CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Piedmont Fayette Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,566
Cash Discount Price: $691
vs. Medicare Baseline: 6.42x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Piedmont Fayette Hospital is $1,566. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $691. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.42x the Medicare baseline. Located in 1255 Highway 54 West, Fayetteville, GA.

Cash / Self-Pay

$691

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,566

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: $691 (283%)

Insurance Median: $1,566 (642%)

Cash: $691 (283% of Medicare)

Ins. Median: $1,566 (642% 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 642% of the Medicare baseline (a markup of 542%). 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
Medicaid / KanCare	$212 - $223	87%
Blue Cross Blue Shield	$574 - $577	235%
UnitedHealthcare	$981 - $1,509	402%
Cigna	$1,119 - $1,566	459%
Alliant Health Plans Of Georgia [10952]	$1,566	642%
First Health [10303]	$1,612	661%
Phcs [10601]	$1,612	661%
Aetna	$1,681	690%
Kaiser [10500]	$1,704	699%
Novanet [10819]	$1,727	708%
Beechstreet [10800]	$1,842	756%
Multiplan [10600]	$1,958	803%

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 $691.
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 Piedmont Fayette 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.