CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Adventist Health Vallejo

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,534
Cash Discount Price: $515
vs. Medicare Baseline: 6.29x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Adventist Health Vallejo is $1,534. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $515. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.29x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.

Cash / Self-Pay

$515

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,534

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: $515 (211%)

Insurance Median: $1,534 (629%)

Cash: $515 (211% of Medicare)

Ins. Median: $1,534 (629% 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 629% of the Medicare baseline (a markup of 529%). 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
Blue Shield Mcr Adv	$31 - $242	13%
Medicare (plans)	$31 - $242	13%
Napa County Mcal Child	$31 - $242	13%
Tricare	$31 - $242	13%
Ah Employee Health Plan-All Plans	$34 - $435	14%
Interplan-All Plans	$38 - $2,407	16%
Kaiser-All Plans	$38 - $3,036	16%
Blue Shield Epn	$42 - $1,744	17%
Blue Shield Non-Epn-All Other Plans	$42 - $1,718	17%
Cigna	$42 - $2,962	17%
UnitedHealthcare	$43 - $2,361	18%
Western Growers-All Plans	$45 - $2,148	18%
Aetna	$54 - $696	22%
Blue Cross Blue Shield	$70 - $1,471	29%
Phcs-All Plans	$76 - $2,037	31%
Health Management Network-All Plans	$118 - $3,148	48%
Three Rivers-All Plans	$125 - $3,333	51%
Medi-Cal	$139 - $241	57%
Va Medi-Cal	$241	99%
Va Mcr-All Other Plans	$242	99%
Blue Shield Behav Hlth	$1,545 - $1,666	634%
Healthnet-All Plans	$2,105 - $2,270	864%
Choicecare-All Plans	$2,404 - $2,592	986%
Beech Street-All Plans	$2,576 - $2,777	1057%
Galaxy Network-All Plans	$3,091 - $3,333	1268%

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 $515.
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 Vallejo 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.