Incision of breast lesion at CASTLE MEDICAL CENTER
640 Ulukahiki St, Kailua, HI · Adventisthealth · · NPI 1316937691
$257.28
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$804.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$29.27 with PACIFIC ADMIN PPO - ALL PLANS vs $804.00 with KFH MEDICAID — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| PACIFIC ADMIN PPO - ALL PLANS | PACIFIC ADMIN PPO - ALL PLANS | $29.27 | ↓ -89% |
| HMSA QUEST ABD | HMSA QUEST ABD | $176.39 | ↓ -31% |
| HWMG/HMAA - ALL PLANS | HWMG/HMAA - ALL PLANS | $227.24 | ↓ -12% |
| MULTIPLAN HMN - ALL PLANS | MULTIPLAN HMN - ALL PLANS | $270.55 | ↑ +5% |
| UHC QUEST - ALL OTHER PLANS | UHC QUEST - ALL OTHER PLANS | $325.43 | ↑ +26% |
| ALOHACARE QUEST MCAID - ALL OTHER PLANS | ALOHACARE QUEST MCAID - ALL OTHER PLANS | $325.43 | ↑ +26% |
| CHOICECARE MEDICARE - ALL PLANS | CHOICECARE MEDICARE - ALL PLANS | $325.43 | ↑ +26% |
| KFH MCR ADV | KFH MCR ADV | $325.43 | ↑ +26% |
| DEVOTED HLTH MCR ADV - ALL PLANS | DEVOTED HLTH MCR ADV - ALL PLANS | $335.19 | ↑ +30% |
| ALOHACARE MCR ADV PROFEE ONLY | ALOHACARE MCR ADV PROFEE ONLY | $341.70 | ↑ +33% |
| HMSA PPO - ALL OTHER PLANS | HMSA PPO - ALL OTHER PLANS | $501.20 | ↑ +95% |
| HMSA HMO | HMSA HMO | $524.82 | ↑ +104% |
| MDX HAWAII PPO - ALL PLANS | MDX HAWAII PPO - ALL PLANS | $598.28 | ↑ +133% |
| STATE OF HI NONPROFIT - ALL PLANS | STATE OF HI NONPROFIT - ALL PLANS | $732.22 | ↑ +185% |
| FIRST HEALTH PPO - ALL PLANS | FIRST HEALTH PPO - ALL PLANS | $755.76 | ↑ +194% |
| OHANA HEALTH PLAN - ALL PLANS | OHANA HEALTH PLAN - ALL PLANS | $804.00 | ↑ +213% |
| KFH MEDICAID | KFH MEDICAID | $804.00 | ↑ +213% |
Visitor-reported prices
Comments
Incision of breast lesion at other Hawaii hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Moanalua Medical Center | HONOLULU | not published | not published |