blood cost in HI
What a culture, blood costs at HI hospitals — and the fair price to aim for.
Typical commercial prices here are +27% above the fair benchmark (1.27×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Hilo Benioff Medical Center prices routine shoppable procedures near 0.7× Medicare (p50 0.80×) while skewing captive emergency, lab, and upper-quartile codes to 1.1× Medicare (p75 0.96×, +20% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 20% below peer Fair BaseRate (0.80×)
- Self-pay cash beats commercial insurance on 49% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (69/100 safety score) with 64% patient recommendation
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.27× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Captive ER (0.5×) & laboratory (0.6×) services average 1.57× higher multiples than routine shoppable care (0.7×)
- Upper-quartile procedures (Q75 0.96×) jump +20% above the median procedure ratio (Q50 0.80×)
- Consolidated metro market (HHI 4,475) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
In general, HI hospitals charge about the fair price for this. how we calculate the BaseRate →
Compared with the rest of the country, HI’s fair BaseRate ($14) is above the national fair price of $12.
Cheapest HI hospitals for a culture, blood
- Hilo Benioff Medical Center · Hilo $10
- North Hawaii Community Hospital, Inc · Kamuela $10
- Kohala Hospital · Kapaau $10
- Kona Community Hospital · Kealakekua $11
- Kuakini Medical Center · Honolulu $11
- Shriners Hospital for Children · Honolulu $14
- Kau Hospital · Pahala $14
- Samuel Mahelona Memorial Hospital · Kapaa $14
- Straub Clinic and Hospital · Honolulu $15
- Leahi Hospital · Honolulu $15
- Adventist Health Castle · Kailua $16
- The Queens Medical Center · Honolulu $18
- Lanai Community Hospital · Lanai City $24
- Molokai General Hospital · Kaunakakai $24
- Kula Hospital · Kula $24
Audit a Bill or Quote at HI Hospital Benchmark (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $12
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $12).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask HI Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $14 Fair BaseRate ($8 Medicare)
Your bill ($34) is $20 above the denoised Fair BaseRate ($14) and 4.3× the $8 Medicare rate.