CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St Francis Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $987
Cash Discount Price: $1,100
vs. Medicare Baseline: 4.05x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St Francis Hospital is $987. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,100. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.05x the Medicare baseline. Located in 7Th and Clayton Sts, Wilmington, DE.

Cash / Self-Pay

$1,100

Average discount available for prompt cash payment at this facility.

Insurance Median

$987

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: $1,100 (451%)

Insurance Median: $987 (405%)

Cash: $1,100 (451% of Medicare)

Ins. Median: $987 (405% 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 405% of the Medicare baseline (a markup of 305%). 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
Pace-Trinity Health	$249	102%
Saint Francis Life	$249	102%
Blue Cross Blue Shield	$254 - $987	104%
Cigna	$256 - $1,048	105%
Medicare (plans)	$260 - $266	107%
Blue Shield - De (Highmark) Medciare Advantage	$262	107%
Highmark Health Options Dual Plan	$262	107%
Aetna	$269 - $1,100	110%
Coventry	$305	125%
Medicaid / KanCare	$593	243%
Blue Benefit Administrators Of Massachusetts	$987	405%
Blue Care Network	$987	405%
Blue Distinction Transplant	$987	405%
Blue Shield - Ca	$987	405%
Blue Shield - Id (Regence)	$987	405%
Blue Shield - Ny Highmark Northeastern	$987	405%
Blue Shield - Ny Highmark Western	$987	405%
Blue Shield - Pa (Highmark)	$987	405%
Blue Shield - Wa (Regence)	$987	405%
Meritain	$1,100	451%
Trustmark Small Business Benefits	$1,100	451%
Devon Health Services	$1,608	660%
Galaxy Health Network	$1,608	660%
Multiplan	$1,608	660%
Prime Health Services	$1,608	660%
Three Rivers Provider Network	$1,608	660%
Wc Corvel	$1,608	660%
Geha	$1,625	667%
UnitedHealthcare	$1,625	667%
Delaware First Health	$1,720	706%

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 $1,100.
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 St Francis Hospital 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.