Cascade Valley Hospital
ArlingtonSnohomish CountyAcute Care Hospitals
Leg artery ultrasound (both legs)
Quality: 4 of 5 (CMS overall rating)Earliest available date: call (360) 435-2133
What you may pay
- With insurance from an employer or private plan
- $119 to $1,258
- Humana Choice Care $119
- Cascade Care Select $387 Lower than typical
- Private Healthcare Systems $1,118 Higher than typical
- First Health Network $1,258 Higher than typical
- Paying yourself (cash price)
- $1,118 Typical
Next step: ask the hospital for a Good Faith Estimate for this procedure (phone number above).
Bills to expect
A procedure usually brings several bills, each from whoever did that part of your care. Here is what to expect, with what Traditional Medicare allows for each doctor’s part in this area (Washington outside King County) and an estimate for private plans.
| Bill | Who sends it | How likely | Status | Traditional Medicare allows | Private plans (estimate) |
|---|---|---|---|---|---|
| Hospital's fee | The hospital | Expected | Published by the hospital: the prices above | — | — |
| Reading doctor | The radiology group or specialist practice that reads it | Expected | Billed separately; amount estimated | $37 | $44 to $66 |
| Ordering doctor's visit | Your doctor | Possible | Billed separately; not priced | — | — |
What you’d pay for these bills
You pay about $86 to $91 of about $430 to $453 billed to your plan.
How each bill comes to you
Hospital's fee
- The provider's charge
- $1,398
- Insurance adjustment
- −$1,011
- Allowed amount
- $387
- Your plan pays
- $309
- Your coinsurance
- $77.35
- You owe
- $77.35
Reading doctor
- The provider's charge
- Not published
- Allowed amount
- $43.61
- Your plan pays
- $34.89
- Your coinsurance
- $8.72
- You owe
- $8.72
- All bills: allowed amounts
- $430
- Your plan pays
- $344
- You owe in all
- $86.07
Who owes what, and when you might owe more
- The insurance adjustment Written off
An in-network provider agrees to accept your plan's allowed amount. The difference between its charge and that amount is written off: you don't owe it, and it shouldn't appear on your bill.
- Deductible You pay
What you pay each year before your plan starts sharing costs. It is applied to bills in the order your plan processes them, so the first bill can take all of it.
- Copay You pay
A fixed amount for a kind of care, such as a hospital stay or a surgeon's visit. Your plan's summary of benefits says whether it applies before or after the deductible, and whether a stay's copay is per day.
- Coinsurance You pay
Your percentage of the allowed amount after the deductible, such as 20%.
- Out-of-pocket maximum Your plan pays
Once your deductible, copays and coinsurance for the year reach it, your plan pays 100% of covered in-network care for the rest of the plan year.
- Each provider bills separately You pay
The hospital, surgeon, anesthesia group, radiologist and pathologist each send their own claim and their own bill. All of them count toward the same deductible and yearly maximum.
- Out of network and surprise bills It depends
A provider outside your plan's network can bill you the difference between its charge and what your plan pays (a balance bill). It can't for emergency care, or when anesthesia, radiology, pathology, an assistant surgeon or a hospital doctor treats you at an in-network hospital: under federal law (the No Surprises Act) and, for Washington-regulated plans and self-funded plans that opt in, RCW 48.49, those groups cannot balance bill you. Your deductible and coinsurance still apply, at in-network amounts.
- Not covered, or no prior authorization It depends
If your plan decides a service isn't covered, or it needed prior authorization that wasn't approved, the plan pays nothing for it and the provider may bill you. Ask the provider to get prior authorization before your care. If an in-network provider didn't get it, the provider's contract may stop it billing you: ask your plan before you pay.
- A second insurance It depends
If you have a second plan, the first plan pays first and the second may then pay some or all of your share. These estimates use one plan only.
- Wait for the Explanation of Benefits You pay
After each claim your insurer sends an Explanation of Benefits (EOB) with the allowed amount, what it paid and what you may owe. It is not a bill. Pay a provider's bill only when it matches the EOB's “you may owe” amount, and ask the provider or insurer about any difference.
- Help from the hospital It depends
Washington hospitals must give free or discounted care based on income, including deductibles and coinsurance for insured patients: free up to 200% or 300% of the federal poverty level depending on the hospital, with discounts above that (RCW 70.170). You can apply after you get a bill. It covers the hospital's bill; doctor groups that bill separately have their own policies.
- If you pay yourself instead You pay
You can choose not to use your insurance and pay the cash price; then nothing counts toward your deductible. Ask each provider for a Good Faith Estimate. If a bill is $400 or more above it, you can dispute it within 120 days.
Get it confirmed before your care
The hospital, each doctor’s group and your insurer can each confirm their part in writing. Here is a request for each one, ready to send from your own email, and what to say if you’d rather call. Nothing you do here is saved.
Coming: CareNavIQ will be able to send these for you, follow up, and tell you when everything is confirmed, with your permission.
Cascade Valley Hospital
Request to send
Subject: Estimate request: leg artery ultrasound (both legs) at Cascade Valley Hospital Hello, I am planning a leg artery ultrasound (both legs) (billing code CPT 93925) at Cascade Valley Hospital. Under Washington law (RCW 70.01.030), I am asking for a written estimate of the hospital's charges, with the billing codes you plan to use. Name: [YOUR NAME] Date of birth: [DATE OF BIRTH] Insurance: [PLAN NAME], member ID [MEMBER ID] Planned date: [DATE, IF KNOWN] Thank you.
If you call. Call (360) 435-2133 and ask for the price estimate or patient financial services line. Say: "I'd like a written estimate for my leg artery ultrasound (both legs)."
20 published prices, grouped by who each price applies to.
Cash price 1 price
| Price | Part of the bill | Hospital’s description | How it’s set | Setting | Source date |
|---|---|---|---|---|---|
| $1,118 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | — | Inpatient or outpatient | — |
List price (before discounts) 1 price
| Price | Part of the bill | Hospital’s description | How it’s set | Setting | Source date |
|---|---|---|---|---|---|
| $1,398 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | — | Inpatient or outpatient | — |
Commercial insurance 11 prices
| Payer | Plan | Price | Part of the bill | Hospital’s description | How it’s set | Setting | Source date |
|---|---|---|---|---|---|---|---|
| Aetna | Commercial | $1,049 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | percent of total billed charges | Inpatient or outpatient | — |
| Cascade Care Select | Commercial | $387 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | fee schedule | Inpatient or outpatient | — |
| Cigna | Commercial | $1,015 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | percent of total billed charges | Inpatient or outpatient | — |
| First Choice | Commercial | $1,118 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | percent of total billed charges | Inpatient or outpatient | — |
| First Health Network | Commercial | $1,258 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | percent of total billed charges | Inpatient or outpatient | — |
| Humana Choice Care | Commercial | $119 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | percent of total billed charges | Inpatient or outpatient | — |
| Kaiser | Commercial | $558 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | fee schedule | Inpatient or outpatient | — |
| Premera | Commercial | $928 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | fee schedule | Inpatient or outpatient | — |
| Private Healthcare Systems | Commercial | $1,118 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | percent of total billed charges | Inpatient or outpatient | — |
| Regence | Commercial | $870 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | fee schedule | Inpatient or outpatient | — |
| United Healthcare | Commercial | $930 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | fee schedule | Inpatient or outpatient | — |
Medicare Advantage 3 prices
| Payer | Plan | Price | Part of the bill | Hospital’s description | How it’s set | Setting | Source date |
|---|---|---|---|---|---|---|---|
| Humana | Medicare | $254 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | fee schedule | Inpatient or outpatient | — |
| Regence | Medicare | $254 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | fee schedule | Inpatient or outpatient | — |
| United Healthcare | Medicare | $242 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | fee schedule | Inpatient or outpatient | — |
Medicaid managed care 4 prices
| Payer | Plan | Price | Part of the bill | Hospital’s description | How it’s set | Setting | Source date |
|---|---|---|---|---|---|---|---|
| Amerigroup | Medicaid | $278 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | case rate | Inpatient or outpatient | — |
| CHPW | Medicaid | $1,400 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | case rate | Inpatient or outpatient | — |
| Coordinated Care | Medicaid | $261 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | case rate | Inpatient or outpatient | — |
| Molina | Medicaid | $261 | Hospital’s fee | HC LOWER EXTREMITY STUDY, COMP BI | case rate | Inpatient or outpatient | — |
Doctors here who do this procedure
2 doctors affiliated with Cascade Valley Hospital billed Traditional Medicare for Leg artery ultrasound (both legs) in 2024, most Medicare services first. See all doctors and practices, including those with no hospital affiliation.
| Doctor or practice | Practice | Medicare quality score | Times billed to Traditional Medicare (2024) | Traditional Medicare amount for their own service (2024) |
|---|---|---|---|---|
| Allen Chen, MD | Vanderbilt University Medical Center | 52 | $37.20 | |
| Peter Brant-Zawadzki, MD | Providence Health And Services- Washington | 27 | $36.47 |
Reading the doctor list
- A higher price doesn’t mean better care. The quality score and the price come from different CMS files and are shown separately on purpose.
- The amount is what Traditional Medicare (original Medicare) approved for the doctor’s or lab’s own service: Medicare’s payment plus the patient’s share. It is not what commercial insurance or Medicare Advantage pays, and the hospital or surgery center bills separately (surgery centers aren’t in this list).
- The Medicare quality score is CMS’s MIPS final score (0 to 100), based mostly on the doctor’s Medicare patients. About half of doctors aren’t scored, so Not rated says nothing bad about a doctor. A group’s score covers everyone in the group.
- CMS doesn’t publish counts under 11 patients, so doctors who rarely bill Medicare for this aren’t listed, and No price published means CMS has no amount for that setting.
- Medicare’s file doesn’t say where a doctor did the procedure, only that they billed it in Washington. Affiliations are the hospitals each doctor lists with Medicare.
See a price that looks wrong? Tell us about it.