CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Clearwater Valley Hospital & Clinics

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $478
Cash Discount Price: $357
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Clearwater Valley Hospital & Clinics is $478. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $357. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.96x the Medicare baseline. Located in 301 Cedar Street, Orofino, ID.

Cash / Self-Pay

$357

Average discount available for prompt cash payment at this facility.

Insurance Median

$478

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: $357 (146%)

Insurance Median: $478 (196%)

Cash: $357 (146% of Medicare)

Ins. Median: $478 (196% 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
Humana	$30 - $859	12%
Nimiipuu Mcr Adv-All Plans	$30 - $483	12%
Regence Blue Shield Mcr	$30 - $478	12%
Veterans Amin-All Plans	$30 - $478	12%
Pacific Source - All Plans	$31 - $478	13%
Blue Cross Blue Shield	$35 - $696	14%
Aetna	$49 - $824	20%
UnitedHealthcare	$57	23%
Idaho Phys Network-All Plans	$62 - $842	25%
Multiplan / Phcs-All Plans	$62 - $859	25%
Geha-All Plans	$63 - $868	26%
Cigna	$64 - $797	26%
First Choice-All Plans	$64 - $868	26%
Corizon Correctnal Med-All Plans	$183 - $647	75%
Regence Blue Shield-All Other Plans	$886	363%

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 $357.
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 Clearwater Valley Hospital & Clinics 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.