CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Samuel Mahelona Memorial Hospital

Billing Code: 74177 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$232

about 0.7× the $356 Medicare rate · typically $202–$441

modeled estimate · not a bill or quote

What this hospital charges insurers

$269

Above the fair price

about $37 over the fair price · 0.8× Medicare

Medicare pays $356 Fair price $232 This hospital $269 Cash price $2,287 Hospital's list price $3,518

How we calculate the fair BaseRate →

How this hospital compares to other HI hospitals

One of the lower prices — 7 of 8 other HI hospitals charge more for the same procedure.

Cheapest $246 Priciest $433

Black dot = this hospital, among the 9 HI hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, abdomen and pelvis (with contrast) is about $232 (about 0.7× the $356 Medicare rate). Samuel Mahelona Memorial Hospital charges insurers about $269, or about $2,287 in cash — above the fair price. Located in Kapaa, HI.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $232. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Humana✓ Kaiser Permanente Blue Cross Blue ShieldAetnaCigna

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$85 - $5,102	24%
Humanamajor	$1,759 - $5,102	494%
Kaiser Permanentemajor	$102 - $9,184	29%
Devoted Health	$94 - $5,613	26%
+ 7 smaller / regional plans	$85 - $9,899

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 2,287), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 74177.

Insurance Before you use insurance

Call your insurance company to confirm Samuel Mahelona Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 74177.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Samuel Mahelona Memorial Hospital

Compare: CT scan, abdomen and pelvis (with contrast) at other HI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.