CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Banner Payson Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $341
Cash Discount Price: $365
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Banner Payson Medical Center is $341. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $365. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.40x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.

Cash / Self-Pay

$365

Average discount available for prompt cash payment at this facility.

Insurance Median

$341

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: $365 (150%)

Insurance Median: $341 (140%)

Cash: $365 (150% of Medicare)

Ins. Median: $341 (140% 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
Arizona Physicians Ipa	$167 - $311	69%
Banner University Health Plan	$167 - $311	69%
Health Choice Arizona, Inc.	$167 - $443	69%
Health Net	$167 - $460	69%
Mercy Care	$167 - $311	69%
Aetna	$309 - $502	127%
Banner Health	$311	128%
Blue Cross Blue Shield	$311 - $1,640	128%
Care 1St	$311	128%
Cigna	$311 - $603	128%
Gila River Health Care Corporation	$311	128%
Kaiser Foundation Health Plan	$311	128%
Triwest Healthcare Alliance Corp - Va Ccn	$311	128%
UnitedHealthcare	$311 - $508	128%
Upmc Health Plan	$311	128%
Wellpoint	$311	128%
Carelon	$326	134%
Humana	$329	135%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$341	140%
Plotkin Health	$341	140%
Arizona Priority Care	$342	140%
Devoted Health Services	$342	140%
Gold Kidney Health Plan	$342	140%
Oscar Health Plan	$513	210%
Quiktrip Corporation	$531	218%
Arizona Medical Network	$682	280%
Provider Network Of America	$682	280%

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 $365.
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 Banner Payson Medical Center 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.