CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $1,318
  • Cash Discount Price: $312
  • vs. Medicare Baseline: 5.41x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Hackensack Meridian Mountainside Medical is $1,318. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $312. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.41x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$312

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,318

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: $312 (128%)
Insurance Median: $1,318 (541%)
Cash: $312 (128% of Medicare)
Ins. Median: $1,318 (541% 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 541% of the Medicare baseline (a markup of 441%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Healthscope Benefits [2290] $163 - $1,318 67%
UnitedHealthcare $163 67%
Aetna $237 97%
Black Lung [6055] $636 261%
Create Flex / Select [3580] $636 261%
Healthcare Highways [2210] $636 - $1,318 261%
Lucent Health [6000] $636 261%
Medicare (plans) $636 261%
Oncology Patient Assistance Programs [2295] $636 261%
Selecthealth [3740] $636 261%
Web Tpa [2115] $636 261%
Worker'S Comp [2125] $636 - $1,441 261%
Wtc Healthcare Sme Karna [8005] $636 261%
First Health [1375] $1,163 - $1,318 477%
Cigna $1,241 - $1,508 509%
Administrative Concepts [1005] $1,318 541%
Allied National Global Care [1035] $1,318 541%
Gilsbar [1425] $1,318 541%
Healthcost Solutions [2415] $1,318 541%
Healthfirst [2395] $1,318 541%
Healthnet [1495] $1,318 541%
Hometown Health [2155] $1,318 541%
Mayo Clinic Health Solutions [2280] $1,318 541%
Multiplan [1680] $1,318 541%
Mutual Of Omaha [1685] $1,318 541%
New Era Life Insurance Company [1705] $1,318 541%
Pan American Life Insurance Co [1770] $1,318 541%
Pba [1775] $1,318 541%
Phcs [1780] $1,318 541%
Planned Administrators Inc [2360] $1,318 541%
Resource One Administrators [2815] $1,318 541%
Trustmark [2030] $1,318 541%
Universal Fidelity [2085] $1,318 541%
Emblem Health [2430] $1,441 591%
Humana $1,441 591%
Mvp Health Plan [2180] $1,508 619%
National Association Of Letter Carriers [1695] $1,508 619%
Samba Health [2305] $1,508 619%
Amerihealth [3520] $1,551 636%
Mva [1690] $1,551 636%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Bay Avenue, Montclair, NJ 07042
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals