CMS Price Transparency Data

Physical therapy (gait training)

Facility: Samuel Mahelona Memorial Hospital

Billing Code: 97116 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$23
about 0.8× the $29 Medicare rate · typically $14–$27
modeled estimate · not a bill or quote
What this hospital charges insurers
$17
Below the fair price — a good deal
about $6 under the fair price · 0.6× Medicare
Medicare pays $29 Fair price $23 This hospital $17 Cash price $155 Hospital's list price $238

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 $17 Priciest $34

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 Physical therapy (gait training) is about $23 (about 0.8× the $29 Medicare rate). Samuel Mahelona Memorial Hospital charges insurers about $17, or about $155 in cash — below the fair price — a good deal. 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 $17 - $119 58%
Humanamajor $119 409%
Kaiser Permanentemajor $119 - $214 409%
Devoted Health $131 451%
+ 7 smaller / regional plans $119 - $231

Self-Pay How to get the cash price

Insurance Before you use insurance

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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