CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Atrium Health Navicent the Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $236
Cash Discount Price: $631
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Atrium Health Navicent the Medical Center is $236. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $631. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.97x the Medicare baseline. Located in 777 Hemlock Street, Macon, GA.

Cash / Self-Pay

$631

Average discount available for prompt cash payment at this facility.

Insurance Median

$236

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: $631 (259%)

Insurance Median: $236 (97%)

Cash: $631 (259% of Medicare)

Ins. Median: $236 (97% 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.

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
Aetna	$30 - $870	12%
Blue Cross Blue Shield	$30 - $601	12%
Georgia Health Advantage	$30 - $236	12%
Humana	$30 - $866	12%
UnitedHealthcare	$30 - $999	12%
Care Source	$31 - $240	13%
Clover	$31 - $240	13%
Eon Health	$31 - $240	13%
Pruitt Health	$32 - $236	13%
Alliant	$37 - $555	15%
Ambetter / Centene	$41 - $643	17%
Cigna	$194 - $668	80%
Securehealth	$196 - $480	80%
Kaiser	$260 - $820	107%
Multiplan	$820 - $1,009	336%
Ibg	$892	366%
Novanet	$1,009	414%
Three Rivers Provider Network	$1,072	440%
Beechstreet	$1,173	481%

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 $631.
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 Atrium Health Navicent the Medical Center 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.