CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Saint Mary's Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $933
  • Cash Discount Price: $1,120
  • vs. Medicare Baseline: 3.83x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Saint Mary's Hospital is $933. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,120. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.83x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$1,120

Average discount available for prompt cash payment at this facility.

Insurance Median
$933

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: $1,120 (459%)
Insurance Median: $933 (383%)
Cash: $1,120 (459% of Medicare)
Ins. Median: $933 (383% 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 383% of the Medicare baseline (a markup of 283%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Connecticut Dept of Correction $264 108%
Aetna $280 - $1,608 115%
Blue Cross Blue Shield $280 - $848 115%
Medicare (plans) $280 - $292 115%
UnitedHealthcare $280 - $2,036 115%
Cca Senior Care Options $286 117%
Cigna $289 - $1,629 119%
Centivo $572 235%
Claimdoc $601 247%
Diversified Administrators $601 247%
Innovative Health Plan II $601 247%
Allegiance $675 277%
Health Partners $675 277%
Magnacare $675 277%
Bcn Domestic $848 348%
Blue Benefit Administrators of Massachusetts $848 348%
Blue Care Network $848 348%
Blue Distinction Transplant $848 348%
Blue Shield - Ca $848 348%
Blue Shield - Id (Regence) $848 348%
Blue Shield - Ny Highmark Northeastern $848 348%
Blue Shield - Ny Highmark Western $848 348%
Blue Shield - PA (Highmark) $848 348%
Blue Shield - Wa (Regence) $848 348%
Health Choices $848 348%
Kaiser Domestic $848 348%
Pre-Employment $848 348%
Unicare $848 348%
Wc Domestic $848 348%
Wellpoint $848 348%
Carelon Behavioral Health $1,018 418%
Health New England $1,080 443%
Geha $1,090 447%
Harvard Pilgrim Healthcare $1,090 447%
Allied National Global Care $1,568 643%
Asrm - Reliance Standard Life Insurance $1,568 643%
Christian Care Ministry $1,568 643%
Dean Health $1,568 643%
Fallon Health $1,568 643%
Family Life Insurance Company $1,568 643%
Ghc Scw $1,568 643%
International Benefit Administrators $1,568 643%
Lifetime Benefit Solutions $1,568 643%
Manhattan Life $1,568 643%
Medi Share $1,568 643%
Multiplan $1,568 643%
Mvp $1,568 643%
PHCS $1,568 643%
Pai $1,568 643%
Pan-American Life $1,568 643%
Paramount HMO $1,568 643%
Trinity Health Share $1,568 643%
1199 National Benefit Fund $1,608 660%
Allied Benefit Systems $1,608 660%
Gravie Admin Services $1,608 660%
Hap $1,608 660%
Luminare Health $1,608 660%
Meritain $1,608 660%
Nippon Life Ins $1,608 660%
Webtpa $1,608 660%
Prime Health Services $1,629 668%
Health Smart $1,731 710%
Connecticare $1,735 - $1,800 712%
United Behavioral Health Eap $2,036 835%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals