CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Adventist Health Castle

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $151
Cash Discount Price: $85
vs. Medicare Baseline: 11.28x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Adventist Health Castle is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 11.28x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$85

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$13.39

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13.39 (100%)

Cash / Self-Pay: $85 (635%)

Insurance Median: $151 (1128%)

Cash: $85 (635% of Medicare)

Ins. Median: $151 (1128% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $13.39 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 1128% of the Medicare baseline (a markup of 1028%). 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	$13	97%
Medicare (plans)	$13	97%
Devoted Hlth Mcr Adv - All Plans	$14	105%
Ohana Health Plan - All Plans	$14	105%
UnitedHealthcare	$19	142%
Multiplan Hmn - All Plans	$20	149%
Pacific Admin Ppo - All Plans	$25 - $47	187%
Uni Health Alliance - All Plans	$25 - $47	187%
Hmsa Hmo	$29	217%
Hmsa Ppo - All Other Plans	$29	217%
Alohacare Quest Mcaid - All Other Plans	$46 - $87	344%
Hwmg/Hmaa - All Plans	$137 - $258	1023%
Mdx Hawaii Ppo - All Plans	$148 - $279	1105%
Health Alliance - All Plans	$149 - $280	1113%
Kfh - All Other Plans	$158 - $298	1180%
First Health Ppo - All Plans	$175 - $329	1307%
Medicaid / KanCare	$186 - $350	1389%
State Of Hi Nonprofit - All Plans	$326 - $612	2435%

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 $85.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80061.

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 80061.
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.