CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Kau Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $204
Cash Discount Price: $375
vs. Medicare Baseline: 0.84x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Kau Hospital is $204. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $375. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.84x the Medicare baseline. Located in 1 Kamani Street, Pahala, HI.

Cash / Self-Pay

$375

Average discount available for prompt cash payment at this facility.

Insurance Median

$204

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: $375 (154%)

Insurance Median: $204 (84%)

Cash: $375 (154% of Medicare)

Ins. Median: $204 (84% 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.

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
Ohana Health Plan	$32 - $209	13%
Alohacare	$32 - $209	13%
Hawaii Medical Service Association	$32 - $204	13%
UnitedHealthcare	$32 - $209	13%
Devoted Health	$35 - $225	14%
Kaiser Permanente	$39 - $245	16%
Health Management Network	$48 - $531	20%
Hawaii Western Management Group	$161	66%

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 $375.
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 Kau Hospital 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.