CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Capital Health Regional Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $2,339
Cash Discount Price: $32,075
vs. Medicare Baseline: 9.60x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Capital Health Regional Medical Center is $2,339. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32,075. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.60x the Medicare baseline. Located in 750 Brunswick Ave, Trenton, NJ.

Cash / Self-Pay

$32,075

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,339

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: $32,075 (13158%)

Insurance Median: $2,339 (960%)

Cash: $32,075 (13158% of Medicare)

Ins. Median: $2,339 (960% 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 960% of the Medicare baseline (a markup of 860%). 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
Fidelis	$264	108%
Clover	$268	110%
Wellpoint	$268 - $1,847	110%
Medicare (plans)	$272	112%
Humana	$274	112%
Cigna	$411 - $32,074	169%
Horizon Nj Health	$456	187%
UnitedHealthcare	$855 - $2,514	351%
Medicaid / KanCare	$913 - $1,826	375%
Aetna	$1,155 - $2,309	474%
Blue Cross Blue Shield	$2,132 - $5,115	875%
Oxford Benefit Plan	$7,784 - $15,567	3193%
Multiplan	$18,176 - $36,351	7456%

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 $32,075.
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 Capital Health Regional 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.