CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Mainehealth Pen Bay Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $334
Cash Discount Price: $1,317
vs. Medicare Baseline: 1.37x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mainehealth Pen Bay Hospital is $334. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,317. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.37x the Medicare baseline. Located in 6 Glen Cove Drive, Rockport, ME.

Cash / Self-Pay

$1,317

Average discount available for prompt cash payment at this facility.

Insurance Median

$334

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: $1,317 (540%)

Insurance Median: $334 (137%)

Cash: $1,317 (540% of Medicare)

Ins. Median: $334 (137% 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
Aetna	$31 - $1,234	13%
Blue Cross Blue Shield	$31 - $1,136	13%
Wellcare	$32 - $241	13%
Humana	$35 - $234	14%
UnitedHealthcare	$35 - $1,311	14%
Multiplan	$60 - $1,323	25%
Harvard Pilgrim Healthcare	$62 - $1,198	25%
Community Health Options	$65 - $1,115	27%
Cigna	$968 - $1,110	397%

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 $1,317.
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 Mainehealth Pen Bay 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.