CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Sanford Hillsboro

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $957
Cash Discount Price: $928
vs. Medicare Baseline: 3.93x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Sanford Hillsboro is $957. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $928. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.93x the Medicare baseline. Located in 12 Third Street Se, Hillsboro, ND.

Cash / Self-Pay

$928

Average discount available for prompt cash payment at this facility.

Insurance Median

$957

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: $928 (381%)

Insurance Median: $957 (393%)

Cash: $928 (381% of Medicare)

Ins. Median: $957 (393% 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 393% of the Medicare baseline (a markup of 293%). 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	$281 - $1,073	115%
Sanford Health Plan Align	$529	217%
Ucare	$568 - $1,019	233%
Aetna	$573 - $1,008	235%
Health Partners	$573 - $905	235%
Medicare (plans)	$573	235%
UnitedHealthcare	$573 - $969	235%
Primewest	$585	240%
Security Health Plan	$638	262%
Sanford Health Plan	$916 - $1,077	376%
Medica	$957 - $1,023	393%
First Choice Health Network	$1,044	428%
Healthez	$1,044	428%
Multiplan	$1,044	428%

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 $928.
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 Hillsboro 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.