CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Holyoke Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $279
Cash Discount Price: $430
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Holyoke Medical Center is $279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $430. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.14x the Medicare baseline. Located in 575 Beech Street, Holyoke, MA.

Cash / Self-Pay

$430

Average discount available for prompt cash payment at this facility.

Insurance Median

$279

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: $430 (176%)

Insurance Median: $279 (114%)

Cash: $430 (176% of Medicare)

Ins. Median: $279 (114% 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
Bmchp	$208	85%
Fallon	$208 - $289	85%
Health New England	$208 - $263	85%
Wellsense Direct Metals Silver	$260	107%
Aetna	$263 - $282	108%
Blue Cross Blue Shield	$263 - $372	108%
Tufts Health Plan	$263 - $309	108%
UnitedHealthcare	$263 - $350	108%
Commonwealth Care Alliance	$276	113%
Wellsense Sco	$279	114%
Wellcare	$282	116%
Gic Unicare	$301	123%
Senior Whole Health	$303	124%
Cigna	$315	129%
Tufts Health Public Plans	$316	130%
Harvard Pilgrim	$350	144%

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 $430.
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 Holyoke Medical Center 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.