How many shoppable procedure prices are published for Kona Community Hospital?

Kona Community Hospital in Kealakekua, HI currently has 111 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

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

Across scored shoppable procedures, Kona Community Hospital's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

What is Kona Community Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Kona Community Hospital an overall hospital quality rating of 2 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Government - State 83 Beds · rural Updated: 7/28/2025

Kona Community Hospital

79-1019 Haukapila Street, Kealakekua, HI 96750 · 111 Priced Procedures · 63% Patient Recommendation

CMS Overall Rating 2 / 5 Stars

Near Fair BaseRate Benchmark

1.03×vs. Fair Market Price

Typical commercial prices here are +3% above the fair benchmark (1.03×) even after accounting for local nurse/doctor wages and patient complexity.

82/100 · Corroborated

82/100Self-Pay Cash Beats Insurance 27% of the Time

File Completeness66

Price Logic93

Peer Alignment73

Clean Billing77

Real Cash Discount100

Premium Quality Tier

3-Star CMS clinical quality rating paired with 1.03× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Kona Community Hospital prices shoppable and inpatient services (1.2× to 1.2× Medicare, divergence 1.00×) in alignment with regional hospital peers (1.03× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#9 of 20 in HI · 40th State Percentile#1,415 of 3,385 in U.S. · 41st National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.91× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 27% of shoppable procedures (99/100 Cash Honesty)
2-Star CMS clinical rating with 63% patient recommendation (66/100 safety score)
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 (1.03× 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.
Commercial insurance median sits at 1.02× Fair BaseRate (1.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
Even at low-cost facilities (1.03× 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.
Consolidated metro market (HHI 4,475) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.2× Medicare

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

Back-Door Captive & ER1.00× Divergence

1.2× Medicare

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

Quantile Tail Spread+10% Upper Tail

Q25 0.91× · Q50 1.02× · Q75 1.12×

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

1.2× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.7× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.2× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.8× MedicareGood

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

0.8× MedicareGood

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

27% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

2 CMS · 66/100Fair

Procedure Prices at Kona Community Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 111 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$42,489	$30,775	1.4×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$31,674	$19,087	unverified
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$29,131	$17,936	1.6×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$27,415	$19,432	1.4×
Total hip replacement CPT Code: `27130`	—	$16,475	$13,413	1.2×
Total knee replacement CPT Code: `27447`	—	$16,475	$13,523	1.2×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$12,551	$8,223	unverified
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$7,142	$6,109	1.2×
Breast lump removal CPT Code: `19120`	—	$4,625	$3,875	1.2×
Inguinal hernia repair CPT Code: `49505`	—	$4,247	$3,629	1.2×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$4,052	$3,372	1.2×
Bunion correction surgery CPT Code: `28296`	—	$4,052	$3,446	1.2×
Cataract surgery with lens implant CPT Code: `66984`	—	$2,917	$2,540	1.1×
Injection procedure for pain management HCPCS Code: `G0260`	—	$2,050	$855	unverified
Trauma team activation HCPCS Code: `G0390`	$3,253	$1,714	$1,453	1.2×
Colonoscopy with biopsy CPT Code: `45380`	—	$1,477	$1,256	1.2×
Vaginal delivery (full package) CPT Code: `59400`	—	$1,419	$2,680	0.5×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,589	$1,144	$981	1.2×
Upper endoscopy with biopsy CPT Code: `43239`	$2,681	$1,135	$987	1.1×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,929	$646	$583	unverified
Blood transfusion CPT Code: `36430`	$1,229	$532	$498	1.1×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,797	$481	$511	0.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,856	$412	$448	0.9×
MRI, lower back (no contrast) CPT Code: `72148`	$1,218	$308	$338	0.9×
MRI, brain (no contrast) CPT Code: `70551`	$1,351	$308	$343	0.9×
MRI, knee or other leg joint CPT Code: `73721`	$1,332	$308	$369	0.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$969	$282	$272	1.0×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,478	$282	$303	0.9×
Rabies immune globulin HCPCS Code: `90375`	$2,319	$275	$322	0.9×
Breathing treatment (nebulizer) CPT Code: `94640`	$864	$267	$201	unverified
CT scan, head (with and without contrast) CPT Code: `70470`	$1,180	$229	$258	0.9×
CT scan, head (with contrast) CPT Code: `70460`	$1,060	$207	$242	0.9×
X-ray, pelvis CPT Code: `72170`	$266	$124	$110	1.1×
Ultrasound, abdomen (limited) CPT Code: `76705`	$475	$130	$126	1.0×
Ultrasound, pelvis CPT Code: `76856`	$481	$131	$130	1.0×
Ultrasound, thyroid and neck CPT Code: `76536`	$446	$130	$132	1.0×
Hepatitis B immune globulin HCPCS Code: `90371`	$608	$140	$151	0.9×
CT scan, chest (no contrast) CPT Code: `71250`	$859	$145	$167	0.9×
CT scan, sinuses CPT Code: `70486`	$764	$141	$166	0.8×
CT scan, neck (cervical spine) CPT Code: `72125`	$750	$143	$169	0.8×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$750	$142	$168	0.8×
CT scan, head (no contrast) CPT Code: `70450`	$859	$138	$160	unverified
CT scan, pelvis CPT Code: `72192`	$750	$145	$163	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$481	$136	$134	unverified
X-ray, chest (single view) CPT Code: `71045`	$252	$103	$92	1.1×
X-ray, shoulder CPT Code: `73030`	$302	$103	$92	1.1×
X-ray, foot CPT Code: `73630`	$279	$103	$92	1.1×
X-ray, chest (two views) CPT Code: `71046`	$302	$103	$93	1.1×
X-ray, neck (cervical spine) CPT Code: `72040`	$372	$103	$93	1.1×
X-ray, hand CPT Code: `73130`	$335	$103	$93	1.1×
X-ray, ankle CPT Code: `73610`	$312	$103	$93	1.1×
X-ray, lower back CPT Code: `72110`	$441	$124	$112	1.1×
Speech therapy (language evaluation) CPT Code: `92507`	$304	$81	$86	0.9×
Office visit, established patient (30-39 min) CPT Code: `99214`	$348	$97	$123	0.8×
Screening mammogram (both breasts) CPT Code: `77067`	$218	$96	$123	0.8×
New patient office visit (30-44 min) CPT Code: `99203`	$150	$82	$110	0.7×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$367	$105	$148	0.7×
X-ray, hip CPT Code: `73502`	$258	$103	$93	unverified
Typhoid vaccine HCPCS Code: `90675`	$774	$325	$347	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$370	$193	$203	1.0×
Drug screening test HCPCS Code: `G0480`	$190	$118	$116	1.0×
Pneumococcal vaccine HCPCS Code: `90732`	$314	$133	$140	0.9×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$251	$101	$111	0.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$207	$73	$64	1.1×
Orthotic fitting and training CPT Code: `97760`	$146	$51	$51	1.0×
Prosthetic fitting and training CPT Code: `97761`	$113	$44	$45	1.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	$276	$65	$87	0.7×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$105	$12	$11	1.1×
Blood test, vitamin D CPT Code: `82306`	$211	$32	$31	1.0×
Physical therapy (functional capacity test) CPT Code: `97750`	$119	$36	$38	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$125	$38	$56	0.7×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$140	$35	$38	unverified
Occupational therapy (therapeutic activities) CPT Code: `97530`	$147	$39	$40	unverified
Flu vaccine injection HCPCS Code: `G0008`	$103	$59	$48	unverified
Pneumonia vaccine injection HCPCS Code: `G0009`	$83	$59	$49	unverified
Colorectal cancer screening HCPCS Code: `G0010`	$54	$59	$49	unverified
Blood test, calcium CPT Code: `82310`	$55	$6	$5	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$43	$6	$5	1.2×
Blood test, complete blood count (CBC) CPT Code: `85025`	$82	$9	$8	1.1×
Blood test, ferritin (iron stores) CPT Code: `82728`	$120	$15	$14	1.1×
Blood test, vitamin B12 CPT Code: `82607`	$127	$17	$16	1.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$155	$20	$19	1.1×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$115	$14	$14	1.0×
Blood test, liver function panel CPT Code: `80076`	$87	$9	$9	1.0×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$133	$31	$35	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$143	$34	$38	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$35	$3	$3	1.0×
Blood test, amylase CPT Code: `82150`	$70	$7	$7	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$34	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$93	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$75	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$72	$7	$7	1.0×
Hepatitis B vaccine HCPCS Code: `90744`	$79	$31	$37	0.8×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$87	$32	$39	0.8×
Physical therapy (gait training) CPT Code: `97116`	$125	$31	$33	unverified
Blood test, potassium CPT Code: `84132`	$48	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$40	$5	$5	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$176	$18	$18	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$38	$4	$4	1.0×
Blood test, hemoglobin CPT Code: `85018`	$26	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$35	$5	$5	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$51	$6	$6	1.0×
Hepatitis C antibody test CPT Code: `86803`	$123	$15	$15	1.0×
Culture, blood CPT Code: `87040`	$95	$11	$11	1.0×
Culture, bacterial CPT Code: `87070`	$108	$9	$9	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$83	$20	$20	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$65	$22	$25	0.9×
Physical therapy (manual therapy) CPT Code: `97140`	$123	$28	$34	0.8×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$129	$15	$25	0.6×
Blood antibody screen CPT Code: `86850`	$150	$20	$46	0.4×
Blood test, basic metabolic panel CPT Code: `80048`	$84	$9	$9	unverified

Showing top 25 high-impact procedures of 111 total

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

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

CMS CCN: 120019

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $42,489

1. Amount on Your Bill or Quote ($) Pre-filled with Kona Community 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 Kona Community 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 +$71,199 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($101,974) is $71,199 above the denoised Fair BaseRate ($30,775) and 4.3× the $23,504 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 Kona Community 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

CMS Overall3/5 Stars (3/5)

Safety Composite66/100

Would Recommend63%

Rated 9 or 10 (HCAHPS)63%

Median ER Wait169 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (449 completed HCAHPS patient surveys). 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

Higher-Quality, Above-Median Price Tier

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

Price Index: 1.15× regional baseline

Quality: 60/100 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 82/100 · Corroborated CMS CCN 120019

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 120019) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage7/28/2025

Validated Rate Rows3,656 (CMS v2.0.0)

File Integrity DigestVerified · CCN 120019

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