CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Nemours Children's Hospital, Delaware

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $641
  • Cash Discount Price: $1,124
  • vs. Medicare Baseline: 2.63x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Nemours Children's Hospital, Delaware is $641. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,124. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.63x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$1,124

Average discount available for prompt cash payment at this facility.

Insurance Median
$641

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: $1,124 (461%)
Insurance Median: $641 (263%)
Cash: $1,124 (461% of Medicare)
Ins. Median: $641 (263% 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 263% of the Medicare baseline (a markup of 163%). 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
Us Family Health Plan $203 83%
Keystone First Hlth Plan $224 - $497 92%
Tricare $253 104%
Celtic Transplant $313 - $1,124 128%
Amerihealth Caritas Delaware $344 - $641 141%
Celtic Transplant For De First Health $393 161%
UnitedHealthcare $413 - $701 169%
Wellpoint Maryland $416 171%
Kidz Partners $425 174%
Health Partners $436 179%
Upmc $445 183%
Fidelis $450 185%
Aetna $477 - $652 196%
Blue Cross Blue Shield $493 - $993 202%
Priority Partners John Hopkins $551 226%
Six Degrees Health Transplant $562 231%
Cigna $618 - $708 254%
Great West-One Health Plan $618 - $708 254%
Ambetter / Centene $641 263%
Geisinger Health Plan $674 276%
Integra Administrative Group $674 276%
National Transplant Network (Ntn) $731 300%
Six Degrees Health $731 300%
Star Healthcare Network $731 300%
Life Trac Solid Organ And Bmt Transplant $787 323%
First Health Network $1,068 438%
Insurance Administrators Of America $1,068 438%
Interlink Transplant Network $1,068 438%
Multiplan $1,068 438%
Preferred Healthcare $1,068 438%
Private Healthcare Systems $1,068 438%
Three Rivers Provider Network $1,068 438%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens