CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Pender Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $275
Cash Discount Price: $432
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Pender Memorial Hospital is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $432. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.13x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$432

Average discount available for prompt cash payment at this facility.

Insurance Median

$275

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: $432 (177%)

Insurance Median: $275 (113%)

Cash: $432 (177% of Medicare)

Ins. Median: $275 (113% 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
Blue Cross Blue Shield	$210 - $355	86%
Humana	$246 - $826	101%
Pace Of The Southern Piedmont	$259	106%
New Hanover Health	$265	109%
Aetna	$266 - $817	109%
Cigna	$267 - $424	110%
Carolina Complete	$270	111%
Nc Department Of Public Safety	$270 - $519	111%
Amerihealth	$275	113%
Wellcare	$275	113%
Ambetter / Centene	$363	149%
Liberty Health	$369	151%
Caresource North Carolina	$384	158%
Plotkin Health	$577	237%
UnitedHealthcare	$702	288%
Medcost	$724 - $806	297%
Employers Choice Network	$932	382%
Three Rivers Provider Network	$932	382%

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 $432.
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 Pender Memorial 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.