CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Novant Health Presbyterian Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $513
Cash Discount Price: $634
vs. Medicare Baseline: 2.10x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Novant Health Presbyterian Medical Center is $513. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $634. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.10x the Medicare baseline. Located in 200 Hawthorne Lane Box 33549, Charlotte, NC.

Cash / Self-Pay

$634

Average discount available for prompt cash payment at this facility.

Insurance Median

$513

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: $634 (260%)

Insurance Median: $513 (210%)

Cash: $634 (260% of Medicare)

Ins. Median: $513 (210% 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 210% of the Medicare baseline (a markup of 110%). 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
Carolina Complete	$178 - $264	73%
Nc Department Of Public Safety	$178 - $464	73%
Amerihealth	$181 - $269	74%
Blue Cross Blue Shield	$181 - $894	74%
UnitedHealthcare	$181 - $885	74%
Wellcare	$181 - $269	74%
Humana	$232 - $1,092	95%
Pace Of The Southern Piedmont	$232	95%
Aetna	$238 - $1,213	98%
Cigna	$239 - $781	98%
Liberty Health	$243	100%
Caresource North Carolina	$336 - $500	138%
Atlantic Corporation Dba Atlantic Packaging	$469 - $697	192%
Amps	$560 - $834	230%
Plotkin Health	$611 - $910	251%
Medcost	$723 - $1,137	297%
Primary Physician Care	$754 - $1,122	309%
Multiplan	$764 - $1,137	313%
Phcs	$764 - $1,137	313%
Employers Choice Network	$988 - $1,471	405%
Three Rivers Provider Network	$988 - $1,471	405%

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 $634.
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 Novant Health Presbyterian Medical Center 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.