CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: The Shriners' Hospital for Children - Boston

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $286
Cash Discount Price: $1,059
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at The Shriners' Hospital for Children - Boston is $286. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,059. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.17x the Medicare baseline. Located in 51 Blossom Street, Boston, MA.

Cash / Self-Pay

$1,059

Average discount available for prompt cash payment at this facility.

Insurance Median

$286

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: $1,059 (434%)

Insurance Median: $286 (117%)

Cash: $1,059 (434% of Medicare)

Ins. Median: $286 (117% 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
Ambetter / Centene	$131	54%
Well Sense Health Plan Nh	$131	54%
Harvard Pilgrim	$155	64%
Cigna	$282	116%
Aetna	$286	117%
Health New England	$286	117%
Blue Cross Blue Shield	$371	152%
Sana Benefits	$400	164%
Tufts Network Health Public Plan	$817	335%

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 $1,059.
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 The Shriners' Hospital for Children - Boston 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.