CMS Price Transparency Data
Ultrasound, leg veins (duplex)
Facility: Greater El Monte Community Hospital
Billing Code: 93970 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 93970
- Insurance Median: $850
- Cash Discount Price: $2,199
- vs. Medicare Baseline: 3.49x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Greater El Monte Community Hospital is $850. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,199. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.49x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$2,199
Average discount available for prompt cash payment at this facility.
Insurance Median
$850
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: $2,199 (902%)
Insurance Median: $850 (349%)
Cash: $2,199 (902% of Medicare)
Ins. Median: $850 (349% 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 349% of the Medicare baseline (a markup of 249%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 |
|---|---|---|
| In Custody-Ca Highway Patrol | $20 | 8% |
| Emanate Health | $135 - $384 | 55% |
| Aids Health Foundation | $168 - $302 | 69% |
| Allied Physicians Medical Group | $168 - $798 | 69% |
| Altamed Health Network | $168 - $302 | 69% |
| Avanti | $168 - $368 | 69% |
| Beverly Hospital | $168 - $338 | 69% |
| Brand New Day | $168 - $384 | 69% |
| Health Net Foundation | $168 - $1,730 | 69% |
| Healthy Way La | $168 | 69% |
| La Care Health Plan | $168 - $1,464 | 69% |
| Other Non Contracted Medi-Cal Hmo | $168 | 69% |
| State Of California | $168 | 69% |
| Care 1St Medi Cal Hmo Cap Exceptional Care | $170 - $200 | 70% |
| Care First Health Plan | $170 - $266 | 70% |
| Allied Physicians | $193 - $453 | 79% |
| Associated Hispanic Physicians | $193 - $276 | 79% |
| Hollywood Presbyterian Adv Med Mcal | $193 | 79% |
| Hollywood Presbyterian Medpoint Mcal | $193 | 79% |
| Caloptima | $198 | 81% |
| Clinica Medica Familiar | $204 - $1,330 | 84% |
| Veterans Administration | $215 | 88% |
| Blue Cross Blue Shield | $246 - $1,330 | 101% |
| Apa/Aco Inc | $302 | 124% |
| Blue Shield Of California | $302 - $1,649 | 124% |
| Cms | $302 | 124% |
| Easy Choice Health Plan | $302 | 124% |
| Health Net Inc | $302 - $1,884 | 124% |
| Other Non Contracted Senior Hmo | $302 | 124% |
| Pacific Alliance Medical Center Reciprocal Contract | $302 | 124% |
| Scan Health Plan | $302 | 124% |
| UnitedHealthcare | $302 - $2,284 | 124% |
| Champus Foundation | $307 | 126% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $307 | 126% |
| Good Samaritan Medical Practice Assoc | $307 - $1,597 | 126% |
| La Care Covered Direct | $307 | 126% |
| Pacificare Of California | $307 - $2,304 | 126% |
| Self-Pay | $307 | 126% |
| Alignment Health Plan | $317 | 130% |
| Molina Healthcare | $317 | 130% |
| Inter Valley Health Plan | $322 | 132% |
| Molina Healthcare Of California | $322 - $1,038 | 132% |
| San Miguel Health Plan | $338 | 139% |
| Bella Vista Medical Group Ipa | $340 - $1,197 | 139% |
| Global Care Medical Group Ipa | $340 - $1,197 | 139% |
| Central Health Plan | $346 - $1,700 | 142% |
| Athens Administrators | $350 | 144% |
| Intercomp | $350 | 144% |
| Interplan | $350 - $1,996 | 144% |
| Multiplan | $350 - $2,262 | 144% |
| Other Non Contracted Work Comp | $350 | 144% |
| Preferred Health Network | $350 | 144% |
| Chinatown Service Center Pace | $362 | 149% |
| Ahmc Health Self-Insurance Epo | $384 | 158% |
| Knox-Keene Act | $384 | 158% |
| Alta Med Health Services Med Grp | $425 - $665 | 174% |
| Ahmc Reciprocity Agreement | $510 - $798 | 209% |
| Ahmc Reciprocity Agreement Senior/Commercial | $510 - $798 | 209% |
| Lincoln Hospital Medical Center | $510 - $798 | 209% |
| Cigna | $547 | 224% |
| California Thoroughbred Horesmans Foundation | $850 - $1,330 | 349% |
| Universal Care | $850 - $1,250 | 349% |
| Care 1St Health Plan | $1,020 - $1,597 | 418% |
| Employee Health Systems Medical Group | $1,020 - $1,597 | 418% |
| Cost Containment Strategies | $1,105 - $1,730 | 453% |
| In Custody Police Dept | $1,105 - $1,730 | 453% |
| Community Care Network | $1,360 - $2,129 | 558% |
| Health Payors Organization | $1,530 - $2,395 | 628% |
| Commercial Non Contract | $1,700 - $2,661 | 697% |
| Medi-Cal Sub Acute | $1,700 - $2,661 | 697% |
| Nuclear Medicine/Whmc | $1,700 - $2,661 | 697% |
| One Legacy | $1,700 - $2,661 | 697% |