CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: San Antonio Regional Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $508
  • Cash Discount Price: $312
  • vs. Medicare Baseline: 2.08x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at San Antonio Regional Hospital is $508. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $312. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.08x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$312

Average discount available for prompt cash payment at this facility.

Insurance Median
$508

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: $312 (128%)
Insurance Median: $508 (208%)
Cash: $312 (128% of Medicare)
Ins. Median: $508 (208% 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 208% of the Medicare baseline (a markup of 108%). 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
Medi-Cal $241 99%
Kaiser Medi-Cal $253 104%
Healthnet Medi-Cal $255 105%
Alpha Care Mg Mcal/Hlthy Kids $265 109%
Heritage Prov Ntwrk/Regal Mcal $265 109%
Molina Medi-Cal $278 114%
Blue Cross Blue Shield $285 - $1,107 117%
Tricare $301 123%
UnitedHealthcare $303 - $1,550 124%
Blue Shield Mcr Adv $307 126%
Caremore Mcr Adv - All Plans $307 126%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $307 126%
Healthnet Mcr Adv $307 126%
Humana $307 126%
Iehp Mcr Adv $307 126%
Inter Valley Hp Mcr Adv- All Plans $307 126%
Kindred Mcr Adv-All Plans $307 126%
Molina Mcr Adv $307 126%
Scan Health Plan Mcr Adv-All Plans $307 126%
Universal Care - All Plans $307 126%
Iehp Mcal $314 129%
Zelis Mcr Adv $322 132%
Kasiser Mcr Adv $328 135%
Blue Shield Epn $333 137%
Imperial Health Mcr Adv-All Plans $338 139%
Aetna $358 - $4,078 147%
Choice Phycn Ntwrk Op Only $384 158%
Molina Exchange-All Other Plans $399 164%
Iehp Comm - All Other Plans $445 183%
Redlands Employee $460 189%
Redlands Hmo-All Other Plans $479 196%
Prime Health - All Plans $537 220%
Healthnet - All Other Plans $734 301%
Ambetter / Centene $742 304%
Kaiser Comm - All Other Plans $856 351%
Epic Health Plan - All Other Plans $1,223 502%
Blue Shield Hmo Pos / Calpers Ppo $1,472 604%
Cigna $1,502 616%
Blue Shield Epo Ppo - All Other Plans $1,582 649%
Pc Inland Valley Scan $2,039 836%
Pc Inland Valley-All Other Plans $2,039 836%
Coventry Ccn/First Hlth - All Plans $2,243 920%
Choicecare Ntwrk-All Plans $2,936 1204%
Multiplan/Phcs - All Plans $2,936 1204%
Networks By Design - All Plans $3,058 1254%
Zelis Comm-All Other Plans $3,058 1254%
Foundation Inland Epo-All Other Plans $3,262 1338%
Foundation Inland Ppo $3,466 1422%
Health Payors - All Plans $3,670 1506%
Interplan - All Plans $3,670 1506%
Wellcare/Easy Choice-All Plans $3,996 1639%
Alpha Care Mg Mcr Adv $4,078 1673%
Central Hlth Plan Mcr Adv-All Plans $4,078 1673%
Epic Health Plan Mcr Adv $4,078 1673%
Prospect Hp-All Plans $4,078 1673%
Providence Clevercare Mcr Adv $4,078 1673%
Heritage Prov Ntwrk/Regal Mcr Adv $4,139 1698%
Clever Care Mcr Adv - All Plans $4,282 1757%
La Salle Hp Mcr Adv-All Plans $4,282 1757%
Alpha Care Mg-All Other Plans $5,098 2091%
Providence Oscar-All Other Plans $5,913 2426%
Heritage Prov Ntwrk/Regal - All Other Plans $7,493 3074%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals