CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Samuel Mahelona Memorial Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$60
about 0.6× the $95 Medicare rate · typically $42–$77
modeled estimate · not a bill or quote
What this hospital charges insurers
$61
About the fair price
about $1 over the fair price · 0.6× Medicare
Medicare pays $95 Fair price $60 This hospital $61 Cash price $317 Hospital's list price $488

How we calculate the fair BaseRate →

How this hospital compares to other HI hospitals

A typical price — 4 charge more and 4 charge less, among the 9 HI hospitals compared.

Cheapest $36 Priciest $67

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 Office visit, established patient (20-29 min) is about $60 (about 0.6× the $95 Medicare rate). Samuel Mahelona Memorial Hospital charges insurers about $61, or about $317 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 $36 - $434 38%
Humanamajor $244 256%
Kaiser Permanentemajor $69 - $439 72%
Devoted Health $63 - $268 66%
+ 7 smaller / regional plans $42 - $473

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

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