▸ Hospital · HI · CCN 121304

Kahuku Medical Center

HAWHA, KAHUKU, HI, 96731

21 bedsCritical Access Hospitals10

Compliance grade

100/100

Rates published

18,173

last crawl 2026-05-23

Procedures tracked

206

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All HI hospitals JSON

Source MRF: https://www.kmc-hi.org/documents/87-0805301_Kahuku-Medical-Center_standardcharges-Updated.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	1	—	—	$11,126	$11,126	$11,126
Psychiatric diagnostic evaluation	CPT	90791	11	$500	$325	$104.43	$359.57	$485
Psychiatric eval with medical services	CPT	90792	6	—	—	$104.43	$163.18	$163.18
Psychotherapy 30 minutes	CPT	90832	11	$233	$151.45	$46.62	$166.94	$226.01
Psychotherapy 45 minutes	CPT	90834	11	$306	$198.9	$75	$219.82	$296.82
Psychotherapy 60 minutes	CPT	90837	11	$452	$293.8	$110.09	$324.82	$438.44
Crisis psychotherapy 60 minutes	CPT	90839	6	—	—	$109.28	$163.18	$163.18
emergency
ED visit level 1	CPT	99281	11	$246	$159.9	$84.1	$185.17	$758
ED visit level 2	CPT	99282	11	$446	$289.9	$121.02	$335.71	$758
ED visit level 3	CPT	99283	11	$735	$477.75	$121.02	$274.42	$758
ED visit level 4	CPT	99284	11	$1,296	$842.4	$121.02	$928.83	$1,257.12
ED visit level 5	CPT	99285	11	$2,011	$1,307.15	$121.02	$613.85	$1,950.67
Critical care, first hour	CPT	99291	11	$2,801	$1,820.65	$121.02	$859.8	$2,716.97
imaging
CT head without contrast	CPT	70450	12	$1,355	$880.75	$38.1	$128.05	$1,314.35
CT head with contrast	CPT	70460	12	$1,350	$877.5	$50.6	$201.97	$1,309.5
CT head with and without contrast	CPT	70470	10	$224	$145.6	$56.87	$212.48	$603.86
CT neck with contrast	CPT	70491	12	$1,427	$927.55	$62.02	$202.22	$1,384.19
MRI brain without contrast	CPT	70551	9	—	—	$261.53	$261.53	$999.12
MRI brain with contrast	CPT	70552	9	—	—	$412.62	$412.62	$1,163.43
MRI brain with and without contrast	CPT	70553	9	—	—	$412.62	$412.62	$1,949.86
Chest X-ray single view	CPT	71045	12	$318	$206.7	$8.21	$97.3	$308.46
Chest X-ray 2 views	CPT	71046	12	$429	$278.85	$9.79	$97.3	$416.13
Chest X-ray 3 views	CPT	71047	12	$364	$236.6	$12.39	$97.3	$353.08
CT chest without contrast	CPT	71250	12	$1,052	$683.8	$51.88	$160.72	$1,020.44
CT chest with contrast	CPT	71260	12	$1,125	$731.25	$55.95	$232.9	$1,091.25
CT chest with and without contrast	CPT	71270	9	—	—	$201.97	$201.97	$760.42
MRI chest without contrast	CPT	71550	9	—	—	$261.53	$261.53	$1,028.8
MRI chest with contrast	CPT	71551	9	—	—	$383.16	$829.6	$1,199.04
MRI chest with and without contrast	CPT	71552	9	—	—	$412.62	$412.62	$2,000.41
Lumbosacral spine X-ray	CPT	72100	9	—	—	$21.96	$119.7	$119.7
CT cervical spine without contrast	CPT	72125	12	$1,052	$683.8	$44.83	$157.9	$1,020.44
CT thoracic spine without contrast	CPT	72128	12	$1,052	$683.8	$44.83	$157.5	$1,020.44
CT lumbar spine without contrast	CPT	72131	12	$1,052	$683.8	$44.83	$157.1	$1,020.44
MRI cervical spine without contrast	CPT	72141	9	—	—	$261.53	$261.53	$959.63
MRI thoracic spine without contrast	CPT	72146	9	—	—	$261.53	$261.53	$1,039.04
MRI lumbar spine without contrast	CPT	72148	9	—	—	$261.53	$261.53	$1,039.04
MRI lumbar spine with and without contrast	CPT	72149	9	—	—	$412.62	$412.62	$1,163.43
MRI cervical spine with and without contrast	CPT	72156	9	—	—	$412.62	$412.62	$1,943.29
MRI lumbar spine with contrast	CPT	72158	9	—	—	$412.62	$412.62	$1,943.29
CT pelvis without contrast	CPT	72192	12	$687	$446.55	$48.66	$161.07	$666.39
CT pelvis with contrast	CPT	72193	12	$1,427	$927.55	$51.88	$213.73	$1,384.19
Shoulder X-ray	CPT	73030	12	$318	$206.7	$8.56	$47.56	$308.46
Humerus X-ray	CPT	73060	12	$318	$206.7	$7.59	$45.3	$308.46
Hand X-ray 3 views	CPT	73130	12	$318	$206.7	$7.9	$45.57	$308.46
MRI upper extremity joint without contrast	CPT	73221	9	—	—	$261.53	$261.53	$972.68
MRI upper extremity joint with and without contrast	CPT	73223	9	—	—	$412.62	$412.62	$1,915.13
Hip X-ray 2 views	CPT	73510	2	—	—	$48.71	$50.2	$51.68
Knee X-ray 1-2 views	CPT	73560	12	$318	$206.7	$7.59	$43.93	$308.46
Ankle X-ray 3 views	CPT	73610	12	$318	$206.7	$7.9	$46.41	$308.46
MRI lower extremity joint without contrast	CPT	73721	9	—	—	$261.53	$261.53	$978.43
MRI lower extremity joint with and without contrast	CPT	73723	9	—	—	$412.62	$412.62	$1,914.3
CT abdomen without contrast	CPT	74150	12	$1,052	$683.8	$53.35	$164.99	$1,020.44
CT abdomen with contrast	CPT	74160	12	$1,359	$883.35	$57.22	$213.73	$1,318.23
CT abdomen with and without contrast	CPT	74170	12	$1,617	$1,051.05	$62.68	$240.67	$1,568.49
CT abdomen and pelvis without contrast	CPT	74176	12	$1,451	$943.15	$77.94	$261.53	$1,407.47
CT abdomen and pelvis with contrast	CPT	74177	12	$2,320	$1,508	$81.8	$412.62	$2,250.4
CT abdomen and pelvis with and without contrast	CPT	74178	12	$2,320	$1,508	$89.78	$423.6	$2,250.4
MRI abdomen without contrast	CPT	74181	9	—	—	$261.53	$261.53	$951.5
MRI abdomen with and without contrast	CPT	74183	9	—	—	$412.62	$412.62	$1,945.28
Abdominal ultrasound complete	CPT	76700	12	$595	$386.75	$31.62	$119.7	$577.15
Abdominal ultrasound limited	CPT	76705	12	$595	$386.75	$26.17	$111.32	$577.15
Retroperitoneal ultrasound complete	CPT	76770	11	$595	$386.75	$64.94	$119.7	$577.15
Obstetric ultrasound first trimester	CPT	76801	12	$566	$367.9	$55.49	$119.7	$549.02
Obstetric ultrasound after first trimester	CPT	76805	12	$566	$367.9	$44.52	$119.7	$549.02
Obstetric ultrasound with fetal anatomy	CPT	76811	12	$844	$548.6	$73.73	$241.95	$818.68
Transvaginal ultrasound	CPT	76830	9	—	—	$50.35	$119.7	$251.46
Pelvic ultrasound complete	CPT	76856	12	$595	$386.75	$30.66	$119.7	$577.15
Scrotal ultrasound	CPT	76870	12	$595	$386.75	$28.42	$119.05	$577.15
Diagnostic mammography unilateral	CPT	77065	3	—	—	$64.13	$90.59	$185.16
Diagnostic mammography bilateral	CPT	77066	3	—	—	$77.83	$113.15	$236.95
Screening mammography bilateral	CPT	77067	11	$336	$218.4	$80.77	$164.64	$325.92
EKG complete	CPT	93000	3	$47	$30.55	$23.63	$24.81	$37.24
EKG tracing only	CPT	93005	12	$294	$191.1	$7.41	$64.37	$285.18
EKG interpretation only	CPT	93010	2	—	—	$8.47	$8.47	$8.47
Transthoracic echocardiogram complete	CPT	93306	6	—	—	$132.88	$563.48	$563.48
Transthoracic echocardiogram	CPT	93307	6	—	—	$127.9	$261.53	$261.53
Stress echocardiogram	CPT	93350	6	—	—	$58.9	$563.48	$563.48
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	2	—	—	$3,602	$16,673	$29,745
COPD w MCC	MS-DRG	190	2	—	—	$3,602	$8,325.07	$13,048
COPD w CC	MS-DRG	191	2	—	—	$3,602	$8,325.07	$13,048
COPD w/o CC/MCC	MS-DRG	192	2	—	—	$3,602	$8,325.07	$13,048
Simple pneumonia & pleurisy w CC	MS-DRG	194	2	—	—	$3,602	$10,197	$16,791
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	2	—	—	$3,602	$8,483.93	$13,366
AMI discharged alive w MCC	MS-DRG	280	2	—	—	$3,602	$13,610	$23,618
AMI discharged alive w CC	MS-DRG	281	2	—	—	$3,602	$12,011	$20,420
AMI discharged alive w/o CC/MCC	MS-DRG	282	2	—	—	$3,602	$10,742	$17,883
Heart failure & shock w MCC	MS-DRG	291	2	—	—	$3,602	$11,865	$20,128
Heart failure & shock w CC	MS-DRG	292	2	—	—	$3,602	$11,865	$20,128
Heart failure & shock w/o CC/MCC	MS-DRG	293	2	—	—	$3,602	$11,865	$20,128
Cardiac arrhythmia w MCC	MS-DRG	308	2	—	—	$3,602	$9,252.56	$14,903
Cardiac arrhythmia w CC	MS-DRG	309	2	—	—	$3,602	$8,794.24	$13,986
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	2	—	—	$3,602	$7,160.96	$10,720
GI hemorrhage w CC	MS-DRG	378	2	—	—	$3,602	$9,338.07	$15,074
GI hemorrhage w/o CC/MCC	MS-DRG	379	2	—	—	$3,602	$7,580.73	$11,559
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	2	—	—	$3,602	$6,938.31	$10,275
Fractures of femur w/o MCC	MS-DRG	533	2	—	—	$3,602	$6,104.62	$8,607.23
Kidney/UTI w MCC	MS-DRG	689	2	—	—	$3,602	$7,991.45	$12,381
Kidney/UTI w/o MCC	MS-DRG	690	2	—	—	$3,602	$7,086.29	$10,571
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	2	—	—	$3,602	$16,208	$28,814
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	2	—	—	$3,602	$16,200	$28,798
Initial hospital care, low complexity	CPT	99221	2	—	—	$53.33	$53.33	$53.33
Initial hospital care, moderate complexity	CPT	99222	2	—	—	$87.63	$87.63	$87.63
Initial hospital care, high complexity	CPT	99223	2	—	—	$116.67	$116.67	$116.67
Hospital discharge, <30 min	CPT	99238	2	—	—	$50.28	$50.28	$50.28
Hospital discharge, >30 min	CPT	99239	2	—	—	$65.64	$65.64	$65.64
lab
Basic metabolic panel (BMP)	CPT	80048	11	$130	$84.5	$8.46	$11.7	$126.1
General health panel	CPT	80050	11	$223	$144.95	$41.19	$106.58	$216.31
Electrolyte panel	CPT	80051	11	$109	$70.85	$7.01	$8.35	$105.73
Comprehensive metabolic panel	CPT	80053	11	$137	$89.05	$10.56	$12.59	$132.89
Lipid panel	CPT	80061	11	$259	$168.35	$13.39	$18.51	$251.23
Renal function panel	CPT	80069	11	$135	$87.75	$8.68	$10.34	$130.95
Hepatic function panel	CPT	80076	11	$130	$84.5	$8.17	$9.73	$126.1
Urinalysis non-automated	CPT	81002	10	$12	$7.8	$3.48	$3.48	$6.96
Urinalysis automated	CPT	81003	11	$36	$23.4	$2.25	$2.68	$34.92
Glucose quantitative	CPT	82947	11	$62	$40.3	$3.93	$17.75	$60.14
Hemoglobin A1c	CPT	83036	11	$133	$86.45	$9.71	$11.57	$129.01
Thyroid stimulating hormone (TSH)	CPT	84443	11	$129	$83.85	$16.8	$34.38	$125.13
Complete blood count with automated differential	CPT	85025	11	$159	$103.35	$7.77	$9.26	$154.23
Complete blood count without differential	CPT	85027	11	$159	$103.35	$6.47	$8.95	$154.23
Urine culture bacterial	CPT	87086	11	$111	$72.15	$8.07	$9.62	$107.67
Urine culture identification	CPT	87088	9	—	—	$8.09	$8.09	$20.81
Tissue exam by pathologist level IV	CPT	88305	8	—	—	$40.64	$56.15	$118
maternity
Fetal non-stress test	CPT	59025	6	—	—	$8.21	$199.49	$199.49
Routine obstetric care including vaginal delivery	CPT	59400	2	—	—	$1,113.88	$1,113.88	$1,113.88
Vaginal delivery only	CPT	59409	6	—	—	$620.4	$3,166.56	$3,166.56
Vaginal delivery with postpartum	CPT	59410	2	—	—	$684.96	$684.96	$684.96
Routine obstetric care with C-section	CPT	59510	2	—	—	$1,500	$1,500	$1,500
C-section delivery only	CPT	59514	2	—	—	$930.03	$930.03	$930.03
C-section with postpartum	CPT	59515	2	—	—	$1,000	$1,000	$1,000
Cesarean section w CC/MCC	MS-DRG	765	1	—	—	$3,681	$3,681	$3,681
Cesarean section w/o CC/MCC	MS-DRG	766	1	—	—	$3,681	$3,681	$3,681
Vaginal delivery w complicating dx	MS-DRG	774	1	—	—	$3,681	$3,681	$3,681
Vaginal delivery w/o complicating dx	MS-DRG	775	1	—	—	$3,681	$3,681	$3,681
office
Office visit, new patient, 15-29 min	CPT	99202	6	$132	$85.8	$48.03	$234	$261.26
Office visit, new patient, 30-44 minutes	CPT	99203	6	$199	$129.35	$68.82	$234	$261.26
Office visit, new patient, 45-59 min	CPT	99204	6	$341	$221.65	$99.17	$234	$261.26
Office visit, new patient, 60-74 min	CPT	99205	2	—	—	$122.28	$122.28	$122.28
Office visit, established patient, 5 min	CPT	99211	3	$23	$14.95	$9.17	$19.76	$31.75
Office visit, established patient, 10-19 min	CPT	99212	3	$67	$43.55	$24.13	$48.92	$67.04
Office visit, established patient, 20-29 minutes	CPT	99213	2	—	—	$36.31	$36.31	$36.31
Office visit, established patient, 30-39 minutes	CPT	99214	6	$205	$133.25	$56.46	$234	$261.26
Office visit, established patient, 40-54 min	CPT	99215	6	$289	$187.85	$83.57	$234	$261.26
preventive
Upper GI endoscopy diagnostic	CPT	43235	6	—	—	$124.03	$924.52	$924.52
Upper GI endoscopy with biopsy	CPT	43239	6	—	—	$139.6	$924.52	$924.52
Sigmoidoscopy diagnostic	CPT	45330	6	—	—	$41.36	$930.71	$930.71
Sigmoidoscopy with biopsy	CPT	45331	6	—	—	$65.59	$930.71	$930.71
Colonoscopy diagnostic	CPT	45378	6	—	—	$193.08	$930.71	$930.71
Colonoscopy with biopsy	CPT	45380	6	—	—	$208.4	$1,212.79	$1,212.79
Colonoscopy with polyp removal	CPT	45385	6	—	—	$276.36	$1,212.79	$1,212.79
surgery
Total shoulder arthroplasty	CPT	23472	6	—	—	$1,020.01	$14,613	$14,613
PCI w drug-eluting stent w MCC	MS-DRG	246	2	—	—	$4,619	$22,444	$40,269
PCI w drug-eluting stent w/o MCC	MS-DRG	247	2	—	—	$4,619	$16,596	$28,572
Hip hemiarthroplasty	CPT	27125	2	—	—	$891.37	$891.37	$7,680
Total hip replacement	CPT	27130	6	—	—	$1,385.91	$14,613	$14,613
Total knee replacement	CPT	27447	6	—	—	$1,492.58	$14,613	$14,613
Knee revision arthroplasty single component	CPT	27486	2	—	—	$1,149.06	$1,149.06	$8,080
Knee revision arthroplasty all components	CPT	27487	2	—	—	$1,483.24	$1,483.24	$8,080
Shoulder arthroscopy with decompression	CPT	29826	2	—	—	$575.82	$575.82	$575.82
Shoulder arthroscopy with rotator cuff repair	CPT	29827	6	—	—	$790.52	$7,407.99	$8,080
Knee arthroscopy with meniscectomy	CPT	29881	6	—	—	$483.75	$3,333.68	$3,333.68
ACL reconstruction	CPT	29888	6	—	—	$842.13	$7,407.99	$8,080
Major small/large bowel procedures w MCC	MS-DRG	329	2	—	—	$4,619	$30,743	$56,867
Major small/large bowel procedures w CC	MS-DRG	330	2	—	—	$4,619	$25,327	$46,036
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	2	—	—	$4,619	$15,202	$25,785
CABG single arterial graft	CPT	33533	2	—	—	$1,847.57	$1,847.57	$1,847.57
CABG 2 arterial grafts	CPT	33534	2	—	—	$1,718.37	$1,718.37	$1,718.37
CABG 3 arterial grafts	CPT	33535	2	—	—	$1,875.81	$1,875.81	$1,875.81
CABG 4+ arterial grafts	CPT	33536	2	—	—	$2,031.76	$2,031.76	$2,031.76
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	2	—	—	$4,619	$11,833	$19,048
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	2	—	—	$4,619	$8,470.49	$12,322
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	2	—	—	$4,619	$25,414	$46,210
Open appendectomy	CPT	44950	6	—	—	$408.32	$3,966.75	$4,243
Laparoscopic appendectomy	CPT	44970	6	—	—	$399.9	$5,837.3	$8,080
Spinal fusion (non-cervical) w MCC	MS-DRG	459	2	—	—	$4,619	$32,044	$59,469
Spinal fusion (non-cervical) w/o MCC	MS-DRG	460	2	—	—	$4,619	$30,289	$55,959
Major joint replacement w MCC	MS-DRG	469	2	—	—	$4,619	$16,765	$28,911
Major joint replacement w/o MCC	MS-DRG	470	2	—	—	$4,619	$12,124	$19,629
Laparoscopic cholecystectomy	CPT	47562	6	—	—	$643.9	$5,837.3	$8,080
Lap cholecystectomy with cholangiography	CPT	47563	6	—	—	$688.39	$5,837.3	$8,080
Hip & femur procedures except major joint w MCC	MS-DRG	480	2	—	—	$4,619	$19,870	$35,121
Hip & femur procedures except major joint w CC	MS-DRG	481	2	—	—	$4,619	$19,435	$34,251
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	2	—	—	$4,619	$14,651	$24,682
Open umbilical hernia repair	CPT	49560	1	—	—	$466.02	$1,829.01	$3,192
Umbilical hernia repair age 5+	CPT	49585	1	—	—	$285.21	$1,738.61	$3,192
Lap inguinal hernia repair	CPT	49650	6	—	—	$309.04	$5,837.3	$5,837.3
Lap incisional hernia repair	CPT	49652	1	—	—	$437.02	$1,814.51	$3,192
Total abdominal hysterectomy	CPT	58150	2	—	—	$837.47	$837.47	$8,080
Vaginal hysterectomy	CPT	58260	6	—	—	$591.29	$5,191.05	$8,080
Lap-assisted vaginal hysterectomy	CPT	58550	6	—	—	$659.77	$5,837.3	$8,080
Lap-assisted vaginal hysterectomy >250g	CPT	58552	6	—	—	$631.57	$10,177	$10,177
Lap salpingo-oophorectomy	CPT	58661	6	—	—	$510.94	$5,837.3	$8,080
OR procedure for obesity w MCC	MS-DRG	619	2	—	—	$4,619	$20,563	$36,507
OR procedure for obesity w CC	MS-DRG	620	2	—	—	$4,619	$20,563	$36,507
OR procedure for obesity w/o CC/MCC	MS-DRG	621	2	—	—	$4,619	$20,484	$36,348
Complex cataract surgery	CPT	66982	6	—	—	$778.5	$2,418.44	$3,192
Cataract surgery with lens implant	CPT	66984	6	—	—	$584.09	$2,418.44	$3,192
Intravitreal injection	CPT	67028	6	—	—	$135.55	$372.51	$372.51
Vitrectomy mechanical	CPT	67042	6	—	—	$680.36	$4,474.81	$8,080
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	2	—	—	$4,619	$9,377.49	$14,136
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	2	—	—	$4,619	$7,832.49	$11,046
PCI single major coronary artery	CPT	92920	6	—	—	$324.64	$5,840.94	$7,680
PCI with drug-eluting stent	CPT	92928	6	—	—	$360.43	$11,889	$11,889
PCI bypass graft	CPT	92937	6	—	—	$359.99	$11,889	$11,889
Left heart catheterization	CPT	93452	6	—	—	$421.94	$3,313.3	$8,080
Coronary angiography with cath	CPT	93455	6	—	—	$515.14	$3,313.3	$8,080
Coronary angiography with bypass cath	CPT	93458	6	—	—	$527.83	$3,313.3	$8,080

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 12)

Payer	Codes covered	Median rate
hmsa	201	$261.53
UnitedHealthcare	154	$197.47
hma	130	$477.79
Kaiser Permanente	127	$219.62
alohacare	127	$201.97
ohana	127	$201.97
Humana	122	$261.53
uha	86	$98.26
hmaa	83	$312.89
mdx	58	$308.46
dmba	58	$254.4
#	42	$186.17

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