CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Adventist Health Castle

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $294
Cash Discount Price: $213
vs. Medicare Baseline: 2.75x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Adventist Health Castle is $294. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $213. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.75x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$213

Average discount available for prompt cash payment at this facility.

Insurance Median

$294

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $213 (199%)

Insurance Median: $294 (275%)

Cash: $213 (199% of Medicare)

Ins. Median: $294 (275% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 275% of the Medicare baseline (a markup of 175%). 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
Multiplan Hmn - All Plans	$40	37%
UnitedHealthcare	$47	44%
Hmsa Hmo	$99	93%
Hmsa Ppo - All Other Plans	$99	93%
Kfh Mcr Adv	$124	116%
Medicare (plans)	$124	116%
Ohana Health Plan - All Plans	$126	118%
Devoted Hlth Mcr Adv - All Plans	$130	122%
Alohacare Quest Mcaid - All Other Plans	$166	155%
Pacific Admin Ppo - All Plans	$423	396%
Hwmg/Hmaa - All Plans	$489	458%
Mdx Hawaii Ppo - All Plans	$531	497%
Health Alliance - All Plans	$532	498%
Kfh - All Other Plans	$565	529%
Uni Health Alliance - All Plans	$620	580%
First Health Ppo - All Plans	$625	585%
Medicaid / KanCare	$665	623%
State Of Hi Nonprofit - All Plans	$1,164	1090%

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 $213.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76705.

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 76705.
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.