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Hilo Kailua Area Hospital Prices

Cash and insurance-negotiated prices at hospitals in and around Hilo Kailua, HI. Part of all Hawaii hospital prices.

Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Good Deal · Below Fair Market
0.80×vs. Fair Market Price
Position vs. 1.00× Fair Price20% Below Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are 20% below the fair benchmark (0.80×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Hawaii Market & Best ValueSummarizes statewide hospital price coverage across Hawaii, the average commercial markup over federal Medicare rates, and the #1 best-value hospital in the state.5 Hospitals · 124 Procedures
Hospitals Priced5 in HITotal hospitals in Hawaii with verified machine-readable price disclosures indexed in the Crystal.
Avg vs. Medicare1.4× MedicareAverage commercial insurance negotiated rate across Hawaii hospitals compared to what federal Medicare pays for the same procedure.
Best Value in HI0.80× FairLowest confounder-adjusted hospital in Hawaii: Hilo Benioff Medical Center (Hilo) at 0.80× fair market price.

Most affordable Hawaii hospital: Hilo Benioff Medical Center (Hilo) at 0.80× the fair price (20% below benchmark).

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

This hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (0.7× Medicare, p50 0.80× Fair BaseRate) and emergency/ancillary services (1.1× Medicare, p75 0.96× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#1 of 20 in HI · 1st State Percentile#273 of 3,385 in U.S. · 8th National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Elective shoppable care is priced 20% below peer Fair BaseRate (0.80×)
  • Self-pay cash beats commercial insurance on 49% of shoppable procedures (99/100 Cash Honesty)
  • CMS clinical safety score (69/100 safety score) with 64% 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 (0.80× 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 (0.5×) & laboratory (0.6×) services average 1.57× higher multiples than routine shoppable care (0.7×)
  • Upper-quartile procedures (Q75 0.96×) jump +20% above the median procedure ratio (Q50 0.80×)
  • Consolidated metro market (HHI 4,475) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Front-Door ShoppableElective / Imaging
0.7× Medicare

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

Back-Door Captive & ER1.57× Divergence
1.1× Medicare

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

Quantile Tail Spread+20% Upper Tail
Q25 0.51× · Q50 0.80× · Q75 0.96×

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
0.7× MedicareGood
Outpatient Surgery & ORBack-Door Captive
0.5× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
0.7× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
0.5× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
0.6× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.1× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
49% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 69/100Fair

Hospitals in the Hilo Kailua area

Ranked by how their prices compare to the fair BaseRate — best value first. The × fair figure is geo-adjusted. Tap any hospital for its full price list.

Compare prices by procedure in Hilo Kailua

Local prices across Hilo Kailua-area hospitals for 124 procedures.

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

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

Inpatient MS-DRG vs. Outpatient CPT Care-Setting Savings

Laparoscopic Gallbladder RemovalDRG 419 vs CPT 47562
Inpatient: $19,131Outpatient: $5,062 Save $14,069 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Cesarean Section DeliveryDRG 788 vs CPT 59510
Inpatient: $13,746Outpatient: $2,513 Save $11,233 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Total Knee Arthroplasty (Replacement)DRG 470 vs CPT 27447
Inpatient: $20,019Outpatient: $9,510 Save $10,509 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Total Hip Arthroplasty (Replacement)DRG 470 vs CPT 27130
Inpatient: $20,019Outpatient: $9,608 Save $10,411 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Uncomplicated Vaginal DeliveryDRG 807 vs CPT 59400
Inpatient: $10,546Outpatient: $2,115 Save $8,431 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Prices are sourced from each hospital's federally-required public price file, most recently published October 2026. The BaseRate is a modeled fair-price estimate — not a bill or quote. How we build these numbers →