CMS Price Transparency Data

Care planning with family

Facility: Samuel Mahelona Memorial Hospital

Billing Code: 90887 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90887
Insurance Median: $118
Cash Discount Price: $153
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Care planning with family at Samuel Mahelona Memorial Hospital is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $153. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 4800 Kawaihau Road, Kapaa, HI.

Cash / Self-Pay

$153

Average discount available for prompt cash payment at this facility.

Insurance Median

$118

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

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Commercial Insurance Negotiated Rates

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

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
UnitedHealthcare	$52 - $118	N/A
Hawaii Western Management Group	$69 - $223	N/A
Hawaii Medical Service Association	$73 - $118	N/A
Alohacare	$118	N/A
Humana	$118	N/A
Kaiser Permanente	$118 - $212	N/A
Ohana Health Plan	$118	N/A
Devoted Health	$129	N/A
University Health Alliance	$132	N/A
Health Management Network	$200	N/A
Mdx Hawaii	$228	N/A

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $153.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90887.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Samuel Mahelona Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90887.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.