How many shoppable procedure prices are published for Kau Hospital?

Kau Hospital in Pahala, HI currently has 96 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Kau Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Kau Hospital's median negotiated commercial rate is 0.8× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Government - State 21 Beds · rural Updated: 2026-06-15

Kau Hospital

1 Kamani Street, Pahala, HI 96777 · 96 Priced Procedures

CMS Overall Rating No CMS Rating

Good Deal · Below Fair Market

0.82×vs. Fair Market Price

Typical commercial prices here are 18% below the fair benchmark (0.82×) after accounting for local nurse/doctor wages and patient complexity.

79/100 · Corroborated

79/100Self-Pay Cash Beats Insurance 49% of the Time

File Completeness66

Price Logic89

Peer Alignment58

Clean Billing84

Real Cash Discount100

Regional Value Leader

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Kau Hospital prices routine shoppable procedures near 0.6× Medicare (p50 0.71×) while skewing captive emergency, lab, and upper-quartile codes to 1.5× Medicare (p75 1.17×, +65% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#2 of 20 in HI · 5th State Percentile#322 of 3,385 in U.S. · 9th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 18% below peer Fair BaseRate (0.82×)
Self-pay cash beats commercial insurance on 49% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (85/100 safety score) with 72% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.82× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Captive ER (0.9×) & laboratory (1.4×) services average 2.50× higher multiples than routine shoppable care (0.6×)
Upper-quartile procedures (Q75 1.17×) jump +65% above the median procedure ratio (Q50 0.71×)
Consolidated metro market (HHI 4,475) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

0.6× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER2.50× Divergence

1.5× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+65% Upper Tail

Q25 0.45× · Q50 0.71× · Q75 1.17×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

0.6× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.8× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.6× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.9× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.4× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.5× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

49% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 85/100Good

Procedure Prices at Kau Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 96 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$40,815	$19,087	2.1×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$40,483	$17,936	unverified
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$19,101	$19,432	1.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$14,553	$8,223	1.8×
C-section delivery (full package) CPT Code: `59510`	$2,704	$2,638	$2,975	0.9×
Vaginal delivery (full package) CPT Code: `59400`	$2,453	$2,388	$2,680	0.9×
Total hip replacement CPT Code: `27130`	$1,340	$1,340	$13,413	0.1×
Total knee replacement CPT Code: `27447`	$1,339	$1,339	$13,523	0.1×
Breathing treatment (nebulizer) CPT Code: `94640`	$655	$655	$201	3.3×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$677	$677	$6,109	0.1×
Breast lump removal CPT Code: `19120`	$628	$628	$3,875	0.2×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$586	$569	$3,372	0.2×
Inguinal hernia repair CPT Code: `49505`	$542	$526	$3,629	0.1×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$586	$246	$448	0.5×
MRI, brain (with and without contrast) CPT Code: `70553`	$364	$240	$511	0.5×
Injection procedure for pain management HCPCS Code: `G0260`	$226	$226	$855	0.3×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$375	$197	$272	0.7×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$355	$176	$583	0.3×
Colonoscopy (diagnostic) CPT Code: `45378`	$428	$184	$981	0.2×
Colonoscopy with biopsy CPT Code: `45380`	$549	$200	$1,256	0.2×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$142	$142	$64	2.2×
Psychiatric evaluation (first visit) CPT Code: `90791`	$188	$148	$185	0.8×
Psychotherapy session (60 minutes) CPT Code: `90837`	$181	$136	$181	0.8×
MRI, brain (no contrast) CPT Code: `70551`	$224	$145	$343	0.4×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$320	$123	$303	0.4×
Upper endoscopy with biopsy CPT Code: `43239`	$484	$139	$987	0.1×
Orthotic fitting and training CPT Code: `97760`	$105	$105	$51	2.1×
Office visit, established patient (30-39 min) CPT Code: `99214`	$150	$93	$123	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$213	$93	$132	0.7×
Ultrasound, abdomen (complete) CPT Code: `76700`	$213	$87	$134	0.6×
Ultrasound, pelvis CPT Code: `76856`	$317	$83	$130	0.6×
CT scan, sinuses CPT Code: `70486`	$148	$100	$166	0.6×
Family therapy session CPT Code: `90847`	$117	$104	$173	0.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$241	$96	$169	0.6×
CT scan, chest (no contrast) CPT Code: `71250`	$242	$94	$167	0.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	$123	$92	$166	0.6×
Hepatitis B immune globulin HCPCS Code: `90371`	$96	$96	$151	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$220	$81	$86	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$104	$104	$86	unverified
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$187	$187	$203	unverified
Pneumococcal vaccine HCPCS Code: `90732`	$140	$133	$140	0.9×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$133	$133	$111	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$106	$63	$87	0.7×
New patient office visit (30-44 min) CPT Code: `99203`	$130	$78	$110	0.7×
Care planning with family CPT Code: `90887`	$91	$73	$107	0.7×
Ultrasound, abdomen (limited) CPT Code: `76705`	$317	$67	$126	0.5×
CT scan, head (no contrast) CPT Code: `70450`	$196	$76	$160	0.5×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$53	$39	$56	0.7×
X-ray, hip CPT Code: `73502`	$263	$43	$93	0.5×
X-ray, lower back CPT Code: `72110`	$317	$46	$112	0.4×
Blood test, lipase CPT Code: `83690`	$35	$10	$7	1.4×
Blood test, creatinine (kidney) CPT Code: `82565`	$26	$7	$5	1.4×
Blood test, basic metabolic panel CPT Code: `80048`	$43	$12	$9	1.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$16	$4	$3	1.3×
Culture, bacterial CPT Code: `87070`	$43	$12	$9	1.3×
Blood test, amylase CPT Code: `82150`	$32	$9	$7	1.3×
Blood test, magnesium CPT Code: `83735`	$34	$9	$7	1.3×
Culture, blood CPT Code: `87040`	$52	$14	$11	1.3×
Blood test, liver function panel CPT Code: `80076`	$41	$11	$9	1.2×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$49	$12	$10	1.2×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$67	$16	$14	1.1×
Blood test, ferritin (iron stores) CPT Code: `82728`	$68	$16	$14	1.1×
Extended office visit (prolonged) HCPCS Code: `G2212`	$37	$32	$33	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$110	$35	$48	0.7×
X-ray, neck (cervical spine) CPT Code: `72040`	$263	$33	$93	0.4×
X-ray, hand CPT Code: `73130`	$263	$33	$93	0.4×
X-ray, ankle CPT Code: `73610`	$263	$32	$93	0.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$20	$5	$4	1.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$20	$5	$4	1.3×
Blood test, complete blood count (CBC) CPT Code: `85025`	$39	$10	$8	1.3×
Blood test, hemoglobin CPT Code: `85018`	$2	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$22	$5	$5	1.0×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$151	$16	$25	0.6×
Physical therapy (gait training) CPT Code: `97116`	$85	$17	$33	0.5×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$84	$18	$35	0.5×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$98	$19	$38	0.5×
Occupational therapy (self-care training) CPT Code: `97535`	$95	$19	$38	0.5×
Colorectal cancer screening HCPCS Code: `G0010`	$23	$23	$49	0.5×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$43	$18	$39	0.5×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$109	$18	$40	0.5×
Pneumonia vaccine injection HCPCS Code: `G0009`	$23	$18	$49	0.4×
X-ray, shoulder CPT Code: `73030`	$263	$30	$92	0.3×
X-ray, foot CPT Code: `73630`	$263	$29	$92	0.3×
X-ray, chest (two views) CPT Code: `71046`	$263	$26	$93	0.3×
Group therapy session CPT Code: `90853`	$33	$24	$100	0.2×
X-ray, chest (single view) CPT Code: `71045`	$263	$19	$92	0.2×
X-ray, pelvis CPT Code: `72170`	$317	$22	$110	0.2×
Psychological testing evaluation CPT Code: `96136`	$49	$23	$128	0.2×
Blood test, vitamin D CPT Code: `82306`	$149	$41	$31	unverified
Blood test, comprehensive metabolic panel CPT Code: `80053`	$53	$13	$11	unverified
Blood test, vitamin B12 CPT Code: `82607`	$76	$21	$16	unverified
Blood test, thyroid (TSH) CPT Code: `84443`	$85	$23	$18	unverified
Hepatitis C antibody test CPT Code: `86803`	$72	$20	$15	unverified
Flu vaccine (high dose) HCPCS Code: `90656`	$37	$23	$25	unverified
Hepatitis B vaccine HCPCS Code: `90744`	$53	$33	$37	unverified
Physical therapy (manual therapy) CPT Code: `97140`	$79	$29	$34	unverified

Showing top 25 high-impact procedures of 96 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Kau Hospital (Zero PHI Required)

CMS CCN: 121301

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash Request Quote

Insurer Median $40,815

1. Amount on Your Bill or Quote ($) Pre-filled with Kau Hospital’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Kau Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$78,869 Above Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your bill ($97,956) is $78,869 above the denoised Fair BaseRate ($19,087) and 6.9× the $14,117 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Public IRS & CMS ownership records classify Kau Hospital as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

Safety Composite85/100

Median ER Wait83 min

Left ER Before Seen0%

Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Quality & Price Benchmark Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Kau Hospital.

Price Index: 0.82× regional baseline

Quality: 57/100 CMS composite

Median Household Income$77,215U.S. Census ACS

Local Uninsured Share4.2%Regional ACS estimate

200% FPL (1 Person)$36,720Common free-care ceiling

400% FPL (Family of 4)$147,920Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 79/100 · Corroborated CMS CCN 121301

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 121301) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-06-15

Validated Rate Rows2,213 (CMS v3.0.0)

File Integrity DigestVerified · CCN 121301

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy