CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Samuel Mahelona Memorial Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $28
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 8.83x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Samuel Mahelona Memorial Hospital is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 8.83x the Medicare baseline. Located in 4800 Kawaihau Road, Kapaa, HI.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$3.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3.17 (100%)
Cash / Self-Pay: $36 (1136%)
Insurance Median: $28 (883%)
Cash: $36 (1136% of Medicare)
Ins. Median: $28 (883% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $3.17 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 883% of the Medicare baseline (a markup of 783%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Hawaii Western Management Group $3 95%
UnitedHealthcare $4 - $28 126%
Hawaii Medical Service Association $4 - $28 126%
University Health Alliance $8 252%
Kaiser Permanente $28 - $50 883%
Humana $28 883%
Alohacare $28 883%
Ohana Health Plan $28 883%
Devoted Health $31 978%
Health Management Network $48 1514%
Mdx Hawaii $54 1703%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

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