Hawaii

What Medicare pays in Hawaii

Billed charges against Medicare allowed amounts in Hawaii, across the 242 procedures Medicare covers most often.

242Procedures
4,299,491Services covered
2.8xBilled vs allowed
#45Rank of 61

Providers here billed the most above the national figure for removal of cataract with insertion of prosthetic lens. The average was $3,061.33 against a national $1,027.76. That is 3.0 times as much.

Whose price this is

These are Medicare figures. The billed column is what providers asked for. The allowed column is what Medicare agreed to pay. Neither is what an uninsured patient gets charged, and neither is what a private insurer negotiates.

The gap between the two columns is the point. A hospital billing three times what Medicare allows tells you the billed number was never a price. It was an opening position.

The 40 most common procedures in Hawaii

ProcedureBilled hereAllowedGapvs national billed
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$235.62$117.042.0x0.86x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$52.22$23.852.2x0.76x
Insertion of needle into vein for collection of blood sample$9.05$8.581.1x0.41x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$162.22$85.351.9x0.86x
Ground mileage, per statute mile$38.61$10.453.7x1.46x
Blood test, comprehensive group of blood chemicals$42.09$10.324.1x0.69x
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$26.48$7.583.5x0.71x
Therapy procedure using manual technique, each 15 minutes$50.67$20.922.4x0.75x
Blood test, lipids (cholesterol and triglycerides)$70.98$13.085.4x0.74x
Therapy procedure using functional activities$61.67$32.321.9x0.83x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$62.71$28.422.2x0.86x
Hemoglobin a1c level$45.90$9.484.8x0.79x
Destruction of precancer skin growth, 2-14 growths$24.16$6.733.6x1.10x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$267.32$115.522.3x0.82x
Blood test, thyroid stimulating hormone (tsh)$59.26$16.433.6x0.62x
Established patient complete exam of visual system$220.04$131.701.7x0.97x
Fixed wing air mileage, per statute mile$155.61$15.1910.2x1.12x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$187.98$76.392.5x0.92x
Manual urinalysis test with examination using microscope, automated$14.25$3.104.6x0.45x
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's$39.52$16.202.4x0.91x
Admn sarscov2 vacc 1 dose$44.51$40.431.1x0.88x
Creatinine level to test for kidney function or muscle injury$23.95$5.064.7x0.52x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$353.04$165.512.1x0.87x
Pathology examination of tissue using a microscope, intermediate complexity$160.44$56.052.9x0.86x
X-ray of chest, 1 view$40.53$8.644.7x0.78x
Administration of influenza virus vaccine$33.63$30.381.1x0.82x
Blood test, basic group of blood chemicals (calcium, total)$36.15$8.254.4x0.75x
Urine microalbumin (protein) level$25.50$5.644.5x0.45x
Imaging of retina$198.49$42.294.7x1.60x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$335.68$158.322.1x0.82x
Photography of the retina$144.69$38.163.8x1.21x
Established patient problem focused exam of visual system$159.02$93.821.7x0.95x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only$47.76$7.906.0x1.07x
Emergency department visit with high level of medical decision making$1,196.87$166.087.2x0.97x
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more$106.81$53.972.0x0.91x
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$231.03$105.622.2x0.87x
Uric acid level, blood$17.05$4.413.9x0.56x
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$246.87$111.392.2x0.89x
X-ray of chest, 2 views$52.15$15.493.4x0.73x
Thyroxine (thyroid chemical), free$29.41$8.813.3x0.34x

The last column compares this state against the national average for the same code. Above 1.00 means providers here billed more.

Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.

← All states  ·  All procedures