CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Good Samaritan Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $5,746
Cash Discount Price: $11,491
vs. Medicare Baseline: 23.57x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Good Samaritan Hospital is $5,746. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,491. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 23.57x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.

Cash / Self-Pay

$11,491

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,746

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: $11,491 (4714%)

Insurance Median: $5,746 (2357%)

Cash: $11,491 (4714% of Medicare)

Ins. Median: $5,746 (2357% 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 2357% of the Medicare baseline (a markup of 2257%). 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
Physicians Medical Group	$139	57%
Blue Cross Blue Shield	$153	63%
Cigna	$354 - $9,193	145%
Blue Shield	$1,526	626%
Medcare Partners	$1,724	707%
Santa Clara Family Health Plan	$2,183	896%
Bright Health	$2,310	948%
Health Net	$2,677	1098%
United	$2,930	1202%
Santa Clara Ipa Comm	$5,746	2357%
Santa Clara Ipa Mcr	$5,746	2357%
Nx Health Network	$6,895	2828%
Sutter Select	$6,895	2828%
Multiplan	$7,469 - $9,193	3064%
Humana	$8,044	3300%
First Health	$8,733 - $11,491	3582%
Healthsmart	$9,193 - $9,768	3771%
Intercontinental Corporation	$9,193	3771%
Pha Pacific Health Alliance	$9,193	3771%
Ppo Next	$9,193	3771%

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 $11,491.
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 Good Samaritan Hospital 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.