CMS Price Transparency Data

Blood test, lipase

Facility: Adventist Health Castle

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $48
Cash Discount Price: $35
vs. Medicare Baseline: 6.97x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Adventist Health Castle is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 6.97x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$35

Average discount available for prompt cash payment at this facility.

Insurance Median

$48

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$6.89

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.89 (100%)

Cash / Self-Pay: $35 (508%)

Insurance Median: $48 (697%)

Cash: $35 (508% of Medicare)

Ins. Median: $48 (697% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.89 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 697% of the Medicare baseline (a markup of 597%). 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
Pacific Admin Ppo - All Plans	$6 - $9	87%
Uni Health Alliance - All Plans	$6 - $9	87%
Devoted Hlth Mcr Adv - All Plans	$7	102%
Kfh Mcr Adv	$7	102%
Medicare (plans)	$7	102%
Ohana Health Plan - All Plans	$7	102%
UnitedHealthcare	$10	145%
Multiplan Hmn - All Plans	$11	160%
Hmsa Hmo	$15	218%
Hmsa Ppo - All Other Plans	$15	218%
Alohacare Quest Mcaid - All Other Plans	$21 - $34	305%
Hwmg/Hmaa - All Plans	$63 - $100	914%
Health Alliance - All Plans	$68 - $109	987%
Mdx Hawaii Ppo - All Plans	$68 - $109	987%
Kfh - All Other Plans	$72 - $116	1045%
First Health Ppo - All Plans	$80 - $128	1161%
Medicaid / KanCare	$85 - $136	1234%
State Of Hi Nonprofit - All Plans	$149 - $238	2163%

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 $35.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 83690.

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 83690.
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.