CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Massachusetts General Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $359
Cash Discount Price: $1,937
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Massachusetts General Hospital is $359. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,937. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.47x the Medicare baseline. Located in 55 Fruit Street, Boston, MA.

Cash / Self-Pay

$1,937

Average discount available for prompt cash payment at this facility.

Insurance Median

$359

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: $1,937 (795%)

Insurance Median: $359 (147%)

Cash: $1,937 (795% of Medicare)

Ins. Median: $359 (147% 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
Tricare	$273	112%
Molina [1014]	$281	115%
Tufts Health Plan [170001]	$281	115%
Tufts Health Public Plans [1013]	$281	115%
UnitedHealthcare	$281 - $2,110	115%
Blue Cross Blue Shield	$287	118%
Commonwealth Care Alliance [1007]	$287	118%
Elder Services [1037]	$287	118%
Humana	$287	118%
Medicare (plans)	$287	118%
Mgb Health Plan [150001]	$287 - $989	118%
Wellsense [1003]	$287	118%
Centers Of Excellence [1026]	$359 - $1,807	147%
Cigna	$1,376 - $2,053	564%
Aetna	$1,802	739%
International Commercial [140001]	$1,859 - $2,110	763%

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 $1,937.
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 Massachusetts General 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.