CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Highlands Cashiers Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $745
Cash Discount Price: $1,789
vs. Medicare Baseline: 3.06x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Highlands Cashiers Hospital is $745. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,789. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.06x the Medicare baseline. Located in 190 Hospital Drive, Highlands, NC.

Cash / Self-Pay

$1,789

Average discount available for prompt cash payment at this facility.

Insurance Median

$745

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: $1,789 (734%)

Insurance Median: $745 (306%)

Cash: $1,789 (734% of Medicare)

Ins. Median: $745 (306% 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 306% of the Medicare baseline (a markup of 206%). 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
Apex Health	$358	147%
Cigna	$587 - $794	241%
Blue Cross Blue Shield	$609 - $745	250%
United	$618 - $1,084	254%
Wellcare	$627	257%
Amerihealth	$633	260%
Partners Health Management	$639	262%
Vaya Health	$639	262%
Amerihealth Caritas	$680	279%
Aetna	$696 - $1,301	286%
Caresource	$787	323%
Oscar	$818	336%
Medcost	$839 - $1,009	344%
Magellan	$1,074	441%
Magellan Behavioral Health	$1,074	441%
Multiplan	$1,431	587%
Avalon Administrative Services	$1,521	624%
Prime Health	$1,574 - $1,610	646%

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 $1,789.
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 Highlands Cashiers 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.