CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Los Robles Hospital & Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $2,479
Cash Discount Price: $8,137
vs. Medicare Baseline: 10.17x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Los Robles Hospital & Medical Center is $2,479. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,137. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.17x the Medicare baseline. Located in 215 W Janss Rd, Thousand Oaks, CA.

Cash / Self-Pay

$8,137

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,479

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: $8,137 (3338%)

Insurance Median: $2,479 (1017%)

Cash: $8,137 (3338% of Medicare)

Ins. Median: $2,479 (1017% 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 1017% of the Medicare baseline (a markup of 917%). 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
Brand New Day	$153	63%
Gold Coast Health Plan	$153	63%
Medcare Partners	$269 - $1,400	110%
Aetna	$318 - $9,335	130%
Bright Health	$495 - $2,573	203%
United	$504 - $2,623	207%
Health Net	$730 - $3,799	299%
Cigna	$945	388%
First Health	$1,220 - $7,468	500%
Choicecare Network	$1,256 - $6,534	515%
Multiplan	$1,436 - $8,868	589%
Ppo Next	$1,436 - $7,468	589%
Interplan Corporation	$1,615 - $8,401	663%
Ventura County Foundation	$1,615 - $8,401	663%
Blue Shield	$1,906 - $2,724	782%

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 $8,137.
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 Los Robles Hospital & 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.