CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Children's Healthcare of Atlanta at Scottish Rite

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,145
Cash Discount Price: $1,671
vs. Medicare Baseline: 4.70x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Children's Healthcare of Atlanta at Scottish Rite is $1,145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,671. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.70x the Medicare baseline. Located in 1001 Johnson Ferry Road, Atlanta, GA.

Cash / Self-Pay

$1,671

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,145

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: $1,671 (685%)

Insurance Median: $1,145 (470%)

Cash: $1,671 (685% of Medicare)

Ins. Median: $1,145 (470% 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 470% of the Medicare baseline (a markup of 370%). 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
Peachstate [43]	$699	287%
Caresource [61]	$718	295%
Amerigroup [102]	$725	297%
Cigna	$1,105	453%
Blue Cross Blue Shield	$1,109 - $1,631	455%
United [5]	$1,109	455%
Ambetter / Centene	$1,119	459%
Oscar [228]	$1,120	459%
Aetna	$1,125	462%
Caresource Marketplace Bronze/Silver/Gold [60]	$1,135	466%
Kaiser [6]	$1,138	467%
Sidecar Health [236]	$1,153	473%
Direct Employer Agreements [72]	$1,170 - $1,420	480%
Coventry [9]	$1,173	481%
Northeast Georgia Heatlh System [808]	$1,253	514%
Veracity Benefits [809]	$1,253	514%
First Health [74]	$1,254	514%
Phcs [93]	$1,420	583%
Secure Health [340]	$1,420	583%
Beech Street [71]	$1,504	617%
Multiplan [92]	$1,638	672%
Novanet [41]	$1,671	685%

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 $1,671.
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 Children's Healthcare of Atlanta at Scottish Rite 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.