CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Sonoma Valley Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $2,274
  • Cash Discount Price: $2,437
  • vs. Medicare Baseline: 9.33x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Sonoma Valley Hospital is $2,274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,437. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.33x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$2,437

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,274

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: $2,437 (1000%)
Insurance Median: $2,274 (933%)
Cash: $2,437 (1000% of Medicare)
Ins. Median: $2,274 (933% 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 933% of the Medicare baseline (a markup of 833%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medi-Cal $241 99%
Tricare $322 132%
Blue Cross Blue Shield $328 - $2,285 135%
Bright Hlth/Brand New Day Mcr Adv $328 135%
Hospice Of Marin-All Plans $328 135%
St Joseph Heritage Hltcare Comm-All Other Plans $328 135%
Veterans Admin-All Plans $328 135%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $345 142%
Cdcr Prison-All Plans $394 162%
Three Rivers (Trpn)-All Plans $394 162%
Mcal Mgd Care (Php)-All Plans $398 163%
Chp - Correctional Health Partners - All Plans $427 175%
Bright Hlth/Brand New Day - All Other Plands $443 182%
Wellpath - All Plans $459 188%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $591 242%
Canopy Health Solutions-All Other Plans $591 242%
Partnership Healthplan-All Plans $845 347%
Comm Care Network(Ccn)-All Plans $1,000 410%
UnitedHealthcare $1,229 504%
Healthnet Hmo/Ppo-All Other Plans $1,358 557%
Blue Shield Ppo-All Plans $1,978 811%
Kaiser-All Plans $2,263 928%
Aetna $2,437 1000%
First Health(Coventry)-All Plans $2,437 1000%
Integrated Health Plan-All Plans $2,577 1057%
Champus-All Plans $2,786 1143%
Cigna $2,786 1143%
Networks By Design - All Plans $2,786 1143%
Great West-One Health Plan Ppo/Pos-All Plans $2,960 1214%
Phcs/Multiplan/Beech St-All Plans $2,960 1214%
Interplan-All Plans $3,064 1257%
Bps-All Plans $3,134 1286%
Ppo Alliance-All Plans $3,134 1286%
Pref Health Networl(Phn)-All Plans $3,134 1286%
Meritage Medical Network Op Only Mcare $3,482 1428%
Scan Mcare-All Plans $3,482 1428%
St Joseph Heritage Hltcare Mcr Adv $3,482 1428%
Correct Care Integ Health-All Plans $4,178 1714%
Employer Direct Healthcare-All Plans $4,178 1714%
Meritage Medical Network Op Only-All Other Plans $4,387 1800%
Creative Legal Services-All Plans $4,527 1857%
Canopy Op Only $6,268 2571%
Vnpn - All Plans $6,268 2571%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals