CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Advocate Good Samaritan Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $912
  • Cash Discount Price: $845
  • vs. Medicare Baseline: 3.74x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Advocate Good Samaritan Hospital is $912. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $845. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.74x the Medicare baseline. Located in 3815 Highland Avenue, Downers Grove, IL.
Cash / Self-Pay
$845

Average discount available for prompt cash payment at this facility.

Insurance Median
$912

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: $845 (347%)
Insurance Median: $912 (374%)
Cash: $845 (347% of Medicare)
Ins. Median: $912 (374% 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 374% of the Medicare baseline (a markup of 274%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Ambetter / Centene $365 150%
Molina $365 150%
Oscar Health Hmo $378 155%
Hstechnology $484 199%
UnitedHealthcare $511 - $1,010 210%
Advocate Employee $666 - $739 273%
Cigna $695 285%
Aetna $912 374%
Private Healthcare Systems $1,048 - $1,352 430%
Blue Cross Blue Shield $1,306 - $1,570 536%
Multiplan $1,352 555%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3815 Highland Avenue, Downers Grove, IL 60515
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals