CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $416
Cash Discount Price: $971
vs. Medicare Baseline: 1.71x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at UMass Memorial Health - Harrington Hospital is $416. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $971. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.71x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$971

Average discount available for prompt cash payment at this facility.

Insurance Median

$416

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: $971 (398%)

Insurance Median: $416 (171%)

Cash: $971 (398% of Medicare)

Ins. Median: $416 (171% 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
Tufts Mcr [10112]	$152 - $304	62%
Blue Cross Blue Shield	$194 - $416	80%
Harvard Pilgrim [10701]	$210 - $504	86%
Workers Compensation [20501]	$266	109%
Champva [11001]	$287	118%
Cigna	$289 - $755	119%
Institution [10406]	$289	119%
Mgb Mcr [10124]	$289	119%
Tufts Us Family [11203]	$289	119%
Aetna	$304 - $971	125%
Commonwealth Care Alliance [10103]	$304	125%
Fallon Mcr Supp [20202]	$304	125%
Fallon Mcr [10105]	$304	125%
UnitedHealthcare	$304 - $971	125%
Senior Whole Health [10110]	$310	127%
Tufts [11201]	$345 - $690	142%
Wellpoint [11112]	$390	160%
Tufts Connectorcare [10507]	$492	202%
Medicaid / KanCare	$505	207%
Hne [11108]	$632	259%
Fallon Connectorcare [10503]	$633 - $1,266	260%
Hsno/Free Care [10801]	$681	279%
First Health Network [11120]	$728	299%
Evernorth Behavioral Health [27]	$777	319%
Connecticare [11105]	$971	398%
Fallon Carelon Hlth [28]	$971	398%
Fallon Mcaid Carelon Hlth [29]	$971	398%
Grants [20507]	$971	398%
Masshealth Mcd Mbhp [38]	$971	398%
Wellsense Mcaid Carelon Hlth [21]	$971	398%

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 $971.
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 UMass Memorial Health - Harrington Hospital 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.