CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Ann & Robert H Lurie Childrens Hospital of Chicago

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $3,154
  • Cash Discount Price: $2,760
  • vs. Medicare Baseline: 12.94x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Ann & Robert H Lurie Childrens Hospital of Chicago is $3,154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,760. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 12.94x the Medicare baseline. Located in 225 E Chicago Ave, Box 140, Chicago, IL.
Cash / Self-Pay
$2,760

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,154

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: $2,760 (1132%)
Insurance Median: $3,154 (1294%)
Cash: $2,760 (1132% of Medicare)
Ins. Median: $3,154 (1294% 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 1294% of the Medicare baseline (a markup of 1194%). 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
Medicare (plans) $670 - $2,656 275%
UnitedHealthcare $870 - $936 357%
Magellan $900 - $3,154 369%
Mercycare Health $1,459 599%
Cigna $1,656 - $2,800 679%
Blue Cross Blue Shield $1,707 - $3,154 700%
Aetna $1,972 - $3,087 809%
Beacon Health Options $1,972 809%
La Rabida Childrens Hospital $1,972 809%
Centegra $2,366 971%
Independent Physicians At Mercy $2,366 971%
Advanced Physicians Association Ipa $2,760 1132%
Health Plus $2,760 1132%
Imagine Health $2,760 1132%
Methodist First Choice $2,760 1132%
Northwest Community Healthcare $2,760 1132%
Presence Health Partners $2,760 1132%
St. Francis $2,760 1132%
Ui Health $2,760 1132%
West Suburban Health Providers $2,760 1132%
Shriners Hospital $2,957 1213%
Swedish Covenant Physician Partners $2,957 1213%
American Psych Systems $3,154 1294%
Health Alliance $3,154 1294%
Macneal Health $3,154 1294%
Healthlink Inc. $3,253 1334%
Cofinity $3,352 1375%
Hfn Inc $3,352 - $3,549 1375%
Humana $3,352 1375%
Principal Healthcare $3,352 1375%
St. Elizabeth $3,352 1375%
First Health $3,470 1423%
Healthstar $3,470 1423%
Preferred Health Network $3,470 1423%
Sagamore Health Network $3,470 1423%
Beech Street $3,549 1456%
Benchmark Health $3,549 1456%
Employer'S Coalition On Health $3,549 1456%
Private Health Care System $3,549 1456%
Security Health Plan $3,549 1456%
Swedish American $3,549 1456%
Wellmark/Healthnetwork $3,628 1488%
Unicare $3,678 - $8,500 1509%
Health Smart $3,746 1537%
Integrated Health Plan $3,746 1537%
Multiplan $3,746 1537%
National Provider Network $3,746 1537%
Wea Insurance Group $3,746 1537%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 225 E Chicago Ave, Box 140, Chicago, IL 60611
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens