CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Children's Specialized Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $876
  • Cash Discount Price: $573
  • vs. Medicare Baseline: 3.59x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Children's Specialized Hospital is $876. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $573. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.59x the Medicare baseline. Located in 200 Somerset St, New Brunswick, NJ.
Cash / Self-Pay
$573

Average discount available for prompt cash payment at this facility.

Insurance Median
$876

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: $573 (235%)
Insurance Median: $876 (359%)
Cash: $573 (235% of Medicare)
Ins. Median: $876 (359% 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 359% of the Medicare baseline (a markup of 259%). 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
Blue Cross Blue Shield $115 - $1,123 47%
First Health $688 282%
Cigna $690 283%
Emblem Health $779 320%
Amerihealth $868 356%
Aetna $876 - $882 359%
Fidelis Care $876 359%
Wellpoint $876 359%
Qualcare Inc $894 367%
UnitedHealthcare $902 370%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Somerset St, New Brunswick, NJ 08901
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens