CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Atrium Health Cleveland

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $391
Cash Discount Price: $1,156
vs. Medicare Baseline: 1.60x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Atrium Health Cleveland is $391. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,156. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.60x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.

Cash / Self-Pay

$1,156

Average discount available for prompt cash payment at this facility.

Insurance Median

$391

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: $1,156 (474%)

Insurance Median: $391 (160%)

Cash: $1,156 (474% of Medicare)

Ins. Median: $391 (160% 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
Amerihealth Caritas	$28 - $326	11%
Carolina Complete Health	$28 - $332	11%
Healthy Blue	$28 - $332	11%
Partners	$28 - $324	11%
Trillium	$28 - $342	11%
UnitedHealthcare	$28 - $1,234	11%
Vaya	$28 - $336	11%
Wellcare	$28 - $332	11%
Alliance	$29 - $387	12%
Cigna	$30 - $1,849	12%
Aetna	$31 - $1,780	13%
Humana	$31 - $232	13%
Blue Cross Blue Shield	$83 - $947	34%
Medcost	$88 - $1,533	36%
Choicecare	$284 - $1,896	117%
Ambetter / Centene	$738 - $839	303%
Employers Health Network	$1,022	419%
Physician Reach Out	$1,156	474%
Magellan	$1,387	569%
Gmmi	$1,503	617%
Quik Trip	$1,503	617%
Carolina Behavioral Health	$1,664 - $1,849	683%
Healthgram	$1,849	759%
First Health	$1,965	806%
Lifesynch Community Choice Care	$1,965	806%
Private Health Care Systems	$2,081	854%
Beechstreet	$2,127	873%
Multiplan	$2,196	901%

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 $1,156.
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 Atrium Health Cleveland 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.