CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Grossmont Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $2,050
Cash Discount Price: $2,722
vs. Medicare Baseline: 8.41x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Grossmont Hospital is $2,050. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,722. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.41x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$2,722

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,050

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: $2,722 (1117%)

Insurance Median: $2,050 (841%)

Cash: $2,722 (1117% of Medicare)

Ins. Median: $2,050 (841% 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 841% of the Medicare baseline (a markup of 741%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Allianz Global Assistance	$120 - $1,814	49%
Blue Shield	$120 - $2,315	49%
Molina	$120 - $3,266	49%
Health Net	$229 - $3,266	94%
Humana	$229 - $2,903	94%
Multiplan	$229 - $2,794	94%
Blue Cross Blue Shield	$544 - $2,794	223%
Aetna	$1,078 - $3,556	442%
Medicare (plans)	$1,078	442%
UnitedHealthcare	$1,078 - $2,722	442%
Kaiser	$1,107 - $2,431	454%
Cigna	$1,452	596%
San Diego Pace	$1,742 - $2,504	715%
County Medical Services	$1,814 - $2,540	744%
Medi-Cal	$1,996 - $2,504	819%
Indian Health Council	$2,177 - $2,722	893%
Managed Health Network	$2,268 - $2,903	930%
Community Health Group	$2,315 - $2,722	950%
Epic Americas	$2,315 - $2,903	950%
California Health And Wellness	$2,722	1117%

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 $2,722.
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 Grossmont 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.