CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Adventist Health Castle

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $30
  • Cash Discount Price: $24
  • vs. Medicare Baseline: 9.46x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Adventist Health Castle is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 9.46x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.
Cash / Self-Pay
$24

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$3.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3.17 (100%)
Cash / Self-Pay: $24 (757%)
Insurance Median: $30 (946%)
Cash: $24 (757% of Medicare)
Ins. Median: $30 (946% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $3.17 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 946% of the Medicare baseline (a markup of 846%). 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.

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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 $1 - $3 32%
Uni Health Alliance - All Plans $1 - $3 32%
Devoted Hlth Mcr Adv - All Plans $3 95%
Kfh Mcr Adv $3 95%
Medicare (plans) $3 95%
Ohana Health Plan - All Plans $3 95%
UnitedHealthcare $4 126%
Multiplan Hmn - All Plans $5 158%
Hmsa Hmo $7 221%
Hmsa Ppo - All Other Plans $7 221%
Alohacare Quest Mcaid - All Other Plans $11 - $27 347%
Hwmg/Hmaa - All Plans $32 - $80 1009%
Health Alliance - All Plans $35 - $87 1104%
Mdx Hawaii Ppo - All Plans $35 - $87 1104%
Kfh - All Other Plans $37 - $93 1167%
First Health Ppo - All Plans $41 - $102 1293%
Medicaid / KanCare $44 - $109 1388%
State Of Hi Nonprofit - All Plans $77 - $191 2429%

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