CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Robert Wood Johnson University Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,092
Cash Discount Price: $638
vs. Medicare Baseline: 4.48x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Robert Wood Johnson University Hospital is $1,092. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $638. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.48x the Medicare baseline. Located in One Robert Wood Johnson Place, New Brunswick, NJ.

Cash / Self-Pay

$638

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,092

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: $638 (262%)

Insurance Median: $1,092 (448%)

Cash: $638 (262% of Medicare)

Ins. Median: $1,092 (448% 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 448% of the Medicare baseline (a markup of 348%). 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
Wellpoint	$85 - $280	35%
Aetna	$280 - $1,975	115%
Blue Cross Blue Shield	$280 - $2,489	115%
Clover Health	$280	115%
Fidelis Care	$280 - $479	115%
Humana	$280	115%
UnitedHealthcare	$286 - $2,452	117%
Wellcare	$558	229%
Emblem Health	$589	242%
Cigna	$805	330%
Amerihealth	$1,047 - $1,435	430%
Qualcare Inc	$1,137	466%
First Health	$1,795	736%

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 $638.
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 Robert Wood Johnson University 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.