Level 1 Breast/Lymphatic Surgery and Related Procedures in Hawaii
What 11 hospitals in Hawaii charged and were paid for level 1 breast/lymphatic surgery and related procedures (APC 5091), from 2024 Medicare claims.
Average charge
$19,024
Hospital list price billed
Average allowed
$4,353
Medicare's payment + patient's share
Medicare paid
$3,454
Average per service
State rank
#48 of 49
1 = lowest average payment
Hospitals in Hawaii billed an average of $19,024 for level 1 breast/lymphatic surgery and related procedures, about 4.4 times the average medicare-allowed amount of $4,353. That payment is 18% above the U.S. average of $3,688.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $4,353Billed $19,024
About 23¢ was paid for every $1 hospitals in Hawaii billed for this service.
Hawaii hospitals: level 1 breast/lymphatic surgery and related procedures
Every Hawaii hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| The Queens Medical CenterHonolulu | 43 | $28,258 | $4,303 | $3,412 |
| Kuakini Medical CenterHonolulu | 40 | $12,863 | $4,384 | $3,493 |
| Pali Momi Medical CenterAiea | 28 | $14,648 | $4,384 | $3,493 |
| Kapiolani Med Ctr for WomenHonolulu | 19 | $17,856 | $4,384 | $3,493 |
| Hilo Medical CenterHilo | 17 | $18,674 | $4,320 | $3,360 |
| Maui Memorial Medical CenterWailuku | – | – | – | – |
| Castle Medical CenterKailua | – | – | – | – |
| Kaiser Foundation HospitalHonolulu | – | – | – | – |
| Wilcox Memorial HospitalLihue | – | – | – | – |
| Straub Clinic and HospitalHonolulu | – | – | – | – |
| North Hawaii Community HospitalKamuela | – | – | – | – |
Lowest and highest allowed amounts in Hawaii
Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| The Queens Medical CenterHonolulu, HI | $4,303 |
|---|---|
| Hilo Medical CenterHilo, HI | $4,320 |
| Kuakini Medical CenterHonolulu, HI | $4,384 |
| Pali Momi Medical CenterAiea, HI | $4,384 |
| Kapiolani Med Ctr for WomenHonolulu, HI | $4,384 |
Highest
| Kuakini Medical CenterHonolulu, HI | $4,384 |
|---|---|
| Pali Momi Medical CenterAiea, HI | $4,384 |
| Kapiolani Med Ctr for WomenHonolulu, HI | $4,384 |
| Hilo Medical CenterHilo, HI | $4,320 |
| The Queens Medical CenterHonolulu, HI | $4,303 |
Level 1 Breast/Lymphatic Surgery and Related Procedures in other states
Questions
How much does level 1 breast/lymphatic surgery and related procedures cost in Hawaii?
In 2024 Medicare data, level 1 breast/lymphatic surgery and related procedures (APC 5091) at 11 hospitals in Hawaii was billed at $19,024 on average, while the average medicare-allowed amount was $4,353, of which Medicare paid $3,454. Your own cost depends on your insurance, deductible and the hospital.
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this service in Hawaii, average charges were 4.4 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Outpatient Hospitals by Provider and Service, 2024. The allowed amount is Medicare's payment plus the patient's coinsurance. CMS omits hospitals with fewer than 11 services for privacy. About the data.