Search
Hospital Profile Critical Access Hospitals Government - State

Samuel Mahelona Memorial Hospital

4800 KAWAIHAU RD, Kapaa, HI 96746

CMS Overall Rating No CMS Rating
Factual Overview

Samuel Mahelona Memorial Hospital is a Critical Access Hospitals (Government - State) operating in Kapaa, HI. Mapped commercial insurance prices across 113 procedures average 3.93x the Medicare baseline. CMS has not published a quality star rating for this facility.

Facility Overview

Setting: rural Bed Count: 5 Beds Teaching Status: Non-Teaching Annual Discharges: 1

Patient Experience

Recommendation Rate: N/A High Patient Rating: N/A ER Wait Time (Med): 59 min Readmission Rate: N/A

Pricing & Transparency

Procedures Mapped: 113 codes Avg Markup vs Medicare: 3.93x Price File In Index: Yes MRF Version: 3.0.0
Procedure & Code Cash Price Actions
Breast lump removal
CPT Code: 19120
 $2,206 Calc
Total hip replacement
CPT Code: 27130
 $11,614 Calc
Total knee replacement
CPT Code: 27447
 $11,614 Calc
Bunion correction surgery
CPT Code: 28296
 $2,960 Calc
Knee arthroscopy with meniscus repair
CPT Code: 29881
 $2,960 Calc
Heart stent placement (inpatient stay)
MS-DRG Code: 322
 Contact Desk Calc
Blood transfusion
CPT Code: 36430
 $1,338 Calc
Digestive disorders treatment (inpatient stay)
MS-DRG Code: 392
 Contact Desk Calc
Upper endoscopy with biopsy
CPT Code: 43239
 $842 Calc
Colonoscopy (diagnostic)
CPT Code: 45378
 $792 Calc
Colonoscopy with biopsy
CPT Code: 45380
 $1,082 Calc
Hip or knee replacement (inpatient stay)
MS-DRG Code: 470
 Contact Desk Calc
Gallbladder removal (laparoscopic)
CPT Code: 47562
 $3,589 Calc
Inguinal hernia repair
CPT Code: 49505
 $3,239 Calc
Vaginal delivery (full package)
CPT Code: 59400
 $4,053 Calc
C-section delivery (full package)
CPT Code: 59510
 $4,449 Calc
Cataract surgery with lens implant
CPT Code: 66984
 $2,088 Calc
CT scan, head (no contrast)
CPT Code: 70450
 $1,041 Calc
CT scan, head (with contrast)
CPT Code: 70460
 $1,011 Calc
CT scan, head (with and without contrast)
CPT Code: 70470
 $767 Calc
CT scan, sinuses
CPT Code: 70486
 $3,027 Calc
X-ray, chest (single view)
CPT Code: 71045
 $170 Calc
X-ray, chest (two views)
CPT Code: 71046
 $187 Calc
CT scan, chest (no contrast)
CPT Code: 71250
 $1,046 Calc
X-ray, neck (cervical spine)
CPT Code: 72040
 $221 Calc
X-ray, lower back
CPT Code: 72110
 $322 Calc
CT scan, neck (cervical spine)
CPT Code: 72125
 $956 Calc
CT scan, lower back (lumbar spine)
CPT Code: 72131
 $717 Calc
X-ray, pelvis
CPT Code: 72170
 $100 Calc
CT scan, pelvis
CPT Code: 72192
 $728 Calc
X-ray, shoulder
CPT Code: 73030
 $115 Calc
X-ray, hand
CPT Code: 73130
 $231 Calc
X-ray, hip
CPT Code: 73502
 $203 Calc
X-ray, ankle
CPT Code: 73610
 $119 Calc
X-ray, foot
CPT Code: 73630
 $114 Calc
MRI, knee or other leg joint
CPT Code: 73721
 $1,132 Calc
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 $1,774 Calc
CT scan, abdomen and pelvis (with contrast)
CPT Code: 74177
 $2,287 Calc
Ultrasound, thyroid and neck
CPT Code: 76536
 $429 Calc
Ultrasound, abdomen (complete)
CPT Code: 76700
 $298 Calc
Ultrasound, abdomen (limited)
CPT Code: 76705
 $460 Calc
Ultrasound, pelvis
CPT Code: 76856
 $496 Calc
Diagnostic mammogram (both breasts)
CPT Code: 77066
 $521 Calc
Screening mammogram (both breasts)
CPT Code: 77067
 $114 Calc
Blood test, basic metabolic panel
CPT Code: 80048
 $76 Calc
Blood test, comprehensive metabolic panel
CPT Code: 80053
 $92 Calc
Blood test, cholesterol (lipid panel)
CPT Code: 80061
 $100 Calc
Blood test, liver function panel
CPT Code: 80076
 $78 Calc
Urinalysis (automated, with microscopy)
CPT Code: 81001
 $36 Calc
Blood test, amylase
CPT Code: 82150
 $63 Calc
Blood test, vitamin D
CPT Code: 82306
 $206 Calc
Blood test, calcium
CPT Code: 82310
 $50 Calc
Blood test, creatinine (kidney)
CPT Code: 82565
 $41 Calc
Blood test, vitamin B12
CPT Code: 82607
 $112 Calc
Blood test, ferritin (iron stores)
CPT Code: 82728
 $80 Calc
Blood test, glucose (blood sugar)
CPT Code: 82947
 $32 Calc
Blood test, average blood sugar (A1c)
CPT Code: 83036
 $83 Calc
Blood test, lipase
CPT Code: 83690
 $61 Calc
Blood test, magnesium
CPT Code: 83735
 $67 Calc
Blood test, potassium
CPT Code: 84132
 $146 Calc
Blood test, PSA (prostate screen)
CPT Code: 84153
 $90 Calc
Blood test, sodium
CPT Code: 84295
 $146 Calc
Blood test, thyroid (TSH)
CPT Code: 84443
 $110 Calc
Blood test, urea nitrogen (BUN, kidney)
CPT Code: 84520
 $36 Calc
Blood test, hemoglobin
CPT Code: 85018
 $18 Calc
Blood test, complete blood count (CBC)
CPT Code: 85025
 $74 Calc
Blood test, clotting time (PT/INR)
CPT Code: 85610
 $44 Calc
Blood test, clotting time (PTT)
CPT Code: 85730
 $54 Calc
Hepatitis C antibody test
CPT Code: 86803
 $106 Calc
Blood antibody screen
CPT Code: 86850
 $129 Calc
Culture, blood
CPT Code: 87040
 $83 Calc
Culture, bacterial
CPT Code: 87070
 $69 Calc
Sepsis treatment (inpatient stay)
MS-DRG Code: 871
 Contact Desk Calc
Flu vaccine (high dose)
HCPCS Code: 90656
 $63 Calc
DTaP vaccine (diphtheria, tetanus, pertussis)
HCPCS Code: 90700
 $85 Calc
MMR vaccine (measles, mumps, rubella)
HCPCS Code: 90707
 $44 Calc
Tdap vaccine (tetanus, diphtheria, pertussis)
HCPCS Code: 90715
 $184 Calc
Varicella (chickenpox) vaccine
HCPCS Code: 90716
 $76 Calc
Pneumococcal vaccine
HCPCS Code: 90732
 $50 Calc
Hepatitis B vaccine
HCPCS Code: 90744
 $25 Calc
Psychiatric evaluation (first visit)
CPT Code: 90791
 $292 Calc
Psychotherapy session (45 minutes)
CPT Code: 90834
 $161 Calc
Psychotherapy session (60 minutes)
CPT Code: 90837
 $150 Calc
Family therapy session
CPT Code: 90847
 $161 Calc
Group therapy session
CPT Code: 90853
 $92 Calc
Care planning with family
CPT Code: 90887
 $153 Calc
Speech therapy (language evaluation)
CPT Code: 92507
 $267 Calc
Speech therapy (group session)
CPT Code: 92508
 $115 Calc
Electrocardiogram (ECG/EKG)
CPT Code: 93000
 $39 Calc
Electrocardiogram (EKG, tracing only)
CPT Code: 93005
 $240 Calc
Echocardiogram (heart ultrasound)
CPT Code: 93306
 $1,976 Calc
Ultrasound, leg veins (duplex)
CPT Code: 93970
 $442 Calc
Breathing treatment (nebulizer)
CPT Code: 94640
 $278 Calc
Physical therapy (therapeutic exercise)
CPT Code: 97110
 $129 Calc
Physical therapy (neuromuscular re-education)
CPT Code: 97112
 $173 Calc
Physical therapy (gait training)
CPT Code: 97116
 $155 Calc
Physical therapy (manual therapy)
CPT Code: 97140
 $120 Calc
Occupational therapy (therapeutic activities)
CPT Code: 97530
 $180 Calc
Occupational therapy (self-care training)
CPT Code: 97535
 $143 Calc
Physical therapy (functional capacity test)
CPT Code: 97750
 $164 Calc
Orthotic fitting and training
CPT Code: 97760
 $183 Calc
Prosthetic fitting and training
CPT Code: 97761
 $169 Calc
New patient office visit (30-44 min)
CPT Code: 99203
 $173 Calc
Office visit, established patient (20-29 min)
CPT Code: 99213
 $317 Calc
Office visit, established patient (30-39 min)
CPT Code: 99214
 $324 Calc
Flu vaccine injection
HCPCS Code: G0008
 $70 Calc
Pneumonia vaccine injection
HCPCS Code: G0009
 $73 Calc
Colorectal cancer screening
HCPCS Code: G0010
 $16 Calc
Prostate cancer screening (blood test)
HCPCS Code: G0103
 $94 Calc
Electrical stimulation therapy
HCPCS Code: G0283
 $45 Calc
Hospital observation (per hour)
HCPCS Code: G0378
 $106 Calc
Drug screening test
HCPCS Code: G0480
 $153 Calc
Extended office visit (prolonged)
HCPCS Code: G2212
 $55 Calc