CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: City of Hope National Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,281
Cash Discount Price: $1,601
vs. Medicare Baseline: 5.25x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at City of Hope National Medical Center is $1,281. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,601. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.25x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$1,601

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,281

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: $1,601 (657%)

Insurance Median: $1,281 (525%)

Cash: $1,601 (657% of Medicare)

Ins. Median: $1,281 (525% 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 525% of the Medicare baseline (a markup of 425%). 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
Blue Cross Blue Shield	$44 - $1,140	18%
Health Net	$97 - $1,909	40%
Cal Optima	$136 - $188	56%
Heritage Provider Network	$168 - $1,140	69%
Inland Empire	$208 - $1,303	85%
Prime Healthcare Keenan	$308 - $1,563	126%
UnitedHealthcare	$893 - $912	366%
Blue Shield	$944 - $2,101	387%
Blue Shield Covca	$969 - $990	398%
Blue Shield Promise	$1,116 - $1,140	458%
Cigna	$1,210	496%
Cencal	$1,276 - $1,303	523%
La Care Health	$1,276 - $1,303	523%
Kaiser	$1,435 - $1,466	589%
Aetna	$1,594 - $1,628	654%
Gold Coast	$1,594 - $1,628	654%
Molina	$1,594 - $2,117	654%
Facey	$1,754 - $1,791	720%
Healthcare Partners	$1,850 - $1,889	759%
St. Joseph Heritage	$1,913 - $1,954	785%
Primecare Medical Network	$2,073 - $2,117	850%
First Health	$2,456 - $2,508	1008%
Phcs Multiplan	$2,870 - $2,931	1177%

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 $1,601.
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 City of Hope National 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.