CMS Price Transparency Data

CT scan, pelvis

Facility: Samuel Mahelona Memorial Hospital

Billing Code: 72192 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$96
about 0.9× the $107 Medicare rate · typically $80–$143
modeled estimate · not a bill or quote
What this hospital charges insurers
$90
About the fair price
about $6 under the fair price · 0.8× Medicare
Medicare pays $107 Fair price $96 This hospital $90 Cash price $728 Hospital's list price $1,120

How we calculate the fair BaseRate →

How this hospital compares to other HI hospitals

Lowest price of the 9 HI hospitals we have prices for — a strong deal.

Cheapest $90 Priciest $145

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, pelvis is about $96 (about 0.9× the $107 Medicare rate). Samuel Mahelona Memorial Hospital charges insurers about $90, or about $728 in cash — about the fair price. Located in Kapaa, HI.

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 $51 - $560 48%
Humanamajor $560 524%
Kaiser Permanentemajor $61 - $1,008 57%
Devoted Health $56 - $616 52%
+ 7 smaller / regional plans $51 - $1,086

Self-Pay How to get the cash price

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

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Facility Profile & Credentials

  • Address: 4800 Kawaihau Road, Kapaa, HI 96746
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - State
  • Hospital Type: Critical Access Hospitals