CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Fairview Bethesda Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $654
Cash Discount Price: $495
vs. Medicare Baseline: 2.68x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Fairview Bethesda Hospital is $654. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $495. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.68x the Medicare baseline. Located in 45 10Th St W, Saint Paul, MN.

Cash / Self-Pay

$495

Average discount available for prompt cash payment at this facility.

Insurance Median

$654

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: $495 (203%)

Insurance Median: $654 (268%)

Cash: $495 (203% of Medicare)

Ins. Median: $654 (268% 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 268% of the Medicare baseline (a markup of 168%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Health Partners	$22 - $961	9%
Itasca Medical Care	$22 - $241	9%
Primewest	$22 - $241	9%
South Country Health Alliance	$22 - $241	9%
Ucare	$22 - $553	9%
Medica	$23 - $892	9%
Hennepin Health	$24 - $246	10%
Blue Cross Blue Shield	$25 - $727	10%
Sanford Health Plan	$30 - $727	12%
Security Health Plan	$30 - $926	12%
UnitedHealthcare	$30 - $705	12%
Wellcare	$30 - $241	12%
America'S Ppo	$556 - $888	228%
First Health	$876 - $1,012	359%
Multiplan	$908 - $1,049	372%
Private Healthcare Systems	$908 - $1,049	372%
Wisconsin Physician Services	$961 - $1,111	394%

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 $495.
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 Fairview Bethesda 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.