CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Adventist Health Castle

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $72
Cash Discount Price: $61
vs. Medicare Baseline: 8.51x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Adventist Health Castle is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 8.51x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$61

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$8.46

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.46 (100%)

Cash / Self-Pay: $61 (721%)

Insurance Median: $72 (851%)

Cash: $61 (721% of Medicare)

Ins. Median: $72 (851% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.46 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 851% of the Medicare baseline (a markup of 751%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Kfh Mcr Adv	$8	95%
Medicare (plans)	$8	95%
Pacific Admin Ppo - All Plans	$8 - $24	95%
Uni Health Alliance - All Plans	$8 - $24	95%
Devoted Hlth Mcr Adv - All Plans	$9	106%
Ohana Health Plan - All Plans	$9	106%
UnitedHealthcare	$12	142%
Multiplan Hmn - All Plans	$13	154%
Hmsa Hmo	$18	213%
Hmsa Ppo - All Other Plans	$18	213%
Alohacare Quest Mcaid - All Other Plans	$25 - $70	296%
Hwmg/Hmaa - All Plans	$73 - $207	863%
Health Alliance - All Plans	$79 - $225	934%
Mdx Hawaii Ppo - All Plans	$79 - $224	934%
Kfh - All Other Plans	$84 - $239	993%
First Health Ppo - All Plans	$93 - $264	1099%
Medicaid / KanCare	$99 - $281	1170%
State Of Hi Nonprofit - All Plans	$173 - $492	2045%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $61.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80048.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Castle is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80048.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.