CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: AHMC Seton Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $1,062
  • Cash Discount Price: $1,774
  • vs. Medicare Baseline: 4.36x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at AHMC Seton Medical Center is $1,062. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,774. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.36x the Medicare baseline. Located in 1900 Sullivan Avenue, Daly City, CA.
Cash / Self-Pay
$1,774

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,062

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: $1,774 (728%)
Insurance Median: $1,062 (436%)
Cash: $1,774 (728% of Medicare)
Ins. Median: $1,062 (436% 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 436% of the Medicare baseline (a markup of 336%). 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 $135 55%
Health Plan Of San Mateo Healthworx $171 70%
San Francisco Health Plan $188 77%
Cmac $193 79%
Hill Physicians Medical Group Inc $193 - $251 79%
Kaiser $193 - $1,945 79%
Health Plan Of San Mateo $195 80%
San Mateo County/San Mateo County General Hospital $207 85%
Asian American Medical Group $232 - $433 95%
North East Medical Services $236 - $341 97%
Brown And Toland Medical Group $241 - $433 99%
Veterans Administration (Va) $243 100%
Blue Cross Blue Shield $246 - $1,802 101%
Jade Health Care Mg $252 - $1,186 103%
Self Pay $319 - $806 131%
Aetna $341 - $1,594 140%
Blue Shield Of California $341 - $2,084 140%
Brand New Day $341 - $433 140%
Care Advantage $341 140%
Chinese Community Health Plan $341 - $1,186 140%
For Your Benefit $341 140%
Healthnet Seniority $341 140%
Humana $341 140%
Imperial Health Plan $341 140%
Medicare (plans) $341 140%
Pacificare $341 140%
Tricare $345 142%
Apcmg $346 - $520 142%
Canopy Health $346 - $624 142%
Covid-19 Uninsured Program $346 142%
UnitedHealthcare $346 - $3,509 142%
Easy Choice Hospital Services $353 145%
Central Health Plan $368 151%
Athens Administrators $395 162%
Corvel Healthcare $395 162%
Multiplan/Bce Emergis $395 - $1,779 162%
Work Comp Other $395 162%
Ahmc Health $433 178%
Knox-Keene Act $433 178%
Workers Compensation Federal $552 226%
Cigna $1,132 464%
Interplan Corporation $1,274 - $1,423 523%
Private Healthcare Sytems Inc $1,593 - $1,779 653%
The First Health Network $1,593 - $1,779 653%
Health Net $1,629 - $1,819 668%
Beech Street Corporation $1,699 - $1,898 697%
Healthcare Foundation Of San Mateo $1,699 - $1,898 697%
Choicecare Network $1,805 - $2,016 740%
Multiplan $1,805 - $2,016 740%
Mills Peninsula Health Services $1,912 - $2,135 784%
Indemnity $2,124 - $2,372 871%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Sullivan Avenue, Daly City, CA 94015
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals