CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Jfk University Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,633
Cash Discount Price: $255
vs. Medicare Baseline: 6.70x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Jfk University Medical Center is $1,633. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $255. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.70x the Medicare baseline. Located in 65 James Street, Edison, NJ.

Cash / Self-Pay

$255

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,633

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: $255 (105%)

Insurance Median: $1,633 (670%)

Cash: $255 (105% of Medicare)

Ins. Median: $1,633 (670% 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 670% of the Medicare baseline (a markup of 570%). 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
Horizon	$48 - $2,492	20%
Karna	$55 - $336	23%
Blue Cross Blue Shield	$104 - $268	43%
Aetna	$242 - $2,275	99%
Amerigroup	$242 - $585	99%
Vaccn	$242 - $268	99%
Wellcare	$242 - $268	99%
United Community/Americhoice	$254 - $281	104%
UnitedHealthcare	$461 - $2,793	189%
Clover	$483	198%
Seoul Medical Group	$577	237%
Cigna	$1,341 - $2,582	550%
Oxford	$1,499 - $2,080	615%
Brighton Health Plan	$1,609 - $2,414	660%
Brighton Health Plan - Jri@Oumc	$1,743	715%
Activecare First McO	$1,877	770%
Intergroup	$1,877	770%
Bergen Risk	$2,012	825%
Prime Health	$2,146	880%
Multiplan - PHCS	$2,280	935%
Qualcare	$2,484	1019%
Amerihealth	$2,537 - $2,652	1041%

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 $255.
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 Jfk University 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.