Office visit, established patient (30-39 min) cost in HI
What a office visit, established patient (30-39 min) costs at HI hospitals — and the fair price to aim for.
Typical commercial prices here are 20% below the fair benchmark (0.80×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Aligned Regional Benchmark Peer
Adventist Health Castle prices shoppable and inpatient services (1.2× to 1.6× Medicare, divergence 1.33×) in alignment with regional hospital peers (1.04× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
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 62% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 77% patient recommendation (74/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (43.5% AGB cap)
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 (1.3×) & laboratory (1.7×) services average 1.33× higher multiples than routine shoppable care (1.2×)
- Upper-quartile procedures (Q75 1.39×) jump +24% above the median procedure ratio (Q50 1.12×)
- Consolidated metro market (HHI 2,350) limits in-network hospital competition (Moderately Concentrated (1,500–2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
In general, HI hospitals charge about the fair price for this. how we calculate the BaseRate →
Compared with the rest of the country, HI’s fair BaseRate ($100) is below the national fair price of $123.
Cheapest HI hospitals for a office visit, established patient (30-39 min)
- Adventist Health Castle · Kailua $85
- North Hawaii Community Hospital, Inc · Kamuela $85
- Samuel Mahelona Memorial Hospital · Kapaa $89
- Kau Hospital · Pahala $93
- Kona Community Hospital · Kealakekua $97
- Hilo Benioff Medical Center · Hilo $98
- Shriners Hospital for Children · Honolulu $98
- Kuakini Medical Center · Honolulu $98
- Straub Clinic and Hospital · Honolulu $101
- Pali Momi Medical Center · Aiea $121
- Wilcox Memorial Hospital · Lihue $121
- Kapiolani Medical Center for Women & Children · Honolulu $121
- The Queens Medical Center · Honolulu $133
- Rehabilitation Hospital of the Pacific · Honolulu $157
- Molokai General Hospital · Kaunakakai $168
Audit a Bill or Quote at HI Hospital Benchmark (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $85
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $85).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask HI Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $100 Fair BaseRate ($58 Medicare)
Your bill ($235) is $135 above the denoised Fair BaseRate ($100) and 4.1× the $58 Medicare rate.