CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Lovelace UNM Rehabilitation Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,165
Cash Discount Price: $388
vs. Medicare Baseline: 4.78x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Lovelace UNM Rehabilitation Hospital is $1,165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $388. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.78x the Medicare baseline. Located in 505 Elm Street Ne, Albuquerque, NM.

Cash / Self-Pay

$388

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,165

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: $388 (159%)

Insurance Median: $1,165 (478%)

Cash: $388 (159% of Medicare)

Ins. Median: $1,165 (478% 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 478% of the Medicare baseline (a markup of 378%). 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
The Health Plan [2915]	$250	103%
Corvel Corp [2235]	$520	213%
Enablecomp [1350]	$531	218%
Worker'S Comp [2125]	$531	218%
Healthscope Benefits [2290]	$620	254%
UnitedHealthcare	$620	254%
Benefit Management [1175]	$647	265%
Zelis [2385]	$647	265%
American Medical Security [2190]	$1,165	478%
Boon-Chapman [2375]	$1,165	478%
Coresource [1315]	$1,165	478%
Coventry Healthcare [1320]	$1,165	478%
Emblem Health [2430]	$1,165	478%
Employee Benefit Management Services [2445]	$1,165	478%
First Health [1375]	$1,165	478%
Fmh Benefit Services [1390]	$1,165	478%
Healthcost Solutions [2415]	$1,165	478%
Healthnet [1495]	$1,165	478%
Healthsmart [1505]	$1,165 - $1,203	478%
Kaiser Permanente [1560]	$1,165	478%
Multiplan [1680]	$1,165	478%
Mutual Of Omaha [1685]	$1,165	478%
National Telephone Cooperative [1700]	$1,165	478%
Northamerica Administrators [1725]	$1,165	478%
Pan American Life Insurance Co [1770]	$1,165	478%
Phcs [1780]	$1,165	478%
Trustmark [2030]	$1,165	478%

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 $388.
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 Lovelace UNM Rehabilitation Hospital 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.