CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Community Medical Center

Billing Code: 93970 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$296

about 1.2× the $244 Medicare rate · typically $277–$478

modeled estimate · not a bill or quote

What this hospital charges insurers

$526

Well above the fair price

about $230 over the fair price · 2.2× Medicare

Medicare pays $244 Fair price $296 This hospital $526 Cash price $419 Hospital's list price $2,018

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

Highest price of the 9 NJ hospitals we have prices for — worth calling around.

Cheapest $215 Priciest $526

Black dot = this hospital, among the 9 NJ hospitals with a price for this procedure. Full list below.

A fair price for a Ultrasound, leg veins (duplex) is about $296 (about 1.2× the $244 Medicare rate). Community Medical Center charges insurers about $526, or about $419 in cash — well above the fair price. Located in Toms River, NJ.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $296. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$250 - $2,452	103%
Blue Cross Blue Shieldmajor	$264 - $1,846	108%
Aetnamajor	$264 - $1,110	108%
Cignamajor	$805	330%
Humanamajor	$264	108%
AmeriHealth	$1,503	617%
Clover Health	$264	108%
Fidelis Care	$255 - $264	105%
WellCare	$526	216%
+ 2 smaller / regional plans	$462 - $1,435

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 419), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 93970.

Insurance Before you use insurance

Call your insurance company to confirm Community Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 93970.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Community Medical Center

Compare: Ultrasound, leg veins (duplex) at other NJ hospitals

Insurance negotiated median for the same procedure, sorted lowest first.