CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Atrium Health Navicent Rehabilitation Hopsital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $242
Cash Discount Price: $572
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Atrium Health Navicent Rehabilitation Hopsital is $242. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $572. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.99x the Medicare baseline. Located in 3351 Northside Dr, Macon, GA.

Cash / Self-Pay

$572

Average discount available for prompt cash payment at this facility.

Insurance Median

$242

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: $572 (235%)

Insurance Median: $242 (99%)

Cash: $572 (235% of Medicare)

Ins. Median: $242 (99% 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 - $789	12%
Blue Cross Blue Shield	$30 - $545	12%
Georgia Health Advantage	$30 - $242	12%
Humana	$30 - $786	12%
UnitedHealthcare	$30 - $999	12%
Care Source	$31 - $247	13%
Clover	$31 - $247	13%
Eon Health	$31 - $247	13%
Pruitt Health	$32 - $242	13%
Alliant	$37 - $503	15%
Ambetter / Centene	$41 - $583	17%
Cigna	$194 - $668	80%
Securehealth	$196 - $480	80%
Ibg	$228 - $809	94%
Kaiser	$260 - $744	107%
Multiplan	$744 - $915	305%
Novanet	$915	375%
Three Rivers Provider Network	$972	399%
Beechstreet	$1,064	436%

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 $572.
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 Rehabilitation Hopsital 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.