CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: North Adams Regional Hospital Corporation

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $562
  • Cash Discount Price: $826
  • vs. Medicare Baseline: 2.31x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at North Adams Regional Hospital Corporation is $562. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $826. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.31x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$826

Average discount available for prompt cash payment at this facility.

Insurance Median
$562

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: $826 (339%)
Insurance Median: $562 (231%)
Cash: $826 (339% of Medicare)
Ins. Median: $562 (231% 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 231% of the Medicare baseline (a markup of 131%). 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
Blue Cross Blue Shield $52 - $891 21%
Mcrmanaged Cca One Care $52 - $239 21%
Medicare (plans) $52 - $243 21%
Comm Hospice $53 - $241 22%
Mcr Miscellaneous $53 - $241 22%
Mcrmanaged Usa Family $53 - $241 22%
Mcrmanaged Va $53 - $241 22%
Medicaid / KanCare $53 - $461 22%
Oth United Vaccn $53 - $241 22%
Tricare $87 - $394 36%
Comm Fallon Qhp $130 - $593 53%
Comm Network Qhpsub $130 - $592 53%
Mcdmanaged Network $130 - $592 53%
Wc Workers Comp $140 - $636 57%
Comm Network Qhpnonsub $147 - $754 60%
Comm Nhp $149 - $678 61%
Comm Unicare $149 - $680 61%
Mcd Masshealth $149 - $376 61%
Mcd New York $149 - $186 61%
Mcd Out Of State $149 - $376 61%
Mcdmanaged Cdphp $149 - $376 61%
Mcdmanaged Hne Mcdaco $149 - $376 61%
Comm Hne Hmo $152 - $691 62%
Comm Hne $160 - $731 66%
Comm Hne Ppo $161 - $734 66%
Mcdmanaged Bmchnp $171 - $391 70%
Aetna $174 - $791 71%
Comm Tufts $182 - $830 75%
UnitedHealthcare $198 - $902 81%
Cigna $207 - $975 85%
Comm Cdphp $207 - $943 85%
Comm Mvp $207 - $943 85%
Comm Oxford $207 - $943 85%
Comm First Health $214 - $996 88%
Comm Connecticare $218 - $996 89%
Comm Consolidated Health $218 - $996 89%
Comm Harvard $218 - $996 89%
Comm Other $218 - $996 89%
Comm Phcs $218 - $996 89%
Comm Self Pay $218 - $996 89%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals