CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Valley Children's Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $1,358
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 5.57x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Valley Children's Hospital is $1,358. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.57x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,358

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%)
Insurance Median: $1,358 (557%)
Ins. Median: $1,358 (557% 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 557% of the Medicare baseline (a markup of 457%). 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
Allcare Ipa $193 79%
Community Care Ipa $193 - $305 79%
Kaiser $195 - $1,591 80%
Dignity Ipa_Formerly Img $270 111%
La Salle Ipa $270 111%
Sante Ipa $270 111%
Central Valley Medical Providers Ipa $290 - $1,224 119%
Sequoia Health Ipa $290 119%
Univseral Healthcare Ipa $290 119%
United Physicians Network Ipa $299 123%
Adventist $341 140%
Blue Cross Blue Shield $350 - $1,389 144%
Cencal Health $382 157%
Kern Family Health Care $386 158%
Central California Alliance For Health $393 161%
Health Net $861 - $1,602 353%
Dignity Health Central Coast $1,212 497%
Community Health $1,346 552%
Stanislaus Partners In Health $1,346 552%
Physicians Choice Medical Group $1,370 562%
Health Plan Of San Joaquin $1,468 602%
Fowler Packing $1,517 622%
Dignity (Formerly Managed Care Systems) $1,542 633%
Kern Legacy $1,591 653%
Blue Shield $1,634 - $1,857 670%
UnitedHealthcare $1,637 - $1,743 672%
Aetna $1,639 672%
First Health Formerly Coventry $1,811 743%
Bakersfield Family Medical Group $1,835 753%
Network By Design $1,896 778%
Community Care Health Plan $1,957 803%
Health Smart $1,958 803%
Key Medical Ipa $1,958 803%
Sutter Health $2,080 853%
Multiplan $2,341 960%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens