CMS Price Transparency Data

Culture, bacterial

Facility: Adventist Health Castle

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $27
  • Cash Discount Price: $26
  • vs. Medicare Baseline: 3.13x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Adventist Health Castle is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 3.13x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.
Cash / Self-Pay
$26

Average discount available for prompt cash payment at this facility.

Insurance Median
$27

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.62

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.62 (100%)
Cash / Self-Pay: $26 (302%)
Insurance Median: $27 (313%)
Cash: $26 (302% of Medicare)
Ins. Median: $27 (313% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.62 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 313% of the Medicare baseline (a markup of 213%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $2 - $11 23%
Uni Health Alliance - All Plans $2 - $11 23%
Alohacare Quest Mcaid - All Other Plans $6 - $30 70%
Devoted Hlth Mcr Adv - All Plans $9 104%
Kfh Mcr Adv $9 104%
Medicare (plans) $9 104%
Ohana Health Plan - All Plans $9 104%
UnitedHealthcare $12 139%
Multiplan Hmn - All Plans $13 151%
Hmsa Hmo $18 209%
Hmsa Ppo - All Other Plans $18 209%
Hwmg/Hmaa - All Plans $18 - $90 209%
Health Alliance - All Plans $20 - $98 232%
Mdx Hawaii Ppo - All Plans $20 - $97 232%
Kfh - All Other Plans $21 - $104 244%
First Health Ppo - All Plans $24 - $115 278%
Medicaid / KanCare $25 - $122 290%
State Of Hi Nonprofit - All Plans $44 - $214 510%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 640 Ulukahiki St, Kailua, HI 96734
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals