CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Sanford Medical Center Fargo

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $831
Cash Discount Price: $1,382
vs. Medicare Baseline: 3.41x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Sanford Medical Center Fargo is $831. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,382. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.41x the Medicare baseline. Located in 801 Broadway North, Fargo, ND.

Cash / Self-Pay

$1,382

Average discount available for prompt cash payment at this facility.

Insurance Median

$831

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: $1,382 (567%)

Insurance Median: $831 (341%)

Cash: $1,382 (567% of Medicare)

Ins. Median: $831 (341% 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 341% of the Medicare baseline (a markup of 241%). 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
Blue Cross Blue Shield	$179 - $433	73%
Sanford Health Plan	$187	77%
Sanford Health Plan Align	$230	94%
Ucare	$247 - $1,215	101%
Aetna	$249 - $1,477	102%
Health Partners	$249 - $708	102%
Medicare (plans)	$249	102%
UnitedHealthcare	$249 - $1,505	102%
Primewest	$254 - $257	104%
Medica	$778 - $831	319%
Security Health Plan	$950	390%
Cigna	$1,555	638%
First Choice Health Network	$1,555	638%
Healthez	$1,555	638%
Multiplan	$1,555	638%

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 $1,382.
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 Sanford Medical Center Fargo 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.