Extended office visit (prolonged) cost in HI
What a extended office visit (prolonged) costs at HI hospitals — and the fair price to aim for.
Typical commercial prices here are 9% below the fair benchmark (0.91×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Cash-Arbitrage Bifurcated Pricer
Pali Momi Medical Center maintains elevated commercial insurance contracts (1.14× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 49% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.95× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 49% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 79% patient recommendation (78/100 safety score)
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 2.1× markup over Medicare rates
- Commercial insurance median sits at 1.09× Fair BaseRate (1.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.44×) jump +32% above the median procedure ratio (Q50 1.09×)
- Consolidated metro market (HHI 2,350) limits in-network hospital competition (Moderately Concentrated (1,500–2,500))
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 below the fair price — a good state to get this done. how we calculate the BaseRate →
Compared with the rest of the country, HI’s fair BaseRate ($34) is about the same as the national fair price of $35.
Cheapest HI hospitals for a extended office visit (prolonged)
- Pali Momi Medical Center · Aiea $20
- Wilcox Memorial Hospital · Lihue $20
- Kapiolani Medical Center for Women & Children · Honolulu $20
- Kohala Hospital · Kapaau $23
- Samuel Mahelona Memorial Hospital · Kapaa $30
- Hilo Benioff Medical Center · Hilo $32
- Kau Hospital · Pahala $32
- Kuakini Medical Center · Honolulu $32
- Straub Clinic and Hospital · Honolulu $33
Audit a Bill or Quote at HI Hospital Benchmark (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $26
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 = $26).
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 $34 Fair BaseRate ($20 Medicare)
Your bill ($72) is $38 above the denoised Fair BaseRate ($34) and 3.6× the $20 Medicare rate.