CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Adventist Health Castle

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $681
Cash Discount Price: $343
vs. Medicare Baseline: 2.79x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Adventist Health Castle is $681. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $343. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.79x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$343

Average discount available for prompt cash payment at this facility.

Insurance Median

$681

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $343 (141%)

Insurance Median: $681 (279%)

Cash: $343 (141% of Medicare)

Ins. Median: $681 (279% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 279% of the Medicare baseline (a markup of 179%). 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
UnitedHealthcare	$140	57%
Hmsa Hmo	$250	103%
Hmsa Ppo - All Other Plans	$250	103%
Alohacare Quest Mcaid - All Other Plans	$267	110%
Kfh Mcr Adv	$282	116%
Medicare (plans)	$282	116%
Ohana Health Plan - All Plans	$288	118%
Devoted Hlth Mcr Adv - All Plans	$296	121%
Pacific Admin Ppo - All Plans	$681	279%
Hwmg/Hmaa - All Plans	$788	323%
Mdx Hawaii Ppo - All Plans	$855	351%
Health Alliance - All Plans	$857	352%
Kfh - All Other Plans	$910	373%
Uni Health Alliance - All Plans	$999	410%
First Health Ppo - All Plans	$1,007	413%
Medicaid / KanCare	$1,071	439%
State Of Hi Nonprofit - All Plans	$1,874	769%

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 $343.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 93970.

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 93970.
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.