CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Adventist Health Lodi Memorial

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $270
Cash Discount Price: $123
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Adventist Health Lodi Memorial is $270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.11x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$270

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: $123 (50%)

Insurance Median: $270 (111%)

Cash: $123 (50% of Medicare)

Ins. Median: $270 (111% 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.

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
Alignment Health Plan (Ahp)-All Plans	$32 - $315	13%
Blue Shield Mcare Adv	$32 - $315	13%
Healthnet Mcare	$32 - $315	13%
Hp Of San Joaquin Mcr Adv	$32 - $315	13%
Humana	$32 - $315	13%
Knnex Health - All Plans	$32 - $378	13%
Medcore(Omni Ipa) Op Only- All Plans	$32 - $992	13%
Tricare	$32 - $315	13%
UnitedHealthcare	$32 - $2,030	13%
Hp Healthy Kids Pro Fee	$34	14%
Ah Employee Health Plan - All Plans	$35 - $566	14%
First Health- All Plans	$39 - $3,130	16%
Blue Shield Epn - All Other Plans	$40 - $1,237	16%
Cigna	$40 - $3,435	16%
Beech Street- All Plans	$42 - $3,435	17%
Blue Shield Non-Epn	$42 - $1,283	17%
Hp Of San Joaquin Ppo - All Other Plans	$42 - $3,626	17%
Multiplan- All Plans	$42 - $3,054	17%
Kaiser Commercial - All Other Plans	$44 - $1,565	18%
Kaiser Mcr Adv	$44 - $315	18%
Networks By Design- All Plans	$44 - $1,908	18%
Western Growers- All Plans	$46 - $3,435	19%
Healthnet- All Other Plans	$47 - $1,875	19%
Blue Cross Blue Shield	$66 - $1,401	27%
Bc Mcal	$93 - $168	38%
Three Rivers Provider Network- All Plans	$112 - $3,435	46%
Celtic Ins Company - All Plans	$125 - $270	51%
Healthnet Mcal	$125 - $345	51%
Hp Mcal Pro Fee	$125 - $185	51%
Hp Of San Joaquin Mcal	$125 - $302	51%
Kaiser Mcal	$125 - $241	51%
Medi-Cal	$125 - $241	51%
Aetna	$238 - $1,707	98%
Cca Health Plan Mcr Adv- All Plans	$315	129%
Bright Health - All Plans	$629	258%

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 $123.
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 Adventist Health Lodi Memorial 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.