CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Mt Sinai Hospital Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $291
  • Cash Discount Price: $366
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mt Sinai Hospital Medical Center is $291. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $366. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.19x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$366

Average discount available for prompt cash payment at this facility.

Insurance Median
$291

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: $366 (150%)
Insurance Median: $291 (119%)
Cash: $366 (150% of Medicare)
Ins. Median: $291 (119% 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.

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
Partners In Hlth - All Plans $188 - $230 77%
Blue Cross Blue Shield $210 - $365 86%
Cigna $240 - $1,286 98%
Tricare $248 102%
Va Healthnet - All Plans $248 102%
Aetna $250 - $1,298 103%
Family Health Network Mcaid - All Plans $250 103%
Advocate Physician Prtnrs Mcr $256 105%
Cenpatico Illinicare Dual $256 105%
Cenpatico Illinicare Mcr - All Other Plans $256 105%
Humana $256 - $1,804 105%
Lawndale Christian - All Plans $256 105%
Meridian/Harmony D-Snp - All Plans $256 105%
Nextlevel Hlth Icp Fhp Aca - All Plans $256 105%
UnitedHealthcare $256 - $448 105%
Molina Mcaid $262 107%
Harmony Behavioral Htlh - All Plans $263 108%
Zing Mcr Adv - All Plans $266 109%
Molina Mcr - All Other Plans $268 110%
Advocate Physician Prtnrs - All Other Plans $281 115%
Ambetter / Centene $281 - $603 115%
Compsych Ip/Op Only - All Plans $282 - $345 116%
Healthlink Hmo $306 - $373 126%
Hfn Platinum $306 - $373 126%
Healthlink Ppo - All Other Plans $330 - $402 135%
Multiplan Primary Ntwrk/Phcs - All Other Plans $330 - $402 135%
Hfn Epo $377 - $460 155%
Multiplan Complementary Ntwrk $377 - $460 155%
Hfn Ppo - All Other Plans $414 - $506 170%
Oscar - All Plans $518 - $632 212%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals