CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: North Carolina Baptist Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $507
Cash Discount Price: $773
vs. Medicare Baseline: 2.08x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at North Carolina Baptist Hospital is $507. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $773. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.08x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.

Cash / Self-Pay

$773

Average discount available for prompt cash payment at this facility.

Insurance Median

$507

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: $773 (317%)

Insurance Median: $507 (208%)

Cash: $773 (317% of Medicare)

Ins. Median: $507 (208% 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 208% of the Medicare baseline (a markup of 108%). 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
Aetna	$234 - $1,349	96%
Apex	$234	96%
Blue Cross Blue Shield	$234 - $534	96%
Cigna	$234 - $952	96%
Devoted	$234	96%
Healthteam	$234	96%
UnitedHealthcare	$234 - $548	96%
Wellcare	$234 - $363	96%
Humana	$236 - $868	97%
Medicare (plans)	$236	97%
Liberty	$269	110%
Medcost	$298 - $1,055	122%
Amerihealth	$340 - $428	139%
Carolina Complete	$340 - $359	139%
Health Blue	$340 - $359	139%
Partners	$340 - $359	139%
Vaya	$343 - $362	141%
Alliance	$347 - $366	142%
Trillium	$350 - $369	144%
Ambetter / Centene	$406 - $428	167%
Oscar	$451 - $571	185%
Directnet	$889 - $938	365%
Cone Health	$1,053 - $1,111	432%
Healthgram	$1,053 - $1,111	432%
First Carolina Care	$1,203 - $1,270	493%
Private Healthcare Systems	$1,233 - $1,301	506%
Multiplan	$1,354 - $1,428	555%

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 $773.
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 North Carolina Baptist 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.