CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Santa Monica - UCLA Med Ctr & Orthopaedic Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $307
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Santa Monica - UCLA Med Ctr & Orthopaedic Hospital is $307. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.26x the Medicare baseline. Located in 1250 16Th Street, Santa Monica, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$307

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%)
Insurance Median: $307 (126%)
Ins. Median: $307 (126% 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.

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
La Care Medi-Cal Hmo $85 - $168 35%
Aetna $134 - $307 55%
Medicare (plans) $134 - $338 55%
St. Jude $134 - $307 55%
Triwest Healthcare Alliance $134 - $307 55%
Blue Shield $135 - $307 55%
La Care Dsnp $135 - $307 55%
Monarch $135 - $307 55%
UnitedHealthcare $135 - $881 55%
Blue Cross Blue Shield $147 - $376 60%
Providence Healthcare $149 - $338 61%
Healthsmart $161 - $368 66%
Central Health Plan $165 - $367 68%
Scan $182 - $415 75%
La Care Covered Ca $192 - $429 79%
Centivo $323 - $737 133%
Health Plan Of Nevada Commercial $375 - $855 154%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1250 16Th Street, Santa Monica, CA 90404
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals