CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: West Valley Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,164
Cash Discount Price: $2,079
vs. Medicare Baseline: 4.77x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at West Valley Medical Center is $1,164. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,079. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.77x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.

Cash / Self-Pay

$2,079

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,164

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: $2,079 (853%)

Insurance Median: $1,164 (477%)

Cash: $2,079 (853% of Medicare)

Ins. Median: $1,164 (477% 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 477% of the Medicare baseline (a markup of 377%). 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
Blue Cross Blue Shield	$26 - $1,975	11%
Molina	$26 - $141	11%
Regence	$635	260%
Select Health Idaho (Eirmc Only)	$663	272%
Corizon Health	$769	315%
True Blue	$821	337%
Cigna	$1,164	477%
Pacificsource Health	$1,241	509%
United	$1,241	509%
Moda	$1,295	531%
St Luke'S Health Partners	$1,351	554%
Four Rivers Hospice	$1,663	682%
Multiplan	$1,663	682%
Humana	$1,746	716%
Geha Ppo Usa	$1,767	725%
Coventry First Health	$1,871	768%
St Alphonsus Health	$1,871	768%

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 $2,079.
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 West Valley 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.