CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Jersey City Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $858
Cash Discount Price: $419
vs. Medicare Baseline: 3.52x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Jersey City Medical Center is $858. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $419. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.52x the Medicare baseline. Located in 355 Grand Street, Jersey City, NJ.

Cash / Self-Pay

$419

Average discount available for prompt cash payment at this facility.

Insurance Median

$858

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: $419 (172%)

Insurance Median: $858 (352%)

Cash: $419 (172% of Medicare)

Ins. Median: $858 (352% 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 352% of the Medicare baseline (a markup of 252%). 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	$126 - $285	52%
Aetna	$285 - $1,191	117%
Blue Cross Blue Shield	$285 - $1,832	117%
Clover Health	$285	117%
Fidelis Care	$285 - $567	117%
Humana	$285	117%
UnitedHealthcare	$290 - $2,452	119%
Emblem Health	$541	222%
Wellcare	$566	232%
Cigna	$805	330%
First Health	$1,211	497%
Amerihealth	$1,228	504%
Qualcare Inc	$1,427	585%

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 $419.
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 Jersey City Medical Center 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.