CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Carolina East Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,072
Cash Discount Price: $881
vs. Medicare Baseline: 4.40x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Carolina East Medical Center is $1,072. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $881. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.40x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$881

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,072

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: $881 (361%)

Insurance Median: $1,072 (440%)

Cash: $881 (361% of Medicare)

Ins. Median: $1,072 (440% 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 440% of the Medicare baseline (a markup of 340%). 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
Humana	$31 - $228	13%
Inclusive Health (Nchirp)-All Plans	$31 - $228	13%
Tricare	$31 - $1,597	13%
Pamlico Co Jail-All Plans	$356 - $425	146%
Craven Co. Jail Systems - All Plans	$389 - $538	160%
UnitedHealthcare	$469 - $1,135	192%
Medcost Ppo Employees And Retirees	$879 - $1,049	361%
Medcost Ppo Ultra (Employees)	$879 - $999	361%
Blue Cross Blue Shield	$935 - $1,095	384%
Medcost Ppo City Employees	$975 - $1,163	400%
Medcost Ppo County Employee	$1,014 - $1,210	416%
Benefit Mgmt, Svcs-All Plans	$1,138 - $1,357	467%
Medcost Benefit Svc-All Other Plans	$1,183 - $1,411	485%
Aetna	$1,186 - $1,415	487%
Acs Consult Svc Inc-All Plans	$1,209 - $1,442	496%
Medcost Ppo Standard	$1,209 - $1,442	496%
Cigna	$1,218 - $1,453	500%

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 $881.
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 Carolina East 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.