CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: North Shore Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $281
  • Cash Discount Price: $3,342
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at North Shore Medical Center is $281. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,342. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.15x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$3,342

Average discount available for prompt cash payment at this facility.

Insurance Median
$281

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: $3,342 (1371%)
Insurance Median: $281 (115%)
Cash: $3,342 (1371% of Medicare)
Ins. Median: $281 (115% 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.

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
Aetna $100 - $2,406 41%
Humana $106 - $1,333 43%
Medicaid / KanCare $106 - $3,342 43%
UnitedHealthcare $108 - $788 44%
Veterans Administration Mill Bill $164 67%
Bc/Bs Of Fl Health Options Hmo $190 78%
Bc/Bs Of Fl Network Blue $190 78%
Bc/Bs Myblue Hmo Hix $192 79%
Healthsun Health Plans $193 - $246 79%
Avmed Broad Network $195 80%
Bc/Bs Of Fl Simplyblue $202 83%
Bc/Bs Of Fl Ppo $203 83%
Oscar Health Plan Hix $205 84%
Bc/Bs Of Fl Blue Select Exchange Non Par $211 87%
Medicare (plans) $211 - $3,342 87%
Self Pay/Uninsured $230 - $292 94%
Leon Health Inc $233 96%
Devoted Health $234 96%
Employer Direct Healthcare $234 - $238 96%
Tricare $235 96%
Hospice Other $238 98%
Veterans Administration Vaccn $238 98%
Cigna $246 - $1,671 101%
Longevity Health Plan $250 103%
Florida Pace Centers $281 115%
Bright Health Management Commercial $285 117%
Centurion Prison $292 120%
Imagine Health $334 137%
Avmed Exchange $416 171%
Ambetter / Centene $440 180%
Molina Marketplace Program Exchange $453 186%
Auto Insurance $476 195%
Avmed Select Network $487 200%
Amerihealth Caritas Next Exchange $511 210%
Bc/Bs Of Fl Phs $1,732 711%
Magellan Behavioral Health $2,005 822%
Dimensions International $2,172 891%
First Health $2,273 932%
Dimension Health Ppo $2,506 1028%
Dimension Health Wc $2,506 1028%
Workers Compensation $2,506 1028%
Beacon Health Strategies Commercial $3,342 1371%
Commercial Non-Contracted $3,342 1371%
Self Pay - Mcd Pending 100 Percent $3,342 1371%
Single Case Agreement $3,342 1371%
United Behavioral Health Psych $3,342 1371%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals