CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Astria Toppenish Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $437
  • Cash Discount Price: $823
  • vs. Medicare Baseline: 1.79x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Astria Toppenish Hospital is $437. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $823. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.79x the Medicare baseline. Located in 502 W Fourth Ave, Toppenish, WA.
Cash / Self-Pay
$823

Average discount available for prompt cash payment at this facility.

Insurance Median
$437

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: $823 (338%)
Insurance Median: $437 (179%)
Cash: $823 (338% of Medicare)
Ins. Median: $437 (179% 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.

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
Medicaid / KanCare $84 - $437 34%
Ambetter / Centene $151 62%
UnitedHealthcare $151 - $1,639 62%
Va $151 - $312 62%
Molina $154 63%
Medicare (plans) $156 - $1,639 64%
Molina_Exchange $197 81%
Premera_Affordable_Care $207 - $748 85%
Li $244 100%
Aetna $250 - $1,746 103%
Cigna $250 103%
Humana $250 - $1,984 103%
Tricare $250 103%
Zenith $252 103%
Chpw_Cascade_Care $346 - $1,250 142%
First_Choice $379 - $1,369 155%
Tpsc $428 - $1,548 176%
Bcchp $549 - $1,984 225%
Great_Rivers $549 - $1,984 225%
Healthcomp $549 - $1,984 225%
Washington_State_Hca $549 - $1,984 225%
Regence $673 276%
Premera $748 307%
Kaiser $935 384%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 502 W Fourth Ave, Toppenish, WA 98948
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals