CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Grandview Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $1,847
  • Cash Discount Price: $709
  • vs. Medicare Baseline: 7.58x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Grandview Medical Center is $1,847. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $709. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.58x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$709

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,847

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: $709 (291%)
Insurance Median: $1,847 (758%)
Cash: $709 (291% of Medicare)
Ins. Median: $1,847 (758% 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 758% of the Medicare baseline (a markup of 658%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $95 39%
Encompass Health $145 59%
Tricare $207 85%
Veterans Eval Services $210 86%
Blue Advantage $215 88%
Humana $215 88%
Medicare (plans) $215 88%
UnitedHealthcare $215 - $1,892 88%
Victory Health $215 88%
Viva Health $215 - $2,313 88%
Select Health $217 89%
Hospice $218 89%
Node Champva $218 89%
Node Va $218 89%
Cigna $219 - $387 90%
Node Devoted Health Mcr Adv $219 90%
Node Clover Health Mcr Adv $220 90%
Aetna $221 - $1,169 91%
Node Wellcare Mcr Adv $223 91%
Node Us Dept Of Labor $273 112%
Blue Cross Blue Shield $290 119%
Ambetter / Centene $327 134%
Healthspring $382 157%
Self Pay $492 - $1,009 202%
Bp Health Advocate $819 - $1,051 336%
Ag Administrators $1,147 - $1,472 471%
Alamed $1,147 - $1,472 471%
Choicecare $1,147 - $1,472 471%
Drummond $1,147 - $1,472 471%
American Employee Alliance $1,311 - $1,682 538%
Healthchoice $1,638 - $2,523 672%
Value Options $1,638 - $2,102 672%
First Health $1,966 - $3,288 806%
Multiplan $1,999 - $2,944 820%
Blue Bell Creameries $2,294 - $2,944 941%
Natl Comp Care $2,458 - $3,154 1008%
Usa Ppo $2,458 - $3,154 1008%
Coventry Work Comp Al $2,563 - $3,288 1051%
Novanet $2,646 - $3,396 1085%
Alabama Wc $2,785 - $3,574 1142%
Cal-Med $2,785 - $3,574 1142%
Corvel $2,785 - $3,574 1142%
Associated Admin $2,949 - $3,784 1210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals